For the past 140 years, intracerebral hemorrhages (ICHs) and miliary aneurysms have been in widespread controversy focusing on autopsied brains. Between 2004 and 2005, the author performed pathological and three dimensional reconstructive studies in surgical specimens that neurosurgeons had confirmed as bleeding points during microsurgery to be the cause of an intracerebral hemorrhage. All of small arteries collected from 42 patients revealed acute arterial dissections at 126 points. And a not ruptured miliary aneurysm was found, of which wall consisted of collagen fibrils. The possibility of rupture in the future was deemed high, with the risk of an ICH. In addition, an acute arterial dissection with the circumference of whole the muscular layer was found and showed thickened collagen fibrils in the adventitia. This type of dissection was thought to have possibility of the cause of the miliary aneurysm.
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