Japanese Journal of Neurosurgery
Online ISSN : 2187-3100
Print ISSN : 0917-950X
ISSN-L : 0917-950X
Volume 11 , Issue 7
Showing 1-21 articles out of 21 articles from the selected issue
  • Type: Cover
    2002 Volume 11 Issue 7 Pages Cover23-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Cover
    2002 Volume 11 Issue 7 Pages Cover24-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Index
    2002 Volume 11 Issue 7 Pages Toc8-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages App9-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Kazuo Hashi
    Type: Article
    2002 Volume 11 Issue 7 Pages 441-445
    Published: July 20, 2002
    Released: June 02, 2017
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    Accounting for the data obtained by the practice of the brain dock and the frequency of subarachnoid hemorrhage, the rupture rate of unruptured intracranial aneurysms in Japan is estimated to be higher than that reported in the ISUIA. The minimum size limit for a rupture rate of 0.5%/year may reside around 3, 4 mm and at 10 mm it exceeds 1%. The mortality of the operation is less than 1% and the risk rate, including morbidity, is less than 5%. Indication of operation should be considered for lesions smaller than 5 mm and for patients older than 70 years.
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  • Yasuaki Tokuhashi
    Type: Article
    2002 Volume 11 Issue 7 Pages 446-452
    Published: July 20, 2002
    Released: June 02, 2017
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    The surgical treatment for metastatic spine tumors has often been chosen as a means to improve QOL. The predicted prognosis and localization or the progress of the lesion are generally used to determine the surgical modality. The most reliable operative indications for metastatic spine tumors are pain and neurological deficits due to spinal instability, and the next most reliable are epidural invasion or radioresistent metastases. Surgical procedures for metastatic spine tumors are roughly divided into two groups. The first, the palliative procedure group, is comprised mainly of posterior decompression and stabilization with instrumentation. The second, the excisional procedure group, comprises aggressive resection of the vertebral bodies and reconstruction of the spine for the purpose of local cure. For patients affected with general disease such as metastatic spine tumor, life expectancy is the most important factor for surgical indication and selection of the surgical procedure. The prognosis is predicted by consultation with specialists for primary cancer or by the use of a scoring system in a preoperative system for evaluation of the prognosis. The consistency between the criteria from our scoring system and the patients'survival periods was 78.7%. Posterior decompression and stabilization was performed as a palliative procedure for thoraco-lumbar metastases in 110 patients, and en bloc spondylectomy was performed as an excisional procedure in 7 patients. Postoperative survival periods for the 117 patients ranged from 10 days to 10 years and 6 months. Though the results for pain relief were satisfactory in both groups, the results for the improvement and prevention of paralysis were unsatisfactory and largely limited in the former group. It is important to apply the proper operative indications and to select surgical procedures in consideration of the patients'goals and within the limits of their life expectancy.
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  • Toyohiko Isu
    Type: Article
    2002 Volume 11 Issue 7 Pages 453-460
    Published: July 20, 2002
    Released: June 02, 2017
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    Surgical selections for cervical spondylosis and disc hernia are controversial. Cervical spondylosis and disc hernia can be approached either posteriorly or anteriorly The author reviewed 480 patients who underwent the anterior approach and 61 patients who underwent the posterior approach for cervical spondylosis and disc hernia during the past 12 years. Anterior cervical decompression seems to be the best approach because posterior spurs and disc hernias are located in the anterior spinal canal. The author thinks that cervical laminoplasty is indicated in patients with 4 or more levels of stenosis associated with calcification of yellow ligament. Anterior decompression and fusion is required in cases of kyphosis. To avoid doner site problems and concentrating stress at the adjacent levels of operated cervical spine, the author devises an anterior approach by vertebrodiscotomy or transvertebral approach, which permitted some movement at the operated disc level. My surgical procedure with poly-L-lactide screws allows early mobilization and does not require the application of an external fixator.
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 460-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Junya Hanakita
    Type: Article
    2002 Volume 11 Issue 7 Pages 461-467
    Published: July 20, 2002
    Released: June 02, 2017
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    In the present paper, surgical approaches for treating lumbar disc herniation are described based upon the author's experience with 1,050 surgical cases. The standard technique for treating lumbar disc herniation (partial hemilaminectomy, or the so-called Love method) is described in detail. Alternative approaches for far lateral disc herniation and midline large disc herniation are also described. Finally, the outcomes and recurrence rates for lumbar disc surgery are discussed.
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  • Hiroaki Nomura, Yukio Horie, Naoya Kuwayama, Michiya Kubo, Hiromichi Y ...
    Type: Article
    2002 Volume 11 Issue 7 Pages 468-470
    Published: July 20, 2002
    Released: June 02, 2017
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    A 53-year-old male suffered consciousness disturbance and right hemiparesis. Cerebral angiography revealed occlusion at the M1 portion of the left middle cerebral artery. Microcatheter was inserted to the occlusion site, and 480,000 IU urokinase were injected. After partial recanalization, the pouch-like shadow at the M1-M2 junction was detected. Follow-up angiography revealed complete recanalization of the left middle cerebral artery, and the pouch-like shadow was diagnosed as a cerebral aneurysm. Radical operation was performed and intraoperative finding demonstrated that the aneurysm was saccular. On the occasion of the thrombolytic therapy, the possibility that the incidental aneurysm locates at the occlusion site should be taken into consideration.
