Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 34, Issue 1
Displaying 1-10 of 10 articles from this issue
  • Shigeki IMAIZUMI, LeeHong CHANG, Yoram COHEN, Pak H. CHAN, Philip R. W ...
    1994 Volume 34 Issue 1 Pages 1-9
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    This study investigated the correlation between in vivo serial T2-weighted magnetic resonance (MR) imaging and changes in superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities, and water, sodium ion (Na+), and potassium ion (K+) contents measured in vitro using rat brain following right middle cerebral artery occlusion in conjunction with bilateral common carotid artery (CCA) occlusion. One hour later the left CCA was released. Serial MR images showed edema developed from the outer cortex towards the center. The T2 signal intensity of the injured right cortex increased with time compared to that of the contralateral cortex. Increased Na+ and water and decreased K+ contents occurred in the injured cortex, indicating that serial T2-weighted MR imaging reflects the changes in water content and Na+ and K+ concentrations determined by biochemical techniques. GSH-Px activity was little changed. Total SOD in the injured cortex decreased 1 hour after ischemia and remained low throughout the experiment. In contrast, SOD activity in the noninfarcted left cortex also decreased after 1 hour but returned to normal after 2 hours of ischemia. Our results suggest that oxygen free radicals are important in developing ischemic brain edema and cerebral infarction.
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  • Katsuhisa KAWAJIRI, Yoshimi MATSUOKA, Koji HAYAZAKI
    1994 Volume 34 Issue 1 Pages 10-14
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 16-year-old male with cerebellar astrocytoma and a 29-year-old male with convexity meningioma, both complicated by hydrocephalus, developed pneumocephalus following tumor removal and shunt emplacement. Both patients underwent ventriculoperitoneal shunt emplacement and total tumor removal, and were discharged from hospital in good condition. After 1 year or 10 months, respectively, pneumocephalus and porencephalic cysts in the temporal lobes developed. Since neuroradiological examination could not locate the bone defects in the skull base, the dura mater covering the anterior cranial fossa was repaired. Fistulae were observed in the cribriform plate in both patients. Postoperatively, one patient showed persistent cerebrospinal fluid rhinorrhea. Intratympanic cerebrospinal fluid retention was demonstrated by tympanic puncture ipsilateral to a porencephalic cyst. The other patient again developed pneumocephalus. Magnetic resonance imaging indicated that the base of the porencephalic cyst was in contact with the tegmen tympani. The dura mater covering the floor of the middle cranial fossa was repaired in both patients, and the symptoms ameliorated. The bone defects in the skull base were apparently deeply involved in the development of the porencephalic cysts, indicating that such cysts provide useful information for locating cranial bone defects.
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  • Satoshi KURODA, Hiroyasu KAMIYAMA, Hiroshi ABE, Katsuyuki ASAOKA, Kenj ...
    1994 Volume 34 Issue 1 Pages 15-19
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 64-year-old female with occlusion of the left internal carotid artery (ICA) developed temporary neurological deterioration after superficial temporal artery to middle cerebral artery anastomosis. Preoperative single photon emission computed tomography (SPECT) showed marked reduction of the cerebral perfusion reserve in the left ICA territory. She suddenly developed aphasia 18 hours after operation. Follow-up SPECT revealed temporary hyperperfusion in the left temporal lobe, strongly suggesting that this unusual complication resulted from bypass flow into the brain tissue with chronic severe ischemia and impaired autoregulation.
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  • Toshihiko KUROIWA, Harushi TANABE, Hiroyuki TAKATSUKA, Motohiro ARAI, ...
    1994 Volume 34 Issue 1 Pages 20-22
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 19-year-old male was admitted following a blow to the face. Computed tomographic (CT) scans 1 hour after injury revealed low-density areas in the bilateral thalami and midbrain, which were enhanced postcontrast except for the core 3 hours later. CT scans 2 days after injury revealed that the size of the low-density areas had increased. CT scans and magnetic resonance images 3 weeks after injury disclosed only small infarcted lesions in the bilateral thalami, the right side of the midbrain, and the left internal capsule. These findings suggest that the injury initially caused thrombus on the basilar arterial wall, leading to occlusion of the perforators, but almost all affected perforators were recanalized. Bilateral thalamic infarction resulting from head injury is unusual, as is the transient nature of the infarction in this case.
