Polycystic kidney剖検例におけるウイリス動脈輪の病理学的検討

PATHOLOGICAL STUDY OF WILLIS'S CIRCLE IN AUTOPSY CASES OF POLYCYSTIC KIDNEY DISEASE

　抄録　多発性のう胞腎に脳動脈瘤を含む多彩な血管病変を伴った2剖検例を経験した。1例は，左中大脳動脈分岐部の動脈瘤と大動脈弁狭窄とを合併し，他の1例には，脳底動脈と前交通動脈とに脳動脈瘤を認め，また，解離性大動脈瘤，脳梗塞，心筋梗塞をも合併していた。本論文では，多発性のう胞腎には全身的な血管系の異常が存在するという想定のもとに，特にウイリス動脈輪を中心とした血管系の病理組織学的検討を行った。組織学的には，内弾性板の断裂，部分的消失が高頻度で見出された。この内弾性板の異常が，多発性のう胞腎における脳動脈瘤合併の頻度を高くしているものと考えられ，さらに，この異常には先天的要因が深く関与しているものと推察された。

Two autopsy cases of polycystic kidney disease with intracranial aneurysms were reported. We made a pathological study of their vascular system with special reference to Willis's circle in order to prove the inherent abnormality of vascular system in patients with polycystic kidney disease.

A 57-year-old man was revealed to have poly-cystic kidney disease with left middle cerebral artery aneurysm and aortic stenosis. The other 58-year-old man was revealed to have polycystic kidney disease with cerebral aneurysms both in anterior communicating artery and basilar artery, aortic dissecting aneurysm, cerebral infarction and myocardial infarction.

Histologically, both abrupt interruption and par-tial disappearance of internal elastic lamina are found frequently in the wall of Willis's circle. This abnormality of internal elastic lamina may be attributable to congenital factors and rise the frequency of occurrence of intracranial aneurysms in polycystic kidney disease.