雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 28, Issue 8 （August 1976）

Brain and Nerve 脳と神経 28巻8号（1976年8月発行）

Japanese English

原著

急性期脳硬塞の脳血管造影所見—とくに追跡検査を行った中大脳動脈閉塞例の検討 ANGIOGRAPHIC FINDINGS OF CEREBRAL INFARCTION IN ACUTE STAGE: ANALYSIS OF FOLLOW-UP CASES IN OCCLUSION OF THE MIDDLE CEREBRAL ARTERY 渡会二郎 ¹ , 上村和夫 ¹ , 奥寺利男 ¹ , 山口昂一 ² Jiro Watarai ¹ , Kazuo Uemura ¹ , Toshio Okudera ¹ , Koichi Yamaguchi ² ¹秋田県立脳血管研究所放射線医学研究部 ²山形大学医学部放射線医学教室 ¹Department of Radiology, Research Institute of Brain and Blood Vessels ²Department of Radiology, Yamagata University School of Medicine pp.769-777

発行日 1976年8月1日 Published Date 1976/8/1

DOI https://doi.org/10.11477/mf.1406203925

PDF(12229KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　脳硬塞の脳血管造影所見に関する報告は数多いが，報告者により異常所見のとり方が異つていたり^{14,16,17,20）}，同じ所見でも異常所見出現頻度がまちまちであり^6），未だに不明確な点が少なくない。これは対象とした脳硬塞が，発生機序（血栓，栓塞など），硬塞巣の部位，範囲および出血性硬塞の有無などに関して必ずしも同じ対象を扱つたものではないなどの他に，検査時期の相違による影響も大きいものと思われる^2,6,16,17）。

　我々は発症後24時間以内に脳血管造影を施行した脳硬塞症例，特にその後数回にわたり追跡検査を行い得た症例につき主に検討した結果，かなりの頻度で異常所見が経時的に変化しかつ消失してゆくのを認めたので，文献的考察も含めてここに報告する。

The angiographic findings in 76patients of cerebral infarction who underwent first carotid angiographies within 24 hours from the onset of symptoms were analyzed.

In 32 of the 76 patients, the occlusions of the middle cerebral artery and its branches were noted and follow-up studies were performed in 20 of the 32. The stumpfs of the occluded vessels were confirmed in all the 20 patients. The main angio-graphic findings of 20 follow-up patients were as follows:

1) Recanalization in the occluded vessels was seen in 15 patients at subsequent angiographic studies. In the majority of these cases, occluded vessels were patent within 4 days of the onset. The complet clearing of the whole middle cerebraltree was found in 8 patients.

2) Early venous filling was found in 15 patients and in 4 of them were accompanied by capillary blush. These findings were demonstrated within 12 days of the onset. In one of the 4 marked capillary blush was found following by the peripheral migration of the embolic fragments into distal branches.

3) Space occupying sign was demonstrated in 8 patients. Hemorrhagic cerebral infarction was recognized in one of the 8 demonstrating patent vessels in the area of the hemorrhagic infarction. The manifestations of space occupying sign were closely related to both the recanalization and delayed time from the onset.

4) Slow emptying of local arteries was also found in 10 patients within 12 days of the onset accompanied by recanalization.

5) In 6 patients, subsequent angiograms in ap-proximately one month after the onset were com-pletely normal.

6) Those main findings such as recanalization, early venous filling, capillary blush, space occupying sign and slow emptying of local arteries could be observed more frequently by adequate follow-up angiographic examinations in the acute stage.