大脳基底核部出血の病理, ことに大出血巣と脳内小動脈瘤の成り立ちについて

概要

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1) Hypertensive intracerebral hemorrhage is the result of the rupture of microaneurysms due to plasmatic arterionecrosis of the intracerebral arteries.<BR>2) Rupture of microaneurysms could be followed by secondary bleeding from all kinds of intracerebral blood vessels, i. e. small arteries, venules and capillaries within and circumjacent regions of hematomas in the brain. The secondary hemorrhage can play important roles on the morphogenesis of massive intracerebral hemorrhage.<BR>3) Acute vascular permeability, which was enhanced by circulatory disturbances in the distal of ruptured artery, by increased venous pressure due to disturbances of venous flow and by increaed resistance in peripheral vessels, is responsible for acute angionecrosis observed in hematomas and in surrounding areas of hematomas.<BR>4) Putaminal hemorrhage might be extended to the thalamus in the same side where was involved by hemorrhagic infarction due to uncul herniation.<BR>5) Blood plasma infiltration into the arterial wall in which medial smooth muscle cell had lost resulted in histolysis in the wall. This arterial lesion has been termed as "plasmatic arterionecrosis" (G. Ooneda).