Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 29, Issue 1
Displaying 1-15 of 15 articles from this issue
  • Hisashi KOJIMA, Masayoshi KOWADA, Yohichi KATSUTA
    1989 Volume 29 Issue 1 Pages 1-5
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Using intact and transected hippocampal slices, we investigated the relationship between CA3 am CAI subfields in the generation of stimulus train-induced bursting. In intact slices, spontaneous burst, , in CA3 always preceded those in CA1, whereas after-discharge bursts in CA3 followed those in CA1 when it was possible to distinguish differences in the burst onset. After transection between CA3 anc CAI, neither spontaneous nor triggered bursts could be induced or maintained in isolated CA1, where only small after-discharge bursts with higher bursting frequency were observed. Some of the mecha. nisms underlying the generation of these stimulus train-induced bursts are discussed.
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  • Akira INOUE, Shinjirou SAITO, Hirofumi KITAMURA, Osamu NAKAI
    1989 Volume 29 Issue 1 Pages 6-9
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Tumor tissues obtained from two patients with growth hormone-producing pituitary adenomas were cultured and treated with bromocriptine, then examined for morphological changes. Untreated tumor cells (controls) were morphologically well preserved and in terms of growth hormone secretion. Tumor cells exposed to bromocriptine for 7 days contained many vacuoles, which, after 14 days of exposure, grew larger and more numerous. These vacuoles appeared to be extensions of endoplasmic reticulum: some were connected to rough or smooth endoplasmic reticulum or, occasionally, to Golgi apparatus, and there were ribosomes on their surfaces. Bromocriptine apparently has cytocidal effects on growth hormone-producing pituitary adenoma in vitro.
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  • Shigekazu TAKEUCHI, Haruhiko KIKUCHI, Jun KARASAWA, Sen YAMAGATA, Izum ...
    1989 Volume 29 Issue 1 Pages 10-14
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Regional cortical blood flow (rCBF) was measured with a thermal diffusion flow probe in 14 cortical regions of 12 young patients with moyamoya disease before and after completion of superficial temporal-middle cerebral artery anastomosis. The prebypass rCBF value was low in most patients, especially in the frontal regions. On temporary occlusion of the cortical artery during the surgical procedure, no significant drop in rCBF occurred. rCBF increased immediately after anastomosis in all but one region and continued to increase for 5-10 minutes in four of the eight regions measured. In the other four regions, rCBF declined gradually after the initial increase, and the final increase was slight. The average increase in rCBF was significant at 1-2 minutes and at 5-10 minutes after anastomosis. However, the latter increase did not bring the flow into the normal range. It may be that the initial increase in postbypass rCBF is determined solely by the pressure gradient between the donor and recipient arteries, and that subsequent rCBF is controlled by other factors within the brain. In one patient who underwent double anastomoses to the frontal and temporal lobes, neither anastomosis increased rCBF in the non-corresponding lobe to recipient artery. This suggests that there is no direct connection between supra and infra-Sylvian arteries and supports the concept of nonuniform epicerebral microcirculation in moyamoya disease.
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  • Ryuya YAMANAKA, Susumu SATOH
    1989 Volume 29 Issue 1 Pages 15-19
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Changes in cerebral blood flow (CBF) were measured and compared in 40 patients with putaminal hemorrhage who underwent either stereotactic hematoma aspiration or conservative treatment. There were no statistically significant differences in mean CBF or hemispheric CBF between the two treatment groups. Although there are claims of the superiority of surgery from the standpoint of integrated cortical function following mild putaminal hemorrhage, the results of this investigation indicate that conservative therapy is adequate in such cases, based on improvement in CBF.
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  • Tomoaki TERADA, Haruhiko KIKUCHI, Yoshihiro KURIYAMA, Izumi NAGATA, Se ...
