Inada Y, Fujitsu K, Kuwabara T, Kim I, Kim F
No To Shinkei. 1979 Jun;31(6):613-20.
It is interesting to note the pathological findings that the rupture of multiple microaneurysms in the basal ganglia appears to be the cause of the hypertensive intracerebral hematoma. But there is few report that the carotid angiogram demonstrated multiple leakages of contrast medium of intracerebral hematoma in vivo than in Westberg's postmortem angiogram. The authors experienced 15 cases of hypertensive intracerebral hematoma whose cerebral angiogram showed extravasation of contrast material. It was fifty-seven per cent of which angiogram within 6 hours after the stroke showed leakage of contrast medium. However, there was remarkably decreased appearance of the extravasation after 9 hours after the stroke. Moreover, emphasis showed be placed upon the facts that eleven cases of 15 cases showed more than two adjacent spotty extravasations of contrast medium and that six cases demonstrated the simultaneous multiple leakages of contrast material from more than two lentriculostriate arteries. These angiographic findings has led us to the conclusion that there is intimate correlation between the large hematoma and multiple ruptures of the microaneurysms of lentriculostriate arteries.
值得注意的是，病理学研究结果显示基底节区多个微动脉瘤破裂似乎是高血压性脑出血的病因。但与韦斯特伯格的尸检血管造影相比，关于活体颈动脉血管造影显示脑内血肿多处造影剂渗漏的报道较少。作者遇到15例高血压性脑出血患者，其脑血管造影显示造影剂外渗。其中57% 的患者在卒中后6小时内的血管造影显示造影剂渗漏。然而，卒中后9小时造影剂外渗的表现明显减少。此外，需要强调的是，15例中有11例显示两个以上相邻的点状造影剂外渗，6例显示来自两条以上豆纹动脉的造影剂同时多处渗漏。这些血管造影结果使我们得出结论，即大血肿与豆纹动脉微动脉瘤的多处破裂之间存在密切关联。
