Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 28, Issue 6
Displaying 1-15 of 15 articles from this issue
  • —Effects of Intracarotid Hyperosmolar Mannitol measured by 3H-thymidine Autoradiography and Bromodeoxyuridine Uptake—
    Tooru INOUE, Toru IWAKI, Masashi FUKUI, Iwao TAKESHITA
    1988 Volume 28 Issue 6 Pages 533-537
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The proliferative activity of intracerebrally implanted rat glioma C6 (RG-C6) tumors in rats was examined by means of 3H-thymidine autoradiography and measurement of bromodeoxyuridine (BrdU) uptake. The effect of intracarotid hyperosmolar mannitol on the cell kinetics of the RG-C6 tumors was studied by the latter method. The labeling index (LI) and distribution of 3H-thymidine-labeled cells were identical to those of the BrdU-labeled cells. The LIs of BrdU-labeled cells were not altered by intracarotid mannitol injection. The influence of intracarotid hyperosmolar mannitol infusion not only on brain tumors but also on normal brain tissue is discussed.
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  • Tadao SONOKAWA
    1988 Volume 28 Issue 6 Pages 538-545
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The development of ischemic cerebral edema was studied in terms of the intracranial hydrostatic factor. Adult mongrel cats underwent occlusion of the right middle cerebral artery via the transorbital approach to induce focal cerebral ischemia. Three hours after the arterial occlusion, hypertension was produced for 30 minutes. Based on the extent of the microcirculation derangement estimated from the regional cerebral blood flow (rCBF) and carbon filling assays, the brain was divided into three zones: the center of the ischemic zone, the periphery of the ischemic zone, and the nonischemic zone. Each zone was observed for changes in the rCBF, the water content of brain tissue, blood-brain barrier impairment, the architecture of the cerebral microvessels, and histology. Comparison of the hypertensive and normotensive groups revealed that the hypertensive animals underwent a progressive decrease in the rCBF in the peripheral ischemic zone after induction of hypertension, which became significant 6 hours after the production of cerebral ischemia. The water content of the peripheral ischemic zone in the hypertensive group was significantly higher than that of the normotensive group during the 6 hours following the induction of ischemia. Experimental hypertension caused a microcirculatory disturbance in the peripheral ischemic zone that steadily spread and worsened; within 24 hours of the induction of ischemia, brain edema progressed. It appears that focal brain edema, which developed in the periphery of the ischemic zone following the induction of transient hypertension and ischemia, grew progressively more severe and contributed to a secondary circulatory disturbance that resulted in global edema.
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  • —Changes in Subcortical Components—
    Ei-ichirou URASAKI, Shin-ichi WADA, Yasuhiko MATSUKADO, Akira YOKOTA, ...
    1988 Volume 28 Issue 6 Pages 546-552
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Short-latency somatosensory evoked potentials (SSEPs) following median nerve stimulation were monitored intraoperatively in 23 patients with cervical cord or posterior fossa lesions. The SSEPs consisted of four subcortical potentials (P9, P11, P13, and N16) prior to the appearance of the cortical potentials. Potentials were also directly recorded from the surgical fields in some cases. Loss of components due to surgical procedures was regarded as abnormal, and the changes in SSEPs correlated well with the generating source of each component. Postoperative neurological deficits were noted in four of the nine patients who had changes in SSEPs or directly recorded potentials, but in three cases the deficits were transient. The authors conclude that monitoring of subcortical potentials is useful in detecting interruption of medial lemniscal pathways during surgery.
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  • —Angiographic Study of Medial Sphenoid Ridge and Tuberculum Sellae Meningiomas—
    Toshiaki YAMAKI, Sumiyoshi TANABE, Tsutomu SOHMA, Teiji UEDE, Toshiyuk ...
    1988 Volume 28 Issue 6 Pages 553-558
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The feeding arteries of 14 parasellar meningiomas treated between 1962 and 1985 were analyzed. Nine were medial sphenoid ridge meningiomas (four of the alar type and five of the clinoidal type) and five were tuberculum sellae meningiomas. Retrospective analysis of the arteries supplying the basal dura of the involved region revealed diverse dural branches originating from both the internal and external carotid systems in this region. These arteries were classified as anterior, posterior, or lateral. Two of the four alar type meningiomas were supplied by lateral feeders, and two by both anterior and lateral feeders. One of the five clinoidal meningiomas was fed by anterior and lateral arteries, and one by posterior arteries. No feeding arteries were identified in the three remaining cases of clinoidal meningioma. Three of the five tuberculum sellae meningiomas had anterior feeders, one had posterior feeders, and one had no angiographically detectable feeders. The tumors of three patients in this series were found to be supplied by both the internal and external carotid systems. It can be concluded that there is a relationship between the sites of parasellar tumors and the internal and external carotid arteries that feed them.
