Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 31, Issue 3
Displaying 1-10 of 10 articles from this issue
  • Kazuyoshi MORIMOTO, Hiroyoshi SHIMIZU, Toru HAYAKAWA, Nobumitsu SHIMAD ...
    1991 Volume 31 Issue 3 Pages 129-134
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The concentrations of purine catabolites in the cerebral interstitial fluid during progression of and recovery from ischemia were studied using brain microdialysis and high-performance liquid chromatography. Sealed 0.5-mm hollow dialysis fibers were stereotactically implanted into either the cerebral cortex or hippocampus of ketamine anesthetized gerbils and perfused with artificial cerebrospinal fluid at 2μl/min. Cerebral ischemia was induced by occlusion of the bilateral common carotid arteries. The reflectance spectra of oxy- and deoxyhemoglobin at the brain surface were monitored over the scalp to assess ischemia and confirm recirculation. Ischemia caused a rapid, 4.8-fold increase in the extracellular concentration of adenosine. The progressive increase in the concentration of adenosine, inosine, and hypoxanthine soon after recirculation is particularly interesting. The subsequent decrease in purine compound concentration was rapid for adenosine but more gradual for inosine and hypoxanthine. Calculated K values for adenosine deaminase and purine nucleoside phosphorylase were 0.045/min and 0.016/min, respectively. However, no xanthine, uric acid, or purine nucleotides were found in the perfusate. These observations indicated the presence of purine catabolites in the cerebral interstitial space as well as consecutive degradation and recycling involving the interconversion of purine compounds by biochemical metabolic pathways.
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  • Motohiro MORIOKA, Tohru MARUBAYASHI, Tsutomu MASUMITSU, Tetsuya HORI, ...
    1991 Volume 31 Issue 3 Pages 135-140
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A gauze sponge wrapping method to prevent recurrent subarachnoid hemorrhage (SAH) after incomplete obliteration of intracranial aneurysm or a residual neck after clipping was developed and tested. The authors performed the gauze wrapping for aneurysms with incomplete obliteration by clipping alone, abnormal changes of the parent artery wall which had the possibility of regrowth or rerupture, and surgical difficulties. The residual neck of the aneurysm or the abnormal arterial wall was tightly and completely wrapped, including the parent artery, and cemented with plastic adhesive. Seventy-eight (22.3%) of 349 surgically treated aneurysms were treated by gauze wrapping (26 wrapping only, 52 clipping and wrapping). The incidence of complications such as infection, angiospasm, and normal pressure hydrocephalus, and the clinical outcome were not significantly different for the wrapping and non-wrapping groups. No recurrent SAH was observed in the wrapping group during 3 months to 8.5 years follow-up. These results suggest that wrapping with gauze sponge is useful in the treatment for ruptured aneurysms which cannot be totally obliterated.
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  • —Report of Two Cases—
    Takayuki TOKUNAGA, Minoru SHIGEMORI, Masaru HIROHATA, Yasuo SUGITA, Ju ...
    1991 Volume 31 Issue 3 Pages 141-145
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Simultaneous development of histologically different primary brain tumors aside from phacomatoses or previous irradiation is rare, and its preoperative diagnosis is still difficult. We report two such cases, a 49-year-old male with an acoustic neurinoma and a cerebellar hemangioblastoma and a 69-year-old female with a parietal convexity meningioma and an ipsilateral frontal lobe astrocytoma. The tumors in the first case developed closely, so some local stimulation probably acted as a developmental factor. However, the tumors in the second case developed in distant areas and were considered coincidental.
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  • —Report of Two Cases—
    Hirofumi OYAMA, Kazuhiko OKAMURA, Masao WATANABE, Shigetoshi NAKAMURA, ...
    1991 Volume 31 Issue 3 Pages 146-151
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    The authors report malignant glioma occurring in two sibling cases. The elder brother presented with right hemiparesis and hemihypesthesia at 14-year-old. Computed tomographic (CT) scanning demonstrated a low-density area in the left frontoparietal lobe. The tumor was partially removed. Histologic diagnosis was glioblastoma multiforme. Radiation therapy was given postoperatively, but he died due to tumor recurrence 15 months after onset. The younger sister was admitted comatose due to intratumoral bleeding at 19-year-old. CT scans showed a high-density area in the right temporal lobe. The tumor was excised subtotally. Histological diagnosis was malignant astrocytoma (grade III). Radiation therapy, chemotherapy (ACNU), and immunotherapy (interferon) were given postoperatively, but she died due to recurrence 34 months after onset.
