Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 35, Issue 3
Displaying 1-10 of 10 articles from this issue
  • Daizo YOSHIDA, Yukio IKEDA, Shozo NAKAZAWA
    1995 Volume 35 Issue 3 Pages 133-135
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    The effect of copper (Cu) depletion on the growth of tumors was investigated in a rat brain tumor model. 9L gliosarcoma cells were injected subcutaneously in 5-week-old male Fischer-344 rats. The control group (n = 18) received a normal diet throughout the experiment and the depletion group (n = 18) received a Cu-deficient diet starting 3 weeks prior to tumor implantation, and 2 mg of Dpenicillamine orally, once daily, on the 3 days before and after implantation. Six animals from each group were killed at 1, 2, and 3 weeks following the implantation to measure the tumor weights and determine the tissue Cu concentration by atomic absorption spectrophotometry. The tumor weights increased much more rapidly in the control than in the depletion group. The Cu concentrations in tumor tissue of the depletion group were significantly lower than in the control group. There was no statistical significance in Cu concentration in the brain tissues of the control and depletion groups. Our study indicated that a Cu-deficient diet and D-penicillamine treatment can inhibit subcutaneous glioma growth in this rat model.
    Download PDF (203K)
  • Toshihiro UEDA, Takao HATAKEYAMA, Saburo SAKAKI, Shinsuke OHTA, Yoshia ...
    1995 Volume 35 Issue 3 Pages 136-143
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    Intracerebral hemorrhagic transformation is one of the most important complications of thrombolytic therapy for acute ischemic stroke. The relationship between changes in markers for the coagulation and fibrinolytic systems and occurrence of hemorrhagic transformation was determined after local intra-arterial thrombolytic therapy using urokinase (UK) (24 patients) or recombinant tissue plasminogen activator (t-PA) (10 patients) within 6 hours of onset. All 34 patients had no hypodensity areas on initial computed tomography scans. Plasma concentrations of fibrinogen-fibrin degradation products (FDP), fibrinogen, α2-plasmin inhibitor (α2-PI), plasmin-α2 plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT), and D-dimer were measured. Hemorrhagic transformation occurred in seven patients (21%) with complete or partial recanalization; four in the UK group and three in the t-PA group. Doses of the thrombolytic agents did not correlate with the incidence of hemorrhagic transformation. The FDP levels in the hemorrhagic transformation group treated with UK significantly increased immediately and 1 hour after the therapy. The α2-PI activities decreased and PIC levels increased in both the hemorrhagic transformation and the nonhemorrhagic groups after the therapy. The TAT levels in both groups tended to be higher than the normal range, but there was no significant difference from the pretreatment levels. The D-dimer levels in the hemorrhagic transformation group were higher than those in the nonhemorrhagic group at 24 hours after the therapy. Furthermore, the D-dimer levels were significantly higher in patients with complete recanalization compared with those with none or partial recanalization. Activation of the fibrinolytic system after thrombolytic therapy may be a risk factor for intracerebral hemorrhagic transformation. D-dimer is useful as a marker for recanalization in thrombolytic therapy for acute ischemic stroke.
    Download PDF (441K)
  • Hiroyuki IMAMURA, Yoshinobu IWASAKI, Kazutoshi HIDA, Ki Hong CHO, Hiro ...
    1995 Volume 35 Issue 3 Pages 144-147
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    Intraoperative spinal sonography was used during cervical anterior approach procedures for cervical discectomy and osteophytectomy to demonstrate spinal pulsation, the protruded disc or osteophyte, the anterior subarachnoid space, and the spinal cord. Spinal pulsation was recognized in some cases before removal of the disc but the anterior subarachnoid space and spinal cord could not be observed. However, the latter were more clearly observed during removal of the disc and could be seen after total removal of the disc and osteophyte. This method allows confirmation of decompression and pulsation of the spinal cord without cutting and removal of the posterior longitudinal ligament.
    Download PDF (418K)
  • Kengo MATSUMOTO, Hisato HIGASHI, Susumu TOMITA, Tomohisa FURUTA, Takas ...
    1995 Volume 35 Issue 3 Pages 148-155
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A simple computed tomography (CT) or magnetic resonance (MR) imaging-guided stereotactic method for guided microsurgical resection of either deep-seated gliomas or tumors adjacent to an eloquent area is described. The technique employs the Brown-Roberts-Wells stereotactic system and twist drills, 2.7 mm in diameter, for the stereotactic placement of 2.4 mm diameter scaled guidance catheters through the calvaria. In a patient with a deep-seated small glioma, less than 2 cm diameter, one catheter was implanted into the center of the enhanced mass through the cerebral cortex. In the other 14 patients, three to six catheters were used which made the tumor border clearer. After implantation of the guidance catheters, the stereotactic frame was removed and a standard open craniotomy performed. Target localization is not affected by brain movement, which is inevitable during open surgery. The tumor involved the frontal lobe in eight patients, the parietal lobe in two, and the thalamus in five. In all cases the lesion was quickly localized and radical removal was acheived. Neurological complications occurred in only one patient who suffered transient hemiparesis after the resection of a lesion in the pyramidal tract. The results demonstrate that microsurgery combined with CT or MR imaging-guided stereotactic placement of guidance catheters is a new option for surgery of deep-seated gliomas or tumors adjacent to an eloquent area.
