シンポジウム 4．
凝血学的にみた循環の生理と病態
凝血学的にみた循環の生理と病態
病理学的所見よりみた脳血管障害
1987 年 28 巻 7 号 p. 1139-1146
詳細
1987 年 28 巻 7 号 p. 1139-1146
Coagulation-fibrinolytic and clinico-pathological investigations were performed on the autopsy cases of the acute cerebrovascular diseases. Results were as follows.
1. Thirteen cases were internal carotid (IC) occlusion treated with urokinase (UK). 1). Marked hemorrhages in the infarct with marked secondary brain stem hemorrhages were found in 2 cases which showed partial recanalization during UK administration (initial dose: 74×104 IU). 2). Brain edema following infarct was marked not only in 6 out of the 7 recanalized cases, but also in 5 out of the 6 unrecanalized cases. 3). Poor collateral circulation to the occluded IC through the circle of Willis was indicated in 5 out of the 6 unrecanalized cases.
2. Forty cases were aneurysmal rupture. 1). Thirty six cases (90%) were hypertensive. 2). Coagulation studies at the time of admission revealed coagulation disorders resulting from hepatic injury in 8 cases (alcoholic: 7, hepatitis B: 1 case). 3). Disseminated intravascular coagulopathy (DIC) were found in 6 cases after severe subarachnoid hemorrhage.
3. Thirty five cases were hypertensive cerebral hemorrhage. 1). Coagulation disorders due to alcoholic hepatic injury were found most frequently in cases with brain stem hemorrhage (5 out of the 6 cases). The pathogenesis was discussed.
