Visually-triggered eye and head movements -gaze saccade- were simultaneously recorded in 12patients with posttraumatic cervical syndromes. In a great number of patients, the reaction time of gaze saccade increased markedly and the abnormality of visual fixation was induced after nuchal stimulation. A local infiltration in the cervical area with 1% procaine or an intravenous injection of centrophenoxine, made prior to the stimulation, no longer induced stimulating effects. On the other hand, there was almost no change in the velocity of the saccade and head turning either before or after cervical stimulation.
The gaze saccade of a patient with a focal hemorrhage in the left superior colliculus had a longer latency. This increased latency was limited to the gaze saccade made on points in the contralateral visual field (contralateral to the lesion). There was no change in the velocity of the saccade and no longer deficit in the gaze accuracy. In a patient with a parietal lobe lesion due to a glioma, there was an increase in the latency to initiate the gaze saccade toward the contralateral side and a slight increase in the number of double saccades.
The pattern of visually evoked effects in abducens and neck motoneurons was investigated by intracellular recording in chloralose anesthetized cats. Following a single shock to the ipsilateral optic disk (ODi), excitatory postsynaptic potentials (EPSPs) were recorded from abducens motoneurons. In some case, inhibitory postsynaptic potentials (IPSPs) or mixed PSPs were also evoked from the ODi. Similar EPSPs, IPSPs or mixed PSPs were induced in the dorsal neck motoneurons. The results suggest the possibility of a similar synaptic linkage from the retino-tectal system to abducens and neck motoneurons.
Intracellular responses were recorded from tectal neurons after stimulation of the cervical afferents. Stimulation of the ipsi or contralateral C2 dorsal root ganglion evoked EPSPs or IPSPs in the tectal neurons, indicating polysynaptic excitatory and inhibitory connections between neck afferents and tectal neurons.

View full abstract

A histochemical study of hydrolytic enzymes such as acid phosphatase and beta-glucuronidase was made on cultured brain tumor cells. Well-differentiated astrocytic cells, oligodendroglioma cells, and medulloblastoma cells showed low activities. Migrating cells and macrophage-like cells showed intense activities. Meningioma cells and schwannoma cells showed relatively intense activities at the early stage of cultivation. At the aged stage, the former showed a characteristic pattern of reaction products. The intensity and distribution of beta-glucuronidase were similar to those of acid phosphatase in cultured brain tumors. The relationship of hydrolytic enzymes to cellular differentiation and viability was discussed.

View full abstract

Neurite formation in culture was examined as a model for nerve regeneration. Dorsal root ganglion cells were isolated from newborn rats and cultured with fresh Eagle's minimum essential medium (MEM) or conditioned medium (CM) obtained from a culture of C6 glioma cells. Their fine structures were examined by electron microscopy. Microspikes were developed rapidly on the cell surface and extended into the substratum. In fresh MEM a rim was formed around the cell body. The rim was widened further and then the neuron was degenerated. In CM, veils were formed between some neighboring microspikes, became enlarged and protruded; thereafter growth cones were formed. As the neurites became extended, microspikes and veils were concentrated on growth cones but disappeared from the cell surface. Microspikes, rims and veils from the cell body were filled with bundles and networks of microfilaments. Growth cones contained agranular reticula, microtubules, mitochondria, vacuoles and microfilaments. Neurons kept in fresh MEM had a large number of neurofilaments but few microtubules in the cell body. Neurofilaments formed large bundles in the degenerating neurons. The neurons in CM had many microtubules but bundles of neurofilaments were not formed. It was suggested that microtubules are essential for initiation and elongation of the neurites and also for nerve regeneration.

View full abstract

A total of 50 meningiomas was immunohistochemically examined for the presence of S-100 protein, an extremely acidic protein unique to the nervous system, by the peroxidase-antiperoxidase technique. Nineteen out of 50 meningiomas revealed unequivocally positive immunoperoxidase staining for S-100 protein. The distribution pattern of S-100 protein positive cells in these 19 meningiomas could be classified into three different types: diffuse (519), sparse (719) and clumpy (719) distribution of the positive cells throughout the sections.
At present it is generally believed that S-100 protein is observed solely in the cells of either neuroectodermal or mesenchymal origin; therefore, the present immunohistochemical results strongly suggest that meningioma may consist of a variety of tumors with different histogenesis in terms of S-100 protein.

