Neurologia medico-chirurgica

Prompt Gamma Ray Spectrometry for In Vivo Measurement of Boron-10 Concentration in Rabbit Brain Tissue

Kanji MUKAI, Yoshinobu NAKAGAWA, Keizo MATSUMOTO

1995 Volume 35 Issue 12 Pages 855-860
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.855

JOURNAL FREE ACCESS

Show abstractHide abstract

Boron-10 concentrations in the brain of live rabbits were measured by prompt gamma ray spectrometry at intervals over a 24-hour period. Boron-10 concentrations in the blood and cerebrospinal fluid (CSF) were also measured. Animals were killed at each interval to obtain brain tissues to measure the boron-10 concentration in the brainstem, cerebral cortex, cerebellar cortex, and basal ganglia, as well as the whole brain. Boron-10 concentrations in the live brain did not differ significantly from those measured in whole brain tissue. Boron-10 concentrations in the blood were much higher than in the brain at each interval after injection. These boron-10 concentrations showed a similar pattern of initial rapid decrease, followed by a more gradual decrease. There was little boron-10 present in the CSF. The brainstem contained a significantly larger concentration of boron-10 than the other tissues. Prompt gamma ray spectrometry has the potential for direct measurement of boron-10 concentrations in the brain of patients undergoing boron neutron capture therapy.

View full abstract

Download PDF (468K)
Retrograde Perfusion of the Cerebral Vein with Antioxidant L Y231617 Reduces Brain Damage in the Rat Focal Ischemia Model

Takeki NAGAO, Y. Lucas YAMAMOTO, Nobuhiro INOUE, Yasushi ITO

1995 Volume 35 Issue 12 Pages 861-868
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.861

JOURNAL FREE ACCESS

Show abstractHide abstract

Retrograde perfusion of the cerebral vein (RPCV) with antioxidant LY231617 was evaluated in the focal ischemia model in rats as a new therapeutic route to deliver cytoprotective agents more selectively and efficiently into ischemic brain tissue. Thirty-six Sprague-Dawley rats were divided into Groups A through D. Focal ischemia was induced for 3 hours in the rats, then all groups were treated differently for 2 hours and then sacrificed. Rats in Group A (n=10) served as the control group and was left untreated. Rats in Group B (n=10) received an intravenous infusion of LY231617 (10 mg/kg/hr). Rats in Group C (n=6) received saline (86μl/min) through RPCV. Rats in Group D (n=10) received LY231617 (10 mg/kg/hr) in saline (86μl/min) through RPCV. The regional cerebral blood flow (rCBF) was measured using [¹⁴C]iodoantipyrine autoradiography, and phorbol 12, 13-dibutyrate (PDBu) binding by in vitro [³H]PDBu autoradiography. Ischemic brain damage was assessed quantitatively after staining with cresyl violet and Luxol fast blue. Rats in Group D showed significantly higher rCBF (41-400%, p < 0.05) in the ischemic cortical and subcortical areas, and a significant reduction (66%, p < 0.01) in the total volume of ischemic damage and reduction of PDBu binding (p < 0.05) in the lateral striatum of the ischemic hemisphere, as compared to the rats in Groups A-C. RPCV with antioxidant LY231617 achieves a more beneficial effect on focal ischemic tissue than regular systemic administration.

View full abstract

Download PDF (600K)
Surgical Removal of Giant Basal Ganglia Arteriovenous Malformations through the Extended Transsylvian Approach Following Preoperative Embolization

—Two Case Reports—

Kazuo MIZOI, Takashi YOSHIMOTO, Yoshihide NAGAMINE, Akira TAKAHASHI, M ...

1995 Volume 35 Issue 12 Pages 869-875
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.869

JOURNAL FREE ACCESS

Show abstractHide abstract

A 12-year-old boy and a 22-year-old male presented with sudden onset of consciousness disturbance with right-sided hemiparesis and aphasia due to massive intracerebral hemorrhage from giant striocapsular arteriovenous malformations (AVMs). Angiography revealed giant AVMs located at the left basal ganglia in both patients. Large frontotemporal craniotomies were performed following staged embolization of the feeding arteries. Through an extended transsylvian approach, the lesions were totally excised with confirmation using intraoperative digital subtraction angiography. The patients showed a transient postoperative worsening of symptoms, but recovered to their preoperative status at discharge. Motor functions of the right upper and lower extremities were graded 4/5 in both patients. These cases demonstrate that combined use of preoperative embolization and intraoperative angiography allows some giant deep AVMs to be resected with encouraging results.

