Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 34, Issue 2
Displaying 1-10 of 10 articles from this issue
  • Hideo TAKIZAWA, Kazuaki SUGIURA, Motoki BABA, J. Douglas MILLER
    1994 Volume 34 Issue 2 Pages 65-69
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The distortion and stress distribution in the brain caused by putaminal hemorrhage were estimated by computer simulation using the finite element method (FEM). The two-dimensional model of a single cerebral hemisphere contained cortex, white matter, caudate nucleus, lenticular nucleus, thalamus, falx, and lateral ventricle. Five types of intracerebral hemorrhage were modeled at different locations in the lenticular nucleus. The models generated putaminal hematomas of various shapes influenced by the location of the bleeding points. Hematomas caused deformation of the brain, collapse of the lateral ventricle, and destruction of the internal capsule. The stress distributions revealed various patterns influenced by the site of bleeding. The stress in the area of the internal capsule corresponded to the extent of destruction of the internal capsule. This study suggests that FEM modeling of putaminal hemorrhage can provide a useful simulation.
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  • Takayuki KUROYANAGI, Hideaki HARA, Shigeaki KOBAYASHI
    1994 Volume 34 Issue 2 Pages 70-75
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The effect of acute cerebral occlusion on the distribution of cerebral perivascular nerves containing catecholamine, neuropeptide Y, and vasoactive intestinal peptide was studied in the three commonly used rat models of cerebral ischemia: Unilateral permanent middle cerebral artery (MCA) occlusion induced with an intraluminal thread technique; unilateral MCA occlusion produced by extraluminal electrocoagulation of the MCA; and transient arterial occlusion of the whole brain induced extracranially by the four-vessel clasp occlusion method for 30 minutes. Animals were sacrificed 3 days after occlusion and the distribution of the perivascular nerves of the MCA studied. Intraluminally occluded MCAs showed a similar distribution of perivascular nerves to those of contralateral and shamoperated MCAs. Extraluminally occluded MCAs demonstrated a marked decrease in perivascular nerves containing catecholamine and peptides while the contralateral MCAs showed normal distribution of the nerves. Extracranial occlusion caused no discernible change in the distribution of perivascular nerves in occluded and sham-operated animals. This study indicates that the different methods of cerebral arterial occlusion have variable effects on the perivascular innervation. Arterial occlusion induced by intraluminal or transient extracranial procedures does not impair cerebral perivascular innervation at least up to 3 days post-occlusion. In contrast, cerebral arterial occlusion by extraluminal electrocoagulation diminishes the perivascular nerves around the occluded cerebral artery.
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  • Masayuki TOMABECHI, Kazuhiro SAKO, Yukichi YONEMASU
    1994 Volume 34 Issue 2 Pages 76-80
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The distribution of exogenous 45Ca in the focal ischemia rat model (middle cerebral artery occlusion) was studied using 45Ca autoradiography. High 45Ca accumulations were observed in the frontal cortex and caudate-putamen corresponding with morphological damage shown by HE staining. Regional 45Ca concentrations were calculated from the optical density on the 45Ca autoradiograms. Rapid uptake of 45Ca in the ischemic brain occurred during the first 5 hours, and continued more slowly between 5 and 24 hours after ischemia. The area of 45Ca accumulation was also expanded between 5 and 24 hours. An area of low 45Ca concentration around the area of high accumulation developed 5 hours after ischemia, which presumably accumulated 45Ca between 5 and 24 hours after ischemia. The lower concentration of 45Ca in the periphery of ischemia may result from: 1) a decrease in the total amount of calcium due to narrowing of extracellular space accompanied by cytotoxic edema, and 2) delayed accumulation of exogenous 45Ca due to reduced clearance of extracellular fluid.
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  • Katsuzo KUNISHIO, Takashi OHMOTO, Tomohisa FURUTA, Kengo MATSUMOTO, Ak ...
    1994 Volume 34 Issue 2 Pages 81-85
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The postoperative recurrence rate was examined in 242 patients with intracranial meningiomas to identify correlations with age, location, histology, or extent of surgery (Simpson''s grade). There was no significant difference in the recurrence rate among the histological subtypes, but malignant meningiomas and hemangiopericytomas tended to recur earlier. Anterior basal meningiomas demonstrated a higher recurrence rate, but this depended on the feasibility of complete surgical removal. The recurrence rates significantly decreased in the order Simpson''s grade I surgery, grade II or III surgery, and grade IV surgery (p < 0.001). These results indicate that the most important factor to influence recurrence is the extent of surgical removal.
