Neurologia medico-chirurgica

Characterization of Immobilized Anti-CD3 Antibody-activated T Lymphocytes for Use in Adoptive Immunotherapy of Patients with Brain Tumors

Takamasa YAMAZAKI, Teruaki SEKINE

1992 Volume 32 Issue 5 Pages 255-261
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.255

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Large numbers of T lymphocytes were successfully cultured for use in adoptive immunotherapy using immobilized anti-CD3 antibody. This method allows more than 1.5 × 10¹⁰ T lymphocytes to be cultured within 2 weeks from only 20 ml of blood. Proliferated T lymphocytes were less cytotoxic than lymphokine-activated killer cells induced with a high dose of interleukin-2, but were more specific for autologous tumor cells as determined by cold target competition. Signal transduction of anti-CD3 antibody induced a population of CD8 positive cells, i.e. cytotoxic T lymphocytes. Adoptive immunotherapy using autologous lymphocytes requires a sufficient number of lymphocytes and high induced cytotoxic activity. This method is promising for clinical adoptive immunotherapy of patients with brain tumors.

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Accessory Middle Cerebral Artery and Duplication of Middle Cerebral Artery

—Terminology, Incidence, Vascular Etiology, and Developmental Significance—

Haruaki YAMAMOTO, Tohru MARUBAYASHI, Tohru SOEJIMA, Shigeaki MATSUOKA, ...

1992 Volume 32 Issue 5 Pages 262-267
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.262

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A series of 455 bilateral carotid angiographies included 14 accessory middle cerebral arteries (AccMCAs) and seven duplication of middle cerebral arteries (Dup-MCAs). The branching patterns of Dup-MCA could be classified as “direct bifurcation” from the internal carotid artery, since most lacked the essential bifurcation or trifurcation at the distal end of the M, portion. On the other hand, Acc-MCAs are probably residual congenital arteries. These anomalous MCAs were apparently associated with epilepsy. Five Acc-MCAs were associated with anterior communicating artery aneurysm at the origin. In addition, a rare case of Dup-MCA with arteriovenous malformation at its origin was found.

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Prediction of Motor Function by Magnetic Brain Stimulation in Patients with Intracerebral Hematoma

Seigo NAGAO, Nobuyuki KAWAI

1992 Volume 32 Issue 5 Pages 268-274
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.268

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Corticospinal motor pathways were monitored with motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation in 13 patients with radiologically confirmed hypertensive intracerebral hemorrhage and varying degrees of hemiparesis. The electromyographic responses of the thenar muscles were recorded. The motor weakness of the upper extremity was assessed at initial monitoring and 3 months after hemorrhage, and correlated with changes in MEP. Absence of MEP in the acute stage indicated poor recovery of muscle strength. No false negative results were seen in our series. The presence of MEP in a completely hemiplegic patient predicted some recovery of motor function. The suppression of amplitude was more accurate than prolongation of latency in predicting the functional recovery. MEP monitoring of patients with hypertensive intracerebral hemorrhage in the acute stage can predict the outcome of motor function.

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Intramedullary Subependymoma with Neurofibromatosis —Report of Two Cases—

Satoshi NAKASU, Yoko NAKASU, Akira SAITO, Jyoji HANDA

1992 Volume 32 Issue 5 Pages 275-280
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.275

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Two cases of subependymoma in the cervical spinal cord associated with stigmata of neurofibromatosis are reported. Magnetic resonance (MR) imaging showed one tumor with a sharp margin, which was well-demarcated intraoperatively and was totally removed. MR imaging showed the other tumor with an irregular margin, which was partly invasive at operation. Subependymomas are rare in the spinal cord and these are the first reported associations with neurofibromatosis.

