Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 32, Issue 2
Displaying 1-10 of 10 articles from this issue
  • Takayuki SUGAWARA, Akira TAKAHASHI, Ching Chan SU, Toshihiro SUGA, Tak ...
    1992 Volume 32 Issue 2 Pages 59-64
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A new liquid embolization material applicable to intracranial lesions was evaluated by selective renal artery embolization in mongrel dogs. Absolute and diluted ethanol, estrogen, and estrogen in 25% ethanol (ethanol-estrogen) were injected. The embolization and side effects were investigated angiographically and histologically. Ethanol-estrogen caused similar embolization to absolute ethanol, but no direct damage to perivascular tissue, and is considered a promising embolization agent in intravascular surgery.
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  • —Histological Study of the Tumor Margin and Surrounding Brain—
    Mitsunobu IDE, Minoru JIMBO, Osami KUBO, Masaaki YAMAMOTO, Hirohisa IM ...
    1992 Volume 32 Issue 2 Pages 65-71
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Thirty-nine cases of intracranial meningiomas were analyzed to identify factors causing brain edema. Edema was significantly correlated with tumor size and the destruction of the leptomeninges and cortex. Meningotheliomatous meningioma tended to have more peritumoral edema. There was no correlation between the presence of edema and location of the tumor or histological features including lymphocytic infiltration and the presence of glial fibrillary acidic protein-positive cells in the tumor tissue. Larger tumors destroy the leptomeninges and cerebral cortex, allowing direct transmission of humoral edema-promoting factor or edema fluid into the white matter, resulting in vasogenic edema.
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  • Masaaki YAMAMOTO, Minoru JIMBO, Mitsunobu IDE, Noriko TANAKA, Yutaka U ...
    1992 Volume 32 Issue 2 Pages 72-79
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    The most suitable antibiotics for chemoprophylaxis in neurosurgery and risk factors for postoperative neurosurgical infection were investigated by retrospective analysis of 807 neurosurgical procedures in 566 patients between 1980 and 1989. Prophylactic antibiotics were administered intravenously for 6 or 7 postoperative days in all instances. The 807 operations were classified according to the antibiotics used into: 1) penicillin, 2) cephem-I, 3) cephem-Il, 4) cephem-III, and 5) others. Postoperative neurosurgical infections occurred in 27 of 807 operations (3.3%), or 27 of 566 patients (4.8%). Hypertension and surgery performed in summer carried a significantly higher risk of infection. Diabetes mellitus, steroid administration, prolonged surgery, re-exploration, and surgery for hemorrhagic cerebrovascular diseases were associated with increased risk, but were not statistically significant. Infection rates by type of chemoprophylaxis were: 3.6% in the penicillin group, 3.7% in the cephem-I group, 1.7% in the cephem-Il group, 5.7% in the cephem-III group, and 2.8% in the others group. This result indicates that the best choice for prophylactic antibiotic therapy may be a secondgeneration cephem.
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  • Shigekazu TAKEUCHI, Akimichi ICHIKAWA, Tetsuo KOIKE, Ryuichi TANAKA, H ...
    1992 Volume 32 Issue 2 Pages 80-83
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 17-year-old boy with known moyamoya disease developed an acute subdural hematoma after a mild head trauma. He had been confined to a wheelchair with contracture in the upper and lower extremities due to juvenile rheumatoid arthritis since age 1 year. He had undergone encephalo-duro-arteriosynangiosis (EDAS) on the right and encephalo-myo-synangiosis (EMS) on the left at 13 years of age. He was admitted with headache, nausea, and vomiting after a fall from his wheelchair at age 17. Computed tomography on admission showed a large acute subdural hematoma in the right frontotemporal region but no bleeding at the EDAS or EMS sites. Cerebral angiography 12 weeks after the head trauma revealed a remarkable reduction in the spontaneous transdural external-internal carotid anastomoses in the right frontal region. The acute subdural hematoma was probably caused by rupture of the spontaneous transdural anastomoses.
