Japanese Journal of Neurosurgery
Online ISSN : 2187-3100
Print ISSN : 0917-950X
ISSN-L : 0917-950X
Volume 12 , Issue 11
Showing 1-22 articles out of 22 articles from the selected issue
  • Type: Cover
    2003 Volume 12 Issue 11 Pages Cover7-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Cover
    2003 Volume 12 Issue 11 Pages Cover8-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Index
    2003 Volume 12 Issue 11 Pages Toc3-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages App4-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Masaaki UNO, Atsuhiko SUZUE, Shinji NAGAHIRO
    Type: Article
    2003 Volume 12 Issue 11 Pages 723-728
    Published: November 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Ischemic heart disease (IHD) was most common complication in patients undergoing carotid endarterectomy (CEA). We evaluated the association of coronary disease in 156 patients undergoing CEA by coronary angiography. We also reviewed the literature about treatment of combined carotid and IHD. In 37 of 156 CEA patients (23.7%) who had a history of IHD, coronary angiography demonstrated more severe coronary occlusive lesions compared to that in patients who did not have history of IHD. Moreover, 21 of 37 patients underwent coronary revascularization during perioperative CEA. However, 49 of 119 (41.2%) who did not have history of IHD showed occlusive coronary lesions, and 12 of 119 (10.1%) underwent revascularization of coronary artery in perioperative CEA. Outcome of CEA in patients with history of IHD was worse than that in patients without. In the literature, 8 to 50% of CEA patients had history of IHD and outcome of CEA in those patients was worse than that in patients without. Recently, off-pump coronary artery bypass (OPCAB) decreased the stroke rate compared to that under operation using pump. If combined CEA and coronary bypass are needed to patients with combined carotid and coronary disease, OPCAB will be useful. In conclusion, coronary angiography and precious treatment must be performed in patients undergoing CEA if patients had a history of IHD or multiple risk factors.
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  • Kunyu HARADA, Atsushi KAMBARA, Hiroshi KAMBARA, Kouji HINO, Kenkichi O ...
    Type: Article
    2003 Volume 12 Issue 11 Pages 729-736
    Published: November 20, 2003
    Released: June 02, 2017
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    In this report, we have evaluated the efficacy of percutaneous endoscopic gastrostomy (PEG) nutrition for senile patients with cerebrovascular disease compared with IVH and naso-gastric tube nutrition. Ninety-four patients over the age of 70 with cerebrovascular disease have a malnutritional condition because of dysphagia, hemiparesis, bulbar paresis, and dementia. They were fed using PEG operated by push method. As operative complication in PEG insertion, post operative bleeding, pulling out the tube by themselves, local infection and pneumonia due to dysswallowing were revealed. The serum albumin levels of patients fed using PEG were 2.7 g/dl on admission and 3.3 g/dl at 8 weeks after PEG nutrition (group A). Those of patients with IVH nutrition (group B) were 2.9 and 3.0 g/dl. Those of patients with naso-gastric tube nutrition (group C) were 2.9 and 3.0 g/dl. The incidences of decubitus were 18.1%, 31.9%, and 22.2% in group A, B, and C. Our results showed 29.8%, 22.2%, and 14.3% improvements in swallowing function in group A, B, and C. Activities of daily living (ADL) of patients with PEG nutrition were 15.4 on admission and 65.4 at 6 months after PEG nutrition. PEG nutrition contributed to the improvement for ADL, especially for feeding activity and toileting. We conclude here that PEG is a reliable nutrition method for aged patients with cerebrovascular disease compared to previous intravenous hypernutrition and naso-gastric tube nutrition.
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  • Yasunori NAGATA, Yuji HONDA, Yoshimi MATSUOKA
    Type: Article
    2003 Volume 12 Issue 11 Pages 737-741
    Published: November 20, 2003
    Released: June 02, 2017
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    We report a case of spontaneous intracranial hypotension (SIH) with bilateral chronic subdural hematoma. The patient was a 32-year-old healthy woman who complained of having a postural headache for the last 1 month. Lumbar spinal tap revealed her cerebrospinal fluid pressure (CSF) to be 50 mmH_20. Gadolinium enhanced MRI showed diffuse meningeal enhancement and RI-cisternography revealed early accumulation of the tracer in her bladder. Conservative therapy was employed and on the eighteenth day she complained of a headache even though she was in the supine position. Three days later she rapidly became comatose and CT revealed enlargement of the left subdural hematoma. The hematoma was evacuated and a continuous epidural saline infusion was administered for 48 hours. She recovered her consciousness the next morning but partial right homonymous hemianopsia and slight left hemiparesis were seen as sequel to the central herniation. SIH is generally considered to have a benign prognosis, but when it is associated with subdural hematoma trantentorial herniation might occur, so the patient should be kept under careful observation.
