Neurological Surgery 脳神経外科52巻5号

2024年09月発行

特集 くも膜下出血のニューフロンティア—病態の再考と治療の進化 Ⅱ 破裂脳動脈瘤の病態—脳動脈瘤はなぜ破裂するのか？

脳動脈瘤が破裂に向かうメカニズム

著者： 青木友浩¹ 井谷理彦¹²

所属機関： ¹東京慈恵会医科大学薬理学講座 ²京都大学大学院医学研究科脳神経外科学

ページ範囲：P.915 - P.923

Point
・脳動脈瘤の病態の本質は，血管分岐部の膨隆病変という特異的形態に起因する非生理的血流負荷により誘発される慢性炎症である．
・脳動脈瘤破裂過程では，病変部微小環境内で炎症により増悪する低酸素環境依存的な血管新生という構造的転換が生じる．
・脳動脈瘤破裂過程では，病変部での慢性炎症の微小環境が好中球を含む微小環境へ質的に転換する．

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