内頸動脈閉塞の1剖検例—内頸動脈および頭蓋内動脈の硬化性血栓性閉塞により広範な脳軟化をきたした1例

AN AUTOPSY CASE OF OCCLUSION OF THE INTERNAL CAROTID ARTERY

Ｉ．はじめに

　内頸動脈閉塞は，臨床的に頭蓋内血管の病変と同様の症状をみるが，1872年Kussmaul^1）がその2剖検例を報告して以来，脳血管性病変の診断術の進歩により臨床報告例は増加している。内頸動脈閉塞の原因は，欧米では動脈硬化性病変によるものが多いとされ，Hutchinson　＆　Yates^2）は，アテローム血栓に起因するとしている。本邦の報告例では，アテローム血栓による内頸動脈閉塞症は，1961年竹内^6）の剖検報告以来9剖検例が報告されているにすぎない。私どもは，最近脳卒中様発作で入院し，全経過18日で死亡した左内頸動脈，右大脳動脈，右椎骨動脈などに動脈硬化性病変に基づく血栓性閉塞をきたし，広範な脳軟化を呈した1剖検例を経験したので報告する。

We examined pathological changes of occlusion of the left internal carotid artery in autopsy case. The patient, 29 year old man, had complained of numbness of the right half of his body for 2 years, and then suffered from the attack of apo-plectic type. By thrombotic stroke, he went into coma, hemiplegia and hemihypesthesia, and died on 18 days after the onset of attack. Cerebral angiogram showed evidence of obstruction of the left internal carotid artery, but the ophthalmic artery was clearly outlined.

The main lesions of the vessels were in the left internal carotid artery, the right arterior, middle, and posterior cerebral arteries, the vertebral artery, and the rami of vertebral and basilar arteries. The cause of occlusion was the cerebral arterial throm-bosis by intimal arteriosclerosis, and the changes of these vessels were accompanied with cerebral softening.

The circulatry impediment, which had been caused by arteriosclosis, brought out cerebral softening and death.