Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 32, Issue 6
Displaying 1-9 of 9 articles from this issue
  • Shigeru MIYACHI, Makoto NEGORO, Takashi HANDA, Kenichiro SUGITA
    1992 Volume 32 Issue 6 Pages 323-327
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A combination of endoscope and high-pressure saline irrigation system was tested in the occlusion of experimental aneurysms, and angioplasty and fibrinolysis of vascular occlusive lesions in canine femoral arteries. Endoscopy provided detailed information about the aneurysmal orifice and lumen and aided balloon placement and detachment. Endoscopy visualized the dynamic changes accompanying thrombolysis and the fine intimal injury due to angioplasty invisible on angiography. Vascular endoscopy is valuable for pre-, intra-, and postoperative evaluation of intravascular interventions.
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  • Shozaburo UEMURA, Jun-ichi KURATSU, Jun-ichiro HAMADA, Susumu YOSHIOKA ...
    1992 Volume 32 Issue 6 Pages 328-332
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Seven cases of intracranial hemangiopericytoma were studied retrospectively to investigate the efficacy of radiation therapy. Tumor response evaluated by computed tomography and magnetic resonance imaging was obvious after 20-30 Gy irradiation. The total reduction rate was 80-90% and continued as long as 5-7 months after treatment. In five patients receiving radiation therapy before radical removal, the tumors were easily removed without massive hemorrhage. Histological inspection of specimens after irradiation showed a significant disappearance of tumor cells. Pyknosis frequently occurred in endothelial cells, and proliferating vessels with hyalinoid degeneration were also seen. Reticulin fibers between tumor cells were fewer, split, or absent. Preoperative radiation therapy is useful in the treatment of hemangiopericytoma involving considerable surgical risk. Postoperative radiation therapy should be given even if removal is complete.
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  • Fuyuki MITSUYAMA, Tetsuo KANNO, Vijanbra K. JAIN, Yutaka NAGATA, Sukeh ...
    1992 Volume 32 Issue 6 Pages 333-337
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A new modified rotation radiation method called “three-dimensional moving field radiation therapy” is described. The new method uses rotation in many planes while maintaining the same isocenter to achieve a good spatial dose distribution. This delivers a high dose to tumors and spares the surrounding normal structures. This easy method can be carried out using the equipment for conventional rotation radiation therapy.
     The new method was superior to the one plane rotation radiation therapy using a physical phantom with film, a chemical phantom using the iodine-starch reaction, and a new biological model using tumor cells. Treatment of six brain tumors irradiated with total air doses of 50-60 Gy caused no hair loss or radiation necrosis.
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  • Akihiro TAKAHASHI, Hiroyasu KAMIYAMA, Hiroyuki IMAMURA, Michio KITAGAW ...
    1992 Volume 32 Issue 6 Pages 338-341
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Two cases of true posterior communicating artery (PcomA) aneurysm are described. A 27-year-old female with subarachnoid hemorrhage demonstrated a saccular aneurysm at the branch of the anterior choroidal artery from the PcomA. The aneurysm was successfully clipped. A 23-year-old male involved in an automobile accident suffered from traumatic subarachnoid hemorrhage. Computed tomography 10 weeks after head injury demonstrated a high-density mass in the right parasellar region, diagnosed as a traumatic aneurysm arising from the PcomA. The aneurysm was successfully clipped. Histological examination demonstrated findings consistent with true aneurysm.
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  • Toru SERIZAWA, Akira SATOH, Akihiro MIYATA, Shigeki KOBAYASHI, Masaru ...
    1992 Volume 32 Issue 6 Pages 342-345
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Two cases of ruptured cerebral aneurysm associated with coarctation of the aorta are presented. The aneurysms were successfully clipped in the acute stage prior to correction of the coarctation. Ruptured aneurysm should be treated as early as possible, and unruptured aneurysm should also be treated before aortic repair, if the general condition of the patient allows.
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  • Kazuhiro ITO, Jiro MUKAWA, Koichi MIYAGI, Eiichi TAKARA, Susumu MEKARU ...
    1992 Volume 32 Issue 6 Pages 346-350
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A rare case of a postmenopausal (60-year-old) female with lymphocytic adenohypophysitis manifesting as a sudden onset of diabetes insipidus is reported. Magnetic resonance imaging with gadolinium-diethylenetriaminepenta-acetic acid enhancement showed a spherical lesion, approximately 1 cm in diameter, in the sella turcica and a thickened, deviated pituitary stalk. The abnormal tissue was totally removed. Histological examination showed marked infiltration of lymphocytes and plasma cells. Postoperatively, the pituitary stalk became normal. Preoperative differentiation of lymphocytic adenohypophysitis from pituitary adenoma is extremely difficult, and biopsy is essential.
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  • Shuzo OKUNO, Jun-ichiro ISHIKAWA, Kazuhiko NOZAKI, Kazuo YAMAMOTO
    1992 Volume 32 Issue 6 Pages 351-355
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    Recurrent intracranial germinoma with multiple spinal metastases occurred in a 16-year-old male presenting with persistent headache and visual disturbances. Computed tomography revealed enhanced lesions in the pineal region, anterior horn, and infundibulum. Conventional irradiation achieved remission, but local recurrences requiring further irradiation occurred after 23 months. Magnetic resonance imaging showed multiple spinal metastases 11 months later. Partial removal of the spinal lesions gave a histological diagnosis of typical germinoma. Postoperatively, intracranial recurrences were again detected. Chemotherapy consisting of intravenous cisplatin and etoposide achieved remission and no recurrence has occurred for 12 months.
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  • Jun NIWA, Keiji SUETAKE, Tohru OKUYAMA, Hiroki HIRAI
    1992 Volume 32 Issue 6 Pages 356-359
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    A 9-year-old girl underwent total removal of a cerebellar astrocytoma complicated by hydrocephalus after postoperative meningitis, requiring a ventriculoperitoneal shunt. Five months later, headache, vomiting, and gait disturbance appeared and computed tomography detected enlarged fourth ventricle. A fourth ventriculoperitoneal shunt resulted in immediate relief of all symptoms. After 2 months, obstruction of the peritoneal tube required shunt reconstruction. This recurred three times in 8 months. At the last operation, tumor cells were detected in the cerebrospinal fluid and the substance clogging the tube. This suggested that the tumor had recurred and clogging by tumor cells had caused the repeated episodes of isolated fourth ventricle. Radiation therapy prevented further shunt obstruction and achieved remission of all signs and symptoms.
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  • Kiyonobu IKEZAKI, Keisuke TODA, Masamitsu ABE, Kazuo TABUCHI
    1992 Volume 32 Issue 6 Pages 360-364
    Published: 1992
    Released on J-STAGE: June 20, 2006
    JOURNAL FREE ACCESS
    An unusual case of a pediatric epidermoid tumor entirely located in the cavernous sinus is reported. A 6-year-old boy presented with left abducens nerve paresis which developed over 2 months. Neuroimaging demonstrated a lesion in the left cavernous sinus. Part of the tumor capsule and the pearly contents were removed by the left pterional approach through Dolenc''s anterolateral triangle. No bleeding from the cavernous sinus occurred. The tumor was histologically identified as an epidermoid tumor. Postoperatively, the abducens nerve paresis improved. The presence of dural reflection in the lateral wall of the cavernous sinus and displacement of the intracavernous internal carotid artery are useful indicators for intracavernous lesions.
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