Japanese Journal of Neurosurgery
Online ISSN : 2187-3100
Print ISSN : 0917-950X
ISSN-L : 0917-950X
Volume 9, Issue 5
Displaying 1-25 of 25 articles from this issue
  • Article type: Cover
    2000 Volume 9 Issue 5 Pages Cover21-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Cover
    2000 Volume 9 Issue 5 Pages Cover22-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Index
    2000 Volume 9 Issue 5 Pages 335-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 336-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Takamasa Kayama, Shinya Sato, Megumi Okochi
    Article type: Article
    2000 Volume 9 Issue 5 Pages 337-344
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    We discussed topics concerning Japanese neurosurgeons and their future prospects by analyzing the present circumstances facing them. For this purpose, we sent our questionnaire to all the current members of the Japan Neurosurgical Society. We received 2,515 replies, for a reply rate of 36.8%. The activities of the Japanese neurosurgeons that we analyzed can be broken down to : clinical work, research work, and eductional activity. From their results, 41.3% of the neurosurgeons are satisfied with their present circumstances. In contrast, 11.7% of the neurosurgeons surveyed are dissatisfied. The principal desire or the principal reasons of their dissatisfaction are 1)a desire to perform more operation, 2)a lack of time for research works, 3)a lock of cases for clinical research in one's own institute, and 4)too much time on dury. The annual number of surgeries performed is directly related to the degree of satisfaction. In general, the more operations performed, the higher the degree of satisfaction. The amount of clinical or basic research works appears to have no relation to the degree of satisfaction. Based on this study, we would like to propose some subjects for Japanese neurosurgeons and the Japan Neurosurgical Society to consider. The subjects are 1)the rearrangement of neurosurgery-related conferences, 2)the systematization of neurosurgery, 3)the spreading and authorizing of neurosurgery, 4)establishing medical networks for neurosurgical fields, 5)raising the unit cost of medical treatment, and 6)seeking an increase in wages for neurosurgeons. These subjects are for the advancement adequate neurosurgical treatment and for the Japan Neurosurgical Society Members' greater happiness.
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  • Kazuko Kamiya
    Article type: Article
    2000 Volume 9 Issue 5 Pages 345-351
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    In Japan, almost 150,000 people die of stroke every year. Stroke is one of the three major causes of death. In this article, the ministerial measures for stroke control taken up to now by the Ministry of Health and Welfare(MHW), are reviewed. Official domestic data on stroke accurrances patients including socio-medical aspect are referred. Also the system of MHW and former measures for stroke control are explained. To design a national strategy for stroke control, the committee has been organized within MHW, and the first report was released in September 1999. This report is summarized here. In Japan, it is expected that many more clinical neurosurgeons will join in our efforts to establish the effective social actions for stroke control.
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 351-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Taketo Hatano, Tetsuya Tsukahara, Kasumi Araki, Osamu Kawakami, Kazuo ...
    Article type: Article
    2000 Volume 9 Issue 5 Pages 352-358
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    Intravascular surgery can be an alternative treatment for vertebral artery ostial(VAO)stenosis. However, percutaneous transluminal angioplasty(PTA)using conventional balloons has sometimes induced wall dissection, elastic recoil restenosis and other complications. Application of intravascular stents may prevent these complications. In this paper, we report our initial experience of stenting for symptomatic VAO stenoses. The mean stenosis rate of those lesions was 81% before stenting and was reduced to 4% after stenting. There were 2 patients with transient neurological complications in the perioperative period. Angiographic follow-up studies more than 3 months after treatment demonstrated restenosis in 3 patients. These cases were successfully treated by PTA. Our initial results demonstrated that stenting is a feasible and safe method of treating stenoses of the vertebral artery ostium.
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  • Keishi Tsunoda, Kenji Tsutsumi, Takashi Hayashi
    Article type: Article
    2000 Volume 9 Issue 5 Pages 359-363
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    The management of odontoid fractures varies widely among different surgeons and has long been a subject of controversy. Particularly, type 2, unstable type 3 and "shallow type" type 3 fractures have a high rate of non-union when treated with external bracing. Anterior screw fixation, originally described Nakanishi and Bohler, has been the best teratment method for these fractures and many surgeons prefer this technique. We here describe a case of atlantoaxial dislocation associated with dens fracture treated with anterior screw fixation and discuss operative indication, technique, and postoperative management.