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  • —Case Report—
    Michinori TANIMOTO, Shotaro TATSUMI, Shogo TOMINAGA, Shuji KAMIKAWA, T ...
    1991 Volume 31 Issue 3 Pages 152-155
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    Metastatic tumors in the choroid plexus are generally considered to be very rare. The authors present a case of lung large cell carcinoma with a single metastatic tumor in the choroid plexus of the lateral ventricle trigone. Precontrast computed tomographic (CT) scans showed an isodensity mass with extensive peritumoral edema, which was considerably enhanced on the postcontrast CT scans. Magnetic resonance (MR) images demonstrated the mass as a low-intensity area on the T, -weighted image and an iso-intensity area on the T2-weighted image. The tumor was clearly differentiated from the peritumoral edema by both CT and MR imaging. The diagnosis was confirmed by surgery.
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  • —Case Report—
    Yasushi SHIBATA, Akio HYODO, Koji TSUBOI, Yoshihiko YOSHII, Tadao NOSE
    1991 Volume 31 Issue 3 Pages 156-158
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A rare case of isolated cerebral varix of the left deep sylvian vein was discovered incidentally in an 11-year-old boy by computed tomographic scanning, magnetic resonance (MR) imaging, and cerebral angiography. MR imaging was most useful in diagnosis of cerebral varix. Review of 21 similar reported cases shows no significant in age, sex, location, or size character.
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  • —A Case Confirmed by Indium-111 Platelet Scintigraphy—
    Hidemitsu NAKAGAWA, Yoshinari ISAKA, Shin NAKAJIMA, Yoshikazu NAKAJIMA ...
    1991 Volume 31 Issue 3 Pages 159-161
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 47-year-old male presented with frequent transient ischemic attacks (TIAs) of weakness of the left upper extremity. Computed tomography demonstrated multiple infarcts in the right cerebral hemisphere. Cerebral angiography showed marked atheromatous changes at the siphon of the right internal carotid artery, characterized by wall irregularities and heterogeneous filling. Indium-111labeled platelet scintigraphy demonstrated abnormal tracer accumulation at the right carotid siphon. Following right carotid artery ligation, this abnormal platelet deposition was resolved and no further TIA was experienced. This suggests that the release of microthrombi from thrombogenic carotid atheroma contributes to embolic stroke.
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  • —Case Report—
    Shigeki KAMEYAMA, Yoshiho HONDA, Kenichi TANIMURA
    1991 Volume 31 Issue 3 Pages 162-164
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A rare association of moyamoya disease with intra and periventricular hemorrhage in an 8-year-old girl is presented. Angiography showed that the cause of hemorrhage was extravasation from the dilated anterior choroidal artery. Ventriculoperitoneal shunt and encephalomyosynangiosis have prevented clinical or neurological deficits for over 6 years.
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  • —Case Report—
    Noriaki KOJIMA, Norihiko TAMAKI, Satoshi MATSUMOTO, Masayasu FUJIWARA
    1991 Volume 31 Issue 3 Pages 165-168
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    A 68-year-old male presented with neurological deterioration after a lucid interval following head trauma. Computed tomographic (CT) scans on admission demonstrated a subdural hematoma in the right frontotemporal region accompanied by subarachnoid hemorrhage in the right Sylvian and interhemispheric fissures. The subdural hematoma was removed via a right frontotemporoparietal craniectomy. However, immediate postoperative CT scans revealed hemorrhage in the third and both lateral ventricles, apparently separate from the primary hemorrhages. Decompressive rupture of damaged subependymal veins is suggested as the cause of the delayed traumatic intraventricular hemorrhage.
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  • —Case Report—
    Naoyuki NAKAO, Yoshitsugu OIWA, Hiroshi MORIWAKI
    1991 Volume 31 Issue 3 Pages 169-172
    Published: 1991
    Released on J-STAGE: September 05, 2006
    JOURNAL FREE ACCESS
    An unusual case of posttraumatic porencephaly preceded by neither overt cerebral contusion nor hemorrhage is reported. The cerebral cortex just above the porencephalic cyst was found intraoperatively to be partially herniated into a fracture line, while the cortex elsewhere was completely intact. The porencephalic cyst communicated with the lateral ventricle. Apparently, brain herniation and the cyst-ventricle communication can be causative factors in the occurrence and growth of posttraumatic porencephaly.
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