Japanese Journal of Neurosurgery
Online ISSN : 2187-3100
Print ISSN : 0917-950X
ISSN-L : 0917-950X
Volume 9, Issue 7
Displaying 1-24 of 24 articles from this issue
  • Article type: Cover
    2000 Volume 9 Issue 7 Pages Cover27-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Cover
    2000 Volume 9 Issue 7 Pages Cover28-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Index
    2000 Volume 9 Issue 7 Pages 475-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 476-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Nobukazu Nakasato, Hiroshi Shamoto, Ken-ichi Nagamatsu, Masaki Iwasaki ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 477-482
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    Spike source estimation determined by preperative magnetoencephalography (MEG) was compared to the postoperative seizure outcome in 17 patients with intractable epilepsy. Interical spike discharge was analyzed during the period from the early slope to the spike peak, using a single dipole model applied to each hemisphere of the helmet-shaped MEG data. According to the accumulation deta of 80% of the spike dipoles, each patient was classified into one of three groups. "Regional" accumulation was found in 8 cases with temporal lobe epilepsy (TLE), who were completely seizure-free following anterior temporal lobectomy (ATL). "Lobar" accumulation was found in 3 cases with TLE and 1 case with frontal lobe epilepsy. These cases resulted in a complete seizure-free diagnosis in 3 cases of the and a worthwhile seizure reduction in the other 1 case. "Multilobar" accumulation was found in 4 cases. Unilateral ATL or frontal lobe resection was performed in these cases. Among them, 1 case became completely seizure-free but the other three cases had residual seizures. Our present analysis of the MEG spikes disregarded possible propagation of spike discharges, but enabled us to predict postsurgical seizure outcomes in a practical and simple way. Surgical indication for epilespy, however, must be decided with the aid of other clinical findings.
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 482-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Jyoji Nakagawara, Tomoko Shintani, Tetsuo Himi, Hirohiko Nakamura
    Article type: Article
    2000 Volume 9 Issue 7 Pages 483-490
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    IN this paper, we evaluate the clinical significance of recent innovative mappings for cerebral blood flow (CBF)-SPECT. In quantitative mapping techniques for CBF-SPECT, stratification of hemodynamic cerebral ischemia was defind using ^<123>I-IMP-ARG method, as follows : Stage 0 ; vascular reserve (acetazolamide-activated rCBF/resting rCBF-1)×100%>30%, Stage I ; resting rCBF>34ml/100g/min (80% of mean rCBF of normal subjects) or 30%&gnE;vascular researve>10%, Stage II ; resting rCBF&lnE;34ml/100g/min and vascular reserve&lnE;10%. In 24 patients with hemodynamic cerebral ischemia due to atherothrombosis of a major artery, the effectiveness of surgical revascularization (STA-MCA anastomosis) was estimated in the MCA territories using this classification. The degree of stage after surgey [Stage 0: 16 (69%), Stage I: 8 (33%), Stage II: 0] was significantly improved in comparison with the degree of stage before surgery [Stage0: 0, Stage I: 7(29%), Stage II: 17(71%)](X^2:p<0.0001). Additionaly, the mean values of resting rCBF and vascular reserve after surgery (35.0±7.2ml/100g/min, 32.9±15.2%) were siginificantly improved in comparison with the values obtained before surgery (29.6±5.3ml/100g/min, -4.5±12.4%) (paired t:p=0.0003, p<0.0001).These results suggest that Stage II hemodynamic cerebral ischemia defined by quantitated CBF SPECT generally corresponded to the "misery perfusion" using PET. In statistical parametric mapping (SPM) for CBF-SPECT, the activation of the auditory cortices was estimated in 14 patients with cochlear implants (C.I.). In comparison with normal volunteers (N=52), the SPM showed a significant hypo-activated area in the left superior temporal gyrus in the 14 patients under the condition of C.I.-OFF. In comparison with these 14 patients under the condition of C.I.-OFF, SPM demonstrated a hyper-activated area in both the primary and auditory cortices in 6 patients with good discrimination of consonants under the condition of C.I.-ON with verbal stimuli. THese results imply that SPM for CBF-SPECT could be useful to detect a localization of higher brain function.
