Dissecting aortic aneurysm as a complication of generalized fibromuscular dysplasia.

This is the first report of a dissecting aneurysm of the aorta caused by generalized vascular fibromuscular dysplasia. An 18-year-old black man suddenly developed paraparesis and bilateral pulse loss below the waist. An aortogram disclosed a dissecting aneurysm of the entire aorta and an obstruction of blood flow below the renal arteries. On postmortem examination, the dissection of the aorta was found to be due to fibromuscular dysplasia that affected not only the aorta, but multiple other arteries as well.     

Dissecting aneurysm of the pulmonary artery

Summary Dissecting aneurysm of the aorta is often seen; similar changes in the pulmonary artery are rare. In the German literature they are unknown. 11 previously described cases have been compiled with their clinical and pathological records, and a new added. The patient, a 45 year old woman, suffered from pulmonary hypertension which resulted in medionecrosis and a large aneurysm of the trunk of the pulmonary artery. She died of haemopericardium after rupture of the artery in two stages, with a tear of 8 cm in the trunk which reached to the bifurcation of the vessel.     

Dissecting aneurysm of the pulmonary trunk

Dissecting aneurysms of the pulmonary trunk are a rare cause of sudden death. We report a case in a patient with pulmonary hypertension secondary to a patent ductus arteriosus. A brief review of the condition is also presented.     

Dissecting aneurysm of cerebral arteries in childhood and adolescence

Summary A nine year old girl died with a massive infarct of the right cerebral hemisphere causing transtentorial and foramen magnum herniation. The infarction was secondary to an idiopathic dissecting aneurysm. The case is unusual in that the supraclinoid segment of the right internal carotid artery, the anterior cerebral artery, and the middle cerebral artery and its three branches were embedded and sectioned longitudinally. The dissection commenced in the supraclinoid segment of the right internal carotid artery, extended into the middle and anterior cerebral arteries, and was accompanied by thrombosis of the false lumen. A literature review of 20 pediatric cases indicates the malignant natural course of the disease (76% mortality in the first two months), and emphasizes the characteristic angiographic string sign. The diagnosis of cerebral arterial dissection during life depends on angiography and a high index of suspicion.     

Dissecting aneurysm of aorta in rats fed with cysteamine

Degeneration of elastic fibres leading to aortic aneurysm and rupture was observed in rats treated with cysteamine. The destructive changes are comparable to those of spontaneously occurring cardiovascular abnormalities in man.     

Dissecting the genes of familial aortic dissections

M/S: Mutations in myosin light chain kinase cause familial aortic dissections Wang et al. (2010) The American Journal of Human Genetics 87: 701–707     

Dissecting aneurysm: a clinicopathologic and histopathologic study of 111 autopsied cases

One hundred eleven autopsy cases of dissecting aneurysm were collected from western Japan. The ratio of males to females was 3:2 and the sixth and seventh decades of life were most frequently affected. All 11 cases of Marfan's syndrome were in patients under 40 years of age. DeBakey's type III dissections showed a male predilection and more severe atherosclerosis than in control cases. Many patients with types I and II dissections died of hemorrhage in the acute phase, while many patients with type III dissection died in the subacute or chronic phase, and half of the patients died of diseases other than hemorrhage. Hypertension was recognized in 73.7% of the 95 cases which showed no other obvious risk factors. Histologic examinations suggested that cystic medial necrosis was related to the pathogenesis of the disease in Marfan's syndrome, but was not so apparent in non-Marfan's syndrome. Laminar medial necrosis was found in many cases, but was considered to be a secondary ischemic change following dissection, as supported by other investigators. There were only a few cases in which dissection seemed to be directly caused by atherosclerosis.