第48回日本神経学会総会
＜企画プログラム＞Common Disease, Lecture Series
30年間の連続剖検例からみた脳血管性障害の特徴と変遷―東京都老人医療センターの成績から―
山之内 博
東京都老人医療センター 現 大森赤十字病院〔〒143-8527 東京都大田区中央4-30-11〕
Of approximately 2,000 pathologically confirmed symptomatic CVD patients, atherothrombotic infarctions were found in 23%, lacunar infarctions in 18%, cardioembolic infarctions in 17%, hypertensive cerebral hemorrhages in 16%, lobar type hemorrhages in 3%, subarachnoid hemorrhages in 4%, progressive subcortical vascular encephalopathy of the Binswanger type (PSVE) in 8%, and others. Among 3 periods from 1975-1984, 1985-1994, 1995-2004, PSVE cases decreased during the last period, but there was no significant difference in the relative proportions of the other types of CVD during these 30 years. History of hypertension was recorded in 2/3-3/4 of the atherothrombotic infarction, in 3/4-4/5 of the lacunar infarction, and in 3/4-4/5 of the cerebral hemorrhage. Severe atherosclerosis in the main stem of cerebral arteries was found in about 3/4 of the atherothrombotic infarction, in about half of the lacunar infarction. Most frequent cardiogenic embolic source was nonvalvular atrial fibrillation showing about 3/4 of the embolic infarctions. The incidence of cerebral arterial aneurysm and of subarachnoid hemorrhage was higher in females than in males.
(臨床神経, 47：758−759, 2007)
key words：動脈硬化性脳梗塞, 非弁膜症性心房細動, 高血圧, 再発, ビンスワンガー
（受付日：2007年5月16日）
