Neurologia medico-chirurgica

Expression of Nerve Growth Factor Receptor by Human Primitive Neuroectodermal Tumors

Takashi KOKUNAI, Hideki SAWA, Shotaro TATSUMI, Norihiko TAMAKI

1994 Volume 34 Issue 8 Pages 523-529
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.523

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The expression of low-affinity nerve growth factor receptor (NGF-R) by primitive neuroectodermal tumors (PNETs) was analyzed in vivo and in vitro to investigate the relationship between NGF-R expression and cellular differentiation. NGF-R was expressed in one medulloblastoma cell line and two neuroblastoma cell lines. When these cells were induced to differentiate by treatment with dibutyryl cyclic adenosine monophosphate, NGF-R was overexpressed and there was increased expression of neurofilament proteins. Immunohistochemistry investigation of tumor tissues demonstrated that NGF-R was expressed by a subset of PNETs with a neuronal phenotype marked by neurofilament protein expression, but not by gliomas and PNETs without a neuronal phenotype. Growth inhibition assay demonstrated that NGF inhibited the growth of cells expressing NGF-R. These results indicate that NGF-R expression is a useful marker of neuronal differentiation by PNETs.

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Lateral Approach for Anterior Thoracic Spinal Lesions

Hiroyuki NAKASE, Hideyuki OHNISHI, Yasuharu WATABE, Hajime TOUHO, Jun ...

1994 Volume 34 Issue 8 Pages 530-533
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.530

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A lateral approach, consisting of a modified transversectomy, hemilaminectomy, and adequate transversectomy with costectomy of 7-8 cm, was used to treat four cases of anterior or anterolateral thoracic lesions, including two cases of thoracic disc herniations, one of thoracic meningioma, and one of hypertrophic pachymeningitis. All patients presented with gait disturbance, but recovered well postoperatively except for one who needed rehabilitation of the lower extremities. This approach provides a greater access to the anterior thoracic canal, and can achieve effective anterior decompression, and a good outcome for thoracic spinal disease if recognized early.

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Effect of Radiosurgery Using Leksell Gamma Unit on Metastatic Brain Tumor —Autopsy Case Report—

Yuh KOIKE, Hiromichi HOSODA, Yuhsuke ISHIWATA, Katsumi SAKATA, Kiyoshi ...

1994 Volume 34 Issue 8 Pages 534-537
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.534

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A 77-year-old male presented with gradual development of right hemiparesis. Postcontrast computed tomography (CT) revealed enhanced lesions in the left parietal and right paraventricular areas. Stereotactic brain biopsy led to a histological diagnosis of metastatic carcinoma. The lesions were treated by radiosurgery using the Leksell gamma unit. CT showed reduced size of the lesions after irradiation. The primary lesion could not be found and he died from pneumonia. Autopsy 3 weeks after the irradiation disclosed histological tumor necrosis, with greater tumor cell kill effects toward the center of the tumor.

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Suprasellar Ectopic Pituitary Adenoma —Case Report—

Michihiro KOHNO, Tomio SASAKI, Yoshitaka NARITA, Akira TERAMOTO, Kinto ...

1994 Volume 34 Issue 8 Pages 538-542
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.538

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A 33-year-old female presented with a suprasellar ectopic pituitary adenoma manifesting as visual disturbances. Preoperative magnetic resonance imaging demonstrated intact pituitary gland and suprasellar cystic tumor, with a preoperative diagnosis of craniopharyngioma. At surgery, the tumor was identified as a suprasellar ectopic pituitary adenoma with intracapsular hematoma. There was no communication between the tumor and intrasellar structures. Total removal of the tumor immediately improved the severe visual disturbance. Ectopic pituitary adenoma should be considered in the differential diagnosis of a suprasellar lesion with intact pituitary gland.

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Dural Arteriovenous Fistula Caused by Sinus Thrombosis —Case Report—

Hajime TOUHO, Hideyuki OHNISHI, Takeki KOMATSU, Norihiko FURUOKA, Jun ...

1994 Volume 34 Issue 8 Pages 543-546
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.543

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A 58-year-old male with a history of idiopathic sinus thrombosis presented with gradual onset of gait disturbance, dementia, and involuntary movement in the upper extremities. Cerebral angiography demonstrated a dural arteriovenous fistula fed by a falx cerebelli branch originating from the left vertebral artery and draining into the inferior vermian vein, the straight sinus, a cortical vein lying on the inferolateral surface of the left cerebellar hemisphere, the ipsilateral superior petrosal sinus, the sigmoid sinus, and the internal jugular vein. Endovascular embolization under fluoroscopic control resulted in complete disappearance of the involuntary movement. Sinus thrombosis may result in development of dural arteriovenous fistula which can cause life-threatening complications, so aggressive therapy should be considered.

