Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 20, Issue 1
Displaying 1-14 of 14 articles from this issue
  • Experience of 110 Cases
    Komei UEKI, Ryuichi TANAKA
    1980 Volume 20 Issue 1 Pages 1-26
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    Treatments of 110 pineal tumors, which were experienced at the Department of Neurosurgery of Niigata University, are reviewed and evaluated. The 110 tumors included 74 germinomas (including germinomas arising in sites other than the pineal region), 11 teratomas, 11 teratoid tumors, 5 mixed teratoma or teratoblastoma and germinomas, 3 glial tumors and 3 tumors with the origin of the pineal parenchyma. Seventy-four intracranial germinomas were located as follows: in the pineal region, 45; suprasellar region, 14; pineal to suprasellar regions, 7; cerebral hemisphere, 3; hypothalamus, 2; periventricular region, 2; and periventricular region and subarachnoid space, 1.
    For the differential diagnosis of pineal tumors, a cerebrospinal fluid cytology to detect the epitheloid cells of germinoma and CT scan were very useful and enabled the diagnosis of germinoma or teratoma without biopsy.
    Follow-up study revealed that radiotherapy for germinomas brought about satisfactory results in the lengths of survival and morbidity, especially in the smaller germinomas. The larger germinomas showed a tendency to recur and seemed to require a larger field of irradiation. Prophylactic irradiation of the whole spinal axis did not seem to be necessary unless surgical intervention was employed.
    Teratomas absolutely have an indication of direct operation and the operative procedures were well-correlated to operative morbidity.
    The treatment of radioresistant pineal tumors of malignant nature such as teratoid tumors, glial tumors or tumors of the pineal parenchyma was difficult. Postoperative radiochemotherapy and immunotherapy are necessary for the treatment of these tumors.
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  • Masahiro FURUSE, Yoshio SUZUKI, Kiyonori TOYAMA, Masao WATANABE, Yoshi ...
    1980 Volume 20 Issue 1 Pages 27-35
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    Fifty cases of basal meningioma, consisting of olfactory groove, tuberculum sellae, middle fossa and sphenoidal ridge meningiomas, were subjected to study on operative gradings and factors influencing surgical limits. Complete resection of basal meningiomas was restricted owing to firm tumorous adhesion to the major vessels at the base of the skull. From the analysis of angiographical findings, it was found that irregular narrowing of the trunks of cerebral arteries as well as dissociation or narrowing at the distal portion of cerebral arteries constitutes convincible figures indicating complete resection as impossible.
    Existence of extradural invasion of the tumor composed another cause of surgical incompletion. Transbasal approach was availably employed for removing such extradural extension. This approach can be applied not only for total removal of the lesion in focal bony invasion but also for relieving visual problems and advancing exophthalmos in cases with wide-spread osseous invasion.
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  • Hayao SHIGA, Akira YAGISHITA, Taketo TSUTSUI, Shimakichi SUZUKI, Kiyos ...
    1980 Volume 20 Issue 1 Pages 37-44
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    CT is very useful for differential diagnosis of unilateral exophthalmos. Lesions extending from the cranial cavity or the paranasal sinus into the orbit can be diagnosed easily by this method. About two thirds of patients with dysthyroid ophthalmopathy have enlargement of the extraocular muscles, and the remaining one third have increase in fatty tissues. Inflammation in the orbit and malignant tumor usually show a diffuse high density which cannot be differentiated from normal intraorbital structures. Benign intraorbital tumor has a localized high density mass and shows definite demarcation. Histological diagnosis frequently cannot be made from absorption density value and contrast enhancement. Therefore, the patient′s age, clinical symptoms, site of lesion and angiographic findings should be considered.
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  • Takuya IKEDA, Yoshikazu IWATA, Jiro NAKATANI, Heitaro MOGAMI, Toshihir ...
