Neurologia medico-chirurgica

The Surgical Treatment of Extracranial Arterial Occlusion

William M. LOUGHEED

1974 Volume 14pt1 Issue SUPPLEMENT Pages 1-4
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_1

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Dural Calification from the Neurosurgical Point of View

Yasuakira TANAKA, Kazuo TAKEUCHI

1974 Volume 14pt1 Issue SUPPLEMENT Pages 5-10
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_5

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A study of dural calcification is presented. The detection by roentgenography of 164 cases of dural calcification among 1, 162 neurological and neurosurgical patients represented an incidence of 14%. Such calcification occurred with the greatest frequency in the falx cerebri, tentorium cerebelli and petroclinoid ligament. The main contributing factors and clinical significance of dural calcification were analyzed.

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Originals Cavernous Sinus Venography by Transbasilic Catheter Technique

Tomio SASAKI, Yasuichi UEDA, Isamu SAITO, Keiji SANO

1974 Volume 14pt1 Issue SUPPLEMENT Pages 11-17
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_11

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The purpose of this paper is to present a new, possibly preferable method for cavernous sinus and orbital venography, by retrograde catheterization from the arm. With this procedure, good opacification of cavernous sinus may be offered also in patients who have heart diseases. This procedure can be tolerated with minimal discomfort. The patterns of the cavernous sinus are demonstrated in those with intracranial diseases. There have been no complications in our initial experience of 28 examinations.

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Diagnostic Value of Stationary Potential Measurement in Head Injuries

Tokuro FUCHINOUE, Shinya MANAKA, Kimiyoshi HIRAKAWA, Keiji SANO

1974 Volume 14pt1 Issue SUPPLEMENT Pages 19-27
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_19

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Traumatic brain injuries were analysed clinically and experimentally by recording stationary potential(SP) which is a very stable component in the electrical phenomena of the brain. SP value is considered to change positively or negatively only when there are organic lesions, severe metabolic changes of the brain, or epileptic seizures.
Clinically, we have measured the SP of 103 head-injured patients. When an organic lesion was located in the cerebral hemisphere, the SP showed various changes according to the location of the lesion.
Positive SP changes were usually seen in the cases of mild cortical compression and subcortical lesions. Clinically, these lesions included epidural hematoma, subdural hematoma without contusion, chronic subdural hematoma, simple depressed fracture and intracerebral hematoma without cortical damage.
Whereas, almost all of the cortical lesions or extensive brain lesions showed negative changes of SP. They were such as cerebral contusion, intracerebral hematoma with vascular lesion, depressed fracture with cortical damage and traumatic epilepsy.
Subsequently, to support these clinical data, experimental cortical compression with clot inserted into subdural and extradural space, subcortical lesion by artificial intracerebral hematoma, cerebral contusion by mechanical destruction were investigated in cats. The experimental results showed the same tendency as the clinical data.
In another experimental study, clarification of the possibility of SP change in concussion was attempted.

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Significance of Vascular Notching of Optic Nerves and Chiasm on Visual Disturbance

Takashi OHWADA, Yoshio MIYASAKA, Hiroshi TAKAGI, Kenzoh YADA, Ikuko KO ...

1974 Volume 14pt1 Issue SUPPLEMENT Pages 29-34
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_29

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The authors have reported five cases of pituitary tumors with notching of the optic nerves and chiasm caused by the overlying anterior cerebral arteries observed under the operating microscope.
Extension of the pituitary tumor seems to push the optic nerves and chiasm upward against the anterior cerebral arteries, producing transverse notching on their surface.
We suggest that this notching is responsible for visual field defects and loss of visual acuity in some cases of pituitary tumor. The possible pathophysiological mechanisms of this phenomenon are also discussed in detail.

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Malignant Primary Meningeal Tumors

Masashi FUKUI, Katsutoshi KITAMURA, Yukichi YONEMASU, Tosuke TAKAKI, T ...

