Athérosclérose cérébrale au Senegal: Étude anatomopathologique

Abstract

A systematic investigation was undertaken on the arteries of the circle of Willis in 203 African patients from a neuropsychiatric department with the purpose of studying atherosclerotic lesions. Among the 203 cases, 93 presented with cerebrovascular accidents — 49 haemorrhagic and 44 ischaemic. A strong ana'ogy with Western populations was noted in regard to onset in the 3rd decade; to the influence of age on the frequency, extent and severity of the lesions; and to the greater frequency of lesions in the larger trunks. The internal carotid artery and the vertebro-basilar system in Senegalese were respectively less seriously affected than the middle cerebral artery and the caroticosylvian system. This finding contrasts with that found in Western populations. After 40 years of age, 90 % of cerebrovascular accidents occurred in atherosclerotic patients. After this age, atherosclerotic lesions were almost equally severe in patients who had had ischaemic accidents as in those who had had haemorrhagic episodes. The two groups were differentiated by the greater degree of hypertension in patients with haemorrhagic accidents. Hypertension was much more frequent in the group of patients who died from cerebrovascular accidents; this disease is known to be an important aggravating factor in atherosclerotis.