心脳卒中の病理学的研究 (II)

Abstract

Cardiocerebral apoplexy is difined as atypical myocardial infarction the onset of which is symptom of cerebrovascular disease which characterized by frequent occurence in older age and malacic lesion of brain, as discribed by Fujii. But, its detailed pathological process remains to be a matter of much controversy. It is therefore necessary to perform further studies of cardiac lesions of cerebrovascular diseases as well as cerebral lesions of myocardial infarction for elucidating the pathology of cardiocerebal apoplexy. Now, we examined cardiac lesions of 35 autopsy cases of cerebral infarction. A study of coronary lesions and myocardial fibrosis has been attempted. 11 cases were associated with myocrdial infarction and 4 cases of them were regarded as cases of typical cardiocerebral apoplexy. Moreover, in many cases over 60 years old involving cases of myocardial infarction we observed marked myocardial fibrosis which strongly indicated the presence of coronary insufficiency. Marked myocardial fibrosis and myocardial infarction were apperrently prominent in cases of cerebral hemorrhage and subarachnoid hemorrhage as discribed by Katoh. If we classify cerebral infarction to massive cortical encephalomalacia, multiple encephalomalacia and few encephalomalacia, myocardial infarction and marked myocardial fibrosis are usually outstanding in the 2nd group.Based on these observations, it may be presumable that the hitheto described cardiocerebral apoplaxy is a pattern of extreme severity and various cases of slight to moderate clinical coursed should be existed.