View full abstract

Download PDF (688K)
Apneic Spells in a Patient with Myelomeningocele without Chiari Type II Malformation

—Case Report—

Toshihiko NISHIMURA, Koreaki MORI, Yasuo SADA, Motoharu FUJII

1995 Volume 35 Issue 12 Pages 876-881
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.876

JOURNAL FREE ACCESS

Show abstractHide abstract

A female neonate with myelomeningocele but without Chiari type II malformation suffered from apneic spells. Magnetic resonance imaging showed no obvious brainstem anomaly. Brainstem auditory evoked potentials were initially abnormal and subsequently deteriorated during the 6 months after birth. The brainstem deficits were not reversed by a ventriculoperitoneal shunt. She died of respiratory distress and cardiac failure at 2 years of age. This case indicates an intrinsic dysfunction in the brainstem of patients with myelomeningocele not complicated by Chiari type II malformation.

View full abstract

Download PDF (446K)
Traumatic Occlusion of the Anterior Cerebral Artery

—Case Report—

Akira ISHIBASHI, Yoshitake KUBOTA, Yoshitake YOKOKURA, Yasushi SOEJIMA ...

1995 Volume 35 Issue 12 Pages 882-885
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.882

JOURNAL FREE ACCESS

Show abstractHide abstract

A 71-year-old female presented with posttraumatic occlusion of the anterior cerebral artery (ACA) after a road accident in which she was hit in the mid-frontal region. Initial computed tomography (CT) demonstrated frontal skull fractures and pneumocephalus. High density areas were also identified in the right basal cisterns, suggesting traumatic subarachnoid hemorrhage. She was alert on admission, but with attendant shock due to crush wounds. Her condition rapidly deteriorated and an emergency amputation of her left leg was performed. After aggressive treatment with transfusion and infusion, her systolic pressure increased to 120 mmHg. Her consciousness remained disturbed. Serial CT disclosed hemorrhagic infarction in the entire medial side of the right frontal lobe. Magnetic resonance angiography demonstrated decreased flow voids in the bilateral A₁ segments and right ACA, and a basilar artery aneurysm, which was unruptured clinically. Three weeks after the injury, she regained consciousness. Six months later, she had motor aphasia and left upper extremity weakness. The clinicopathological mechanism causing the traumatic occlusion of the ACA in the present case was probably dissecting aneurysm.

View full abstract

Download PDF (446K)

False Traumatic Aneurysm of the Dorsal Wall of the Supraclinoid Internal Carotid Artery

—Case Report—

Kiyoshi SAITO, Mustafa K. BASKAYA, Masato SHIBUYA, Yoshio SUZUKI, Keni ...

1995 Volume 35 Issue 12 Pages 886-891
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.886

JOURNAL FREE ACCESS

Show abstractHide abstract

A 32-year-old male presented with subarachnoid hemorrhage following head trauma. Initial carotid angiography revealed an aneurysm protruding from the dorsal wall of the supraclinoid internal carotid artery. Two weeks later, following two additional hemorrhagic episodes, repeat carotid angiography showed severe vasospasm and dramatic expansion of the aneurysm. He died 17 days after the accident. Autopsy and histological examination confirmed the diagnosis of a traumatic, false aneurysm of the internal carotid artery. Improved prognosis requires early recognition and surgical obliteration of such aneurysms.

View full abstract

Download PDF (608K)

Ruptured Aneurysm of the Distal Posterior Inferior Cerebellar Artery in a Neonate

—Case Report—

Kazuo HOSOTANI, Yasuhiko TOKURIKI, Yoshihiro TAKEBE, Kenji KAWAGUCHI, ...