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  • Yoko Kato, Kazuhiro Katada, Yuko Ogura, Hirotoshi Sano, Motoharu Hayak ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 491-496
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    Introduction : 3D-CT angiography (3D-CTA) is a non-invasive imaging modality for cerebral aneurysms. 3D-CTA is helpful in evaluating the configuration of the aneurysm, the surrounding vessels and the inside of the aneurysm dome. Clinical application of this technique to complicated large cerebral aneurysms, showed that anatomical details of cerebral aneurysms such as orifice of aneurysm, intraluminal thrombus, and calcification of the wall could be clearly demonstrated by 3D-CT endoscopic imaging. Using the 3D-imaging method of helicl CT, virtual veiws of various surgical approaches can be obtained and compared preperatively. This information was found to be very useful for determining difficult aneurysms for coil embolization or direct surgey, including complicated and broad-based aneurysms. Methods : Helical CT scanners (TOSHIBA X-vigor) are used to image intracranial vascular lesions. At present, nearly stereoscopic images at a pixel size of 0.35×0.35×0.4mm are obtained by reconstruction under the following conditions : slice thickness, 0.8mm ; couch top speed, 1.0mm/sec. ; 130kV ; 220mA ; visual field, 18cm in diameter (11cm after extension) ; pitch, 0.4mm ; and opposed beam interpolation. Results and clinical application : In virtual vascular 3D-CT endscopy, the lumen of the cerebral aneurysm is displayed by the surface rendering method. Its clinical applications include : (1) Determination of the 3D aneurysm morphology, as well as the dome and neck region. The smallest detectable lesion was 1.5mm. (2) Preoperative simulation. (3)Allows the confirmation of parent blood vessels flowing into aneurysms and the sites of blood vessels flowing out of aneurysms and visualization of aneurysmal lumen calcification. Coronal and sagittal sections can demonstrate whether the branches will be derived from aneurysm or aneurysmal neck. One limitation with 3D-CTA is in delineation of perforating arteries which are less than 1.2mm in diameter. A problem with virtual vascular 3D-CT endoscopic images is that endoscopic findings in the vascular wall are incomplete because of the partial volume effect and pulsation of the aneurysm and vascular wall. Conclusions : Helical scanning CT is an excellent and non invasive diagnostic modality for cerebral aneurysm detection. 3D-CT angiography has distinct advantages for evaluating an aneurysm and for determining og the most appropriate therapeutic modality. More precise and useful images will be obtained by recently developed half-second, submillimeter, real multirow helical CT.
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  • Chuzo Tanaka, Masaki Fukunaga, Toshihiko Ebisu, Masahiro Umeda, Ichio ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 497-504
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    Recent advances in fast imaging sequences, data analyses, and the optimal task paradigm have enabled functional magnetic resonance imaging (fMRI)to be a promising technique for the non invasive measurement of brain function. fMRI is now a common procedure for presurgical planning in many neurosurgical institutes, because this technique does not require any special apparatuses. This review highlights the principles and clinical applications of fMRI, such as determination of the sensorimotor cortex, the dominant hemisphere, the resection area around the eloquent cortex, and the epileptic focus.
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 504-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Yoshihiro Takanashi, Masamichi Shinonaga, Hiroshi Manaka
    Article type: Article
    2000 Volume 9 Issue 7 Pages 505-509
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    To achieve better cosmesis and the protection of underlying structures, the use of titanium craniofacial plate has been adapted to the replacement of cranial bone flaps following pterional approach. In the previous common practice, wire suture induces significant artifacts on computed tomographic(CT) scans and magnetic resonance imaging(MRI), whereas synthetic suture allows sinking of the bone flaps. However, a review of 20 cases with titanium plate fixation following pterional approach has revealed there have been excellent cosmesis, no sinking of the bone flaps, and no complications related to the titanium plate. Furthermore, very little influence is involved with postoperative artifacts on MRI and CT scans. With use, the system takes no more time than current methods. It has been also proved that titanium plate fixation in case of pterional approach can provide better psychlogical effect. The use of titanium craniofacial plates is benefitial in patients with pterional approach.