    1980 Volume 20 Issue 1 Pages 45-51
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    The high sensitivity of Doppler ultrasound for monitoring venous air embolism was confirmed by injecting various amounts of air into the jugular veins of dogs in the upright position. The frequency distribution of the Doppler sound changed by air embolism was analyzed on the sonogram and was compared with polygraphic recordings of pathophysiological data from animals and clinical cases. An electronic alarm circuit triggered by the intensity and duration of the Doppler output of a particular frequency range characteristic for air embolism was designed and tested with animals and clinical data. This device detects variations in Doppler output from preoperative levels, thereby relieving the anesthesiologist and surgical team from the need of monitoring the Doppler sound throughout surgery.
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  • Toyofumi SHISHIDO, Kenji NAKAYAMA, Kazuto SHOJIMA, Mitsou WATANABE, Sh ...
    1980 Volume 20 Issue 1 Pages 53-60
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    Fourteen cases of surgically treated acute subdural hematomas were studied. The indication of external decompressive hemicraniectomy for these cases of acute subdural hematomas was studied in detail according to postoperative intracranial pressure (pICP) changes in combination with their preoperative neurological, cardiorespiratory and angiographic findings.
    The pICP changes were classified into three groups according to the maximum values of intracranial pressures and the patterns of the pressure changes.
    Group one: pICP increased rapidly and progressively immediately after the operation, and then it reached the level of mean arterial blood pressure. This rapid increase of pICP in this group seemed to be the result of cerebral vasomotor paralysis. There was no effective treatment for these cases.
    Group two: pICP remained in the range of 40 to 70mmHg. Preoperative neurological examinations of these cases showed semicoma or coma not having the signs of brain stem dysfunction. Preoperative angiograms revealed the delay of circulation time and fairly good filling of small arteries in an early arterial phase. Operative findings in these cases showed that extensive cerebral contusion affected more than two lobes without any definitive brain swelling. Postoperative intracranial pressure might have continued to increase as shown in Group one, if external decompressive hemicraniectomy had not been performed for these cases. It was considered that external decompressive hemicraniectomy should be restricted to this group.
    Group three: pICP remained 10 to 30mmHg. Indication of external decompressive hemicraniectomy was not suggested for cases in this group.
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  • Akinori KONDO, Tsunemaro KOYAMA, Junichiro ISHIKAWA, Toshiki YAMASAKI
    1980 Volume 20 Issue 1 Pages 61-66
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A patient with an occipito-vertebral anastomosis associated with interesting clinical symptoms is presented. This 38-year-old male had a history of recurrent and reversible ischemic episodes of the vertebro-basilar system for more than 10 years. Surgical obliteration of this abnormal anastomotic channel resulted in gradual improvement of most of his clinical symptoms. The steal phenomenon of blood supply from the vertebro-basilar system to the external carotid artery via the anastomotic channel was thought to be responsible for clinical symptoms.
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  • A Case Report
    Akinori KONDO, Junichiro ISHIKAWA, Junya HANAKITA, Tsunemaro KOYAMA
    1980 Volume 20 Issue 1 Pages 67-72
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A complete form of rare vascular malformation named “unilateral retinocephalic vascular malformation” in a 25-year-old woman with a clinical history of more than 15 years is presented. This case was also associated with other cerebral vascular anomalies such as a saccular aneurysm and an azygos pericallosal artery. The difference between usual arteriovenous malformation and this extensive vascular malformations in terms of the incidence of intracranial hemorrhage and also epileptic seizures is briefly commented upon.
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  • Minoru SHIGEMORI, Nobuto KOJO, Jun MIYAGI, Mitsuo WATANABE, Shinken KU ...