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  • Izumi Yuzawa, Nobuyuki Kawano, Sachio Suzuki, Kiyotaka Fujii, Yoichi I ...
    Article type: Article
    2000 Volume 9 Issue 5 Pages 364-369
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    A case of solitary cerebral cysticercosis is reported. The patient, a 46-year-old man complaining of head dullness, had been in Manila, the Philippines a month before his admission to Kitasato University Hospital. MRI and CT scans showed a small solitary cystic lesion in the left temporal lobe which was located at the cerebral surface. His neurology and blood/stool tests were within the normal range. A well circumscribed encapsulated cyst of about 1 cm in diameter was surgically resected. Histologically, the lesion was consistent with cysticercus of Taenia solium having a scolex with hooklets and suckers. As the patient had no prior history of discharging worm segments in his stool, and as he has displayed no other abnormalities, we surmise that he was freshly recently infected, having ingested an egg of the worm with fresh vegetables. Reviewing the literature, the cases of solitary cerebral cysticercosis seem to be the increasing in Japan recently. It may be due to an increase in the number of Japanese travelers to other countries or it may also be due to the increased import of fresh vegetables from contaminated countries. Therefore, solitary single cysticercosis should be included in the differential diagnosis of a cystic lesion in the brain.
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 369-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Haruki Yamakawa, Katsuhiko Hayashi, Yasuhiko Kaku, Kazuki Deguchi, Nob ...
    Article type: Article
    2000 Volume 9 Issue 5 Pages 370-374
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    Intracranial extension of acquired cholesteatoma from the middle ear is rare. A 49-year-old man has taken a radical mastoidectomy for cholesteatoma with otitis media, following right facial-hypoglossal anastomosis 17 years ago. On March, 1998, he was admitted with complaints of convulsive attacks following severe headache and high fever for 2 weeks. Neurological examination on admission revealed mild limb ataxia and VIIth., VIIIth., XIIth.nerve palsies in the right side. MRI demonstrated a mixed intensity mass without enhancement effect located on the cerebellopontine angle and the petrous bone in the right side. Tumor was totally removed by the right lateral suboccipital craniectomy. The pathological examination showed typical cholesteatoma. The postoperative course was uneventful. Seventeen cases of acquired cholesteatoma extending to the intracranial space were reviewed on the literature including ours, only 4 of whom had long interval more than 8 years to last intracranial operation. In the present case, it appears to take a long time to be detected as a cerebellopontine angle tumor not only because no progressive symptoms revealed before the second operation but this tumor had the benign "slow growth" characteristics, although the tumor might have already extended to the intracranial space at the initial radical mastoidectomy.
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  • Takashi Araki, Yuji Akaike, Manabu Sakamoto, Kenji Maeda, Masashi Taka ...
    Article type: Article
    2000 Volume 9 Issue 5 Pages 375-380
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    The authors present 2 cases of spontaneous cerebellar hemorrhage in children who resulted in poor outcome, and the 47 previous cases reported in the literature were reviewed. Case 1 : An 8-year-old girl had sudden episode of headache and vomiting, and was admitted to our department with coma demonstrating acute respiratory failure 2 hours after the first attack. A large hematoma was pointed out on the vermis with obstructive hydrocephalus on CT scan. The hematoma was evacuated, but post operative CT scans showed diffuse hypoxic change on the bilateral cerebral hemispheres. Inspite of intensive management contained brain hypothermia therapy, the patient was expired. Case 2 : A 9-year-old boy was admitted with coma and apnea 2 hours after the first attack. A CT scan demonstrated massive intracerebellar hematoma compressed the quadrigeminal cistern completely. The patient was expired without surgical intervention because of its critical vital signs. No bleeding source was identified in both cases. Spontaneous cerebellar hemorrhage is uncommon in children, and favorable outcome is obtained by surgical intervention, especially in the CT era, but poor outcome patients exist certainly. Poor prognosis is supposed to be concerned with 1)coma state, 2)compressed quadrigeminal cistern on CT scan, 3)the time duration from the onset to admission. Thus meticulous attention and treatment are emphasized in the primary care for the children with spontaneous cerebellar himorrhage.
