title: Lectin-like oxidized low-density lipoprotein receptor 1 and matrix metalloproteinase expression in ruptured and unruptured multiple dissections of distal middle cerebral artery: case report.
abstract: OBJECTIVE
  Oxidized low-density lipoprotein receptor 1 (LOX1) is a critical factor for atherosclerosis in a variety of vascular diseases; however, its major role in cerebral arterial dissecting aneurysm is unclear.
  
  
  METHODS
  We present a case of remarkable contrast of LOX1 expression in ruptured and unruptured multiple middle cerebral artery dissections and discuss the correlation of LOX1 with matrix metalloproteinases (MMPs). A 59-year-old woman presented with subarachnoid hemorrhage associated with left temporal subcortical hematoma. Emergent cerebral angiography demonstrated aneurysmal dilatation at the origin of the left anterior temporal artery (ATA) and occlusion on the distal side of ATA. Infectious aneurysm was excluded. Intraoperative findings showed ruptured dissection of the left ATA and unruptured aneurysmal dilatation of another temporal branch of the left M1 portion. Both lesions were trapped by clips and resected. Histopathological examination confirmed that both ruptured and unruptured aneurysmal dilatations were diagnosed as arterial dissections. Immunohistochemical examination demonstrated remarkable expressions of LOX1, MMP-2, and MMP-9 in hypertrophic media outside the intima in ruptured dissection, on the other hand, those expressions in the intima and inside hypertrophic media in the unruptured dissection.
  
  
  CONCLUSIONS
  This is the first report to reveal immunohistochemical findings of LOX1 and MMPs in multiple dissections of MCA. The contrast localization of LOX1 and MMPs might contribute to the fragility of the arterial wall layer of ruptured/unruptured arterial dissections.
authors: Department of Neurosurgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba, Sendai, Miyagi, 980-8574, Japan. satsushi2002@yahoo.co.jp
authors: Atsushi
authors: A
authors: Saito
authors: Miki
authors: M
authors: Fujimura
authors: Takashi
authors: T
authors: Inoue
authors: Hiroaki
authors: H
authors: Shimizu
authors: Teiji
authors: T
authors: Tominaga
mesh_terms: D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D020778:Matrix Metalloproteinase 2 / Q000096:biosynthesis; D020780:Matrix Metalloproteinase 9 / Q000096:biosynthesis; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D018384:Oxidative Stress / Q000502:physiology; D051127:Scavenger Receptors, Class E / Q000378:metabolism*; D013345:Subarachnoid Hemorrhage / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology
chemical_list: D051127:Scavenger Receptors, Class E; D020782:Matrix Metalloproteinases; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9