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  • Yosuke WATANABE, Shuichi OKI, Masayuki SUMIDA, Naoyuki ISOBE, Yukari K ...
    Type: Article
    2003 Volume 12 Issue 11 Pages 742-746
    Published: November 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Postoperative hemorrhage located remotely from the operative site as a complication of intracranial surgery is a rare event, especially when it involves the cerebellum after supratentorial craniotomy. We report 2 cases of cerebellar hemorrhage after supratentorial surgery, which had similar clinical findings and CT images. Two cases of unruptured right middle cerebral aneurysms were found in a 57-year-old male and a 61-year-old man. The aneurysms were clipped through the pterional approach in both cases without any problems during the surgical procedures. Cerebrospinal fluid was suctioned from the carotid and prechiasmatic cistern during the operation, but no marked brain shrinkage was observed. Postoperative CT scans showed that the hemorrhages were located in the cerebellar vermis and bilateral superior folia of the cerebellum. It was thought that the cause of the cerebellar hemorrhage in both these cases was the hemorrhagic infarction with venous hypertension to which a bridging vein was stretched as a result of cerebellar shrinkage following the removal of cerebrospinal fluid.
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  • Kenji SHIMADA, Kiyohito SHINNO, Keishi NARUSE, Masayuki KUWAHARA
    Type: Article
    2003 Volume 12 Issue 11 Pages 747-752
    Published: November 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    A 54-year-old man presented with a few years history of headache. The patient had no neurological deficit. Neuroimaging studies revealed a nonenhancing, extradural cystic lesion overlying the left frontal convexity. The majority of the lesion seemed to be located in the intradiploic space of the frontal bone. Diffusion-weighted MR imaging showed a homogeneous hypointense mass. We performed a craniotomy and removed the whole tumor along with the entire cyst wall. Histological examination disclosed that the tumor capsule consisted of a layer of pseudostratified ciliated columnar epithelium that stained positive for pankeratin and cytokeratin 7 and negative for GFAP and S-100. Therefore, this tumor was identified as an endodermal cyst. Endodermal cysts are usually found in the spinal canal and an intracranial occurrence of this cyst is exceptional. In addition, the extraaxial, extradural and supratentorial location of this endodermal cyst is extremely rare. We speculate that abnormal embryogenesis during differentiation of the embryonic disc may have played a key role in the pathogenesis of this case.
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 752-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Makoto HIROSE, Keisuke TSUTSUMI, Ichiro KAWAHARA, Yoshitaka MATSUO, Hi ...
    Type: Article
    2003 Volume 12 Issue 11 Pages 753-756
    Published: November 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    We report a rare case of a ventriculoperitoneal shunt dysfunction resulting from a fracture of the distal catheter, probably due to calcification of the degraded shunt system. A 40-year-old woman visited our department complaining of a headache and neck pain. She had been given a ventriculoperitoneal shunt for hydrocephalus associated with aqueductal stenosis when she was 24 years old. A CT-scan showed ventricular dilatation, and X-rays revealed a fracture of the distal catheter in the lower right portion of the neck, with heavy calcification surrounding the catheter. Such calcification indicates degeneration and tethering of the shunt catheter, but this has rarely been observed in adult patients. This complication should be considered as a cause of shunt dysfunctions associated with long-standing silastic ventriculoperitoneal shunts, even in adults.
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 757-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 758-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 759-
    Published: November 20, 2003
    Released: June 02, 2017
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    Download PDF (112K)
  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 760-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 774-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 775-
    Published: November 20, 2003
    Released: June 02, 2017
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    Download PDF (76K)
  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 776-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 777-
    Published: November 20, 2003
    Released: June 02, 2017
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  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 781-
    Published: November 20, 2003
    Released: June 02, 2017
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    Download PDF (112K)
  • Type: Appendix
    2003 Volume 12 Issue 11 Pages 781-
    Published: November 20, 2003
    Released: June 02, 2017
    JOURNALS FREE ACCESS
    Download PDF (112K)
  • Type: Cover
    2003 Volume 12 Issue 11 Pages Cover9-
    Published: November 20, 2003
    Released: June 02, 2017
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