Experimental Studies on Cerebral Hemorrhage

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With a hope to clarify the relationship between vasospasm and cerebral hemorrhage, we made occlusion of cerebral arteries of the dogs. After clinical observation of period varying from several days to a few months, dogs were sacrificed and macroscopic and histologic examinations were performed. (1) Occlusion of the middle cerebral artery alone resulted in mild hemorrhage in 2, large softening in one and moderate softening in 3 out of 27 dogs studied. Clinically, dogs recovered from severe hemiplegia quickly in most of the cases. (2) Combined occlusion of the anterior and middle cerebral arteries resulted in massive hemorrhage in 3, mild hemorrhage in 4, minimal hemorrhage in 3 and etat lacunaire in one among a total of 14 dogs in this group. Clinically dogs died in coma or severe hemiplegia in almost all instances. (3) Combined occlusion of 2 or more arteries including middle and posterior cerebral, basilar, superior anterior cerebellar and anterior spinal arteries resulted in massive hemorrhage in 5, mild hemorrhage in 7, minimal hemorrhage in 3, large softening in 3 and internal hydrocephalus in 1 out of 23 dogs. (4) These experiments showed that by occluding 2 or more cerebral arteries, the incidence of cerebral hemorrhage becomes remarkably higher than by occlusion of the middle cerebral artery alone. This may indicate the importance of circulatory regulation by anastomotic channels. But the areas supplied by the anterior spinal artery showed a high incidence of vascular lesion due to its occlusion alone. (5) In the histological examination of the arecrosis may be the result of blood invasion into the vessel wall from vessel lumen eitherby the dissection of the intima or by the change in permeability of the vascular wall. (8) On the bases of above mentioned data, it is concluded that if vasospasm play a role in cerebral hemorrhage, it may wellas of hemorrhage or their surroundings, there can be seen the same changes of the vessel walls as seen in the human pathology of cerebral hemorrhage. (6) On the other hand, by the occlusion of larger pial veins we were unable to produce a larger hemorrhage. Also in the histological examination of the surrounding areas of minimal hemorrhage, we found a marked increase in thrombus formation in the lumen of smaller veins instead of the changes in vessel walls as seen in massive hemorrhage by arterial occlusion. (7) Although both angionecrosis and venous dilatation may be the direct cause of hemorrhage, we consider an arterial engorgement by sudden occlusion of pial arteries with subsequent venous stasis may be more pertinent. Furthermore, it is postulated that the angione be in pial arteries resulting in circulatory stasis in the area supplied by their proximal branches.
International Heart Journal刊行会の論文

Experimental Studies on Cerebral Hemorrhage

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