Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
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Volume 36, Issue 10
Displaying 1-10 of 10 articles from this issue
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  • Concanavalin A-induced Open Neural Tube Defects in Chick Embryos
    Takayuki INAGAKI, Kyu-Chang WANG, Russell G. HIGBEE, David G. MCLONE, ...
    1996 Volume 36 Issue 10 Pages 691-697
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.691
    JOURNAL FREE ACCESS
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    Open neural tube defects developed in 12 of 122 alive chick embryos treated with exogenous lectin (concanavalin-A) at stages between 10 or 14 as defined by Hamburger and Hamilton. Embryos treated at stage 10, the time of anterior neuropore closure, developed exencephaly or extensive neural openings from the level of rhombencephalon to the thoracic spinal cord, while embryos treated at stages between 11 and 14, at posterior neuropore closure, developed only small myeloschisis in the thoracolumbar region. The failure of neural tube closure at a critical time is a major cause of neural tube defects.
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  • Clinical Significance of Ki-67 Staining Index in Acoustic Neurinoma
    Masao YOKOYAMA, Masayuki MATSUDA, Satoshi NAKASU, Masayuki NAKAJIMA, J ...
    1996 Volume 36 Issue 10 Pages 698-703
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.698
    JOURNAL FREE ACCESS
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    The correlation between various clinical parameters and MIB-1 (Ki-67) staining indices was evaluated in 58 acoustic neurinomas. The index ranged from 0.37% to 6.61% (mean 1.70%), and did not correlate with age, sex, or initial tumor volume. Sixteen of the 18 tumors removed subtotally or partially showed regrowth, and two showed a volume reduction. The 16 patients with regrowth were divided into two groups according to Ki-67 staining index, <2.00% and ≥2.00%. These groups had a significant difference in tumor doubling time (TDT). In addition, there was a significant logarithmic correlation between Ki-67 staining index and TDT. Ki-67 staining index can be used as an index of regrowth rate in partially or subtotally removed acoustic neurinomas. Intraoperative assessment of Ki-67 staining index may be useful for better management planning as well as the estimation of prognosis.
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  • Expression of N-ras Gene in Gliomas
    Hideo TSURUSHIMA, Koji TSUBOI, Yoshihiko YOSHII, Tadao OHNO, Kotoo MEG ...
    1996 Volume 36 Issue 10 Pages 704-708
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.704
    JOURNAL FREE ACCESS
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    Expression of N-ras gene was examined by northern blot analysis in two cases of astrocytoma (grade II), four cases of glioblastoma multiforme (six samples including two recurrent tumors), and normal brain tissues. Expression of N-ras gene was only found in the two recurrent glioblastoma multiforme samples. Southern blot analysis found no significant difference in copy numbers of N-ras gene in preand post-recurrence samples. The histological diagnosis of the two recurrent tumors was glioblastoma multiforme at both first recurrent presentation. However, the tumors had progressed during recurrence, because of worsened histological findings, such as increased cellularity, pleomorphism, and vascularity. These tumors recurred at very short intervals. Enhanced expression of N-ras>/I> gene by disorder of transcription may be a factor in the progression of glioblastoma multiforme.
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  • Cerebral Blood Flow in Normal Brain Tissue of Patients with Intracranial Tumors
    Yoshiya NAKAYAMA, Akira TANAKA, Shigehiko KUMATE, Shinya YOSHINAGA
    1996 Volume 36 Issue 10 Pages 709-715
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.709
    JOURNAL FREE ACCESS
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    Pre- and postoperative cerebral blood flow (CBF) changes in the normal brain tissue of 17 patients with intracranial tumors were studied to determine the value for planning therapeutic strategy. The tumors included eight astrocytomas, seven meningiomas, one metastasis, and one arachnoid cyst. The patients were divided into two groups based on the mass effect seen on computed tomography (CT) scans. Group A comprised six patients with midline shift or evidence of herniation; Group B, 11 patients with no mass effect or local compression only. CBF and vasoresponse to acetazolamide were measured in the bilateral hemispheres, cortices, and thalami using xenon-enhanced CT, excluding the area of tumor extension, before and 2-3 weeks after tumor excision. Preoperative CBF was reduced bilaterally but more markedly ipsilateral to the tumor. The CBF reduction was significantly greater in Group A than in Group B. Acetazolamide caused CBF to increase by 70.5-99.1 % in Group B but only increase by 1.7-9.6% or paradoxically decrease in Group A. Postoperatively, the CBF tended to recover partially in Group A but persisted or deteriorated in Group B. The more pronounced CBF reduction and poor or paradoxical response to acetazolamide preoperatively and postoperative CBF restoration in Group A may indicate that ischemia was more important than metabolic depression in these patients. In contrast, the excessive response to acetazolamide and the postoperative CBF deterioration in Group B may indicate that CBF reduction was secondary to metabolic depression. Mass effect is a key predictor for functional recovery following surgical decompression of intracranial tumors.
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  • Brainstem Arteriovenous Malformation with a Pedicle Aneurysm Treated by Endovascular Surgery and Proton-beam Radiosurgery —Case Report—
    Yuji MATSUMARU, Akio HYODO, Koji TSUBOI, Yoshihiko YOSHII, Tadao NOSE, ...
