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Etiologic Mechanisms in Cerebral Atherosclerosis: Preliminary Study of 3,839 Cases

Etiologic Mechanisms in Cerebral Atherosclerosis: Preliminary Study of 3,839 Cases Abstract Atherosclerosis denotes a pathologic process primarily affecting the intima of larger arteries and characterized by focal thickening in which stainable lipids can be demonstrated.1-3 The lesions have shown at one extreme almost exclusive fibrous composition with little lipid material; while at the other extreme, they may contain lipid accumulations of massive proportions.4-6 Within the intracranial cavity, true atherosclerotic changes are seen chiefly along the vessels of the circle of Willis. Because of the nature of these changes, they are readily visible to the naked eye even in the earliest stages of their development. In spite of a very extensive literature on atherosclerosis, there is still considerable difference of opinion regarding the mechanisms involved in its etiology.7-11 One of the great difficulties in evaluating the available medical literature with regard to specific etiologic factors in this degenerative arterial disease is the fact that investigators have used different recording and References 1. Aschoff, L.: Über Arteriosklerose , Ztschr Neurol Psychiat 167:214, 1939.Crossref 2. Duff, G. L., and McMillan, G. D.: Pathology of Arteriosclerosis , Amer J Med 11:92, 1951.Crossref 3. Leary, T.: Genesis of Atherosclerosis , Arch Path 32:507, 1941. 4. Virchow, R.: " Phlogose und Thrombose in Gefass-system ," in Gesammelte Abhandlungen zur wissenschaftlichen Medizin , Frankfurt: Meidinger Sohnu Comp, 1856. 5. Ceelen, W.: Die Pathologie der Arteriosklerose , Deutsch Med Wschr 55:1913, 1929.Crossref 6. Tuthill, C. R.: Cerebral Arteries in Relation to Arteriosclerosis , Arch Path 16:453, 1933. 7. Saltykow, S.: Atherosklerose bei Kaninchen nach wiederholten Staphylokokkeninjektionen , Beitr Path Anat 43:147, 1908. 8. Saphir, O., and Gore, I.: Evidence for Inflammatory Basis of Coronary Arteriosclerosis in Young , Arch Path 49:418, 1950. 9. Willis, G. C.: Localizing Factors in Atherosclerosis , Canad Med Ass J 70:1, 1954. 10. Texon, M.; Imparato, A. M.; and Lord, J. W., Jr.: Hemodynamic Concept of Atherosclerosis: Experimental Production of Hemodynamic Arterial Disease , AMA Arch Surg 80:47, 1960.Crossref 11. Wacker, L., and Hueck, W.: Über experimentelle Atherosklerose und Cholesterinamie , München Med Wschr 60:2097, 1913. 12. Wolkoff, K.: Über Atherosklerose der Gehirnarterien , Beitr Path Anat 91:515, 1933. 13. White, N. K.; Edwards, J. D.; and Dry, T. J.: Relationship of Degree of Coronary Atherosclerosis With Age in Man , Circulation 1:645, 1950.Crossref 14. Roberts, J. C., Jr.; Moses, C.; and Wilkins, R. H.: Autopsy Studies in Atherosclerosis: I. Distribution and Severity of Atherosclerosis in Patients Dying Without Morphologic Evidence of Atherosclerotic Catastrophe , Circulation 20:511, 1959.Crossref 15. Moossy, J.: Development of Cerebral Atherosclerosis in Various Groups , Neurology (Minneap) 9:569, 1959.Crossref 16. Baker, A. B., and Iannone, A.: Cerebrovascular Disease: I. Large Arteries of the Circle of Willis , Neurology (Minneap) 9:321, 1959.Crossref 17. World Federation of Neurology: Collaborative Study of Epidemiological Factors in Cerebrovascular Disease , Antwerp, 1959. 