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  • Masanori Tsutsumi, Tatsumi Hirotsu, Hisao Koga, Kazuo Tabuchi
    Article type: Article
    2000 Volume 9 Issue 7 Pages 510-514
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    Neurofibroma associated with neurofibromatosis is a common benign tumor of skin arising from the peripheral nervous system, however, solitary giant neurofibroma of the scalp with or without character of neurofibromatosis type 1 is rare, and only a few cases have been reported. We experienced a rare case of 50-year-old female with a solitaly giant scalp neurofibroma which involved the left fronto-parieto-occipital regions. She first noticed a small lump at her left parieto-occipital regions and it grew slowly. The tumor had rich vascularity and there was thinning of the skull beneath the tumor. We successfully resected the giant scalp tumor and discussed the nature and surgical problem of the tumor.
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  • Mikine Shibayama, Yatsuo Ito, Kaoru Ichihara, Kiyo Nakabayashi, Nozomu ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 515-520
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    We report the case of the youngest patient who has suffered from a rare clear cell meningioma of the thoracic spine. The patient was an 8-year, 6-month-old girl noted with a deteriorating gait and hypesthesia below the S1 level. Magnetic resonance imaging showed an intradural extramedullary tumor at the vertebral level between The 10 and Th 12, which was totally removed using a posterolateral approach (Simpson II). The tumor was attached to the dura mater and dorsal rootlet at the 10th thotacic root exit zone. Pathological findings revealed a glycogen-rich clear cell meningioma with marked stromal hyaline connective tissue. Clear cell meningiomas are a new subtype recognized at the latest World Health Organization Committee of Brain Tumor Pathology. The tumors are characterized by a clear cytoplasm containing abundant glycogen and numerous stromal hyalinized collargen deposits. It has diverse clinical characteristics compared to typical meningiomas, such as a younger onset (less than 40-year-old), no sex predilection, frequent spinal intradural occurrence especially the lumbar region, and frequent local recurrence and metastases. Clear cell meningioma is rare but important clinically as a subtype of spinal meningioma.
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  • Tatsuo Sakamoto, Hajime Ono, Yoshihiro Hoshikawa, Yoshimasa Yasuhara, ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 521-523
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    A 49-year-old woman with Chiari I malformation and syringomyelia was reported. MRI revealed the spontaneous resolution of the syringomyelia remain unknown. However, a small number of similar cases have been reported in the literature.
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  • Daisuke Suyama, Masayoshi Matsumoto, Masaharu Yasue, Osamu Matsubara, ...
    Article type: Article
    2000 Volume 9 Issue 7 Pages 524-526
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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    We report herein a case of an 85-year-old male presenting with an intradiploic skull dermoid cyst arising from the temporal bone. The majority of reported skull dermoid cyst cases have involved young patients, with adult cases being relatively rare. Most reported cysts have been localized in frontal or periorbital regions. One of the factors suggesting that the tumors had arisen in these regions was a tendency for neurological deficits or massive extracranial extension, which was detected in the early stages. As skull demoid cysts that extend intracranially typically induce only negligible neurological deficits, they have the potential of going undetected for long periods of time as a small scalp mass. When differentiating asymptomatic skull lesions, carefull consideration should be given to the possibility of dermoid cysts even in elderly patients.
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  • [in Japanese], [in Japanese]
    Article type: Article
    2000 Volume 9 Issue 7 Pages 527-528
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 528-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • [in Japanese]
    Article type: Article
    2000 Volume 9 Issue 7 Pages 529-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • [in Japanese]
    Article type: Article
    2000 Volume 9 Issue 7 Pages 530-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 531-532
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 533-536
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 537-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Appendix
    2000 Volume 9 Issue 7 Pages 538-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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  • Article type: Cover
    2000 Volume 9 Issue 7 Pages Cover29-
    Published: July 20, 2000
    Released on J-STAGE: June 23, 2025
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