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  • Seiya KATO, Hirobumi SEKI, Keiji KOSHU
    1994 Volume 34 Issue 1 Pages 23-26
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 54-year-old male presented with spontaneous acute epidural hematoma in the ventral cervical spine. The neurological deficits gradually improved spontaneously before surgery commenced. Serial magnetic resonance imaging demonstrated disappearance of the hematoma. He was managed conservatively and was discharged without deficits about 1 month after onset. Immediate surgical decompression may not be necessary if neuroimaging and clinical examinations suggest that spinal epidural hematoma will resolve spontaneously.
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  • Shigeo MATSUMOTO, Toyoshiro YAMAMOTO, Sadahiko BAN, Takahiko MOTOZAKI, ...
    1994 Volume 34 Issue 1 Pages 27-29
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 62-year-old female was admitted with complaints of sudden proptosis of the left eye and severe left orbital pain without history of trauma or previous illness. Computed tomography and magnetic resonance imaging demonstrated a biconvex extraconal hematoma in the upper part of the left orbit. Surgical exploration of the orbit revealed the presence of a subperiosteal hematoma without a causative lesion. Such spontaneous subperiosteal hematoma of the orbit is extremely rare, but may result from an occult vascular disorder.
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  • Kiyonobu IKEDA, Junkoh YAMASHITA, Sotaro HIGASHI
    1994 Volume 34 Issue 1 Pages 30-34
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 13-year-old boy with a rare giant fusiform aneurysm at the horizontal portion of the middle cerebral artery (M1) presented with progressively severe throbbing headache. The aneurysm was reconstructed by tandem application of nine fenestrated clips and coating of the remnant of the aneurysm. However, he was readmitted 3 months later because of recurrent aneurysms at the proximal and distal M1 portions which had been coated. The aneurysms were trapped after rupture occurred during a second operation. Aneurysm trapping combined with superficial temporal artery-middle cerebral artery bypass surgery may be a better method to treat such aneurysms.
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  • Chitoshi KADOYA, Yasunori MOMOTA, Ei-ichirou URASAKI, Shin-ichi WADA, ...
    1994 Volume 34 Issue 1 Pages 35-37
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 52-year-old female admitted for subarachnoid hemorrhage and preoperative angiography revealed bilateral symmetrical middle cerebral artery aneurysms, which were successfully clipped. Postoperative angiography revealed bilateral symmetrical aneurysms in the distal anterior cerebral arteries, which were not identified on the preoperative angiograms, and were also clipped successfully. Such multiple aneurysms should not be treated by bilateral approaches in a one-stage operation.
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  • Masashi TAMAKI, Kikuo OHNO, Tsutomu ASANO, Yasunari NIIMI, Toshiki UCH ...
    1994 Volume 34 Issue 1 Pages 38-43
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 54-year-old female presented with a cryptic arteriovenous malformation (AVM) of the choroid plexus of the fourth ventricle causing intraventricular hemorrhage. Computed tomography and magnetic resonance imaging disclosed the lesion near the fourth ventricle, but bilateral vertebral angiograms showed no abnormalities. The preoperative diagnosis was cavernous angioma. The mass was removed completely, and histological examination demonstrated an AVM of the choroid plexus. Vascular malformations of the choroid plexus of the fourth ventricle are extremely rare. The possibility of this lesion being the cause of primary intraventricular hemorrhage of unknown origin should always be considered.
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  • Shigeo MATSUMOTO, Toyoshiro YAMAMOTO, Kan-etsu OKURA
    1994 Volume 34 Issue 1 Pages 44-47
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 3-month-old boy presented with a tail associated with lipomeningocele. Computed tomography and magnetic resonance imaging clearly demonstrated the presence of spina bifida and lipoma continuous from the tail to the thickened conus medullaris. The human tail may be related to spinal dysraphism and requires detailed neuroimaging investigation, and possibly microsurgery to prevent the tethered cord syndrome.
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