View full abstract

Forty-five patients with spinal neurinomas, including 7 cases of neurofibroma, were operated on in our clinics between 1962 and 1982. In that period, 104 spinal tumors were seen at the University of Tokyo, and the ratio of neurinomas to meningiomas was 3.4 to 1. In Japan and the Republic of China, spinal neurinomas are clearly more frequent than spinal meningiomas.
Frequent initial symptoms were neuralgic pain in 22 cases, weakness of the region of the involved nerve(s) in 11, and dysesthesia or numbness in 5. The side of the initial symptom corresponded with that of the lesion in 35 cases (77.8%), was contralateral in 3 cases, indefinite in 3, and bilateral in 4. Patients showing only neuralgic pain or weakness of the involved nerve(s) were classified as Stage I (3 patients); those presenting neurological dysfunction but able to walk by themselves were classified as Stage II (16 patients); those presenting paraplegia and consequently unable to walk were classified as Stage III (23 patients); and those presenting tetraplegia and unable to sit were classified as Stage IV (3 cases). All patients in Stage IV had cervical neurinomas and 2 of them were neurofibromas. Bladder disturbance was closely correlated with the exacerbation of neurological dysfunction: In Stage I, there was no bladder disturbance, in Stage 11 12.5%, in Stage 111 78.3%, and in Stage IV 100%.
The follow-up review of these 45 cases showed good functional recovery except for 1 case of neurofibroma in Stage IV who is now bedridden.

View full abstract

A total of 52 patients with growth-hormone (GH) secreting adenoma were treated by transsphenoidal microsurgery. The procedure, as a rule, consisted of complete debridement of tumorous tissue while preserving as much normal pituitary tissue as possible. In 47 of the 52 patients (90%), the blood GH level was normalized, and the abnormal response of blood GH level to TRH and LH-RH disappeared after surgery in 25 out of 37 cases (68%). In all 16 patients with diabetes mellitus, a complete cure or improvement was observed and the five cases with bitemporal hemianopsia showed improvement of the visual acuity and the visual field.

View full abstract

The development of a simplified lumbar subarachnoid-peritoneal (L-P) shunt technique was previously reported by the authors. In this procedure a spinal tube is inserted through a puncture needle, eliminating the need for laminectomy.
This paper is a follow-up report presenting data based on 158 cases and 191 shuntings. Attention is focused on the types of complications and shunt troubles as well as their causes.
The relationship between the incidence of shunt troubles and the use of a flushing devices was also investigated. It was concluded that shunt troubles occur more frequently when a flushing device is used. For this reason, a one-piece L-P shunt is now being studied. Finally the remaining problems in respect to L-P shunt procedures are described.

View full abstract

A case is presented of a 55-year-old man with pulseless disease, associated with an intracranial aneurysm located at the right vertebral-posterior inferior cerebellar artery, which ruptured to cause an episode of subarachnoid hemorrhage.
Surgical treatment for the ruptured saccular aneurysm was carried out via the right suboccipital approach and the aneurysmal neck was clipped. On the second postoperative day, he suffered an attack of myocardial ischemia. Thereafter, the postoperative course was uneventful except for transient hoarseness and dysphagia.
It is unknown whether the aneurysm and pulseless disease occurred independently or whether the aneurysm developed secondarily from the altered hemodynamic flow produced by the pulseless disease; however, it can be presumed that abnormal intracranial hemodynamic forces did play some role in the development of the aneurysm.

View full abstract

Two cases of saccular aneurysms arising from the posterior communicating artery itself are presented. They account for 0.5% of the 409 intracranial aneurysms we have treated. Classification of so-called posterior communicating artery aneurysms and the incidence of aneurysms arising from the posterior communicating artery itself are reviewed, and the surgical significance of this aneurysm is briefly discussed.

View full abstract

A rare case of teratoma occurring in the fourth ventricle of an elderly adult was reported. Seventeen reported cases of teratoma in the posterior fossa were reviewed with our present case, among which 6 teratomas were found in the fourth ventricle. The differential diagnosis from the other tumors was easy in this case with CT scan.

View full abstract

A 77-year-old man with an asymptomatic calcified chronic subdural hematoma is reported. Thirtyseven years elapsed between the time of the head trauma and diagnosis. The advanced age of the patient when the calcified chronic subdural hematoma was diagnosed and the long interval between the trauma and diagnosis were both unusual features of this case. As far as we know, this patient is the oldest reported in the literature. Removal of calcified chronic subdural hematoma in the elderly is neither necessary nor beneficial.

View full abstract