昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
脳浮腫の動脈圧迫効果に関する研究
基底核の限局性壊死について
小林 寛
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ジャーナル フリー

1967 年 27 巻 7 号 p. 541-554

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The relation between the herniation due to cerebral swelling and the angio-architectural nosologic significance represented physically by the anoxia of the brain has been probed, with special analysis of the process of local lesion in stem ganglia.
1) When the Aa. corporis striati anteriores, is compressed due to cerebral swelling at the base of the brain by sphenoid ridge or tentorial edge, necrosis results at the front half of Putamen and Caput nuclei caudati which are its supply area. As an example of this case, the post mortem examination of traumatic cerebral swelling has been given here.
2) When the Aa. corporis striati mediae is compressed, necrosis results in the upper half of the Caput nuclei caudati, the Putamen and a section of the Globus pallidus. As an example, the post mortem examination of protracted hanging and protracted carbon monoxide poisoning has been given.
3) When the A. chorioidea anterior is compressed, necrosis results in the Globus pallidus. As an example, the post mortem examination of protracted carbon monoxide poisoning has been given, though many such examples have been given to date.
4) Whether the local necrosis in stem ganglia is of bilateral or unilateral nature depends on the difference in solidity related with the degree of cerebral swelling and the congenital course of the blood vessels or the acquired arterial sclerosis.
In view of the foregoing, the occurrence of local necrosis in stem ganglia can be recognized in deaths of various causes where hypoxia continues to exist, but the necrosis section cannot be differentiated according to deaths of specific cause. The reason is that the damaged section will be decided by finding out which artery scattered in stem ganglia has been compressed. In other words, the uniform explanation is that compression is related with herniation of the brain.

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