A histopathological study of the brain of patients who died of cerebral vasospasm after rupture of cerebral aneurysm

Sakaki, T.; Tanikake, T.; Kyoi, K.; Utsumi, S.; Kikuchi, H.; Oshima, M.; Hiasa, Y.; Murata, Y.

No Shinkei Geka. Neurological Surgery 8(9): 845-850

1980


ISSN/ISBN: 0301-2603
PMID: 7432597
Document Number: 158290
Cerebral angiospasm seriously affects the prognosis of the patient with ruptured aneurysm. Of 44 patients with ruptured aneurysm who died from cerebral ischemia due to cerebral angiospasm, histopathological studies of brains of 18 patients were performed without intragenic factors (radical surgical operation, prolonged artificial breathing, etc.). In all cases, cerebral infarctions were observed in the area fed by the spastic artery. The size and extent of the cerebral infarction varied. In 12 patients who died in the acute stage (within 3 wk after subarachnoid hemorrhage), those who survived longer showed more severe and wide cerebral infarction, while those who died earlier showed more localized infarction in the basal ganglia and thalamus. In 6 cases who died in the chronic stage (3 wk after subarachnoid hemorrhage) the cerebral infarction was slight. No ischemic changes were observed in the brain stem, except for secondary petechial hemorrhage due to incisural herniation in cases with extensive cerebral infarction.

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