クモ膜下出血後のいわゆる脳血管攣縮: Rigor arteriae?

概要

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It is well known that so called vasospasm is one of the most important factors complicating the management of patients with subarachnoid hemorrhage from cerebral aneurysms.<BR>We have made prospective and histological study of the intracranial arteries with angiographically demonstrated arterial narrowing in 6 cases. In 4 of them, the course of vasospasm was investigated by repeated angiographies. At autopsy, main intracranial arteries were carefully dissected free from the base of the brain. Serial sections were cut and stained for light microscopy and electron microscopy. The arterial wall corresponding to the angiographic vasospasm showed various structural changes.<BR>In constriction stage, we have found contraction of the median smooth muscle cells, intimal edema due to eodothelial injuries, and thrombus formation. And, at the stage of dilatation of the arterial lumen, it was noted that there were necrosis of the medial smooth muscle cells and thickening of the intima.
The Japanese Society on Surgery for Cerebral Strokeの論文