18. Bürger, M., and Schomka, G.: Ergebnisse und Bedeutung chemischer Gewebsuntersuchungen für die Altersforschung , Klin Wschr 7:1944, 1928.Crossref 19. Simms, H. S.: Problems of Aging and of Vascular Disease , Science 95:183, 1942.Crossref 20. Jores, L.: Über die Arteriosklerose der kleinen Organarterien und ihre Beziehungen zur Nephritis , Virchows Arch Path Anat 178:367, 1904.Crossref 21. Hughs, F. W. T., and Perry, C. B.: Senile Arterial Changes in Child Aged Seven Weeks , Bristol Med Chir J 46:219, 1929. 22. Werner, S.: Beiträge zur Frage der nach chronischen Nierenveränderungen auftretenden Knochenwachstumsstörungen , Arch Kinderheilk 118:145, 1939. 23. Benda, C.: Über einen Fall von schwerer infantilen Koronararterieusklerose als Todesursache , Virchows Arch Path Anat 254:600, 1925.Crossref 24. Baggenstoss, A. H., and Keith, H. M.: Calcification of Arteries of Infant , J Pediat 18:95, 1941.Crossref 25. Groddeck, H.: Sektionbefunde bei über Achtzigjährigen , Ztschr Altersforsch 1:238, 1939. 26. Baker, A. B.; Iannone, A.; and Kinnard, J.: Cerebrovascular Disease: VI. Relationship to Disease of Heart and Aorta , Neurology (Minneap) 11:63, 1961.Crossref 27. Baker, A. B.; Kinnard, J.; and Iannone, A.: Cerebrovascular Disease: VIII. Role of Nutritional Factors , Neurology (Minneap) 11:380, 1961.Crossref 28. Pick, R., et al: Estrogen-Induced Regression of Coronary Atherosclerosis in Cholesterol-Fed Chicks , Circulation 6:858, 1952.Crossref 29. Russ, E. M.; Eder, H. A.; and Barr, D. P.: Protein-Lipid Relationships in Human Plasma , Amer J Med 11:468, 1951.Crossref 30. Eilert, M. L.: Effect of Estrogens on Partition of Serum Lipids in Female Patients , Metabolism 2:137, 1953. 31. Barr, D. P.: Influence of Sex and Sex Hormones Upon Development of Atherosclerosis and Upon Lipoproteins of Plasma , J Chron Dis 1:63, 1955.Crossref 32. Baker, A. B., and Iannone, A.: Cerebrovascular Disease: VII. Study of Etiologic Mechanisms , Neurology (Minneap) 11:23, 1961.Crossref 33. Wuesk, J. H., and Edwards, J. E.: Degree of Coronary Atherosclerosis in Bilaterally Oophorectomized Women , J Lab Clin Med 40:963, 1952. 34. Oliver, M. F., and Boyd, G. S.: Effect of Bilateral Ovariectomy on Coronary-Artery Disease and Serum-Lipid Levels , Lancet 2:690, 1959.Crossref 35. Duguid, J. B.: Atheroma of Aorta , J Path Bact 29:371, 1926.Crossref 36. Texon, M.: Hemodynamic Concept of Atherosclerosis With Particular Reference to Coronary Occlusion , Arch Intern Med 99:418, 1957.Crossref 37. Beneke, M.: Über die Anfänge der Arteriosklerose , Klin Wschr 9:2182, 1930. 38. Moschcowitz, E.: Cause of Arteriosclerosis , Amer J Med Sci 178:244, 1929.Crossref 39. Wolkoff, K.: Über Atherosklerose der Gehirnarterien , Beitr Path Anat 91:515, 1933. 40. Adams, R. D., and vander Eecken, H. M.: Vascular Disease of Brain , Ann Rev Med 4:213, 1953.Crossref 41. Blumenthal, H. T.; Handler, F. P.; and Blache, J. O.: Histogenesis of Arteriosclerosis of Larger Cerebral Arteries With an Analysis of Importance of Mechanical Factors , Amer J Med 17:337, 1954.Crossref 42. Young, W., et al: Quantitation of Atherosclerosis: I. Relationship of Artery Size , Amer J Cardiol 6:288, 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Etiologic Mechanisms in Cerebral Atherosclerosis: Preliminary Study of 3,839 Cases