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  • Motoo KUBOTA, Osamu WATANABE, Manabu TAKASE, Takahiro HASHIMOTO
    1992 Volume 32 Issue 2 Pages 84-87
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 58-year-old female was readmitted with pulsatile tinnitus in the right ear 8 months after subtemporooccipital transtentorial clipping of a peripheral superior cerebellar artery aneurysm. On examination, she was normal except for pulsatile bruit over the right mastoid region. Angiography showed a fistulous communication between the muscular branches of the right vertebral artery and the deep cervical vein. The incision of the aneurysm surgery was supratentorial, so the only possible cause of the upper cervical arteriovenous (AV) fistula was fine gold acupuncture needles implanted for bronchial asthma 18 years before. The AV fistula disappeared spontaneously after 1 month, possibly because of thrombosis of the affected veins.
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  • Yoshikazu OKADA, Takeshi SHIMA, Masahiro NISHIDA, Kanji YAMANE
    1992 Volume 32 Issue 2 Pages 88-92
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 21-year-old male presented with visual disturbance followed by severe headache. Computed tomography showed right thalamic hemorrhage entering the right lateral ventricle. Cerebral angiography revealed bilateral symmetrical arteriovenous malformations (AVMs) fed by the lenticulostriate, anterior choroidal, and lateral posterior choroidal arteries and draining into the vein of Galen. Partial removal of the right AVM induced bleeding on the left side, probably due to postoperative hemodynamic changes. Bilateral symmetrical cerebral AVMs are extremely rare, but provide serious problems for surgical intervention in the deep cerebrum.
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  • Yoshihiro YAMAMOTO, Zhen WEINING, Takeo OHASHI
    1992 Volume 32 Issue 2 Pages 93-95
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    An intracavernous cavernous hemangioma occurred in a 34-year-old female presenting with amenorrhea and hyperprolactinemia. Computed tomography (CT) showed a homogeneously enhanced mass in the right cavernous sinus. The time-density curve detected by dynamic CT showed significant delayed flow in the lesion. The mass was significantly reduced in size by local irradiation (50 Gy). Dynamic CT may be useful in differentiating cavernous hemangioma, and radiation therapy should be considered for preferred treatment to surgical intervention.
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  • Yoshinobu IWASAKI, Ryo YAMAUCHI, Minoru AKINO, Toyohiko ISU, Hiroshi A ...
    1992 Volume 32 Issue 2 Pages 96-99
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 62-year-old female presented with multiple sacral nerve root cysts manifesting as localized unilateral perineal pain. Myelography just after contrast material injection revealed multiple cysts at the sacral level. However, perioperative dye injection showed hardly any flow in the reverse direction. Only the S3 nerve was constricted by hyperplasia of the dura mater, and adhered to the cyst wall. Other nerves were not constricted, nor adhered to cyst walls. The S3 nerve constriction and tight adhesion was the cause of the pain. The one-way flow of spinal fluid from the spinal subarachnoid space to the cysts is probably closely correlated with cyst formation.
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  • Naoyuki NAKAO, Kenji KUBO, Hiroshi MORIWAKI
    1992 Volume 32 Issue 2 Pages 100-103
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A case of cranial metastasis of hepatocellular carcinoma associated with epidural hematoma in a 58-year-old male is presented. The epidural hematoma demonstrated an unusual chronic clinical course and computed tomographic appearance. Associated bleeding from either the diploic marrow or emissary veins might be a cause of the slowly expanding hematoma, and the outward displacement of the artificial bone-flap implanted previously may also have contributed to the chronic course.
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  • Katsuyoshi MINEURA, Toshio SASAJIMA, Masayoshi KOWADA, Toshihide OGAWA
    1992 Volume 32 Issue 2 Pages 104-106
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 41-year-old male developed radiation-induced bilateral cystic frontal lobe necroses after irradiation for an olfactory neuroblastoma. Computed tomography (CT) and magnetic resonance (MR) imaging revealed the lesions, one containing a fluid-blood level on CT scans and niveau formation on MR images. It was proved to be a coagulated hematoma within the cyst at surgery. Such a fluid-blood level in a radiation-induced cyst has never been reported, although hemorrhage frequently accompanies delayed radiation necrosis. Positron emission tomography with multiple tracers may be useful in differentiating cerebral radiation necrosis from tumor recurrence, because of absence of abnormal tracer accumulation.
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