CLINICOPATHOLOGICAL FEATURES OF THE INTRACRANIAL ARTERY DISSECTION and VASA VASORUM

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This research is a clinicopathological and experimental study to investigate characteristic features and pathogenesis of the cerebral artery dissection, especially focusing on development and disruption of the intra-arterial wall vasa vasorum. The following results were revealed and presented in som papers.# Clinicopathological study : Histopathological studies of the lesions of the intracranial dissecting aneurysm and atherosclerotic occlusive disease of the carotid artery were studied. In these diseases of the different clinical categories, the following common findings were revealed ; 1) intra-arterial wall hemorrhage associated with rich development of the vasa vasorum in the media, 2)findings showing wall-disruption of the vasa vasorum communicating with intra-wall hemorrhage, 3)advanced and localized atherosclerotic changes around these lesions. Judging from these pathological findings, significance of advanced atherosclerotic changes with abnormal development of the vasa vasorum … More in the media were suspected to be a causative factor of the arterial wall dissections. Clincal study for true diagnosis and treatment of the intracranial dissecting aneurysms were also performed based on these pathological studies.# The histopathological study was aimed to give more clear guidance to the management of ruptured aneurysm of the posterior circulation. And in this study we found that, there was an evidence of dissection between media and adventitia, in the four autopsy cases, but not extended beyound the dilated portion in the fusiform type and localized at the base of the aneurysm in the lateral protrusion type and so surgical treatment by neck clipping in the lateral protrusion type and by trapping in the fusiform type should be a radical treatment.# Experimental study : Production of the animal model of advanced atherosclerosis with development of the vasa vasorum were tried, but this purpose were not succeed. We would like to continue and accomplish the experimental studies. Less