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  • Hirohiko Arimoto, Hiroki Shirotani, Tadashi Inohara, Kenichiro Ono, Ak ...
    Type: Article
    2002 Volume 11 Issue 7 Pages 471-474
    Published: July 20, 2002
    Released: June 02, 2017
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    A 59-year-old woman was transferred to our hospital because of mental confusion and gait disturbance. Magnetic Resonance Imaging (MRI) showed ring-enhanced lesions in the right cerebellar hemisphere and obstructive hydrocephalus. Emergency operation was performed because of her progressive neurological deterioration. Operative findings revealed that the lesions were cerebellar abscesses. Anaerobic bacteria was cultured from the abscess. Her systemic survey was performed. Echocardiogram showed high-echoic vegetation on the mitral valve. Therefore, infective endocarditis was diagnosed to be a cause of the abscess. Following 6 weeks-ABPC administration, the patient was discharged with no neurological deficit. We reported a rare case of cerebellar abscess associated with infective endocarditis.
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 474-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Osamu Matsubara, Daisuke Suyama, Masayoshi Matsumoto, Masaharu Yasue, ...
    Type: Article
    2002 Volume 11 Issue 7 Pages 475-478
    Published: July 20, 2002
    Released: June 02, 2017
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    A 44-year-old man was admitted to our hospital with symptoms of severe headaches, decreased visual acuity in right and bilateral visual field defects. Computed tomography and magnetic resonance imaging (MRI) of the brain revealed multiple high density/intensity lesions in both cerebral hemispheres. A suprasellar tumor with homogenous high intensity on Ti-weighted image and a heterogenous high intensity on T2-weighted image was demonstrated in MRI. The lesion was comfirmed angiographically as cryptic. The intraoperative findings suggested a hematoma probably originating from the suprasellar tumor compressing the right optic nerve. After removal of the tumor and hematoma, his visual acuity and field defect dramatically improved. The pathological diagnosis was cavernous angioma. The term"chiasmal apoplexy"was first used by Maitland et al. in 1982 to describe abrupt retro-orbital or frontal pain associated with visual field defect caused by acute bleeding in the optic chiasma. Our review of the recent literature suggests that the chiasmal apoplexy caused by a hemorrhagic lesion out side of the optic nerve itself is very rare. Immediate surgical removal of the lesion and hematoma seems to be the optimal choice.
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  • Nobutaka Horie, Nobuaki Takahashi, Shoji Furuichi, Katsuharu Mori, Nor ...
    Type: Article
    2002 Volume 11 Issue 7 Pages 479-483
    Published: July 20, 2002
    Released: June 02, 2017
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    A case of choroidal metastasis treated with gamma-knife stereotactic radiosurgery is reported. A 54-year-old man with lung cancer was referred to our hospital for gamma-knife radiosurgery. His visual acuity in the left eye was impaired due to choroidal metastasis from lung carcinoma. MRI and fundus photography showed a choroidal mass located in the temporal portion of the posterior pole of the eye. A 15-Gy peripheral dose was administered by gamma-knife technique, at the 50% isodose line using an 8-mm collimator (3 shots). Complete immobilization of the eye was achieved with a orbicular muscle anesthetic block, anesthetic drops, and subsequent transconjunctival fixation of the four rectus muscles. During the 20-week follow-up, local tumor control was achieved, and his visual acuity remained unchanged. Gamma-knife radiosurgery is useful for choroidal metastasis. Immobilization of the eye is indispensable for this treatment.
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  • Shingo Yamasaki, Kunio Hashimoto, Keigo Shigeta, Yoshihisa Kawano
    Type: Article
    2002 Volume 11 Issue 7 Pages 484-491
    Published: July 20, 2002
    Released: June 02, 2017
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    Two cases with ruptured dissecting aneurysms of posterior circulation treated with intravascular stents were reported. In one case, a de novo vertebral dissecting aneurysm (DA), which developed over 11 years after proximal clip obliteration for contra-lateral vertebral DA, was treated with double sheeted stents. In another case, a basilar DA was treated with a stent and GDCs (Guglielmi detachable coils). Both cases were free of rebleeding after stent placement, and gained angiographical cure of the DA's preserving parent arteries in 6 and 3.5 months, respectively. Although a stent might change the hemodynamics of a DA and promote the restoration of arterial wall with endothelial lining, its efficacy in prevention of rebleeding in the acute stage is still uncertain. From our 2-case experiences, a combined treatment using a stent and GDCs is feasible for a DA with a localized and relatively large protrusion, whereas double sheeted stent placement might be useful for a DA without a localized protrusion.
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 491-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 492-493
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 494-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 495-498
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Appendix
    2002 Volume 11 Issue 7 Pages 499-
    Published: July 20, 2002
    Released: June 02, 2017
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  • Type: Cover
    2002 Volume 11 Issue 7 Pages Cover25-
    Published: July 20, 2002
    Released: June 02, 2017
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