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2005 Fiscal Year Final Research Report Summary

Research on the Cause of Hypertension-induced Intracerebral Hemorrhages : Charcot-Bouchard Microaneurysms and Arterial Dissections.

Research Project

Project/Area Number 14570173
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Human pathology
Research InstitutionTokyo Metropolitan Organization for Medical Research

Principal Investigator

KOJIMA Hideaki  Tokyo Metropolitan Organization for Medical Research, Tokyo Metropolitan Institute for Neuroscience, Vice Director, 東京都神経科学総合研究所, 副参事研究員 (40234760)

Co-Investigator(Kenkyū-buntansha) EGUCHI Hiromi  Tokyo Metropolitan Organization for Medical Research, Tokyo Metropolitan Institute for Neuroscience, Research Fellow, 研究員 (20370976)
Project Period (FY) 2002 – 2005
KeywordsIntracerebral Hemorrhage / Penetrating Artery / Acute Arterial Dissection / Elastopathy / Microaneurysms / Hypertension
Research Abstract

Materials & Methods : The just bleeding arteries of 45 cases of Intracerebral Hemorrhage (ICH) were identified directly during craniotomy, which were resected after hemostasis, fixed with formalin, embedded in paraffin. Serial sections cut 15 micrometer long, and stained with Elastica van Gieson's method. In addition to usual histopathological examinations, necessary serial sections were three-dimensionally reconstructed by a computer program TRI (Ratoc System Engineering Co.).
These 45 patients were showing good prognosis.
Results : 1)Locations of ICHs were 27 cases of putamen, 11 of white matter, 2 of thalamus, 4 of cerebellum, and 1 of pons.
2)Age of the patients at onset was 65.4+/-10.2 SD as a mean. Male suffered at 40s year-old, earlier than female. But after 50 year-old, male and female suffered constantly. This fact suggests us that ICHs might been not related with ageing, and it have to examine by much larger patients of ICHs.
3)As a relation to hypertension before onset, only 60% … More of the patients were hypertensive, and 20% were not, in addition, about 20% were unknown.
4)Among 45 cases, 3 cases were only coagulation tissue without any arteries. Excluding these 3 insufficient materials, all the 42 cases showed acute arterial dissections at 115 points. There were no atherosclerosis, medial necrosis (Oneda).
5)In addition, not rupture area of these dissecting arteries showed abnormal internal elastic lamina ( IEL) such as irregular thickening, disconnections, and torn looking like onion slices. But medial smooth muscle layer seemed intact. These abnormal IEL changes were thought to be the cause of acute cerebral arterial dissections resulting in ICHs : elastopathy.
6)By the way, one case revealed a Charcot-Boushard microaneurysm (MA), 700 micrometer in diameter, which was not ruptured but connected with an artery. In this case, ruptured and dissecting arteries were small, 50 micrometer in diameter, running around the MA. This MA consisted of collagen fibers, some of which were parallel running fibrils of collagen. There were no medial smooth muscle layer, no IEL. These were looking like never compensated intimal thickening by hypertension, but an adoventitia of the artery wall. This will be necessary to the further researches, the pathological sequences changing an artery to a MA. By the way, lumen of this MA was empty. We supposed that a MA had been dolichoectatic aneurysms of a basilar artery, but there were no organized thrombi within the lumen and no fragmentation of IEL, so this MA was different from dolichoectatic aneurysms of penetrating arteries.
Conclusion : The direct cause of ICHs is multiple acute arterial dissections of cerebral penetrating arteries. And this based upon the elastopathy. Less

  • Research Products

    (23 results)

All 2006 2005 2004 2003 2002 2000

All Journal Article (20 results) Book (3 results)

  • [Journal Article] 脳内出血において脳外科的に採取できた,いわゆる微小動脈瘤の一例2006

    • Author(s)
      菊地洋介, 小島英明, 江口弘美, 村山千香子, 水谷 徹, 秋間道夫
    • Journal Title

      日本病理学会誌 95(1)(発表予定)(in press)

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Subarachnoid hemorrhage not caused by ruptured aneurysm in Moyamoya disease.2006

    • Author(s)
      Marushima, A., Yanaka, K., Matsuki, T., Kojima, H., Nose,T.
    • Journal Title

      J Clinical Neuroscience 13(1)

      Pages: 146-149

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Subarachnoid hemorrhage not caused by ruptured aneurysm in Moyamoya disease.2006

    • Author(s)
      Marushima, A., Yanaka, K., Matsuki, T., Kojima, H., Nose, T.
    • Journal Title

      J Clinical Neuroscience 13(1)

      Pages: 146-149

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] 脳内出血の原因は穿通枝動脈の急性解離である。2005

    • Author(s)
      小島英明, 江口弘美, 水谷徹
    • Journal Title

      臨床病理 53巻捕冊

      Pages: 214

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Repeated Vertebral Artery Dissections. An Autopsy Case Report.2005

    • Author(s)
      Marushima, A., Yanaka, K., Okazaki, M., Kojima, H., Nose,T.
    • Journal Title