    1989 Volume 29 Issue 1 Pages 20-25
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Dynamic computed tomographic (DCT) scans with iodine contrast enhancement were compared with simultaneously obtained xenon CT studies of cerebral blood flow (CBF) in 15 patients with subacute or chronic cerebrovascular ischemic disease. Specifically, the width and corrected first moment (cMTI), as demonstrated by DCT, were compared with the regional CBF (rCBF) data and the rCBF map obtained with xenon CT. The DCT and rCBF images were well correlated in patients without, but poorly correlated in those with, leptomeningeal anastomotic collateral circulation. The correlation of rCBF and 1/width with 1/cMTI was significant (r = 0.78, p < 0.01) in the former, but not in the latter. These data were thought to reflect a difference in the tracer inflow pattern between the patients with and those without leptomeningeal anastomoses. Our series did not include patients with acute cerebral infarction or recanalization, which are thought to be associated with marked changes in cerebral blood volume in the affected region. However, the influence of cerebral blood volume should be studied in detail in our subacute or chronic series.
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  • —Case Report—
    Hisanori YOSHIMOTO, Akihiko TAKECHI, Kenji SHIBATA, Keiji OHTA, Hirosh ...
    1989 Volume 29 Issue 1 Pages 26-28
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    We report a late middle-aged female in whom a renal angiomyolipoma was discovered by ultrasound after she developed hemorrhagic shock following surgery for a ruptured cerebral aneurysm. This appears to be the first reported case of the coexistence of a cerebral aneurysm and a renal angiomyolipoma. The associations between cerebral aneurysm and various other pathological conditions are discussed, and attention is directed to diagnostic techniques and characteristic findings.
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  • —Case Report—
    Kenji ARAI, Shunro ENDO, Yutaka HIRASHIMA, Akira TAKAKU
    1989 Volume 29 Issue 1 Pages 29-31
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 72-year-old male hospitalized for disturbance of consciousness and vomiting was found to have a left vertebral artery fenestration and a left posterior inferior cerebellar artery aneurysm. The aneurysm was successfully clipped through the lateral suboccipital approach and he recovered with minimal deficits. The association of vertebral artery fenestration and posterior inferior cerebellar artery aneurysm is rare. and their etiologies and relationship are discussed.
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  • —Case Report—
    Hiroaki YOKOYAMA, Masaki TSUJIMURA, Masahiko SHIMADA, Kazuo MORI
    1989 Volume 29 Issue 1 Pages 32-34
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 52-year-old female with a huge cavernous hemangioma in the middle cranial fossa received preoperative radiation therapy to reduce intraoperative bleeding from the tumor. Following irradiation the tumor decreased in size and was subtotally removed with ease. Preoperative irradiation is highly beneficial in such cases.
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  • —Case Report—
    Susumu ISHIKAWA, Satoshi KUWABARA, Atsushi FUKUMA, Hirotaka SEO, Seiic ...
    1989 Volume 29 Issue 1 Pages 35-39
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Computed tomography (CT) allows earlier diagnosis of intracranial cavernous angioma than was formerly possible. However, cerebellar lesions are uncommon. Cerebellar cavernous angioma with hemorrhage was diagnosed in a 54-year-old male who suddenly developed nausea and vomiting, then declined over the following week and developed ataxia and nystagmus. Blood pressure was normal, and he had no history of hypertension or hemorrhagic diathesis. Precontrast CT revealed an irregularly-shaped, hyperdense lesion in the left cerebellum and an associated hematoma. Injection of contrast medium did not significantly enhance the lesion. Vertebral angiography demonstrated only an avascular mass in the cerebellum. A semiliquid hematoma was evacuated and a vascular nodule was removed from the posterior wall of the hematoma cavity. The histopathological diagnosis was cavernous angioma.
    Nine sufficiently documented reports of cerebellar cavernous angioma are reviewed and the clinical and radiological features of these lesions are discussed.
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  • —Case Report—
    Yoshikazu OKADA, Takeshi SHIMA, Shigejiro MATSUMURA, Masahiro NISHIDA, ...
    1989 Volume 29 Issue 1 Pages 40-43
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 4-month-old infant was hospitalized following a generalized convulsion. Computed tomography showed a lesion of heterogeneous high density and a large low-density area in the right frontal lobe. At surgery, an angiomatous tumor was found within a large cyst containing bloody fluid. Histopathological diagnosis was a cavernous hemangioma. Only eight other cavernous hemangiomas in infants have been reported. The characteristic clinical features and computed tomographic findings of these cases are discussed.
