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増大特集 あしたの脳梗塞
脳小血管病変―脳アミロイド血管症の病理を中心に
著者： 緒方絢1 山西博道1 植田初江2
所属機関： 1枚方総合発達医療センター 2国立循環器病研究センター臨床検査部病理部門
ページ範囲：P.879 - P.885
文献概要
はじめに
脳アミロイド血管症（cerebral amyloid angiopathy：CAA）は，中枢神経系の血管壁にアミロイドが進行性に沈着し，続発性血管病変をもたらす病態を表す。CAAには，多数を占める高齢者の孤発性CAA（sporadic CAA）と稀な遺伝性CAA（hereditary CAA）がある。本稿では孤発性CAAの病理像について述べる。孤発性CAAではアミロイドβペプチド（amyloid βpeptide：Aβ）が沈着する。このアミロイドはアルツハイマー病の脳にみられるものである1-4)。高血圧および他の血管危険因子に伴う非アミロイド性の脳小血管病（以降は高血圧性脳小血管病と呼ぶ）はCAAとともに脳小血管病の主なものなので5)，高血圧性脳小血管病との相違点を念頭において述べる。
本稿では筆者らの経験した所見を中心に記述し，文献的考察を加える。遺伝性脳小血管病については本稿では触れない。
脳アミロイド血管症（cerebral amyloid angiopathy：CAA）は，中枢神経系の血管壁にアミロイドが進行性に沈着し，続発性血管病変をもたらす病態を表す。CAAには，多数を占める高齢者の孤発性CAA（sporadic CAA）と稀な遺伝性CAA（hereditary CAA）がある。本稿では孤発性CAAの病理像について述べる。孤発性CAAではアミロイドβペプチド（amyloid βpeptide：Aβ）が沈着する。このアミロイドはアルツハイマー病の脳にみられるものである1-4)。高血圧および他の血管危険因子に伴う非アミロイド性の脳小血管病（以降は高血圧性脳小血管病と呼ぶ）はCAAとともに脳小血管病の主なものなので5)，高血圧性脳小血管病との相違点を念頭において述べる。
本稿では筆者らの経験した所見を中心に記述し，文献的考察を加える。遺伝性脳小血管病については本稿では触れない。
参考文献
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