脳血管攣縮の血管生物学

Biological aspects of cerebral vasospasm

はじめに

　脳血管攣縮（cerebral vasospasm：VS）とは，くも膜下出血（SAH：脳動脈瘤・脳動静脈奇形の破裂，外傷などによる）あるいは細菌性髄膜炎に伴って生じる脳動脈内腔の持続的狭窄を意味する。ここではSAH後VSについて述べる。

While oxyhemoglobin (oxyHb) is deemed the principal cause of cerebral vasospasm following subarachnoid hemorrhage, the mechanism whereby it leads to vasospasm is by no means clear. Of importance is the fact that prolonged contraction of arterial smooth muscle is not the sole feature of cerebral vasospasm, particularly in humans. Vasospasm is also associated with the occurrence of organic changes in the arterial wall as well as the derangement of cerebral microcirculation. These additional features may play a pivotal role when vasospasm in the proximal arteries incurs delayed ischemic neurological deficits and cerebral infarction.