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Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 01/2012; 112(1):84-9. · 0.12 Impact Factor
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ABSTRACT: Spontaneous cerebral artery dissection is a common cause of ischemic stroke in young adults and children. Dissection is often related to arterial wall weakness the cause of which is unknown. An aim of the present paper was to carry out an electron microscopic study of skin arteries and arterioles in patients with ischemic stroke caused by cerebral artery dissection. Skin biopsy samples from 3 patients (2 men and one women, 15, 25 and 43 years of age, respectively) were studied. Electron microscopy revealed changes of endothelial, smooth muscle cells and fibroblasts in the skin microvessels. These changes included the decrease in the number of mitochondria and their alterations (vacuolization, destruction of the cristae, the presence of the needle-shaped crystals and crystal-like inclusions) and swelling of the endoplasmic reticulum. Some of these changes were characteristic of mitochondrial diseases. The changes in the extracellular matrix (thickening of the subendothelial layer and deposition of microcalcificats) were also detected. It is assumed that the mitochondrial cytopathy found in the skin microvessels may be also present in large cerebral arteries. This could underlie dysplastic changes in the cerebral artery wall and predispose to its dissection.
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 01/2011; 111(7):54-60. · 0.12 Impact Factor
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ABSTRACT: Skin and muscles biopsy specimens of a patient harboring A3243G mutation in mitochondrial DNA, with dissection of internal carotid and vertebral arteries, associated with MELAS were studied using histochemical and electron-microscopy techniques. Ragged red fibers, regional variability of SDH histochemical reaction, two types of morphologically atypical mitochondria and their aggregation were found in muscle. There was correlation between SDH histochemical staining and number of mitochondria revealed by electron microscopy in muscle tissue. Similar mitochondrial abnormality, their distribution and cell lesions followed by extra-cellular matrix mineralization were found in the blood vessel walls. In line with generalization of cytopathy process caused by gene mutation it can be supposed that changes found in skin and muscle microvessels also exist in large cerebral vessels causing the vessel wall "weakness", predisposing them to dissection.
Arkhiv patologii 74(2):51-6.
