Segmental Arterial Mediolysis Involving Both Vertebral and Middle Colic Arteries Leading to Subarachnoid and Intraperitoneal Hemorrhage

Shinoda, Narihide; Hirai, Osamu; Mikami, Kazuyuki; Bando, Toshiaki; Shimo, Daisuke; Kuroyama, Takahiro; Matsumoto, Masato; Itoh, Tomoo; Kuramoto, Yoji; Ueno, Yasushi

doi:10.1016/j.wneu.2015.12.058

Cited by 25 publications

(28 citation statements)

References 10 publications

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“…3) SAM affects multiple arteries. [3][4][5][6][7][8][9][10] We previously reported a patient who died of SAMrelated subarachnoid hemorrhage, with new/old multiple intracranial artery dissection, 11) and a patient who died of SAM-related intraperitoneal hemorrhage, with old IVA dissection. 12) However, there has been only one case report in which the SAM-related rupture of both intracranial and -peritoneal arteries led to subarachnoid and intraperitoneal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Kalva et al reported the development of new extracranial internal carotid artery dissection during follow-up in 3 of 14 patients with IPA dissection. 10) Furthermore, Shinoda et al 8) presented a case in which dissecting middle colic artery rupture-related intraperitoneal hemorrhage occurred 8 days after endoscopic hemostasis for subarachnoid hemorrhage related to IVA dissection. 8) In patients with IVA dissection, the presence of systemic SAM and new onset of dissection must be considered in addition to intracranial artery dissection.…”

Section: Discussionmentioning

confidence: 99%

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Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Kageyama

Mukai

2018

JNET

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Objective: To examine the involvement of segmental arterial mediolysis (SAM) in intracranial artery dissection. Methods:In four autopsy cases of subarachnoid hemorrhage related to the rupture of the intracranial vertebral artery (IVA) with intraperitoneal hemorrhage, we calculated the extent of arterial dissection using elastica van Gieson staining from the tissue sections of the left/right IVAs and intraperitoneal arteries (IPAs), and examined the properties of the vascular smooth muscle and responses of mesenchymal cells using immunostaining with anti-α smooth muscle antibody (SMA) and anti-S100A4 antibodies. Results:The length of the adventitia at the site of IVA rupture was ≤2.4 mm, and that of disruptions of the internal elastic lamina was 5.4-11 mm. The IVA/IPA rupture sites showed acute arterial dissection. In the blood vessels at the sites of dissection, defect/necrosis of the vascular smooth muscle, which are characteristic of SAM, were noted. In three cases, the topical infiltration of mesenchymal cells was observed in the adventitia at the dissected site of the ruptured IVA. In all cases, dissection of unruptured intracranial or -peritoneal arteries was also present. Its pathological properties vary from acute to old dissection. Conclusion:Autopsy revealed SAM-related systemic multiple arterial dissection in all cases, suggesting the involvement of SAM in the development of intracranial artery dissection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Kageyama

Mukai

2018

JNET

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“…We identified 12 published cases [6, 12–22]. The key features of these reported cases are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…2014 [21]?Celiac artery, dissectionBoth ICAs, stroke?Stroke?Shinoda et al. 2016 [22]47maleMiddle colic artery, ruptured fusiform aneurysm*Extracranial VA, thyreocervical artery, incidental dissections; intradural VA, ruptured dissection*+SAH → abdominal hemorrhageCoil occlusion*Welch et al. 2017 [6]61maleSplenic artery aneurysm, hemorrhagePosterior spinal artery aneurysm_Spinal SAHabdominalhemorrhageEmbolization

ACA anterior cerebral artery, ICA internal carotid artery, PcomA posterior communicating artery, MCA middle cerebral artery, SAH subarachnoidal hemorrhage, VA vertebral artery

…”

Section: Discussionmentioning

confidence: 99%

Concomitant Retroperitoneal and Subarachnoid Hemorrhage Due to Segmental Arterial Mediolysis

et al. 2017

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“…There have been sporadic reports on SAM complicating vertebral artery or splanchnic artery aneurysms, 6,7) and the condition has often been detected due to rupture of some aneurysm. If abnormalities such as aneurysm and dissection of head and neck vessels are noted, it is recommended to perform general vascular assessment with systemic diseases such as SAM and fibromuscular dysplasia (FMD) in mind.…”

Section: Introductionmentioning

confidence: 99%

A Case of Vertebro-vertebral Arteriovenous Fistula Clinically Diagnosed as Segmental Arterial Mediolysis Complicated by Celiac Artery Aneurysm Suspected in a State of Impending Rupture

Kuramoto

Shimo

Hori

et al. 2017

JNET

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Objective: Vertebro-vertebral arteriovenous fistula (VVAVF) is a rare disorder that often forms a high blood flow shunt.It is mostly due to trauma, but it is occasionally caused by systemic diseases. Segmental arterial mediolysis (SAM) is characterized by non-inflammatory/non-atherosclerotic segmental lysis of the arterial media and is often diagnosed due to intraperitoneal hemorrhage from a ruptured abdominal visceral artery.Case Presentation: A 45-year-old male with right VVAVF presented with pulsating tinnitus and underwent coil embolization of the right vertebral artery around the fistula. Cerebral angiography disclosed multiple aneurysms in the head and neck region. Abdominal contrast-enhanced CT showed a dissecting aneurysm extending from the celiac artery to the splenic artery. Since impending rupture was suspected, the aneurysm was embolized later at the radiology department. Conclusion:A case of VVAVF complicated by SAM is reported. If multiple arterial abnormalities are observed, systemic examination and appropriate intervention are important.

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Segmental Arterial Mediolysis Involving Both Vertebral and Middle Colic Arteries Leading to Subarachnoid and Intraperitoneal Hemorrhage

Cited by 25 publications

References 10 publications

Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Pathomorphological Examination of Patients with the Simultaneous Rupture of Dissecting Intracranial Vertebral and Intraperitoneal Arteries: Involvement of Segmental Arterial Mediolysis in Intracranial Artery Dissection

Concomitant Retroperitoneal and Subarachnoid Hemorrhage Due to Segmental Arterial Mediolysis

A Case of Vertebro-vertebral Arteriovenous Fistula Clinically Diagnosed as Segmental Arterial Mediolysis Complicated by Celiac Artery Aneurysm Suspected in a State of Impending Rupture

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