    1996 Volume 36 Issue 10 Pages 716-720
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.716
    JOURNAL FREE ACCESS
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    A 39-year-old male presented with a small pontine hemorrhage and subarachnoid hemorrhage. Angiography showed a small left pontine arteriovenous malformation (AVM) associated with a small aneurysm on the pedicle feeding the AVM. The pedicle aneurysm was occluded by microcoils. The AVM was then treated by proton-beam radiosurgery. Follow-up angiography 2 years later revealed that the AVM had disappeared completely without neurological deficit. The combination of embolization and proton-beam radiosurgery was curative in this patient with a pontine AVM associated with an aneurysm on the feeding artery, showing that these techniques can be used to treat inoperable vascular lesions safely.
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  • Treatment of Suprasellar Arachnoid Cyst —Two Case Reports—
    Yoshihisa OKA, Yoshiaki KUMON, Kanehisa KOHNO, Masahiro SAITOH, Saburo ...
    1996 Volume 36 Issue 10 Pages 721-724
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.721
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    A 10-month-old girl presented with mental retardation and enlarged head, and a 3-year-old girl presented with epilepsy, both due to suprasellar arachnoid cysts. Magnetic resonance imaging demonstrated the suprasellar arachnoid cyst and the relationship between the cyst and surrounding structures. The 10-month-old patient with accompanying hydrocephalus was treated by fenestration of the cyst wall into the basal cistern. Postoperatively, bilateral subdural effusion appeared and subdural-peritoneal shunting was required. Thereafter, she regained the ability to walk. Two years postoperatively, the cyst reenlarged but communication between the cyst and surrounding cisterns and her development was normal, so she has been followed conservatively. The 3-year-old patient presented without hydrocephalus and was treated by cyst-peritoneal shunting using a Codman-Medos programmable valve through craniotomy. Postoperatively, the cyst was reduced and there has been no recurrence for 2 years and 5 months. We consider that cyst-peritoneal shunting is the most effective treatment for suprasellar arachnoid cyst.
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  • Asymptomatic Hypothalamic Hamartoma Associated with an Arachnoid Cyst —Case Report—
    Toshihiko ISAKA, Susumu NAKATANI, Toshiki YOSHIMINE, Fumiharu AKAI, Ma ...
    1996 Volume 36 Issue 10 Pages 725-728
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.725
    JOURNAL FREE ACCESS
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    A 42-year-old male presented with the complaint of mild left facial numbness. Magnetic resonance imaging demonstrated a solid tumor in the interpeduncular cistern and a huge arachnoid cyst in the left middle cranial fossa. The tumor appeared isointense to the surrounding cerebral gray matter on T1-weighted images and hyperintense to that on T2-weighted images. The tumor was partially resected. Histological findings were characteristic of hamartoma. The mild left facial numbness was probably due to compression of the left trigeminal nerve by the arachnoid cyst. Asymptomatic hypothalamic hamartomas may occur in adults with atypical clinical presentations.
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  • Total Capsular Calcification in a Prolactinoma —Case Report—
    Tetsuyoshi HORIUCHI, Yuichiro TANAKA, Shigeaki KOBAYASHI, Akira YOKOH, ...
    1996 Volume 36 Issue 10 Pages 729-732
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.729
    JOURNAL FREE ACCESS
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    A 42-year-old male presented with a prolactin-producing pituitary adenoma with an atypical radiological appearance. The tumor was incidentally found by magnetic resonance imaging, which demonstrated a cystic tumor in the enlarged and partially empty sella turcica. Computed tomography revealed the tumor was surrounded by calcification with an egg-shell appearance. The serum prolactin level was 37 ng/ml. The operative finding was a calcified shell-containing cystic tumor. Immunohistochemical staining revealed prolactin-positive cells. The combination of the unusual calcification, and enlarged and partially empty sella was considered to be a sequela of spontaneous degeneration of the tumor.
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  • Aspergilloma in the Paracavernous Region -Two Case Reports-
    Atul GOEL, Trimurti NADKARNI, Anand P. DESAI
    1996 Volume 36 Issue 10 Pages 733-736
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.733
    JOURNAL FREE ACCESS
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    A 30-year-old male and a 40-year-old female presented with Aspergillus fungal granuloma in the cerebral locations involving the gasserian ganglion and its divisions in one case and was densely adherent to the lateral dural wall of the cavernous sinus in the other. Both patients were otherwise healthy with no evidence of immuno-suppression. The lesions resembled benign tumor on preoperative imaging and intraoperative consistency and vascularity. The lesions were successfully and completely resected. Both patients developed major cerebral arterial territory infarcts in the postoperative phase, remote from the site of operation, leading to crippling neurological deficits in one patient and death in the other. The unusual location and the unusual and similar clinical course suggests that awareness of the possibility of ischemic complications after surgical resection of intracranial aspergillomas is necessary.
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  • Turbo Spin-echo Magnetic Resonance Imaging Depiction of Facial Nerve Compression by a Vertebral Artery in a Patient with Hemifacial Spasm —Technical Note—
    Hiroyuki KATANO, Mitsuhito MASE, Ken KAMIYA, Tatsuo BANNO, Toshiaki MI ...
    1996 Volume 36 Issue 10 Pages 737-739
    Published: 1996
    Released on J-STAGE: April 10, 2006
    DOIhttps://doi.org/10.2176/nmc.36.737
    JOURNAL FREE ACCESS
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    Turbo spin-echo magnetic resonance (MR) imaging of a patient with hemifacial spasm clearly demonstrated vascular compression of the facial nerve by the vertebral artery. The high resolution images of this method may be an appropriate alternative to preoperative cerebral angiography. Turbo spin-echo MR imaging is a diagnostic procedure of choice for patients with hemifacial spasm and possibly trigeminal neuralgia.
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