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  • —A New Shunting Apparatus with Intraventricular Fluid Pressure Monitoring—
    Shizuo OI, Satoshi MATSUMOTO
    1988 Volume 28 Issue 6 Pages 559-561
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The authors describe a newly developed ventricular trocar that allows accurate intraventricular pressure measurement at the time of shunt emplacement. This device assures correct positioning of the ventricular tube and enhances safety on insertion. In slit ventricle syndrome, for example, the use of this trocar provides exact diagnosis on the basis of pressure monitoring and facilitates insertion of the tube.
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  • Shizuo OI, Hiroshi YAMADA, Seishiro URUI, Satoshi MATSUMOTO
    1988 Volume 28 Issue 6 Pages 562-567
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The pathogeneses of the majority of congenital central nervous system (CNS) anomalies have been explained from an organopathogenetic standpoint based on embryopathic (or fetopathic) findings relating to specific developmental stages. There have been, however, numerous reports from Europe and North America suggesting that genopathic or gametopathic disorders are involved in these embryo pathogeneses. Perhaps because congenital CNS anomalies are not encountered in Japan as frequently as in western countries, to date no systematic or comprehensive studies of such syndromes have been published in Japan. The authors analyzed data obtained during the last 7 years from seven families in which CNS anomalies, all affecting siblings, occurred. Among this series were three cases of craniosynostosis, two of hydrocephalus, one of lissencephaly, and one of arachnoid cyst. With the exception of the arachnoid cyst, in all cases the incidence pattern suggested an hereditary mode other than X-linked. For at least three generations, only siblings had been affected; there were no documented chromosome anomalies in any other family members. In six cases of CNS anomalies there were associated chromosome anomalies, but there was no evidence that these were inherited. In this series the incidences of sibling involvement by type of anomaly were 16.7% for lissencephaly, 10.7% for craniosynostosis, 2.6% for congenital hydrocephalus, and 2.6% for arachnoid cyst. These data strongly suggest that genopathic processes are more important than gametopathic factors in the embryopathogeneses of CNS anomalies. Also, in Japan, the genetic syndromes may be relatively mild and their transmission may be predominantly autosomal recessive.
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  • —Case Report—
    Masayuki MATSUDA, Masaharu ICHIKAWA, Satoshi NAKASU, Jyoji HANDA
    1988 Volume 28 Issue 6 Pages 568-574
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 9-month-old boy with recent signs of delayed behavioral development was found to have a large epithelium-lined cyst located ventral to the medulla oblongata. The cyst was resected, and microscopic examination revealed its wall to be lined by a single layer of columnar epithelial cells containing secretory granules, a coating material, and a basement membrane. Electron microscopic findings suggested an endodermal origin. Previous reports of cystic lesions in the posterior fossa, apart from arachnoid cysts, are reviewed and the role of magnetic resonance imaging in locating lesions in the posterior fossa is discussed.
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  • —Case Report—
    Hidenori OGASAWARA, Tetsuji INAGAWA, Mitsuo YAMAMOTO, Kazuko KAMIYA
    1988 Volume 28 Issue 6 Pages 575-578
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    An elderly woman suffered rupture of an aneurysm on the anterior cerebral artery, which had developed from the proximal end of a fenestration in the artery. These features were visualized angiographically and confirmed during surgery. Aneurysms rarely develop from fenestrations in the anterior cerebral artery; to date, only eight cases have been reported in the literature. The findings concerning aneurysms associated with fenestration suggest that congenital factors are involved in their pathogenesis.
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  • —Report of Two Cases—
    Youichi ITOYAMA, Akinobu FUKUMURA, Nobuhito NONAKA, Yoshihiro ITOH, Se ...
    1988 Volume 28 Issue 6 Pages 579-583
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Although the association between fibromuscular dysplasia (FMD) and intracranial aneurysms is well known, giant aneurysms are rarely encountered in this context. The authors treated two patients with FMD accompanied by giant intracranial aneurysms, one in the left cavernous sinus and the other at the left vertebral artery. Neither patient underwent surgery; with conservative treatment both patients' neurological symptoms abated. The characteristic features of FMD are outlined and various aspects of the association between FMD and intracranial aneurysms are discussed, with particular emphasis on the possible etiology and the treatment of giant aneurysms accompanying FMD.