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Intracranial Seeding Following Surgery for Spinal Cord Astrocytoma —Case Report—

Hiromichi UMEZU, Yojiro SEKI, Tadashi AIBA, Shoji MATSUYA

1992 Volume 32 Issue 5 Pages 281-284
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.281

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We report a case of intracranial dissemination developing approximately 6 months after partial removal of a spinal cord astrocytoma in a 40-year-old male. The clinical course and postmortem findings indicate that the tumor originated in the cervical cord and extended into the subarachnoid space, first the spinal canal and later intracranially. Spinal cord glioma dissemination through the cerebrospinal fluid is more common than previously considered and indicates a dismal prognosis. An aggressive approach, including radical surgery, entire neuraxis irradiation, and adjuvant chemotherapy, is suggested as the initial treatment for malignant spinal cord glioma to prevent subsequent dissemination.

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High Cervical Intradural Lipoma —Case Report—

Kohsuke YAMASHITA, Yasuhiro YONEKAWA, Teruaki KAWANO, Tetsuya TSUKAHAR ...

1992 Volume 32 Issue 5 Pages 285-288
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.285

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A rare high cervical intradural subpial lipoma unassociated with spinal dysraphism manifested by a slowly progressive myelopathy simulating Brown-Sequard syndrome in a 37-year-old male. The diagnosis was based on neuroradiological imaging. Intraoperative recording of somatosensory evoked potentials showed recovery of the prolonged N₂₀ latency, indicating adequate decompression was achieved.

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Persistent Trigeminal Artery Associated with Brainstem Infarct —Case Report—

Fumiyuki MOMMA, Susumu OHARA, Takashiro OHYAMA

1992 Volume 32 Issue 5 Pages 289-291
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.289

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A 47-year-old male presented with a sudden onset of right hemiparesis and numbness of the left face. Magnetic resonance imaging demonstrated a lacunar infarct in the ventral pons. Cerebral angiography demonstrated a persistent trigeminal artery (PTA) anastomosing the left internal carotid artery to the distal basilar artery. Bilateral vertebral arteries and the basilar artery below the PTA junction were extremely hypoplastic. The bilateral posterior communicating arteries were embryonic. The posterior fossa circulation was almost independent from the circle of Willis. The poor vascular supply to the posterior fossa probably caused the brainstem infarct.

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Coexistence of Extracranial Internal Carotid Artery Aneurysm and Multiple Intracranial Aneurysms —Case Report—

Hiroshi TOKIMURA, Koji TODOROKI, Tetsuhiko ASAKURA, Masayuki ATSUCHI, ...

1992 Volume 32 Issue 5 Pages 292-295
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.292

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A rare case of extracranial internal carotid artery (ICA) aneurysm coexisting with intracranial multiple aneurysms in a 64-year-old female is reported. The three intracranial aneurysms were clipped uneventfully by two-stage craniotomies. The extracranial ICA aneurysm at the infratemporal region was excised through a high cervical route and ICA was reconstructed by an end-to-end direct anastomosis. Ours is the first case reported of extra and intracranial aneurysms surgically treated successfully.

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Anomalous Origin of the Anterior Cerebral Artery and Congenital Skull Dysplasia —Case Report—

Hiroaki ONISHI, Junkoh YAMASHITA, Fumihide ENKAKU, Hirosuke FUJISAWA

1992 Volume 32 Issue 5 Pages 296-299
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.296

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A 37-year-old male had a ruptured anterior communicating artery aneurysm associated with an anomalous right anterior cerebral artery originating from the right internal carotid artery immediately distal to the ophthalmic artery and running between the optic nerves. The anomaly was associated with congenital skull dysplasia and other systemic bone anomalies, apparently an incomplete form of cleidocranial dysostosis. The aneurysm was successfully clipped with hematoma evacuation.

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Spontaneous Epidural Hematoma from a Hepatocellular Carcinoma Metastasis to the Skull —Case Report—

Yoshio NAKAGAWA, Eiji YOSHINO, Kenzo SUZUKI, Atsushi TATEBE, Hiromu AN ...

1992 Volume 32 Issue 5 Pages 300-302
Published: 1992
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.32.300

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A rare case of acute epidural hematoma originating from a hepatocellular carcinoma metastasis to the skull in a 52-year-old male is reported. The skull metastasis and epidural hematoma were completely removed, but he died of large liver tumor. Histological examination of the removed tumor showed many sinusoid-like blood vessels, which probably lead to hemorrhage and formation of epidural hematoma.

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