Archives of Neurology , Volume 10 (6) – Jun 1, 1964

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Publisher
American Medical Association
Copyright
Copyright © 1964 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1964.00460180083008
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Abstract

Abstract Atherosclerosis denotes a pathologic process primarily affecting the intima of larger arteries and characterized by focal thickening in which stainable lipids can be demonstrated.1-3 The lesions have shown at one extreme almost exclusive fibrous composition with little lipid material; while at the other extreme, they may contain lipid accumulations of massive proportions.4-6 Within the intracranial cavity, true atherosclerotic changes are seen chiefly along the vessels of the circle of Willis. Because of the nature of these changes, they are readily visible to the naked eye even in the earliest stages of their development. In spite of a very extensive literature on atherosclerosis, there is still considerable difference of opinion regarding the mechanisms involved in its etiology.7-11 One of the great difficulties in evaluating the available medical literature with regard to specific etiologic factors in this degenerative arterial disease is the fact that investigators have used different recording and References 1. Aschoff, L.: Über Arteriosklerose , Ztschr Neurol Psychiat 167:214, 1939.Crossref 2. Duff, G. L., and McMillan, G. D.: Pathology of Arteriosclerosis , Amer J Med 11:92, 1951.Crossref 3. Leary, T.: Genesis of Atherosclerosis , Arch Path 32:507, 1941. 4. Virchow, R.: " Phlogose und Thrombose in Gefass-system ," in Gesammelte Abhandlungen zur wissenschaftlichen Medizin , Frankfurt: Meidinger Sohnu Comp, 1856. 5. Ceelen, W.: Die Pathologie der Arteriosklerose , Deutsch Med Wschr 55:1913, 1929.Crossref 6. Tuthill, C. R.: Cerebral Arteries in Relation to Arteriosclerosis , Arch Path 16:453, 1933. 7. Saltykow, S.: Atherosklerose bei Kaninchen nach wiederholten Staphylokokkeninjektionen , Beitr Path Anat 43:147, 1908. 8. Saphir, O., and Gore, I.: Evidence for Inflammatory Basis of Coronary Arteriosclerosis in Young , Arch Path 49:418, 1950. 9. Willis, G. C.: Localizing Factors in Atherosclerosis , Canad Med Ass J 70:1, 1954. 10. Texon, M.; Imparato, A. M.; and Lord, J. W., Jr.: Hemodynamic Concept of Atherosclerosis: Experimental Production of Hemodynamic Arterial Disease , AMA Arch Surg 80:47, 1960.Crossref 11. Wacker, L., and Hueck, W.: Über experimentelle Atherosklerose und Cholesterinamie , München Med Wschr 60:2097, 1913. 12. Wolkoff, K.: Über Atherosklerose der Gehirnarterien , Beitr Path Anat 91:515, 1933. 13. White, N. K.; Edwards, J. D.; and Dry, T. J.: Relationship of Degree of Coronary Atherosclerosis With Age in Man , Circulation 1:645, 1950.Crossref 14. Roberts, J. C., Jr.; Moses, C.; and Wilkins, R. H.: Autopsy Studies in Atherosclerosis: I. Distribution and Severity of Atherosclerosis in Patients Dying Without Morphologic Evidence of Atherosclerotic Catastrophe , Circulation 20:511, 1959.Crossref 15. Moossy, J.: Development of Cerebral Atherosclerosis in Various Groups , Neurology (Minneap) 9:569, 1959.Crossref 16. Baker, A. B., and Iannone, A.: Cerebrovascular Disease: I. Large Arteries of the Circle of Willis , Neurology (Minneap) 9:321, 1959.Crossref 17. World Federation of Neurology: Collaborative Study of Epidemiological Factors in Cerebrovascular Disease , Antwerp, 1959. 