1995 Volume 35 Issue 12 Pages 892-895
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.892

JOURNAL FREE ACCESS

Show abstractHide abstract

A 34-day-old male presented with a rare neonatal ruptured aneurysm of the distal posterior inferior cerebellar artery manifesting as a 10-day history of enlargement of head circumference. Magnetic resonance imaging revealed hydrocephalus and a round infratentorial enhanced lesion which compressed the medulla. Left vertebral angiography demonstrated an aneurysm on the telovelotonsillar segment of the left posterior inferior cerebellar artery. Ventriculoperitoneal shunt emplacement and proximal artery clipping were performed. The cerebrospinal fluid was bloody, suggesting aneurysm rupture had caused hydrocephalus. His postoperative course was uneventful, and neurological and developmental findings were normal 7 months later. Present neuroimaging, surgical, and neuroanesthesiology techniques allow successful surgical intervention in cases of neonatal ruptured aneurysm.

View full abstract

Download PDF (235K)

Ventral Spinal Subdural Hematoma

—Case Report—

Tatsuhito YAMAGAMI, Hajime HANDA, Kenichiro HIGASHI, Jun B. TAKAHASHI

1995 Volume 35 Issue 12 Pages 896-900
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.896

JOURNAL FREE ACCESS

Show abstractHide abstract

A 26-year-old male presented with a very rare spinal subdural hematoma which developed 3 days after minor trauma. Magnetic resonance imaging showed the very large hematoma, extending from the C-1 to the T-i l levels, ventral to the spinal cord. An attempt to remove the hematoma via a posterior approach on the next day failed. On the 3rd hospital day, the hematoma was partially removed at the C7-T1 intervertebral level through an anterior approach. Neurological signs of paraplegia, and urinary and bowel disturbances did not improve postoperatively.

View full abstract

Download PDF (389K)

Multiple Neuroepithelial Tumors of Different Cell Types

—Case Report—

Takuya AKAI, Shinichiro TAKAHASHI, Makoto SONOBE, Kyouichi SUGITA

1995 Volume 35 Issue 12 Pages 901-904
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.901

JOURNAL FREE ACCESS

Show abstractHide abstract

A 31-year-old male developed intramedullary tumors in the medulla oblongata and the upper cervical spinal cord. He was first admitted with tetraparesis. Magnetic resonance (MR) imaging revealed a low intensity mass lesion in the medulla oblongata. The tumor was removed and diagnosed as a pilocytic astrocytoma. Nine years later, he was readmitted with motor weakness and dysesthesia in the right arm. MR imaging revealed a mass lesion in the cervical cord. This tumor was removed and diagnosed histologically as ependymoma. We suggest that the displacement of primitive spongioblasts with subsequent differentiation resulted in an astrocytoma and an ependymoma in adjacent areas.

View full abstract

Download PDF (404K)

Retroperitoneal Approach for Lumbar Lateral Meningocele

—Case Report—

Masaru MIYATA, Shun YAMASAKI, Takao YOSHIDA, Masahide MATSUBARA, Masao ...

1995 Volume 35 Issue 12 Pages 905-908
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.905

JOURNAL FREE ACCESS

Show abstractHide abstract

A 29-year-old female with neurofibromatosis presented with a right lumbar lateral meningocele. Abdominal computed tomography (CT) showed a huge right retroperitoneal cyst expanding anterolaterally and displacing the right kidney. CT following myelography disclosed the cyst expanding through a wide defect of the right pedicles of the T-12 and L-1 vertebrae. The cyst was resected through a retroperitoneal approach with right flank oblique incision. Postoperatively, cerebrospinal fluid leakage occurred, which improved after lumboperitoneal shunt. Careful screening for lateral meningocele, including the lumbar region, should be undertaken in a patient with neurofibromatosis who presents with vertebral anomalies.

View full abstract

Download PDF (515K)

Cerebral Sparganosis Mansoni

—Case Report—

Tatsunori OKAMURA, Mitsuo YAMAMOTO, Keiji OHTA, Takashi MATSUOKA, Tohr ...

1995 Volume 35 Issue 12 Pages 909-913
Published: 1995
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.35.909

JOURNAL FREE ACCESS

Show abstractHide abstract

An 80-year-old male with paresis of the right upper extremity underwent surgery for a suspected metastatic brain tumor. A live Sparganum mansoni worm was removed from the parietal lobe through a left parietal craniotomy. Retrospective evaluation of magnetic resonance (MR) images revealed ipsilateral ventricular dilatation, despite the presence of a mass lesion resembling a metastatic brain tumor. This interesting MR imaging finding is an important point for differentiating between a brain tumor and cerebral sparganosis.

View full abstract

Download PDF (502K)

Register with J-STAGE for free!