| Japanese |
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| Title | 脳スキャンによりWatershed Infarction症例を見い出した1例の検討 |
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| Subtitle | 原著 |
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| Authors | 川口新一郎*, 飯尾正宏*, 千葉一夫*, 村田啓*, 松井謙吾*, 山田英夫*, 阿部正秀*, 戸張千年* |
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| Organization | *東京都養育院附属病院核医学放射線部 |
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| Journal | 核医学 |
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| Volume | 15 |
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| Number | 1 |
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| Page | 17-26 |
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| Year/Month | 1978/2 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「緒言」1966年Adamsらは病理学的にwatershed infarction例の報告を行っている. 脳スキャンでは, 1972年Hawesらが今われわれがみると多分に疑いのある症例ではあるが, 9例のwatershed infarction例を (異常を示した38 CVD脳スキャン例の実に24%に当る) , そして1976年Enzmannらが鎌状赤血球症小児のwatershed infarctionの一臨床例を報告している. われわれは過去4年6ヵ月間に当院で行った786例のCVD脳スキャン例についてCVDの異常描出部位の分布を再精査し, 右前・中大脳動脈および右後・中大脳動脈の境界領域 (watershed) のみに異常を示したwatershed infarctionの1例を認めたので検討を行った. このwatershed infarction例は持続的に病気が進行し, 脳梗塞症で死亡した. 本症の最終剖検にてwatershed部のみならず中大脳動脈領域広範に及んだ大軟化巣が確認されたので, watershed infarction症例の機序を解明するため, 脳スキャン上2大脳動脈にまたがる広範な脳梗塞症を呈した4例についても追加検討を行った.「対象と方法」対象は都教育院附属病院核医学部門で1972年6月から1976年11月迄に脳スキャンを行った1503例 (2162回) - 男793名・女710名, 平均年齢は66.1歳 (0〜100歳) - である. |
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| Practice | 臨床医学：一般 |
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| English |
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| Title | Watershed Infarction in the Aged |
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| Subtitle | Original Articles |
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| Authors | Schinichiro KAWAGUCHI, Masahiro IIO, Kazuo CHIBA, Hajime MURATA, Kengo MATSUI, Hideo YAMADA, Masahide ABE, Chitose TOBARI |
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| Organization | Tokyo Metropolitan Geriatric Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 15 |
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| Number | 1 |
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| Page | 17-26 |
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| Year/Month | 1978/2 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] Since its first mention by Adams et al. (1966) , cases of watershed infarction have been reported infrequently. In 1972 Hawes et al. made a first report of the cases by brain scans in 9 cases (24%) out of 38 abnormal CVD brain scans. However author believe that validity of his diagnosis still remains to be reexamined. In 1976 Enzmann et al. reported bilateral watershed infarction proven by brain scintigraphy in a only case with Sickle Cell Disease. Seven hundreds and eighty six CVD cases out of 1503 brain scans in our laboratory in the last 4 years and 6 months were carefully investigated and both clinical and pathological findings were evaluated. As a result (1) Out of 786 cases of CVD, positive brain scans were obtained in 22.3% and negative brain scans in 40.8%. (2) There found no difference in the incidences of the CVD lesion between both hemispheres. (3) Four cases (2.3%) showed simultaneously occured bilateral CVDs of middle cerebral artery (MCA) . (4) Incidence of CVD were in anterior cerebral artery (ACA) 1.1%, in MCA 93.1%, in posterior cerebral artery (PCA) 2.3% and in Cerebellar artery 0.6%. One case (77 y.o. Female) showed Watershed Infarction in her second scan which proved focal hot lesions overlaped the distributions of right ACA and MCA and right MCA and PCA. This case showed continuous deteriolation and died 4 month after the 2nd scan which showed Watershed Infarction. Autopsy performed revealed extensive softening in the right hemisphere including Watershed regions. The transient finding of watershed lesion in this case was considered to be one of early sign of progressive & extensive cerebral softening. (6) Because of the progress of this case four other cases of widespread involvement of ACA & MCA were examined. Including the case of watershed infarction all these 5 cases were characterized by the high grade stenosis or occulusion of carotid artery. |
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| Practice | Clinical medicine |
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