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  • Shoichiro KAWAGUCHI, Toshisuke SAKAKI, Shigeru TSUNODA, Tetsuya MORIMO ...
    1994 Volume 34 Issue 2 Pages 86-90
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    The outcomes of carotid endarterectomy (CEA) including long-term results in 121 patients (126 procedures) were retrospectively analyzed to identify the causes of operative morbidity. The angiographic internal carotid artery (ICA) stenosis was severe (> 70%) in 62 patients and moderate (50-70%) with ulceration in 64. The arterial wall was sutured primarily in 91 patients and with patch graft in 35. The outcomes 3 months after operation were good recovery in 86 patients, moderately disabled in 20, severely disabled in 11, and death in four. Three patients suffered operative morbidity (2.5%). During follow-up, three patients (2.6%) suffered transient ischemic attack on the operative side due to middle cerebral artery stenosis (50%) or ICA occlusion at the origin, and recurrent stenosis (40%) of the common carotid artery and ICA (1 each). In the latter two cases, the artery was primarily sutured. Improved therapeutic results require use of patch vein graft for the arterial wall suture, checking of the CEA patency, and prevention of intracranial ischemic events and hemorrhage due to associated lesions.
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  • Masaru TAMURA, Takashi SHIBASAKI, Satoru HORIKOSHI, Nobuo ONO, Akira Z ...
    1994 Volume 34 Issue 2 Pages 91-94
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    Eight patients with small gliomas (6 low-grade and 2 high-grade) localized in a single gyrus or less than 2 cm diameter were investigated using positron emission tomography and single photon emission computed tomography. All three tumors examined demonstrated hypermetabolism of amino acids. High-grade gliomas demonstrated hypermetabolism of glucose and high blood flow, but normal or low oxygen metabolism. High-grade gliomas also showed accumulation of 201Tl chloride and high or low accumulation of 123I-isopropyl iodoamphetamine. These indications allow preoperative diagnosis of the malignancy of small gliomas, which is important because small gliomas with high-grade malignancy need more extensive removal and adjuvant therapy.
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  • Yoshihisa OKA, Yoshiaki KUMON, Shinsuke OHTA, Saburo SAKAKI, Shiro OHU ...
    1994 Volume 34 Issue 2 Pages 95-99
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    Three patients with chronic subdural hematoma associated with middle fossa arachnoid cyst were treated by irrigating the hematoma through burr holes, because the symptoms were considered mainly due to increased intracranial pressure caused by the subdural hematoma. The symptoms disappeared immediately afterwards, so no surgery for the middle fossa arachnoid cyst was done. The patients were followed by magnetic resonance imaging. No subdural hematoma recurred during a postoperative period of 11 months to 2.5 years, and the arachnoid cyst reduced in size in two patients. We recommend irrigation of the subdural hematoma as the initial procedure of choice for such cases.
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  • Kohsuke YAMASHITA, Yoichi SUZUKI, Hideyuki YOSHIZUMI, Jun B. TAKAHASHI ...
    1994 Volume 34 Issue 2 Pages 100-103
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. Magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.
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  • Takumi ABE, Kiyoshi MATSUMOTO, Tohru ARUGA
    1994 Volume 34 Issue 2 Pages 104-107
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 48-year-old female presented with a unique combination of ruptured aneurysm of the right middle cerebral artery (MCA) manifesting as sudden loss of consciousness associated with arteriovenous malformation (AVM) in the right parietal lobe and left primitive trigeminal artery (PTA) variant. Angiography revealed the right MCA aneurysm, AVM fed by the right anterior cerebral artery and MCA, and contralateral PTA variant. The PTA variant was an anomalous posterior cerebral artery originating from the ipsilateral cavernous internal carotid artery. The neck of the aneurysm was successfully clipped and the AVM was totally removed.
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  • Hiromichi UMEZU, Tetsuro SANO, Tadashi AIBA, Masamitsu UNAKAMI
    1994 Volume 34 Issue 2 Pages 108-110
    Published: 1994
    Released on J-STAGE: May 22, 2006
    JOURNAL FREE ACCESS
    A 60-year-old female presented with mild cerebellar dysfunction due to a calcified tumor attached to the undersurface of the tentorium cerebelli demonstrated by cranial computed tomography, and a lung mass on a chest x-ray film. The calcified nature and location made preoperative differentiation between metastatic brain tumor and meningioma difficult. Operation subsequently revealed that the brain tumor was a metastasis from lung adenocarcinoma. Metastatic brain tumors can be calcified, and should be considered in the differential diagnosis of calcified intracranial lesions.
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