Which histologic findings are characteristic of cerebral aneurysms?

Updated: Dec 06, 2018
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Gross pathologic examination may reveal brownish pigmentation and fibrous adhesions of surrounding brain parenchyma. Aneurysm size may be diminished on postmortem examination, although a multilobular shape may be appreciated. A ruptured fundus may be visualized with calcifications of the aneurysm wall and intraluminal thrombus.

  • Microscopic examination reveals defects in the normal architecture of the vessel wall. The tunica media and internal elastic lamina may be absent or degenerated, with hemosiderin-laden phagocytes and lymphocytic infiltration.

  • Infectious aneurysms may exhibit an infected embolus adherent to a necrotic arterial wall. The intima and internal elastic lamina may be destroyed with an inflammatory infiltrate consisting of polymorphonuclear cells, lymphocytes, and macrophages.

  • Myofilament fragmentation and sarcolemmal destruction may be seen with vasospastic vessels.


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