Microvascular patterns in human medullary tegmentum at the level of the area postrema

The aim of the present study was to evaluate the regional differences in microvessel density (MVD) of the human medullary tegmentum in adults and newborns/infants. Transverse serial sections of formalin-fixed, paraffin-embedded brainstems, taken from 16 adult and eight newborn/infant subjects, were stained with anti-von Willebrand factor (vWF) polyclonal antibodies. The boundaries of the area postrema (AP), dorsal motor vagal nucleus (DMVN), solitary tract nucleus (STN), solitary tract (ST) and hypoglossal nucleus (XII) were defined, all vessels were counted and the values were divided by the areas. In adult cases, statistically significant heterogeneity in MVD was found among the nuclei studied ( P < 0.001). DMVN and AP showed higher MVD with respect to XII and ST ( P < 0.001). The MVD of STN was lower with respect to DMVN ( P < 0.001) and higher with respect to XII and ST ( P < 0.05). The MVD and capillary density of the AP of newborns/infants were not significantly different with respect to adults. In sections of the medulla of adult subjects stained with anti-vWF, all vessels showed an intense reaction of endothelial cells whereas in the DMVN, XII, STN and ST of newborns/infants, only rare, isolated vessels showed anti-vWF reactivity and in the AP, 41 ± 21% of vessels expressed vWF. Differences in MVD among the nuclei may be related to their different functions and metabolic demands. Light and heterogeneous expression of vWF in endothelial cells of newborns/infants indicates that differentiation of microvasculature in the human medullary tegmentum extends beyond fetal stages.