ABSTRACT
BACKGROUND: Superficial siderosis (SS) of the central nervous system is a rare disease characterized by deposition of hemosiderin along the leptomeninges due to chronic or recurrent bleeding into the subarachnoid space. The association of unruptured intracranial aneurysm (IA) and cortical SS is quite rare. METHODS: A systematic literature review to assess possible commonalities and/or differences of previous reported cases was undertaken. We report an additional case from our institution. RESULTS: A 40-year-old woman presented with a history of generalized seizures over the past year. There was no clinical history suggestive of aneurysm rupture. Magnetic resonance imaging revealed 2 aneurysms of the right middle cerebral artery (MCA) bifurcation associated with hemosiderin deposition along the right sylvian fissure and a third aneurysm of the left MCA bifurcation. Magnetic resonance imaging showed wall enhancing thickening of the larger right MCA aneurysm. The patient underwent surgical clipping of all 3 MCA aneurysms in a staged procedure. Histological examination revealed hemosiderin deposits within the aneurysm wall and surrounding gliosis. CONCLUSIONS: Our literature review found 24 reported cases of unruptured IA associated with cortical SS. The possible source for leakages could be neovessels visible in IA walls. The case reported illustrates an uncommon presentation of recurrent bleeding from an IA as a source of SS. The presence of an apparently unruptured IA surrounded by cortical SS on imaging studies is of high relevance as this should be considered a sign of aneurysm wall instability and should indicate prompt treatment.
Subject(s)
Intracranial Aneurysm , Siderosis , Adult , Female , Humans , Hemosiderin/metabolism , Hemosiderosis/complications , Hemosiderosis/diagnostic imaging , Intracranial Aneurysm/surgery , Intracranial Aneurysm/complications , Intracranial Aneurysm/diagnostic imaging , Magnetic Resonance Imaging , Siderosis/complications , Siderosis/diagnostic imaging , Subarachnoid Hemorrhage/diagnostic imaging , Subarachnoid Hemorrhage/surgery , Subarachnoid Hemorrhage/etiology , Subarachnoid Hemorrhage/complicationsABSTRACT
OBJECTIVES@#To observe the changes of the formation time of venous thrombus in rats, and to provide new ideas and methods for the estimation on thrombus formation time of the forensic cases died from thrombosis.@*METHODS@#Totally 80 rats were randomly divided into 10 groups （0 h, 3 h, 6 h, 12 h, 1 d, 3 d, 1 week, 2 weeks, 3 weeks and 4 weeks after operation）. A vein thrombosis model was established by the "narrow" method. The processes of thrombosis, organization, recanalization and the features of change on hemosiderin and calcium salt were observed by HE stain, Perls stain and Von Kossa stain. The expression changes of CD61, α-SMA and CD34 were observed by immunohistochemical staining technique.@*RESULTS@#Platelets adhered to the exposed blood vessel intima 3 h after operation, and platelet trabeculae were formed by the repeated accumulation of platelets 1 d after operation. The thrombus organization formed through the fibroblasts from vessel wall that grew into the interior of the thrombus 3 d after operation. Endothelial cells covered the surface of thrombus and then the new blood vessels were reformed, and the vessels were reconstructed. The expression of CD61 upregulated at the stages of the thrombus formation （3 h） and thrombus reformation （4 weeks）, and reached the peak 1 d after thrombus formation. The release of hemosiderin and the initial expression of α-SMA were detected 3 d later. Calcium deposit and expression of CD34 were observed 1 week later.@*CONCLUSIONS@#The hemosiderin, calcium salt, CD61, α-SMA and CD34 show time-dependent changing characteristics, which is expected to provide a reference for the estimation on thrombus formation time of the forensic cases died from thrombosis.
Subject(s)
Animals , Rats , Antigens, CD34/analysis , Hemosiderin/metabolism , Venous Thrombosis/pathologyABSTRACT
Hemosiderin deposition is not often recognized on routine examination with hematoxylin and eosin staining; however, iron stains may be helpful in the evaluation of hemosiderin deposition in infant autopsies. This report describes the data obtained from autopsy of 86 infants and children whose deaths were investigated at the Forensic Medicine Council Bursa Morgue Department from January 2000 to January 2003. A histochemical technique was used to identify hemosiderin in lung, liver and spleen specimens, which was correlated with other descriptive variables such as the reported cause of death, postmortem interval, trauma history, gender, and age. There was a weakly positive but significant correlation between lung and liver hemosiderin scores (Spearman's rank correlation coefficient, rho=0.348, p=0.001); i.e., given an increase in lung hemosiderin scores, an increase in liver hemosiderin scores was also observed. Similarly, a marked positive correlation between spleen and liver hemosiderin scores (Spearman's rank correlation coefficient, rho=0.335, p=0.002) was observed. The probability of spleen hemosiderin-positive cases belonging to the age group under 6 months was found to be 4.3 times greater than those who were hemosiderin-negative (95% confidence interval, 1.6-11.8). After the major differential diagnoses were ruled out, this study demonstrated, that depending on the statistically assessed morphometric grounds, the presence of hemosiderin deposits in the liver and spleen were significantly higher in the age group under 6 months.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Age Factors , Cause of Death , Forensic Pathology , Hemosiderin/metabolism , Liver/pathology , Lung/pathology , Macrophages/pathology , Spleen/pathologyABSTRACT
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Subject(s)
Humans , Lung/pathology , Lung , Hemosiderin/analysis , Hemosiderin , Hemosiderin/metabolism , Macrophages/chemistry , Lung/metabolism , Anti-Bacterial Agents/adverse effects , Sirolimus/adverse effectsABSTRACT
Se presenta una mujer de veinte años con amenorrea secundaria desde los diecisiete años debida a hipogonadismo hipogonadotrófico. Cinco meses antes de su ingreso comenzó con disnea y edemas; al ingreso presentaba insuficiencia cardíaca congestiva y en el ecocardiograma dilatación biventricular. Respondió escasamente al tratamiento farmacológico y murió con diagnóstico de miocardiopatía congestiva. la autopsia evidenció depósitos férricos en todos los parénquimas. El diagnóstico de hemocromatosis primaria no fue planteado en vida porque esta enfermedad es extremadamente rara en mujeres premenopáusicas (AU)
Subject(s)
Adult , Humans , Female , Hemochromatosis/complications , Hypogonadism/complications , Heart Failure/complications , Hemochromatosis/pathology , Myocardium/metabolism , Hemosiderin/metabolism , Hypogonadism/diagnosis , Diagnosis, DifferentialABSTRACT
Se presenta una mujer de veinte años con amenorrea secundaria desde los diecisiete años debida a hipogonadismo hipogonadotrófico. Cinco meses antes de su ingreso comenzó con disnea y edemas; al ingreso presentaba insuficiencia cardíaca congestiva y en el ecocardiograma dilatación biventricular. Respondió escasamente al tratamiento farmacológico y murió con diagnóstico de miocardiopatía congestiva. la autopsia evidenció depósitos férricos en todos los parénquimas. El diagnóstico de hemocromatosis primaria no fue planteado en vida porque esta enfermedad es extremadamente rara en mujeres premenopáusicas