Neurologia medico-chirurgica

Characteristics of Histamine Receptors in Human Cerebral Arteries

Takuji TAKAGI, En-Chow TAN, Shoji SHIBATA

1993 Volume 33 Issue 10 Pages 675-681
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.675

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Histamine and 2, 2-pyridylethylamine, an H₁-receptor agonist, (both 10^-8-10^-3 M) caused contraction of human cerebral artery preparations in the absence of active tension, while dimaprit, an H₂-receptor agonist, caused vasorelaxation. The histamine-induced vasoconstriction was blocked non-competitively by tripelennamine, an H₁-receptor antagonist. In the presence of cimetidine, an H₂-receptor antagonist, histamine-induced contraction was enhanced. The histamine-induced contraction was not affected by phentolamine or propranolol, but abolished by nifedipine. In prostaglandin F_2α-precontracted arteries, histamine and dimaprit caused relaxation, while 2, 2-pyridylethylamine had no apparent effect. Histamine-induced relaxation was much greater in the presence than in the absence of an H₁-antagonist. The vasorelaxation induced by histamine in the presence of an H₁-antagonist was also inhibited by an H₂-antagonist. Histamine caused no apparent relaxation in precontracted preparations without endothelium. The present results provide further evidence that histamine causes either vasocontraction or vasodilation in human cerebral arteries, and suggest that vasocontraction and vasorelaxation are due to the activation of H₁- and H₂-receptors, respectively. The relaxation induced by histamine may also be related to the endothelium-derived relaxing factors released from endothelial cells.

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Roles of Embryonic Astrocytes and Schwann Cells in Regeneration of Adult Rat Dorsal Root Axons: Qualitative Observations

Kenji KIKUCHI, Alan TESSLER, Masayoshi KOWADA

1993 Volume 33 Issue 10 Pages 682-690
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.682

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Transplants of fetal spinal cord support regeneration of severed dorsal root axons and allow synapse formation. To analyze the components of the transplants that provide this favorable environment, we studied whether or not 1) the embryonic spinal cord transplants contain Schwann cells, a major producer of laminin, and 2) whether dorsal roots regenerate into transplants of immature astrocytes. We used calcitonin gene-related peptide (CGRP), laminin and glial fibrillary acidic protein (GFAP) immunocytochemistry to identify regenerated axons, Schwann cells and astrocytes, respectively. CGRPimmunoreactive axons regenerated into embryonic day 14 fetal spinal cord transplants, but the transplant did not contain laminin. Dorsal roots immunoreactive for CGRP also regenerated into suspensions of cultured astrocytes. The transplanted astrocytes also favored the expression of laminin and GFAP. CGRP-labeled axons regenerated and distributed widely into the polycarbonate tubes coated with poly L-lysine and containing medium with or without cultured astrocytes. These results indicate that Schwann cells are not likely to account for dorsal root regeneration into transplants of fetal spinal cord and that astrocytes may in fact induce regeneration. Regeneration may also take place in response to various environments.

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Chronic Subdural Hematoma May be Preceded by Persistent Traumatic Subdural Effusion

Keiji MURATA

1993 Volume 33 Issue 10 Pages 691-696
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.691

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The incidence of traumatic subdural effusion (TSE) was analyzed to clarify the relationship with subsequent chronic subdural hematoma (CSH) in 500 patients with head injury evaluated over a 36-month period. TSE occurred in 108 patients (21.6%), and CSH developed in 29 (5.8%) of these. The incidence of TSE was high, although only hospitalized patients were included because of the necessity for serial computed tomography. TSE frequently developed into CSH, and all CSH followed TSE. Therefore, TSE is closely associated with CSH and subdural effusion is probably a preliminary stage necessary for the formation of CSH.

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Epidermoid Cysts of the Callosal Region —Three Case Reports—

Shigeru FURUHATA, Fumito YAMADA, Sakae FUKUDA, Mitsuhiro OTANI, Shigeo ...

1993 Volume 33 Issue 10 Pages 697-699
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.697

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Three patients with rare epidermoid cyst in the callosal region are described, two adjacent and one in the corpus callosum. Computed tomography revealed atypical features, i.e. a large, well-defined highdensity mass unenhanced postcontrast and a well-defined hypodense mass with marginal calcification in one case each. Such a diffuse high-density mass may be caused by hemorrhage, highly concentrated protein or calcification of keratinized debris within the cyst. Marginal calcification may occur for unknown reasons. The cysts were subtotally removed.

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Treatment of Anterior Sacral Meningocele —Case Report—

Akihiko HINO, Shigenobu TAKETOMO, Takeki IWASAKI

1993 Volume 33 Issue 10 Pages 700-702
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.700

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A 30-year-old female presented with a long history of dysmenorrhea and severe constipation. Radiological evaluation and magnetic resonance imaging revealed findings characteristic of an anterior sacral meningocele. Surgical treatment through the posterior transsacral approach failed, because the neck and orifice of the meningocele were too large to perform a simple neck ligation. A second operation successfully resected the connecting dural stalk of the meningocele and reconstructed the thecal sac. Microsurgical reconstruction of the thecal sac through the transsacral approach is a favorable option even for a large meningocele with a wide neck and ostium.