    1980 Volume 20 Issue 1 Pages 73-79
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A case of agenesis of the left internal carotid artery associated with an aneurysm of the anterior communicating artery which developed with an acute onset of subarachnoid hemorrhage due to its rupture is presented. The anomaly was demonstrated on angiogram and confirmed at operation for the aneurysm. The absence of the foramen lacerum detected on the axial view of the skull suggested the congenital nature of the anomaly. Fifteen cases (including our own) of total absence of unilateral or bilateral internal carotid arteries associated with intracranial aneurysms were collected from the literature. Nine of these patients (64.3%) had an aneurysm on the anterior communicating artery. The importance of altered hemodynamic forces on the circle of Willis produced by the agenesis of the internal carotid artery as one of the causative effects of the aneurysm in our case is discussed.
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  • Report of a Successfully Treated Case
    Kazuyo KAMIYAMA, Yoshiharu SAKURAI, Jiro SUZUKI
    1980 Volume 20 Issue 1 Pages 81-84
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    Most of the so-called posterior communicating artery aneurysms actually originate at the internal carotid-posterior communicating artery junction. The incidence of aneurysms arising solely from the posterior communicating artery itself is reported to be 0 to 3.3% of the total cases. A 28-year-old female was the only case who had an aneurysm originating at the posterior communicating artery itself in a total of 1, 080 saccular aneurysm cases managed at our clinic. In this case, trapping the aneurysm in the posterior communicating artery was performed.
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  • Takashi YOSHIMOTO, Keita UCHIDA, Jiro SUZUKI, Tokuo WADA
    1980 Volume 20 Issue 1 Pages 85-88
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A case of traumatic intraventricular extravasation, outlining the lateral ventricle bycarotid angiography is reported.
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  • Takao NAKAMURA, Tsuneo TAKASHIMA, Katsumi ISOBE, Akira YAMAURA
    1980 Volume 20 Issue 1 Pages 89-93
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    Rapid neurological alteration was observed in association with concave deformity of the skin flap following a large decompressive craniectomy. In an erect position, hemiparesis and dysphasia showed marked deterioration with a sinking skin flap and CT-scan showed considerable distortion of the underlying brain tissue. Those changes were rapidly improved by restoration of normal curvature of the skin flap in a supine position. EEG findings coincided with such rapid alteration. Neurological changes may be due solely to concave deformity of the skin flap and the underlying brain tissue; this characteristic phenomenon might be described as “the syndrome of the sinking skin flap.” The presence of shunt system seems to play an important role in appearance of such a phenomenon.
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  • Tadashi KOJIMA, Shiro WAGA, Yoshito MOROOKA
    1980 Volume 20 Issue 1 Pages 95-99
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A case of huge invasive chromophobe pituitary adenoma is reported. The tumor extended to the right middle and posterior fossa, and recurred one year following resection and irradiation. The patient developed visual disorders, hyperprolactinemia, right trigeminal nerve involvement and left hemiparesis. Review of pertinent literature indicates that there is no better treatment than non-radical resection followed by irradiation for invasive adenomas at present.
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  • A Case Report
    Satoru KUBOTA, Yukihiko ANDO, Yutaka TSUTSUMI, Takayoshi MATSUI
    1980 Volume 20 Issue 1 Pages 101-106
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A surgical case of a 12-year-old boy having lipoma with dysgenesis of the corpus callosum is reported.
    Plain skull film on frontal projection showed a midline radiolucent area with left peripheral linear calcifications. Computed tomographic (CT) scan revealed a very low absorption area with calcifications in the midline frontal region and separation of both anterior horns of the ventricles. Convulsions became controllable with minimal doses of anticonvulsants after surgery.
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  • A Case Report
    Masashi FUKUI, Fumio SHIMA, Miho ABE, Yoshiki TSUKAMOTO, Naofumi HAYAB ...
    1980 Volume 20 Issue 1 Pages 107-111
    Published: 1980
    Released on J-STAGE: August 17, 2007
    JOURNAL FREE ACCESS
    A rare case of intracranial angioblastic meningioma with local recurrence and metastasis in the skull is reported. Treatment of metastatic meningioma is discussed.
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