[Cerebrovascular disease. Its characteristics from autopsy series in the Tokyo Metropolitan Geriatric Hospital during recent 30 years].

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.