Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications
Background and Purpose The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries—arteries branching directly from high-pressure intracranial arte...
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Korean Stroke Society
2025-01-01
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| Series: | Journal of Stroke |
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| Online Access: | http://j-stroke.org/upload/pdf/jos-2024-01655.pdf |
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| author | Radosław Rzepliński Sylwia Tarka Michał Tomaszewski Michał Kucewicz Albert Acewicz Jerzy Małachowski Bogdan Ciszek |
| author_facet | Radosław Rzepliński Sylwia Tarka Michał Tomaszewski Michał Kucewicz Albert Acewicz Jerzy Małachowski Bogdan Ciszek |
| author_sort | Radosław Rzepliński |
| collection | DOAJ |
| description | Background and Purpose The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries—arteries branching directly from high-pressure intracranial arteries, supplying vital neural structures such as the internal capsule, and characterized by a diameter of well below 1 mm, which makes them difficult to visualize with standard radiological examinations. This study aimed to analyze the morphology of the perforator origins, which constitute connection points between high-pressure intracranial arteries and microcirculation. Methods Twenty-three human basal ganglia specimens with the middle cerebral artery (MCA, including 172 perforating arteries) and ten brainstem specimens with the basilar artery (BA, including 162 perforating arteries) were prepared and scanned using microcomputed tomography. The geometry and structure of the perforating arteries were analyzed using radiological images and additional histological studies. Results The ostia of the perforating arteries were ellipsoidal in shape with median stenosis severity of 23% and 20% for MCA and BA perforators, respectively. The local narrowing structure was typical of neointimal hyperplasia. Statistical analysis revealed that the severity of stenosis may be related to age and cardiovascular health. Conclusion Origins of the deep cerebral perforators are locally narrowed by neointimal hyperplasia, which may be a protective mechanism to adjust high blood pressure to the microcirculation. The narrowings may lead to chronic hypoperfusion and play a role in the pathophysiology of cerebral small vessel disease. |
| format | Article |
| id | doaj-art-6c64f3d55be04aa18e4d798c428fe95e |
| institution | DOAJ |
| issn | 2287-6391 2287-6405 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Stroke Society |
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| series | Journal of Stroke |
| spelling | doaj-art-6c64f3d55be04aa18e4d798c428fe95e2025-08-20T03:03:08ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052025-01-01271526410.5853/jos.2024.01655560Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical ImplicationsRadosław Rzepliński0Sylwia Tarka1Michał Tomaszewski2Michał Kucewicz3Albert Acewicz4Jerzy Małachowski5Bogdan Ciszek6 Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland Department of Neuropathology, Institute of Psychiatry and Neurology, Warsaw, Poland Institute of Mechanics and Computational Engineering, Faculty of Mechanical Engineering, Military University of Technology, Warsaw, Poland Institute of Mechanics and Computational Engineering, Faculty of Mechanical Engineering, Military University of Technology, Warsaw, Poland Department of Neuropathology, Institute of Psychiatry and Neurology, Warsaw, Poland Institute of Mechanics and Computational Engineering, Faculty of Mechanical Engineering, Military University of Technology, Warsaw, Poland Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, PolandBackground and Purpose The pathogenesis of neurovascular diseases and various types of dementia is tightly connected to cerebral circulation. An area that requires further exploration is the system of deep cerebral perforating arteries—arteries branching directly from high-pressure intracranial arteries, supplying vital neural structures such as the internal capsule, and characterized by a diameter of well below 1 mm, which makes them difficult to visualize with standard radiological examinations. This study aimed to analyze the morphology of the perforator origins, which constitute connection points between high-pressure intracranial arteries and microcirculation. Methods Twenty-three human basal ganglia specimens with the middle cerebral artery (MCA, including 172 perforating arteries) and ten brainstem specimens with the basilar artery (BA, including 162 perforating arteries) were prepared and scanned using microcomputed tomography. The geometry and structure of the perforating arteries were analyzed using radiological images and additional histological studies. Results The ostia of the perforating arteries were ellipsoidal in shape with median stenosis severity of 23% and 20% for MCA and BA perforators, respectively. The local narrowing structure was typical of neointimal hyperplasia. Statistical analysis revealed that the severity of stenosis may be related to age and cardiovascular health. Conclusion Origins of the deep cerebral perforators are locally narrowed by neointimal hyperplasia, which may be a protective mechanism to adjust high blood pressure to the microcirculation. The narrowings may lead to chronic hypoperfusion and play a role in the pathophysiology of cerebral small vessel disease.http://j-stroke.org/upload/pdf/jos-2024-01655.pdfcerebrovascular circulationcerebral small vessel diseasesneuroanatomydementiabrain agingintracranial stenosis |
| spellingShingle | Radosław Rzepliński Sylwia Tarka Michał Tomaszewski Michał Kucewicz Albert Acewicz Jerzy Małachowski Bogdan Ciszek Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications Journal of Stroke cerebrovascular circulation cerebral small vessel diseases neuroanatomy dementia brain aging intracranial stenosis |
| title | Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications |
| title_full | Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications |
| title_fullStr | Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications |
| title_full_unstemmed | Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications |
| title_short | Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications |
| title_sort | narrowings of the deep cerebral perforating arteries ostia geometry structure and clinical implications |
| topic | cerebrovascular circulation cerebral small vessel diseases neuroanatomy dementia brain aging intracranial stenosis |
| url | http://j-stroke.org/upload/pdf/jos-2024-01655.pdf |
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