内頸動脈閉塞症について—臨床例25例の考察

CLINICOPATFIOLOGICAL STUDY ON 25 CASES WITH OCCLUSION OF INTERNAL CAROTID ARTERY

I．はじめに

　内頸動脈閉塞症については，その臨床像・治療・発生病理などについてすでに数多くの報告がある。本症には臨床的に脳卒中と一律に診断加療されるものが多く注意を要するが，脳血管撮影の発達・普及などにより本症の診断は現在ではさして困難なものではない。しかしながら，その治療および発生病理に関しては，なお問題が少なくない現状といえよう。

　われわれは昭和39〜41年の2年間に脳血管研究所美原記念病院において，内頸動脈閉塞症計25例（うち2例は両側）を経験し，その臨床像にあわせて，生化学的ならびに病理学的検討を加え，若干の知見をえたので文献的考察を加えてここに報告する。

Twenty five cases with complete occlusion of in-ternal carotid artery identified by means of four vessel angiography, out of 769 cases with cerebro-vascular disease were reported.

Twenty two cases were male and remaining three cases were female.

Besides the clinical feature, gas-chromatographical analysis of fatty acids in serum as well as that of occluded arterial wall was investigated.

In general, increasing of parmitinic and oleinic acids and decreasing of linolic acid was detected.

Histopathological study of 15 cases out of 25 cases was also performed.

Arteriosclerotic changes with marked intimal thick-ening and organized thrombi were recognized in almost all cases.

In only one case, associated with rheumatic fever, there found marked inflammatory cellular infiltration whithin the medial layer.