1974 Volume 14pt1 Issue SUPPLEMENT Pages 35-46
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_35

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1) Out of 160 primary meningeal tumors surgically treated, 10 cases had histologically malignant tumors. Of them two cases of sarcoma and one case of meningioma with marked invasiveness were filed in malignant (sarcoma) group, and six cases of angioblastic meningioma of hemangiopericytoma type and one case of meningioma with partial invasiveness in semimalignant group. 2) Average duration of symptoms before admission was 3.2 months in the malignant group, 13.6 months in the semimalignant group and 28.5 months in the benign meningioma group. Incidences of papilledema was seen in 80% of the malignant and semimalignant groups and 58.5 % in the benign meningioma group. 3) Plain skull X-ray films did not reveal a marked osteoplastic change of the skull related to the tumor in the malignant and semimalignant groups. Lytic or destructive changes of the skull at the tumor site were noted in two cases. 4) An angiographic characteristic of meningeal tumors with malignancy was in most cases a marked blood supply from the intracerebral arteries into the tumor. 5) Of nine cases of postoperative survivals, recurrence occurred in three cases and probable recurrence in one other case, all of which were of angioblastic meningioma. 6) Irradiation resulted in some clinical improvements in two cases of angioblastic meningioma, but it was not curative after all. 7) Complete surgical excision was the best method for the prognosis of meningeal tumors with malignancy. If neuroradiological findings suggest a meningeal tumor with malignancy, surgical tactics should be radical in its true sense.

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Stiffness of Cerebral Arteries—Its Role in the Pathogenesis of Cerebral Aneurysms

Kouzo MORITAKE, Hajime HANDA, Atsushi OKUMURA, Kozaburo HAYASHI, Hidey ...

1974 Volume 14pt1 Issue SUPPLEMENT Pages 47-53
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_47

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Distensibility of human cerebral arteries was compared quantitatively with extracranial arteries using a parameter which was obtained from the pressure-radius data. It was found that cerebral arteries were much stiffer than the extracranial arteries of comparative sizes. The stifiness of cerebral arteries reached nearly maximum at the middle age and did not progress thereafter. Effect of arterial stiffness on blood flow was also examined using pulsatile flow in polymer tubes with different distensibility under the influence of sinusoidally oscillating pressure. The stiffer the tube was, the higher was pulsatile pressure. It is concluded that much larger fluctuation of pressure may occur in the cerebral arteries compared with extracranial arteries and induce the degenerative change or structural weakness in the wall, especially at the apex of bifurcation, which may play important roles in the pathogenesis of cerebral aneurysms and the mechanism of their growth and rupture.

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Cerebrovascular Moyamoya Disease IIIrd Report—The Study on the Aging of the Perforating Branches and the Possibility of Collateral Pathway

Namio KODAMA, Jiro SUZUKI

1974 Volume 14pt1 Issue SUPPLEMENT Pages 55-67
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_55

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In Cerebrovascular “Moyamoya” Disease, children and adults show different aspects of abnormal net-like vessels (called “Moyamoya”) at the base of the brain. The reason for the difference has not been clarified as yet. In order to explain the reason, this study was undertaken to investigate possibilities and morphology of the anastomosis among the perforating branches as well as the influence of their aging by means of micro-angiography and/or graphical reconstruction of serial sections.
1) Three groups of fetuses, children and adults were subjected to the study of the aging of Aa. corporis striati mediae. The number, courses, and shapes of vessels, that is, such items as diverting angle at the middle cerebral artery, smoothness or irregular changing of their courses or directions as well as diameters are carefully observed by microangiography. Changes with aging were found remarkable among all of these items. It must be noted that the younger had the more arteries, suggesting easiness of collateral formation.
2) The existence of anastomosis among the perforating branches with one another, between these vessels and Aa. medullaris were clearly verified by graphical reconstruction of serial sections. It was also observed that the pattern of the anastomosis and the caliber of each anastomosis varied with aging. This observation may well indicate that the “Moyamoya” vessels appeares as collateral pathways based on the perforating branches and also that “Moyamoya” vessels are easily formed in the younger than in the older.

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Anterior Communicating Artery Aneurysm not Visualized by Angiography. Report of Two Successfully Operated Cases

Shunro ENDO, Jiro SUZUKI

1974 Volume 14pt1 Issue SUPPLEMENT Pages 69-73
Published: 1974
Released on J-STAGE: December 28, 2006

DOIhttps://doi.org/10.2176/nmc.14pt1.SUPPLEMENT_69

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The diagnostic bases for ruptured anterior communicating artery aneurysm, which can not be visualized by repeated bilateral carotid angiographies are discussed in this paper. Direct operations were performed successfully in two such cases based on diagnosis from clinical signs and angiographic findings.

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