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  • —Case Report—
    Shobu SHIBATA, Takafumi JINNOUCHI, Kazuo MORI
    1989 Volume 29 Issue 1 Pages 44-47
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 42-year-old male was found to have cerebral radiation necrosis 2 years after a split course of radiation therapy following subtotal excision of a left parasagittal meningioma. The surgical specimens were studied by means of conventional ultrathin sectioning and freeze-fracture replication techniques. The electron density of the capillary endothelium was decreased, as was the degree of surface infolding. The width was irregular, and there was an unusually large number of pinocytotic vesicleg (37/μm2). The endothelium was also discontinuous, and the basal laminae were irregular in thickness. The pericapillary space was markedly enlarged, and accumulation of a fibrin-like substance was noted in the extravascular space. The pericapillary zone contained inflammatory cells. However, the tight junctions were preserved and the intercellular junctions were composed of five strands that appeared to consist of continuous particles. The authors conclude that activated pinocytotic vesicles play an important role in increasing vessel permeability in delayed cerebral radiation necrosis and that leakage may occur through interruntions in the endothelium.
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  • —Case Report—
    Kumiko YOSHII, Shozo YAMADA, Tadashi AIBA, Syunji MIYOSHI
    1989 Volume 29 Issue 1 Pages 48-51
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A cerebellopontine angle lipoma accompanied by a bony protrusion from the left petrous pyramid was discovered in a 35-year-old female with a 10-year history of vertigo and a 3-year history of left tinnitus. Following subtotal removal of the tumor, the frequency of vertigo increased and she was deaf in the left ear. The symptoms, radiological and pathological features, and surgical management of this rare tumor are discussed.
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  • —Case Report—
    Shinichi NAKANO, Hisao UEHARA, Shinichiro WAKISAKA, Kazuo KINOSHITA
    1989 Volume 29 Issue 1 Pages 52-54
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 58-year-old female had a 1-year history of headache, ataxia, and taste disturbance and then developed speech disturbance. She was found to have a meningioma of the fourth ventricle, a very rare site for this type of tumor. It did not adhere to the cerebellar tentorium or dura mater and was totally removed without difficulty. Magnetic resonance imaging, but not computed tomography or angiography, provided adequate information for correct diagnosis. The literature concerning fourth ventricle meningiomas is reviewed and the diagnostic advantages and limitations of computed tomography, angiography, and magnetic resonance imaging are discussed.
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  • —Case Report—
    Hiroshi HASEGAWA, Shoji BITOH, Amami KATOH, Kazuyoshi TAMURA
    1989 Volume 29 Issue 1 Pages 55-59
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The authors report a rare case involving neurofibromatosis associated with bilateral vertebral arteriovenous fistulas and atlantoaxial dislocation. Multiple neurofibromas in the craniocervical junction appeared to be the cause of the atlantoaxial dislocation in this patient, and the dislocation might have contributed to the formation of the bilateral vertebral arteriovenous fistulas. The fistulas were successfully treated by a combination of balloon embolization and surgery followed by occipitocervical fusion.
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  • —Case Report—
    Masanori ITO, Kiyoshi SATO, Chikashi MARUKI, Taizo NITTA, Akira OHNUKI ...
    1989 Volume 29 Issue 1 Pages 60-64
    Published: 1989
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    It is well known that when Sturge-Weber syndrome manifests with seizures in early infancy, hemiparesis develops early, seizures become intractable, and motor weakness and mental retardation are progressive. In North America and Europe, early surgical intervention is recommended in such cases. However, neurosurgical management of Sturge-Weber syndrome has not been reported in Japan. The authors describe a 4-month-old boy with Sturge-Weber syndrome accompanied by intractable seizures who was successfully treated by a two-stage hemispherectomy. Two years postoperatively he remains free of seizures and is active, although his psychomotor development is moderately retarded. Surgical treatment of Sturge-Weber syndrome, including long-term results, is discussed in detail.
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