Neurologia medico-chirurgica

Effects of ACNU and Cranial Irradiation on the Mouse Immune System

Ryuya YAMANAKA, Ryuichi TANAKA, Seiichi YOSHIDA, Hiroshi MORI, Norio T ...

1993 Volume 33 Issue 2 Pages 65-70
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.65

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The effects of ACNU and cranial irradiation on the immune system were studied in three groups of 90 mice: Group A, intraperitoneal injection of ACNU (30 mg/kg); Group B, single exposure of 10 Gy to the head; and Group C, intraperitoneal injection of ACNU (30 mg/kg) and single exposure of 10 Gy to the head. Peripheral white blood cell counts, spleen cell subsets, natural killer (NK) cell activity, lymphocyte blastogenesis, and production of interferon (IFN)-γ were analyzed once a week for 6 weeks after treatment. In Group A, NK cell activity decreased between weeks 4-5, concanavalin A blastogenesis decreased during weeks 1-5, and the levels of L3T4 (CD4) and Lyt2 cells (CD8) and IFN-γ production decreased during weeks 2-5. However, all tested parameters returned to the normal range at 6 weeks. In Group B, all parameters except for the L3T4 cell level and the IFN-γ production decreased during week 1, and returned to the normal range thereafter. The concentration of L3T4 cells decreased during week 2 and between weeks 5-6. The IFN-γ production increased during week 1, decreased during week 2, and returned to the normal range thereafter. In Group C, the suppressive effects were severe and continued for a longer period than in either Group A or B. Concanavalin A blastogenesis, L3T4 cell concentration, and IFN-γ production were still suppressed after 6 weeks. Therefore, intensive radiochemotherapy for brain tumor may suppress the immunological function.

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Experimental Investigations Concerning a New Liquid Embolization Method: Combined Administration of Ethanol-estrogen and Polyvinyl Acetate

Takayuki SUGAWARA, Akira TAKAHASHI, Ching Chan SU, Toshihiro SUGA, Tak ...

1993 Volume 33 Issue 2 Pages 71-76
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.71

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A new embolization agent combining ethanol-estrogen and polyvinyl acetate was evaluated angiographically and histologically in 18 canine renal arterial systems. Peripheral vessels of less than 100 μm diameter were obliterated by thrombus induced by ethanol-estrogen, and larger vessels were obliterated by polyvinyl acetate casts and⁄or thrombus. This embolization method is easily controlled and has fewer adverse effects, so is suitable for intravascular applications, especially in the head and neck regions.

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Pathological Anatomy of Autopsy Brain with Malignant Glioma

Masaru TAMURA, Chihiro OHYE, Yoichi NAKAZATO

1993 Volume 33 Issue 2 Pages 77-80
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.77

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The morphology of supratentorial malignant glioma was examined in autopsy brains from three anaplastic astrocytoma and 11 glioblastoma multiforme patients. Large histological preparations and routine preparations were used to investigate the primary lesion site, infiltration to adjacent brain, and cerebrospinal fluid (CSF) dissemination. The primary lesion sites showed active tumor growth with mass effect in three cases, necrotic tumor and brain with no or mild mass effect in nine, and no residual tumor in two. Tumor infiltration included extensive bilateral cerebral hemisphere infiltration in seven cases, moderate infiltration of one or two lobes in three, minimal infiltration just beyond the tumor bed in two, and no infiltration in two. Infiltration occurred along the fiber tract and subependymal tissue. CSF tumor cell dissemination occurred in the ventricular system in two cases, cerebral subarachnoid space in five, and spinal subarachnoid space in one. Small fibrillated cells and small anaplastic cells predominated in infiltrated lesions and CSF dissemination.

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Growth Hormone producing Pituitary Adenomas: MR Characteristics and Pre- and Postoperative Evaluation

Shushovan CHAKRABORTTY, Shizuo OI, Michio YAMAGUCHI, Norihiko TAMAKI, ...

1993 Volume 33 Issue 2 Pages 81-85
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.81

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Twelve patients with growth hormone-producing pituitary adenomas were investigated to evaluate correlations between magnetic resonance (MR) appearance and tissue characteristics, sellar expansion, suprasellar tumor extension, and tumor consistency. MR imaging could detect microadenomas with a characteristic enhancement delay of gadolinium-diethylenetriaminepenta-acetic acid in the surrounding normal pituitary gland. Macroadenomas and giant tumors appeared on T₂-weighted images as mostly high intensity, while varied greatly on T₁-weighted images. The signal intensities of growth hormone-producing adenomas were more homogeneous (80%) than those of other functioning and non-functioning adenomas on T₁-weighted images. However, there was no typical MR imaging for the tissue characteristics of the growth hormone-producing adenomas, and no particular correlation with suprasellar extension or consistency. Postoperative MR findings showed that the transcranial approach was superior for total or subtotal removal of large tumors, especially with suprasellar extension up to the upper third ventricle. The transsphenoidal approach can achieve a satisfactory decompressive effect on the optic chiasm, but more radical removal is required to achieve a normal hormone level.

