Acute Gastric Lesions Following the Cerebral Apoplexy K. Tsuneoka 1 , M. Ono 1 , T. Aida 1 , H. Ishihara 1 , M. Ozeki 1 , K. Hamanaka 1 , K. Ohashi 1 , Y. Saito 1 13rd. Department of Internal Medicine, Nippon Medical School pp.1617-1622
Published Date 1975/12/25
DOI https://doi.org/10.11477/mf.1403112117
  • Abstract
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 There are many cases in which we encounter the sudden hematemesis or bloody stool following the apoplexy attack, and, moreover, such bleeding often causes the death of the apoplexy patients. The bleeding is usually due to the acute gastroduodenal lesions. Concerning to the correlation between these central nervous lesions and the gestrointestinal lesions. Rokitansky first made his report in 1861, and, since then, many studies have been brought out about their genetic mechanism, using the animal experiments. On the other hand, the reports about the gastroduodenal lesions were made only for the autopsy cases, because the seriousness and the rapid process of apoplexy prevented the examination. Lately, however, the evolution of the gastroscopy made it possible for us to examine those lesions of the living patients and to make the early diagnosis and the early therapy.

 We had four cases (among the 134 apoplexy cases) of the gastric and duodenal ulcers with hematemesis or bloody stool, to which the endoscopic examination of the bleeding source was made. The investigation of these cases and the bibliographical study led us to the following conclusion.

 Conclusion  1) In the autopsy cases, 19~23% of the apoplexy patients showed some gastrointestinal lesions, the lesion of the brain usually located in the brain stem. The circulatory disturbance in, however, or the pressure to the hypothalamus also caused the gastrointestinal lesions frequently.

 2) Those above gastrointestinal lesions were hemorrhagic erosion, acute ulcer and the acute aggravation of chronic ulcer. Hemorrhagic erosion occurred in every part of the stomach, while the acute ulcer arranged along the axis of ordinates and covered a wide space, distinct from the chronic ulcer.

 3) The initial symptom of those gastrointestinal lesions seemed, in many cases, a sudden profuse bleeding after apoplexy attack, though in a few cases a small quantity of bleeding preceeded it. It can be conjectured that the bleeding source was formed one or two weeks after the attack.

 4) The “pan-view” type fiber-scope is the best for the safe gastroscope examination even with the serious patients.

Copyright © 1975, Igaku-Shoin Ltd. All rights reserved.


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