CLINICOPATHOLOGICAL FEATURES OF THE INTRACRANIAL ARTERY DISSECTION and VASA VASORUM

本研究是一项临床病理和实验研究，旨在探讨脑动脉夹层的特征和发病机制，特别是关注动脉内血管壁血管的发展和破坏。以下结果已在SOM论文中披露和呈现。临床病理学研究：本文对颅内夹层动脉瘤和颈动脉粥样硬化性闭塞症的病变进行了组织学研究。在这些不同临床类别的疾病中，发现了以下共同的发现：1）动脉壁内出血与中膜血管丰富发育相关，2）显示血管壁破裂与壁内出血相通的发现，3）这些病变周围的晚期和局部动脉粥样硬化改变。从这些病理结果来看，晚期动脉粥样硬化病变伴血管发育异常的意义 ...更多信息 怀疑是动脉壁夹层的致病因素。基于这些病理学研究，还进行了颅内夹层动脉瘤的真实诊断和治疗的临床研究。#组织病理学研究旨在为后循环动脉瘤破裂的治疗提供更明确的指导。在这项研究中，我们发现，在四例尸检病例中，有中膜和外膜之间夹层的证据，但在梭形类型中没有延伸到扩张部分之外，在侧向突出型中局限于动脉瘤的基部，因此通过颈夹闭术治疗侧向突出型和通过陷入梭形类型应该是根治性治疗。实验研究：作者曾尝试建立伴有血管发育的晚期动脉粥样硬化动物模型，但未能成功。我们希望继续并完成实验研究。少

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