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  • —Case Report—
    Yutaka HIRASHIMA, Shunro ENDO, Keiji KOSHU, Akira TAKAKU
    1988 Volume 28 Issue 6 Pages 584-587
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 69-year-old female with frequent episodes of vertigo was found to have persistent trigeminal artery and ulcerative stenosis of the ipsilateral carotid bifurcation. The clinical symptoms, pathogenesis, and treatment of this anomaly are discussed.
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  • —Case Report and Review of the Literature—
    Kazuhito HASHIMOTO, Kiyotaka FUJII, Kenichi NISHIMURA, Michihiro KIBE, ...
    1988 Volume 28 Issue 6 Pages 588-593
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 24-year-old female in the sixth month of pregnancy developed headache and vomiting caused by an intraventricular hemorrhage from moyamoya vessels. Superficial temporal artery-middle cerebral artery bypass surgery was performed when she was in the seventh month of pregnancy in order to prevent intracranial rebleeding or a cerebrovascular ischemic attack during labor and delivery. The patient delivered successfully at full term, without complications. The clinical features and management of patients with such rare occurrences during pregnancy are discussed and seven previously reported cases are reviewed.
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  • —Case Report—
    Youichi ITOYAMA, Akinobu FUKUMURA, Yoshihiro ITOH, Ei-ichirou URASAKI, ...
    1988 Volume 28 Issue 6 Pages 594-597
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Nontuberculous pyogenic spinal infection (vertebral osteomyelitis) often favors the thoracic and lumbar regions but seldom involves the cervical levels. Recently we encountered a case of upper cervical spinal infection that produced sudden onset of quadriplegia. This patient was hypocalcemic due to vitamin D deficiency (osteomalacia), which may have predisposed him to the spinal infection. Appropriate treatment resulted in excellent recovery.
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  • —Case Report—
    Nobuhiko AOKI
    1988 Volume 28 Issue 6 Pages 598-600
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 22-year-old female with compensated hydrocephalus suffered head trauma and developed an intracerebral hematoma with ventricular rupture and subsequent decompensation of the hydrocephalic process. Her consciousness progressively deteriorated, and ventricular drainage was performed to normalize her extremely high intracranial pressure. This case provides important information concerning traumatic brain damage in patients with hydrocephalus.
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  • —Case Report—
    Nobuhiko AOKI
    1988 Volume 28 Issue 6 Pages 601-603
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    An elderly male became semicomatose, with aggravation of right hemiparesis, due to massive air collection in the subdural space immediately after craniotomy for wrapping of an aneurysm. A subdural tap disclosed very low pressure within the cranial cavity. The neurological manifestations were not caused by tension pneumocephalus, but were presumed to be secondary to downward deviation of the brain parenchyma. Rapid resolution of the neurological signs was achieved by replacement of the air with saline. In this pathological condition, which has been referred to as “sunken brain syndrome, ” neurological symptoms develop secondarily to downward displacement of the brain parenchyma. This complication should be kept in mind as a neurosurgical risk in patients with brain atrophy.
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  • —Case Report—
    Yoshihiko YOSHII, Junichi TOSA, Shingo TAKANO, Shizuo SHIRAI, Tetsuo O ...
    1988 Volume 28 Issue 6 Pages 604-609
    Published: 1988
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A choroid plexus papilloma (CPP) was discovered in the right lateral ventricle of a 16-month-old girl who presented with signs of increased intracranial pressure following a minor head trauma. The tumor was accompanied by communicating hydrocephalus, which, at surgery, was found not to obstruct the flow of cerebrospinal fluid (CSF). Electron microscopy revealed the fine structure of the tumor to be essentially that of normal choroid plexus. Although the tumor appeared to have the potential to be highly secretory, there was no evidence of hypersecretion of CSF in our ultrastructural study. Removal of the tumor alone was sufficient to reduce the hydrocephalus after some intervals.
    Because the volume of the CPP was two to three times that of normal choroid plexus and the dilated ventricle did not decrease in size immediately after surgery, it appears that communicating hydrocephalus with CPP does not result solely from hypersecretion of CSF by tumor cells. Additional causes may be an increase in the total CSF volume as a function of the tumor bulk and malabsorption of CSF due to a high CSF protein content.
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