Width of sulcus and thickness of gyrus in patients with cerebral atherosclerosis: a new tool for the prevention of vascular cognitive impairment
| Autor: | Bárbara Cecílio da Fonseca, Sanívia Aparecida de Lima Pereira, Luciano Alves Matias da Silveira, Mara Lúcia da Fonseca Ferraz, Luciana Santos Ramalho, Maria Helena Soares, Vicente de Paula Antunes Teixeira, José Eduardo dos Reis Félix, Lourimar José Morais |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pathology medicine.medical_specialty Cognition disorders Cerebrovascular disorders Cerebral arteries Severity of Illness Index Statistics Nonparametric 030218 nuclear medicine & medical imaging Disfunção cognitiva 03 medical and health sciences 0302 clinical medicine Gyrus Intracranial arteriosclerosis Cognitive dysfunction Reference Values medicine Humans Transtornos cognitivos Cognitive Dysfunction Vascular dementia Aged Aged 80 and over Tomografia computadorizada por raios X lcsh:R5-920 Analysis of Variance business.industry Dementia Vascular Tomography X-ray computed Reproducibility of Results General Medicine Arteriosclerosis Sulcus Arteriosclerose intracraniana medicine.disease Intracranial Arteriosclerosis Temporal Lobe Calcarine sulcus medicine.anatomical_structure Cerebral atherosclerosis Female Cerebral amyloid angiopathy Occipital Lobe business lcsh:Medicine (General) Tomography X-Ray Computed 030217 neurology & neurosurgery Transtornos cerebrovasculares |
| Zdroj: | Revista da Associação Médica Brasileira v.64 n.8 2018 Revista da Associação Médica Brasileira Associação Médica Brasileira (AMB) instacron:AMB Revista da Associação Médica Brasileira, Vol 64, Iss 8, Pp 684-691 Revista da Associação Médica Brasileira, Volume: 64, Issue: 8, Pages: 684-691, Published: AUG 2018 |
| ISSN: | 1806-9282 |
| Popis: | SUMMARY BACKGROUND AND PURPOSE Cerebral atherosclerosis is the main cause of lesions that contribute to vascular cognitive impairment and vascular dementia, followed by arteriosclerosis of small vessels and cerebral amyloid angiopathy. The purpose of this study was to compare the post-mortem radiological alterations of autopsied adults with the macroscopic alterations in the posterior region of these brains in order to establish a relationship between the two forms of analysis and to discuss the relevance of the prevention of vascular cognitive impairment in patients with encephalic atherosclerosis. MATERIALS AND METHODS Thirteen brains were analysed macroscopically to assess the degree of atherosclerosis of the basilar and the posterior cerebral arteries. The patients were autopsied in the Subject of General Pathology at General Hospital of Triângulo Mineiro Federal University in Uberaba, state of Minas Gerais, Brazil. The qualitative analysis of atherosclerosis was performed with classification into mild, moderate or severe. In the posterior region of the brains, width of sulcus and thickness of gyrus were measured by macroscopic analysis and by tomographic analysis. RESULTS AND CONCLUSIONS There was a decrease in calcarine sulcus width and an increase in medial temporal occipital gyrus thickness in patients with a higher degree of atherosclerosis, macroscopically and in tomography, respectively. Low oxygenation caused by atherosclerosis probably leads to an encephalic parenchyma inflammation that causes microglial cells hypertrophy provoking increase in the gyrus thickness and decrease in the sulcus width, as observed in the present study. RESUMO INTRODUÇÃO E OBJETIVO A aterosclerose cerebral é a principal causa de lesões que contribuem para o comprometimento cognitivo vascular (CCV) e demência vascular, seguida da arteriosclerose de pequenos vasos e da angiopatia amiloide cerebral. Sendo assim, este estudo comparou as alterações radiológicas post mortem de adultos autopsiados com as alterações macroscópicas na região posterior desses encéfalos a fim de estabelecer uma relação entre as duas formas de análise e discutir sobre a relevância da prevenção do CCV em pacientes com aterosclerose encefálica. MATERIAL E MÉTODOS Treze encéfalos foram analisados macroscopicamente para avaliar o grau de aterosclerose das artérias basilar e cerebral posterior. Os pacientes foram autopsiados na disciplina de Patologia Geral no HC-UFTM em Uberaba, Minas Gerais, Brasil. A análise qualitativa da aterosclerose foi realizada com as classificações discreta, moderada ou acentuada. A espessura dos giros e a largura dos sulcos na região posterior dos encéfalos foram analisadas macroscopicamente e por tomografia computadorizada. RESULTADOS E CONCLUSÃO Houve diminuição na largura do sulco calcarino e aumento na espessura do giro occipital temporal medial de acordo com o aumento do grau de aterosclerose macroscopicamente e por tomografia, respectivamente. A baixa oxigenação causada pela aterosclerose provoca a inflamação do parênquima encefálico, provavelmente levando à hipertrofia das células da micróglia e ao consequente aumento dos giros e estreitamento dos sulcos, como observado no presente estudo. |
| Databáze: | OpenAIRE |
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