RESUMO
PURPOSE: The objective of this article is to highlight the fact that cerebral aneurysms in children are heterogeneous unlike in the adult population. MATERIAL AND METHODS: This is a retrospective review of 17 children with intracranial aneurysms who were managed at a single institution from 2004 to 2009. RESULTS: The median age was 12 years (range 10 months-17 years). Sixty-five percent of the aneurysms were saccular and 24% were fusiform. There was one infectious and one distal lenticulostriate aneurysm. Patients with saccular aneurysms were predominantly male and presented more commonly with intracranial hemorrhage (91%). The fusiform aneurysms were dissecting in nature or chronic with intramural thrombus and mass effect. The treatment was dependent upon the type and location of the aneurysm. CONCLUSION: Pedriatic aneurysms are a heterogeneous group of intracranial arterial diseases with different etiologies, diverse morphology, and dissimilar clinical manifestations.
Assuntos
Aneurisma Infectado/patologia , Dissecção Aórtica/patologia , Doença Cerebrovascular dos Gânglios da Base/patologia , Aneurisma Intracraniano/patologia , Adolescente , Fatores Etários , Dissecção Aórtica/complicações , Aneurisma Infectado/complicações , Doença Cerebrovascular dos Gânglios da Base/complicações , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Aneurisma Intracraniano/complicações , Trombose Intracraniana/etiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Hemorragia Subaracnóidea/etiologiaRESUMO
PURPOSE: To investigate, through an immunohistochemical method, whether there is deposition of plasma proteins in the wall of lenticulostriate, cortical and leptomeningeal arteries of hypertensive patients, with and without lipohyalinosis. METHOD: Forty patients with essential hypertension were selected at random, 20 with lipohyalinosis in the lenticulostriate arteries (HH group) and 20 without lipohyalinosis (H group), matched with 20 normotensive controls (C group). RESULTS: Plasma protein deposits were identified in eight patients (40%) in the C group, in 15 patients (75%) in the H group, and in all 20 patients (100%) in the HH group, the difference being significant for the H group and highly significant for the HH group, as compared with the C group. In all groups, the distribution of plasma protein deposits, subendothelial in normal arteries, and diffuse, irregular in the wall of arteries with lipohyalinosis, was more frequent in the lenticulostriate arteries of the putamen. CONCLUSION: Deposition of plasma proteins in the lenticulostriate arteries seems to be relatively frequent in normotensive individuals, starting in middle age. Such process appears to be intensified by hypertension, especially in individuals with lipohyalinosis.
Assuntos
Doença Cerebrovascular dos Gânglios da Base/patologia , Gânglios da Base/irrigação sanguínea , Proteínas Sanguíneas/isolamento & purificação , Hipertensão/fisiopatologia , Artéria Cerebral Média/fisiopatologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Gânglios da Base/patologia , Estudos de Casos e Controles , Humanos , Hialina/metabolismo , Imuno-Histoquímica , Lipídeos , Pessoa de Meia-Idade , NecroseRESUMO
PURPOSE: To investigate, through an immunohistochemical method, whether there is deposition of plasma proteins in the wall of lenticulostriate, cortical and leptomeningeal arteries of hypertensive patients, with and without lipohyalinosis. METHOD: Forty patients with essential hypertension were selected at random, 20 with lipohyalinosis in the lenticulostriate arteries (HH group) and 20 without lipohyalinosis (H group), matched with 20 normotensive controls (C group). RESULTS: Plasma protein deposits were identified in eight patients (40 percent) in the C group, in 15 patients (75 percent) in the H group, and in all 20 patients (100 percent) in the HH group, the difference being significant for the H group and highly significant for the HH group, as compared with the C group. In all groups, the distribution of plasma protein deposits, subendothelial in normal arteries, and diffuse, irregular in the wall of arteries with lipohyalinosis, was more frequent in the lenticulostriate arteries of the putamen. CONCLUSION: Deposition of plasma proteins in the lenticulostriate arteries seems to be relatively frequent in normotensive individuals, starting in middle age. Such process appears to be intensified by hypertension, especially in individuals with lipohyalinosis.
PROPÓSITO: Investigar, por meio de método imuno-histoquímico, a deposição de proteínas plasmáticas na parede das artérias lentículo-estriadas, corticais e leptomeníngeas em pacientes com hipertensão arterial, com e sem lipo-hialinose. MÉTODO: Quarenta pacientes com hipertensão arterial foram selecionados aleatoriamente, sendo 20 com lipo-hialinose nas artérias lentículo-estriadas (grupo HH) e 20 sem lipo-hialinose (grupo H), pareados com 20 controles normotensos (grupo C). RESULTADOS: Depósitos de proteínas plasmáticas foram identificados em oito pacientes (40 por cento) do grupo C, em 15 pacientes (75 por cento) do grupo H e em todos os 20 pacientes (100 por cento) do grupo HH, a diferença sendo significativa para o grupo H e altamente significativa para o grupo HH, quando comparada com o grupo C. Em todos os grupos, a distribuição dos depósitos de proteínas plasmáticas, subendotelial em artérias normais e difusa, irregular, na parede das artérias com lipo-hialinose, foi mais freqüente nas artérias lentículo-estriadas do putâmen. CONCLUSÃO: A deposição de proteínas plasmáticas nas artérias lentículo-estriadas parece ser um fenômeno relativamente freqüente em indivíduos normotensos, a partir da meia-idade. Tal processo parece ser intensificado pela hipertensão arterial, particularmente naqueles pacientes com lipo-hialinose.