Neurosurgery for Cognitive Disorder
Online ISSN : 2436-0937
Volume 3, Issue 1
Displaying 1-7 of 7 articles from this issue
  • Kuniaki Ogasawara
    Article type: review-article
    2022 Volume 3 Issue 1 Pages 1-8
    Published: February 01, 2022
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    To meaningfully define cognitive improvement after carotid endarterectomy (CEA), each patient was determined as postoperative cognitive improvement based on subjective cognitive assessment by a neurosurgeon and the patient's next of kin and changes of neuropsychological test scores. As a result, the prevalence of postoperative cognitive improvement was 11%. Studies using single-photon emission computed tomography, positron emission tomography and magnetic resonance imaging showed that CEA improves cerebral blood flow and metabolism, neurotransmitter receptor function, and white matter microarchitecture, leading to postoperative cognitive improvement. Pre-existing cerebral white matter hyperintensities on magnetic resonance imaging adversely affect cognitive improvement after CEA.

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  • Yoshihiko Yoshii
    2023 Volume 3 Issue 1 Pages 9-19
    Published: February 01, 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    (Purpose)

    We examined the factors that cause mild cognitive decline (MCI) to develop dementia after a long course.

    (Case and Method)

    In the same case, there are 10 normal cases with less than 10 points at the time of initial diagnosis and 23

    MCIs between 10 and 16.6 points in ADASJ that are more than 3 years.

    Hippocampal atrophy (+) was a VSRAD-Z value of 2.0 or more or -Ratio of 5 times or more, cerebral ischemia (+) was a case of periventricular or deep subcortical white matter lesions of grade 3 or higher, and cerebral blood flow reduction was a case of two or more outliers in the disease specific area analysis

    (SVA) 3 index.

    Cognitive function items were classified into four categories of memory, orientation, language, and act, and were evaluated by the ratio of each total score, and factors that resulted in dementia (16.6 or higher in ADASJ) were examined.

    (Result)

    Dementia was not involved in the presence or absence of hippocampal atrophy, ischemic changes, and decreased cerebral blood flow, and was common in inactive life cases, significantly reducing orientation function.

    (Conclusion)

    Although it was suggested that active life improves disorientation function as a measure to prevent the progression of cognitive impairment in cases with normal and MCI levels at the time of initial diagnosis, further intervention studies are needed to determine whether inactive life conditions contribute to the progression of cognitive impairment or as a result of the progression of cognitive impairment.

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  • Tamio Ito, Yoshiyasu Sumi, Daisuke Mori, Koji Oka
    2023 Volume 3 Issue 1 Pages 20-30
    Published: February 01, 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    < Introduction> Ordinary Alzheimer’s disease (AD) has recent memory disturbance as initial symptom, which is often accompanied by general deterioration in judgment and executive dysfunction, and cortical symptoms such as aphasia and apraxia. However, there are subtypes of AD with language symptoms as the main symptom, Matsuda, et al. 1) Logopenic primary progressive aphasia, 2) Difficulty wording/kanji amnesic agraphia →transcortical sensory aphasia, 3) Left temporal lobe type (semantic dementia (SD)like AD). This time, we also experienced 1) 3 cases, 2) 1 case, and 3) 6 cases in in these 3 types, so we will present representative cases and report on the diversity of language symptoms of AD.

    <Methods> In addition to examininig the clinical symptoms of each case by interview, we also examined neurological symptoms, MRI, SPECT, neuropsychological tests (HDS-R, MMSE), and SLTA.

    <Results> The age at onset was 70 years or older. It was difficult to differentiate AD from SD, because all cases were not underwent SPECT and SLTA.

    <Conclusions> Language functional evaluation is important to understand the original cognitive functions of AD, and understanding the language symptoms of AD is also useful for differential diagnosis from other diseases.

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  • Satoru Takaya, Chie Motizuki, Kimiko Hatano, Eriko Ogasawara, Motohumi ...
    2023 Volume 3 Issue 1 Pages 31-36
    Published: February 01, 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    Our hospital was certified as the Hokkaido dementia disease medical center in 2014, and a neurosurgeon is in charge. In this study, we examined the difference in consultation status between our center by neurosurgeons and the center by psychiatrists. Differential diagnosis of dementia was performed on 248

    patients who first visited our hospital from April, 2020 to March, 2021. The diagnostic categories were as follows: normal 5%, mild cognitive impairment (MCI) 37%, Alzheimer type dementia (ATD) 26%, mixed dementia 10%, dementia with Lewy bodies (DLB) 8%, vascular dementia (VaD) 6%, frontotemporal dementia1%, and others 13%. In conclusion, MCI was more common than ATD at the neurosurgeon's center, and patients were seen at an early stage of memory disturbance. In addition, there was a tendency for mixed types of VaD and ATD to be common.

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  • - Recent Trends in Outpatient Neurosurgery
    Nozomi Suzuki, Teruo Kimura, Kazuo Takasugi, Adam Tucker, Hirotaka Sat ...
    2023 Volume 3 Issue 1 Pages 37-43
    Published: February 01, 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    「Purpose」 Recently we have observed changes in disease presentation in outpatient care at the department of Neurosurgery. In particular, neurodegenerative diseases including dementia have been increasing. Here, we examined approaches to dementia treatment and presented several representative cases.

    「Subjects and Methods」 We categorized dementia-related disease groups into four groups (treatable dementia, geriatric epilepsy, Parkinson’s disease (PD) and Dementia with Lewy bodies (DLB), Alzheimer’s disease (AD) / mild cognitive impairment (MCI) and other dementia), and conducted a self-assessment survey on the quality of diagnosis and treatment.

    「Results」 Accuracy of MCI and diagnostic treatment of dementia types other than AD were considered inadequate.

    「Conclusion」 In order to provide more comprehensive dementia management and therapy, greater neurosurgeon involvement and consultation is needed in the future.

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  • Toshio Ikota, Satoshi Kano
    Article type: case-report
    2023 Volume 3 Issue 1 Pages 44-47
    Published: February 01, 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS

    【Purpose】An autopsy case of idiopathic normal pressure hydrocephalus (iNPH) is reported.

    【Case】A 75-year-old man presented with gradual progression of memory impairment, gait disturbance, and urinary incontinence. A diagnosis of iNPH was made, and V-P shunt was performed, and the symptoms improved significantly. He later died of renal failure and an autopsy was performed.

    In the brain parenchyma, mild senile plaques and neurofibrillary tangles were observed in the hippocampus. A trace of lacunar infarction was found in the pons. In the cerebrospinal fluid system, fibrosis of the arachnoid membrane near the superior sagittal sinus and a decrease in granule cells were observed. No inflammatory changes were observed. Lateral ventricular choroid plexus epithelial cells were present almost normally.

    【Conclusion】As pathological findings, retraction and fibrosis of arachnoid granules near the superior sagittal sinus were observed.

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  • 2023 Volume 3 Issue 1 Pages M1-M2
    Published: 2023
    Released on J-STAGE: February 01, 2023
    JOURNAL FREE ACCESS
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