Three-Dimensional Pathological Analysis of Cerebral Aneurysm Initiation

Cerebral aneurysm is known to initiate at the cerebral artery bifurcation. The pathological mechanism of cerebral aneurysm awaits further understanding especially on its initiation. This study sought to elucidate the three-dimensional structure of cerebral vascular bifurcations with and without aneurysms using human cadavers. The two cases had aneurysmal initiations out of total 7 cases. The studied structure was intimal hyperplasia, tunica media and internal elastic lamina, which were recognized by elastica masson staining. The results showed that the non-existence of tunica media and internal elastic lamina was found in the lesion without aneurysm. The non-existence of intimal hyperplasia was only found in the lesion with aneurysm. These data suggest that the formation of intimal hyperplasia may be related with the initiation of aneurysm. We regarded the boundary of existence arteriosclerosis as the position for new arteriosclerosis occurs and thought the direction of new arteriosclerosis grows would influence whether the cerebral aneurysm initiates or not.