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  • Tsuneyuki Fukushima, Takuji Takagi, Takahisa Fuse
    Article type: Article
    2000 Volume 9 Issue 5 Pages 381-385
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    We report a 59-year-old woman who suffered from subarachnoid hemorrhage and had a saccular aneurysm on the fenestration in the distal third of the basilar artery. The anteriorly projecting aneurysm arising at the proximal end of the fenestration was clipped via the subtemporal transtentorial approach. We reviewed 64 cases of aneurysms on the basilar artery fenestration including ours. The group consisted of 32 men and 30 women, and 2 unidentified cases. Their ages ranged from 19 to 78 years. There were 10 patients(15.6%)younger than 30 years old, 15(23.4%)between 30-39, 20(31.3%)between 40-49, 10(15.6%)between 50-59, and 7(10.9%)older than 60, respectively. Fifty four patients(84.3%)presented subarachnoid hemorrhage, 6(9.4%)presented a focal neurological deficit, 2(3.2%)had incidental aneurysms, and in the other 2 the symptoms were unknown. Among the 64 cases, there were 55(86.0%)aneurysms located in the proximal third, 4(6.3%)in the middle third, and 5(7.7%)in the distal third of the basilar artery, respectively. Sixty two aneurysms(96.9%)arose at the proximal end of the fenestration, and 2 aneurysms arose distally. The aneurysms projected anteriorly in 40 patients, posteriorly in 12, and anteriorly and posteriorly in 2. In the other 10 patients the direction of the aneurysms could not be identified. The surgical approach for distal third basilar trunk aneurysms has mostly been taken via the subtemporal approach with or without tentorial incision. As an other approach, coil embolization via the intravascular approach has been reported.
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  • Tomohisa Okada
    Article type: Article
    2000 Volume 9 Issue 5 Pages 386-388
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    The purpose of this study was to investigate the risk of rebleeding when patients with ruptured cerebral aneurysms, who were scheduled for early operations, underwent their aneurysm surgery the day after admission, instead of immediately that same night. Between 1982 and 1997, there were 72 patients who were candidates for this study admitted to our institution. The patients were managed with bed rest in a dark room and strict control of systemic blood pressure was maintained while they were waiting for their operations. All of the 72 patients underwent aneurysm surgery the following day, 29.3 hours on average after admission, without significant symptoms or signs of rebleeding. In conclusion, this study showed that the risk of rebleeding in patients with ruptured cerebral aneurysms, who underwent their aneurysm surgery the day after admission, instead of immediately that same night, at midnight was minimal when strict preoperative management was exercised.
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  • Hiroshi Manaka, Hideki Sakai, Ichiro Nakahara, Nobuyuki Sakai, Tetsuro ...
    Article type: Article
    2000 Volume 9 Issue 5 Pages 389-391
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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    A 32-year-old lady had an unruptured right internal carotid-opthalmic artery aneurysm, accompanied with a large arteriovenous malformation on the same side. She underwent coil embolization for the aneurysm. Two days after embolization, she experienced a sudden onset of visual disturbance on the right side caused by occlusion of visual disturbance on the right side caused by occlusion of a branch of the retinal artery. The ophthalmic artery usually has a rich collateral pathway from the external carotid artery, so visual disturbance seldom occurs with the occlusion of the ophthalmic artery.In this case a small thromboembolism seemed to occlude a branch of the retinal artery after recanalization of the ophthalmic artery. Considering that a complication like that of this case can occur, an adequate anticoagulant therapy should be performed in this aneurysm.
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  • [in Japanese], [in Japanese]
    Article type: Article
    2000 Volume 9 Issue 5 Pages 392-393
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • [in Japanese], [in Japanese]
    Article type: Article
    2000 Volume 9 Issue 5 Pages 393-394
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 395-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 396-397
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 398-399
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 400-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 401-404
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Appendix
    2000 Volume 9 Issue 5 Pages 405-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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  • Article type: Cover
    2000 Volume 9 Issue 5 Pages Cover23-
    Published: May 20, 2000
    Released on J-STAGE: June 02, 2017
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