18. Bürger, M., and Schomka, G.: Ergebnisse und Bedeutung chemischer Gewebsuntersuchungen für die Altersforschung , Klin Wschr 7:1944, 1928.Crossref 19. Simms, H. S.: Problems of Aging and of Vascular Disease , Science 95:183, 1942.Crossref 20. Jores, L.: Über die Arteriosklerose der kleinen Organarterien und ihre Beziehungen zur Nephritis , Virchows Arch Path Anat 178:367, 1904.Crossref 21. Hughs, F. W. T., and Perry, C. B.: Senile Arterial Changes in Child Aged Seven Weeks , Bristol Med Chir J 46:219, 1929. 22. Werner, S.: Beiträge zur Frage der nach chronischen Nierenveränderungen auftretenden Knochenwachstumsstörungen , Arch Kinderheilk 118:145, 1939. 23. Benda, C.: Über einen Fall von schwerer infantilen Koronararterieusklerose als Todesursache , Virchows Arch Path Anat 254:600, 1925.Crossref 24. Baggenstoss, A. H., and Keith, H. M.: Calcification of Arteries of Infant , J Pediat 18:95, 1941.Crossref 25. Groddeck, H.: Sektionbefunde bei über Achtzigjährigen , Ztschr Altersforsch 1:238, 1939. 26. Baker, A. B.; Iannone, A.; and Kinnard, J.: Cerebrovascular Disease: VI. Relationship to Disease of Heart and Aorta , Neurology (Minneap) 11:63, 1961.Crossref 27. Baker, A. B.; Kinnard, J.; and Iannone, A.: Cerebrovascular Disease: VIII. Role of Nutritional Factors , Neurology (Minneap) 11:380, 1961.Crossref 28. Pick, R., et al: Estrogen-Induced Regression of Coronary Atherosclerosis in Cholesterol-Fed Chicks , Circulation 6:858, 1952.Crossref 29. Russ, E. M.; Eder, H. A.; and Barr, D. P.: Protein-Lipid Relationships in Human Plasma , Amer J Med 11:468, 1951.Crossref 30. Eilert, M. L.: Effect of Estrogens on Partition of Serum Lipids in Female Patients , Metabolism 2:137, 1953. 31. Barr, D. P.: Influence of Sex and Sex Hormones Upon Development of Atherosclerosis and Upon Lipoproteins of Plasma , J Chron Dis 1:63, 1955.Crossref 32. Baker, A. B., and Iannone, A.: Cerebrovascular Disease: VII. Study of Etiologic Mechanisms , Neurology (Minneap) 11:23, 1961.Crossref 33. Wuesk, J. H., and Edwards, J. E.: Degree of Coronary Atherosclerosis in Bilaterally Oophorectomized Women , J Lab Clin Med 40:963, 1952. 34. Oliver, M. F., and Boyd, G. S.: Effect of Bilateral Ovariectomy on Coronary-Artery Disease and Serum-Lipid Levels , Lancet 2:690, 1959.Crossref 35. Duguid, J. B.: Atheroma of Aorta , J Path Bact 29:371, 1926.Crossref 36. Texon, M.: Hemodynamic Concept of Atherosclerosis With Particular Reference to Coronary Occlusion , Arch Intern Med 99:418, 1957.Crossref 37. Beneke, M.: Über die Anfänge der Arteriosklerose , Klin Wschr 9:2182, 1930. 38. Moschcowitz, E.: Cause of Arteriosclerosis , Amer J Med Sci 178:244, 1929.Crossref 39. Wolkoff, K.: Über Atherosklerose der Gehirnarterien , Beitr Path Anat 91:515, 1933. 40. Adams, R. D., and vander Eecken, H. M.: Vascular Disease of Brain , Ann Rev Med 4:213, 1953.Crossref 41. Blumenthal, H. T.; Handler, F. P.; and Blache, J. O.: Histogenesis of Arteriosclerosis of Larger Cerebral Arteries With an Analysis of Importance of Mechanical Factors , Amer J Med 17:337, 1954.Crossref 42. Young, W., et al: Quantitation of Atherosclerosis: I. Relationship of Artery Size , Amer J Cardiol 6:288, 1960.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1964

References