      Cerebrovasc Dis 20(1)

      Pages: 61-65

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Repeated Vertebral Artery Dissections - An Autopsy Case Report.2005

    • Author(s)
      Marushima, A., Yanaka, K., Okazaki, M., Kojima, H., Nose, T.
    • Journal Title

      Cerebrovasc Dis 20(1)

      Pages: 61-65

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Healing process of cerebral dissecting aneurysms presenting with subarachnoid hemorrhage.2004

    • Author(s)
      Mizutani, T., Kojima, H., Asamoto,S
    • Journal Title

      Neurosurgery 54(2)

      Pages: 342-348

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 部分血栓化した巨大本幹脳動脈瘤の臨床経過と病理所見 : 慢性解離性脳動脈瘤の概念。2004

    • Author(s)
      水谷 徹, 小島英明
    • Journal Title

      脳卒中の外科 32(5)

      Pages: 331-337

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 脳内出血はmicroaneurysmの破裂によって生じるのか?2004

    • Author(s)
      小島英明
    • Journal Title

      医学のあゆみ 209(13)

      Pages: 1034-1035

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 突然死に隠された脳の血管病変 : 脳血管非分岐部動脈瘤を中心に2004

    • Author(s)
      小島英明
    • Journal Title

      日本法医学雑誌 58(1)

      Pages: 39-40

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 書評 : 中枢神経系の微細血管構築。2004

    • Author(s)
      小島英明
    • Journal Title

      医学のあゆみ 211(4)

      Pages: 312-313

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Healing process of cerebral dissecting aneurysms presenting with subarachnoid hemorrhage.2004

    • Author(s)
      Mizutani, T., Kojima, H., Asamoto, S
    • Journal Title

      Neurosurgery 54(2)

      Pages: 342-348

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Clinicopathological study of partially- thrombosed dolichoectatic cerebral aneurysms.2004

    • Author(s)
      Mizutani, T., Kojima, H.
    • Journal Title

      Surgery for Cerebral Stroke. (in Japanese) 32(5)

      Pages: 331-337

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Does the rupture of microaneurysms really cause Intracerebral hemorrhages ?2004

    • Author(s)
      Kojima, H.
    • Journal Title

      J Clinical and Experimental Medicine. (in Japanese) 209(13)

      Pages: 1034-1035

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Microarchitectures of the human cerebral arteries.2004

    • Author(s)
      Kojima, H
    • Journal Title

      J Clinical and Experimental Medicine. (in Japanese) 211(4)

      Pages: 312-313

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] 高血圧性脳内出血 : 出血源としての動脈解離の可能性。2003

    • Author(s)
      小島英明, 丸島愛樹
    • Journal Title

      分子脳血管病 2(1)

      Pages: 30-35

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Hypertension-induced Intracerebral hemorrhage : possiblely caused by arterial dissections as a rupture.2003

    • Author(s)
      Kojima, H., Marushima, A.
    • Journal Title

      Molecular Cerebrovascular Diseases (in Japanese) 2(1)

      Pages: 30-35

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] いわゆる高血圧性脳内出血の発症原因のなぞ。2002

    • Author(s)
      小島英明
    • Journal Title

      日本醫事新報 4066

      Pages: 33-36

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] A mystery of causing hypertension-induced intracerebral hemorrhage.2002

    • Author(s)
      Kojima, H
    • Journal Title

      Japan Medical News (Nikon-Iji-Shimpo) (in Japanese ) 4066

      Pages: 33-36

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Arterial dissections of penetrating cerebral arteries causing hypertension-induced cerebral hemorrhage.2000

    • Author(s)
      Mizutani, T., Kojima, H., Miki Y.
    • Journal Title

      J Neurosurg 93

      Pages: 859-962

    • Description
      「研究成果報告書概要(欧文)」より
  • [Book] 所プロジェクト研究・報告書 「脳動脈解離に関する臨床・病理学的研究」(平成14年度〜平成16年度)2005

    • Author(s)
      小島英明
    • Total Pages
      193
    • Publisher
      (財)東京都医学研究機構・東京都神経科学総合研究所
    • Description
      「研究成果報告書概要(和文)」より
  • [Book] 下正宗、前田環、村田哲也、森谷卓也 編集 「コアテキスト1 : 人体の構造と機能」 第4章 : 神経性調節と刺激の受容。(分担執筆)pp.91-1342003

    • Author(s)
      小島英明
    • Total Pages
      336
    • Publisher
      医学書院
    • Description
      「研究成果報告書概要(和文)」より
  • [Book] Neuronal controls and reception of stimuli. In Coretext I Structure and Functions of the Human. (eds by Shimo, M., Maeda, T., Murata, T., Moriya, T.) (in Japanese )2003

    • Author(s)
      Kojima, H
    • Total Pages
      91-134
    • Publisher
      Igaku-Shoin, Tokyo, Japan.
    • Description
      「研究成果報告書概要(欧文)」より

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Published: 2007-12-13  

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