Apoptosis of endothelial cells in vessels affected by cerebral vasospasm

BACKGROUND Cerebral vasospasm after subarachnoid hemorrhage is a prolonged contraction that leads to cerebral ischemia or infarction. Morphological studies of ce rebral arteries during vasospasm have shown extensive necrosis of smooth-mu scle cells and desquamation and dystrophy of endothelial cells. The mechani sm of cellular death is unknown. METHODS We report an observation of apoptotic changes in the cerebral arteries of a patient who died after suffering severe cerebral vasospasm caused by aneur ysmal rupture. Subarachnoid hemorrhage and cerebral vasospasm were confirme d by computed tomography scanning and angiogram. Histological and immunohis tological examinations for apoptosis were performed in cerebral arteries. F or control, the arteries from another patient, who died of trauma without h ead injury, were used. RESULTS Corrugation of the internal elastic lamina and increased amounts of connect ive tissue was demonstrated by light microscopy. Apoptotic changes, charact erized by condensation of chromatin of the nucleus and detachment from the basal membrane, were found on transmission electron microscopy in endotheli al cells. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triph osphate-biotin nick end labeling reaction revealed positive staining of the nuclei of the endothelial cells. CONCLUSIONS This study demonstrates that apoptosis occurred in the cerebral arteries in a patient who died of cerebral vasospasm. The possible role of apoptosis i n cerebral vasospasm is discussed. (C) 2000 by Elsevier Science Inc.