Cardiovascular Pathology
Volume 19, Issue 4 , Pages 248-251, July 2010

Segmental arterial mediolysis of varying phases affecting both the intra-abdominal and intracranial vertebral arteries: an autopsy case report

  • Ayako Ro

      Affiliations

    • Department of Legal Medicine, School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan
    • Tokyo Medical Examiner's Office, Tokyo, Japan
    • Corresponding Author InformationCorresponding author. Department of Legal Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Tel.: +81 3 5269 7300; fax: +81 3 5269 7300.
    • ,
  • Norimasa Kageyama

      Affiliations

    • Tokyo Medical Examiner's Office, Tokyo, Japan
    • ,
  • Akihiro Takatsu

      Affiliations

    • Tokyo Medical Examiner's Office, Tokyo, Japan
    • ,
  • Tatsushige Fukunaga

      Affiliations

    • Tokyo Medical Examiner's Office, Tokyo, Japan

Received 18 December 2008; received in revised form 5 February 2009; accepted 9 February 2009. published online 17 April 2009.

Abstract 

We report an autopsy case of segmental arterial mediolysis (SAM) of various phases occurring in both the intracranial vertebral artery (IVA) and intra-abdominal arteries. The patient was a 70-year-old male found dead in his house. The cause of death was massive intra-abdominal hemorrhage owing to a ruptured right gastroepiploic artery. Histopathological examination revealed that there was a broad arterial dissection as long as 20 cm in the right gastroepiploic artery associated with SAM in the injurious phase. In addition, SAM in the reparative phase was observed as organized arterial dissections in the left gastric artery. Furthermore, SAM in the reparative phase was detected as an arterial dissection in the right IVA undergoing an organizing process. These three lesions were considered to have developed at different times. SAM occurring in both the intra-abdominal and intracranial vertebral arteries is extremely rare. This coincidence may provide a clue to the relationship between SAM and spontaneous IVA dissection.

Keywords: Segmental arterial mediolysis, Arterial dissection, Intra-abdominal artery, Intracranial vertebral artery, Autopsy

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PII: S1054-8807(09)00008-8

doi:10.1016/j.carpath.2009.02.002

Cardiovascular Pathology
Volume 19, Issue 4 , Pages 248-251, July 2010

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