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Intraforaminal Neurinoma in the Lumbosacral Region

Tsutomu KATO, Bernard GEORGE, Kraus Luc MOURIER, Guillaume LOT, Fran&c ...

1993 Volume 33 Issue 2 Pages 86-91
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.86

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A series of 12 patients with intraforaminal neurinomas in the lumbosacral space was reviewed. Our classification according to tumor extension relative to the affected root into intradural intra-arachnoid, intraforaminal extra-arachnoid, and extraforaminal types was useful in determining the best surgical approach to achieve root preservation and minimal postoperative deficits. Where sacrifice of roots was unavoidable, surprisingly few neurological deficits occurred.

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Hyperbaric Oxygen Therapy Adjunctive to Mild Hypertensive Hypervolemia for Symptomatic Vasospasm

Kiyotaka KOHSHI, Akira YOKOTA, Nobuhide KONDA, Masahiro MUNAKA, Hideok ...

1993 Volume 33 Issue 2 Pages 92-99
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.92

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The efficacy of hyperbaric oxygen (HBO) therapy was evaluated retrospectively in 43 patients who developed symptomatic vasospasm following acute aneurysm surgery. HBO therapy was given as an adjunct to mild hypertensive hypervolemia in 24 patients. Before HBO therapy, 17 patients had no infarct (Group 1), and seven had infarcts (Group 2) caused by vasospasm. A further 19 patients received mild hypertensive hypervolemia alone (Group 3). Cerebral infarcts developed in four Group 1 and 12 Group 3 patients. A good outcome 1 month after surgery was achieved by 13 Group 1 (76%), one Group 2, and seven Group 3 patients (37%). Fifteen of the 24 patients who received HBO therapy responded to HBO exposure, and 12 responding patients (80%) had a good outcome. During HBO exposure, electroencephalographic improvements were all accompanied by neurological improvements. There were no complications related to HBO therapy. HBO therapy adjunctive to mild hypertensive hypervolemia is helpful in preventing cerebral infarction associated with symptomatic vasospasm.

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Vertebral Artery Aneurysm at the Level of the Cervicomedullary Junction —Case Report—

Nobuhiko AOKI, Tatsuo SAKAI, Akihiro OIKAWA

1993 Volume 33 Issue 2 Pages 100-102
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.100

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A 39-year-old male presented with a ruptured vertebral artery aneurysm at the level of the cervicomedullary junction. Neuroradiological imaging demonstrated the aneurysm but not the anatomical relationships. Surgery in the chronic stage revealed that the aneurysm arose from the lowest part of the intradural vertebral artery. No vertebral artery proximal to the aneurysmal neck was identified in the intradural space. Clipping was difficult through the intradural approach. Acute treatment of such aneurysms requires control of the extradural vertebral artery with temporary clipping.

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Completely Thrombosed Giant Fusiform Aneurysm in a Young Patient —Case Report—

Kunitada HARA, Touru SHIROUZU, Toshinori WATANABE, Tomohiro FURUKAWA, ...

1993 Volume 33 Issue 2 Pages 103-107
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.103

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A completely thrombosed giant fusiform aneurysm of the peripheral anterior cerebral artery occurred in a 16-year-old female, with a familial and personal history of vascular headache for 4 or 5 years. She was admitted in a drowsy state with severe headache. Computed tomography revealed subarachnoid hemorrhage and intracerebral hemorrhage as a mottled and ring-like high-density area in the left paramedian frontal lobe not enhanced postcontrast. Left carotid angiography demonstrated an avascular mass and a 5 cm defect in the A₃ portion of the anterior cerebral artery. The rupture of the giant fusiform aneurysm was confirmed intraoperatively.

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Posttraumatic Cerebral Arterial Spasm —Case Report—

Mitsunobu IDE, Minoru JIMBO, Masaaki YAMAMOTO, Noriko TANAKA

1993 Volume 33 Issue 2 Pages 108-110
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.108

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Posttraumatic cerebral arterial spasm occurred in a 51-year-old male after a fall striking the left frontal region of the head. The initial computed tomography was identical to that of severe subarachnoid hemorrhage from ruptured aneurysm. He was neurologically stable for the 1st week following the accident, but his condition deteriorated rapidly, culminating in death due to severe delayed cerebral arterial spasm on the 15th day after injury. Postmortem examination revealed neither cerebrovascular abnormalities such as aneurysm or arteriovenous malformation nor evidence of torn arteries.

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The Use of Gore-tex Vascular Grafts in Microvascular Decompression for Patients with Hemifacial Spasm —Technical Note—

Totaro TAKEUCHI, Eishi KASAHARA

1993 Volume 33 Issue 2 Pages 111-113
Published: 1993
Released on J-STAGE: May 26, 2006

DOIhttps://doi.org/10.2176/nmc.33.111

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Microvascular decompression was performed in 10 hemifacial spasm patients using Gore-tex vascular grafts as a prosthesis. Postoperative complication (transient deafness) occurred only in one patient, and recurrence in none during follow-up of 1-51 months, indicating that Gore-tex is a very effective prosthesis.

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