    Download PDF (1356K)
  • —Four Case Reports—
    Takao NAKAGAWA, Toshihiko KUBOTA, Yuji HANDA, Hirokazu KAWANO, Kazufum ...
    1995 Volume 35 Issue 3 Pages 156-159
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    Four patients with prosthetic heart valves suffered intracranial hemorrhage (cerebral hemorrhage in one patient, cerebellar hemorrhage in one, and chronic subdural hematoma in two) during long-term oral anticoagulant drug therapy (warfarin). In all patients, warfarin was discontinued and its effect neutralized by vitamin K, then surgery was performed after the thrombotest value exceeded 50%. No uncontrollable bleeding occurred at surgery. Warfarin was discontinued until 3-7 days postoperatively. Intravenous heparin administration was used to prevent embolic complications and the dose was modified based on the activated clotting time measured at the bedside. One patient, who could not receive heparin administration because of massive bleeding, developed myocardial infarction due to coronary artery thromboembolism 2 days after operation and died 4 days later. The other patients received heparin administration and were alive and well at the most recent follow-up examinations. Heparin administration monitored by activated clotting time is a useful method to prevent embolic and bleeding complications in the surgical treatment of intracranial hemorrhage in patients with prosthetic heart valves receiving long-term anticoagulant therapy.
    Download PDF (393K)
  • —Case Report—
    Hideaki IMAI, Nobuo ONO, Akira ZAMA, Masaru TAMURA
    1995 Volume 35 Issue 3 Pages 160-164
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A 6-year-old boy presented with a pontine abscess initially misdiagnosed as brainstem glioma, but he deteriorated rapidly and developed new symptoms of respiratory distress. Magnetic resonance (MR) imaging revealed a rapidly growing mass lesion in the pons. Microsurgical evacuation of the abscess via a suboccipital retromastoid approach resulted in neurological improvement and resolution of the lesion on MR images. Brainstem abscess can be successfully treated with early, accurate diagnosis based on MR imaging and appropriate microsurgical and antibiotic management.
    Download PDF (350K)
  • —Case Report—
    Kensuke KAWAI, Tomio SASAKI, Akira YANAI, Akira TERAOKA
    1995 Volume 35 Issue 3 Pages 165-167
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A 42-year-old male presented with a high cervical chordoma detected at an early stage and manifesting only as neck pains. Serial cervical roentgenograms over 8 years confirmed the slow growth character of this malignant tumor. Computed tomography and magnetic resonance imaging provided clear visualization of the tumor localized in the anterior aspect of the C-2 vertebral body. The tumor was totally removed through a transoral approach. Early diagnosis of vertebral chordoma is difficult due to the slow growth character and insidiousness of initial symptoms, but meticulous examination of serial roentgenograms, followed by neuroimaging, can achieve early detection of cervical chordoma.
    Download PDF (292K)
  • —Case Report—
    Shin-ichi OTSUKA, Akinori KONDO, Hideki TANABE, Mitsuo SATO, Nobuki MA ...
    1995 Volume 35 Issue 3 Pages 168-171
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A 58-year-old male presented with a 1 month history of left retro-orbital pain and diplopia. Computed tomography demonstrated an isodense intraorbital tumor with slight homogeneous enhancement. Magnetic resonance imaging showed the tumor was isointensity on T1-weighted imaging, slightly high intensity on T2-weighted imaging, and slightly enhanced by gadolinium-diethylenetriaminepenta-acetic acid. Left external carotid angiography showed a tumor stain fed from the branches of the left internal maxillary artery. The tumor was partially removed. The histological diagnosis was malignant lymphoma. Tumor staining is rare in intraorbital malignant lymphoma and is not adequate for differential diagnosis of intraorbital tumors, so biopsy is essential.
    Download PDF (617K)
  • —Case Report—
    Ryuhei KITAI, Masanori KABUTO, Hirokazu KAWANO, Hatsuji UNO, Hidenori ...
    1995 Volume 35 Issue 3 Pages 172-174
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A 62-year-old male presented with a rare brain metastasis from malignant mesothelioma manifesting as headache and progressive left hemiparesis. He had previously undergone pleurectomy for malignant mesothelioma. Chest x-ray films showed no recurrence of mesothelioma. Computed tomography and magnetic resonance imaging revealed a homogeneously enhanced nodular mass adjacent to the falx in the right frontal lobe. The tumor was totally removed and diagnosed histologically as brain metastasis from malignant mesothelioma. Following surgery, left hemiparesis improved gradually. Brain metastasis from malignant mesothelioma is usually discovered in the terminal stage or at autopsy. Surgical removal and radiotherapy should be considered for isolated lesions.
    Download PDF (359K)
  • —Case Report—
    Yuji NIKAIDO, Masami IMANISHI, Tatsuhiko MONOBE
    1995 Volume 35 Issue 3 Pages 175-178
    Published: 1995
    Released on J-STAGE: March 30, 2006
    JOURNAL FREE ACCESS
    A 65-year-old male presented with a rare lipoma in the quadrigeminal cistern manifesting as left abducens nerve paresis which was effectively treated by total extirpation. The usual neurological symptoms of lipoma in the quadrigeminal cistern are intracranial hypertension and hydrocephalus which can be successfully treated by shunt operation. Direct surgery is indicated when the symptoms are ascribed to localized symptoms, but tumor removal should be partial if the superior cerebellar arteries are involved.
    Download PDF (289K)
feedback
Top