Abstract

Introduction: Brain arteries, large and small, are exposed to aging and acquired risk factors simultaneously. Therefore, we hypothesize that pathological changes noted with brain large artery aging, such as intima thickening, luminal dilatation and/or atherosclerosis, will be observed in their penetrating arterial branches. Methods: We extracted 1,695 brain large arteries and 1,233 corresponding penetrating arteries from 211 autopsied brains (mean age 67 ± 18 years, 60% men, 73% non-Hispanic white, 17% with brain infarcts). From each arterial segment we obtained measures of lumen, wall, intima and interadventitial diameters, and percentage stenosis using a semi-automated method based on color-thresholding. We visually rated the presence of concentric intima thickening and/or atheromas. We used hierarchical models to relate large artery characteristics to their penetrating arteries. Results: Of the 1695 large arteries, 182 (11%) were sectioned in continuity with the ostia of penetrating arteries and 1,233 (42%) exhibited cross-sections of their penetrating arteries at their peripheries (Figure 1). Of the 182 penetrating artery ostia, 123 (67%) exhibited intima thickening and in 46 (37%), the ostia was the only location in the cross-section of the large artery that had intima thickening. The mean luminal diameter of penetrating branches was 280 ± 231 μ and 19% had intima thickening (Figure 1). Large artery characteristics were associated with measures of penetrating artery disease (table 1). Conclusion: We found evidence that pathological changes in brain large arteries are observed in their penetrating arterial branches, supporting the notion that brain arterial aging occurs as a continuum. The unique geometric configuration of the penetrating artery ostia may predispose them to intimal thickening early on. Segregating brain arterial disease into small or large artery underestimates the extent of cerebrovascular disease attributed to each category.

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