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Penetrating Injury of the Transverse Sinus by a Nail-gun —Case Report—

Takashi OKADA, Kazuya FUTAMI, Hironobu MUKAI, Kiyonobu IKEDA, Junkoh Y ...

1993 Volume 33 Issue 10 Pages 703-705
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.703

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A 46-year-old male presented with a penetrating injury of the transverse sinus caused by a nail-gun. Open craniotomy reflected a doughnut-shaped bone flap and the 45 mm long nail, which was fortunately only touching the edge of the sinus, successfully removed. A wide surgical exposure and careful manipulation of the embedded nail are important to avoid inadvertent injury to the venous sinus and the surrounding brain tissues during the surgical procedure.

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Intracranial Cavernous Angioma Manifesting as Subarachnoid Hemorrhage —Case Report—

Masaaki YAMAMOTO, Takeo FUKUSHIMA, Koichi IKEDA, Susumu NAGASAKA, Seis ...

1993 Volume 33 Issue 10 Pages 706-709
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.706

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A 56-year-old male presented with a posterior fossa cavernous angioma manifesting as persistent headache with mild neck stiffness. Lumbar puncture revealed subarachnoid hemorrhage (SAH). Repeated four-vessel angiography failed to identify the source of the SAH. Magnetic resonance (MR) imaging demonstrated multiple small lesions in the posterior fossa and cerebral hemispheres, and the SAH. A mass arising from the biventral lobule of the right cerebellar hemisphere extended exophytically into the cisterna magna with intratumoral hemorrhage. These findings were compatible with the presumptive diagnosis of SAH from the mass at the right biventral lobule. The lesion was totally removed through a suboccipital craniectomy without sequelae. The histological diagnosis was cavernous angioma. Intracranial cavernous angioma presenting only as SAH has never been reported before. The use of MR imaging in establishing the diagnosis of vascular malformations is emphasized, particularly when neither computed tomography nor angiography can adequately visualize the origin of SAH.

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Unusual Meningeal Tuberculoma —Case Report—

Tomohisa OKADA, Tazuka YOSHIDA, Takahiko ASAI, Akira SHINTANI

1993 Volume 33 Issue 10 Pages 710-712
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.710

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A 60-year-old male presented with bilateral papilledema. Neuroimaging showed a densely enhanced flat tumor within the interhemispheric region in the frontal and parietal lobes with sulcal obliteration and enhancement. There was no history of tuberculous infection. Histological examination of the excised tissue from the flat tumor within the interhemispheric region was consistent with tuberculoma. Multiple antituberculous agent therapy resolved the papilledema and reduced the tumor.

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Management of a Broken Atrial Catheter Migrated into the Heart: A Rare Complication of Ventriculoatrial Shunt —Case Report—

Takahisa MORI, Masahiko ARISAWA, Masaaki FUKUOKA, Kazuumi TAMURA, Masa ...

1993 Volume 33 Issue 10 Pages 713-715
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.713

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A 21-year-old male, who had undergone a ventriculoatrial shunt for hydrocephalus 5 years previously, became stuporous. A roentgenogram revealed that the distal segment of the broken atrial catheter had migrated and become lodged in the heart. Because the fragment had not adhered to the myocardium, it was easily retrieved by the transvenous approach with a retriever catheter. If the migrated catheter does not adhere to the myocardium, transvenous catheter retrieval is absolutely necessary. If, however, the migrated catheter adheres to the myocardium, an open thoracotomy would be required for retrieval, or the alternative of warfarin administration without retrieval may be the treatment of choice, as long as other problems do not occur.

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Transbrachial Approach with Turn Over Technique for Selective Cerebral Angiography —Technical Note—

Hajime TOUHO, Jun KARASAWA, Hideyuki OHNISHI, Hiroyuki NAKASE, Yasuhar ...

1993 Volume 33 Issue 10 Pages 716-718
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.716

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A new technique to obtain selective internal carotid, external carotid and vertebral artery angiograms through the transbrachial route using a special 4-Fr long catheter and long guidewire positioned by a turn over technique is described. The technique was used in 25 geriatric patients to obtain angiograms without persistent complications.

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Three-dimensional Hi-Vision System for Microneurosurgical Documentation Based on Wide-vision Telepresence System Using One Camera and One Monitor

Hiroshi OKUDERA, Shigeaki KOBAYASHI, Kazuhiko KYOSHIMA, Hiroshi SAITO, ...

1993 Volume 33 Issue 10 Pages 719-721
Published: 1993
Released on J-STAGE: June 20, 2006

DOIhttps://doi.org/10.2176/nmc.33.719

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A three-dimensional (3-D) high-definition television (Hi-Vision) system suitable for attachment to a stereoscopic operating microscope allowing 3-D medical documentation using one Hi-Vision camera and one Hi-Vision monitor is described. The system provides 3-D high-definition microneurosurgical recorded images suitable for viewing on a screen or monitor, or for printing.

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