心脳卒中の病理学的研究VII

Abstract

The term cardiocerebral apoplexy was advocated by Okinaka and later defined as a syndrome by Fujii et al.This syndrome begins with a symptome of cerebral apolexy and has sometimes macroscopic encephalomalacia combined with evidence of acute myocardial infarction.For the purpose of investigation of this syndrom, the cerebrum in 41 unselected consecutive cases of myocardial infarction were pathologically studied and following results were obteined.1) Seventeen cases had macroscopic encephalomalacia without bleeding (39%).The remaining cases had no macroscopic changes (61%).2) Three cases of the former change group had vascular thrombi around the point 1cm distal to the origin of middle cerebral arteries.3) The rest of cases with no macroscopic cerebral abnormalities showed variable non-specific microscopic changes which were not particularly related to acute myocardial infarction.4) In comparison with the macroscopic cerebral change group to non change group, arterial atherosclerosis was more severe in the former group.5) Three cases of clinical cardiocerebral apoplexy were found in macroscopic change group.6) Concerning to the pathogenesis, cardiocerebral apoplexy is thought to be the results of severe ischemia of systemic organs including heart and brain.