Histological Features of Cerebral Arteries and Brain Parenchyma in Cadavers Who Had Died from Hemorrhagic Stroke

Abstract

Cerebral atherosclerosis is a risk factor for stroke. Several contents in the atheromatous plaque have been identified, but some have not yet been quantified. This is especially true for lipids. This study aims to compare the histology, vascular wall contents of the cerebral artery ipsilateral to the hemorrhagic lesion, and hemorrhagic parenchyma to that of the contralateral and the control. The A1, M1, and P1 segments of cerebral arteries from twelve stroke cadavers and those from eight control cadavers were used in this study. All segments were prepared for H&E, Sudan black B, trichrome, and modified Verhoeff’s Van Gieson stains and were then analyzed for vascular parameters, lipid area, collagen area, and elastic density, respectively. The results show that the wall areas of A1 and P1 ipsilateral to hemorrhagic lesions were significantly larger than those of the contralateral. The areas of the vascular lumen of M1 ipsilateral and contralateral to the hemorrhagic lesion were significantly smaller than that of the control. The largest lipid area was found in the ipsilateral M1 among the three groups. The collagen area in the ipsilateral M1 was significantly larger than that of the control. Finally, the elastic fibers in all ipsilateral segments had significantly less density than that of the control. The nervous parenchyma contralateral to the hemorrhage was shown to be an impaired tissue. In conclusion, high accumulations of lipids and collagen, along with low elastic density in the ipsilateral M1, might have reduced the size of its lumen and its flexibility, potentially resulting in a hypertensive hemorrhage.