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Occlusion of Internal Carotid Artery and Formation of Anterior Communicating Artery Aneurysm in Cervicocephalic Fibromuscular Dysplasia —Follow-up Case Report—

Youichi ITOYAMA, Shodo FUJIOKA, Shuichi TAKAKI, Motohiro MORIOKA, Taku ...

1994 Volume 34 Issue 8 Pages 547-550
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.547

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A 44-year-old female with cervicocephalic fibromuscular dysplasia (FMD) suffered a subarachnoid hemorrhage 10 years after presenting with left impaired extraocular movement. Carotid and vertebral angiography had shown string-of-beads sign in the left external carotid artery and fusiform aneurysms in the left carotid cavernous portion and in the left vertebral artery. On admission, the left carotid angiogram showed complete occlusion of the left internal carotid artery and the right carotid angiogram showed a new anterior communicating artery aneurysm. The territory of the left middle cerebral artery was supplied from the right internal carotid artery via the anterior communicating artery and from the basilar artery via the posterior communicating artery. Occlusion of the main arteries is rare in the clinical course of FMD. We suggest that hemodynamic stress due to occlusion of the internal carotid artery contributed to formation of the anterior communicating artery aneurysm, possibly associated with intrinsic changes of the arterial wall induced by FMD.

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Successful Percutaneous Transluminal Angioplasty of the Intracranial Vertebral Artery 1 Month after Total Occlusion —Case Report—

Shinya HONDA, Takahisa MORI, Masaaki FUKUOKA, Ken KAJITA, Masahiko ARI ...

1994 Volume 34 Issue 8 Pages 551-554
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.551

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A 51-year-old male suffering from recurrent cerebral ischemia due to total occlusion of the bilateral intracranial vertebral arteries more than 1 month old was successfully treated by percutaneous transluminal angioplasty (PTA). The totally occluded portion from the right intracranial vertebral artery to the basilar artery was adequately dilated. Follow-up angiography approximately 3 months after angioplasty demonstrated no evidence of restenosis. His symptoms have not recurred. PTA is potentially a much less invasive and safer reconstruction than bypass surgery for total occlusions of the intracranial vertebral arteries less than 3 months old.

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Fenestration of the Middle Cerebral Artery Associated with an Aneurysm —Case Report—

Hideo NAKAMURA, Akira TAKADA, Takuichiro HIDE, Yukitaka USHIO

1994 Volume 34 Issue 8 Pages 555-557
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.555

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A 36-year-old female suddenly developed a severe headache. Computed tomography demonstrated subarachnoid hemorrhage in the left Sylvian fissure. Left carotid angiography revealed a fenestration at the distal portion of the M₁ portion of the left middle cerebral artery, and an aneurysm arising from the proximal end of the fenestration. These findings were confirmed when the aneurysm neck was clipped. The embryonic origin of this lesion indicates that congenital factors may result in aneurysm formation.

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Solitary Bone Cyst of the Cervical Spine —Case Report—

Takao NAKAGAWA, Hirokazu KAWANO, Toshihiko KUBOTA

1994 Volume 34 Issue 8 Pages 558-560
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.558

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A 63-year-old female presented with an extremely rare solitary bone cyst in the spine involving the C-5 vertebral body. Computed tomography showed an air-density area inside the cyst, without postcontrast enhancement. Magnetic resonance imaging demonstrated a low-intensity lesion on both T₁- and T₂-weighted images. At surgery, the cyst cavity contained no fluid. Histological examination of the surgical specimen revealed that the cyst wall was lined by a thin fibrous membrane. This rare bone cyst may have originated from a defect in the epiphyseal plate of the vertebral body.

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Hemimegaloencephaly with Periventricular Heterotopia —Case Report—

Shuichi SUGIYAMA, Masami FUJII, Sadahiro NOMURA, Tetsuo YAMASHITA, Har ...

1994 Volume 34 Issue 8 Pages 561-564
Published: 1994
Released on J-STAGE: May 22, 2006

DOIhttps://doi.org/10.2176/nmc.34.561

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A 7-year-old girl was admitted with an unusual anomaly of hemimegaloencephaly associated with periventricular heterotopia manifesting as intractable seizures and mental retardation. Magnetic resonance (MR) imaging showed left hemispheric hypertrophy and left ventricular dilatation. Proton density-weighted MR imaging revealed a periventricular lesion isointense with gray matter. MR imaging is an effective method for diagnosing hemimegaloencephaly and heterotopia.

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