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Vascular convolutes in the brain: a peculiar entity.

The present study intends to systematically assess a lesion with potential clinical expression - the vascular convolutes of the brain parenchyma. Those, firstly described by Gertz and Frydl in 1987, are frequently reported in various studies as being associated to aging. Their mechanism seems to be an arteriolar tortuosity. The association with pathologically important manifestations, as brain infarct or hemorrhage could be of clinical importance. The study was done on 70 consequently autopsied cases, on paraffin-embedded material, using the classical histological staining methods: Hematoxylin-Eosin and Masson's Trichrome, as well as the Gömöri silver method for reticulum. In our series, only two cases had specific features suggesting vascular convolutes. More frequently were encountered vascular tortuosities, which seems unrelated to the former. We conclude that vascular convolutes and vascular tortuosities are dissimilar lesions. Both are less represented in reality than reported in the literature. Possible mechanisms of the two changes and their pathogenic significance are discussed.