Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Volume 36, Issue 2
Displaying 1-10 of 10 articles from this issue
  • Tetsuyuki YOSHIMOTO, Kiyohiro HOUKIN, Hiroshi ABE
    1996 Volume 36 Issue 2 Pages 67-71
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Activated leukocytes may be involved in the reperfusion injury of the brain. The expression of intracellular adhesion molecule-1 (ICAM-1) (CD54) and lymphocyte function-associated antigen-1 (LFA-1) (CD 11 a/CD 18) are important for the interaction of activated leukocytes with the brain. Therefore, the expression of ICAM-1 in the cerebral vessels and LFA-1 on leukocytes were examined after reperfusion in a rat four-vessel occlusion model. Model rats underwent reperfusion (15, 30, and 60 min, and 6, 12, and 24 hrs) following 30 minutes of forebrain ischemia. Immunohistological staining for ICAM1 and LFA-1 was performed in each subgroup. ICAM-1 expression increased after 1-hour reperfusion and persisted on the cerebral microvessels in both the subcortical region and the basal ganglia. Leukocytes stained by LFA-1 were observed in the capillary vessels after 6-hour reperfusion. Increased expression of ICAM-1 and LFA-1 were induced by reperfusion, and this may be important in reperfusion injury of the brain.
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  • Kiyohiro HOUKIN, Hiroshi ABE, Yuji HASHIGUCHI, Shigemi SERI
    1996 Volume 36 Issue 2 Pages 72-77
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    The chronological changes of blood-brain barrier disruption, and diffusion and absorption of edema fluid were investigated in rats with cold-induced brain injury (vasogenic edema) using magnetic resonance imaging. Contrast medium was administered intravenously at 3 and 24 hours after lesioning as a tracer of edema fluid. Serial T1-weighted multiple-slice images were obtained for 180 minutes after contrast administration. Disruption of the blood-brain barrier was more prominent at 24 hours after lesioning than at 3 hours. Contrast medium leaked from the periphery of the injury and gradually diffused to the center of the lesion. Contrast medium diffused into the corpus callosum and the ventricular system (cerebrospinal fluid). Disruption of the blood-brain barrier induced by cold injury was most prominent at the periphery of the vasogenic edema. Edema fluid subsequently extended into the center of the lesion and was also absorbed by the ventricular system. Magnetic resonance imaging is a useful method to assess the efficacy of therapy for vasogenic edema.
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  • Satoshi KURODA, Kiyohiro HOUKIN, Hiroshi ABE, Mamoru TAMURA
    1996 Volume 36 Issue 2 Pages 78-86
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    The cerebral oxygenation state of five patients was continuously and non-invasively monitored using near-infrared spectroscopy (NIRS) during carotid artery balloon occlusion for comparison with somatosensory evoked potential (SEP) monitoring and regional cerebral blood flow (rCBF) measurements. In patients with marked reduction of rCBF and deteriorated SEP, NIRS demonstrated a continuous decrease in oxy-hemoglobin and total hemoglobin and an increase in deoxy-hemoglobin, indicating the occurrence of severe hypoxia in the ipsilateral hemisphere because of inadequate collateral circulation. In contrast, NIRS showed only a transient (< 2 min) change in these parameters in the patients who showed no remarkable changes in SEP or rCBF, suggesting that well-developed collateral circulation immediately improved cerebral hemodynamics in the ipsilateral hemisphere. These results suggest that NIRS can provide direct and valuable information on cerebral hemodynamic changes during carotid artery balloon occlusion.
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  • Hiroshi WANIFUCHI, Mikihiko TAKESHITA, Nobuo AOKI, Takakazu KAWAMATA, ...
    1996 Volume 36 Issue 2 Pages 87-90
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 30-year-old female and a 38-year-old male developed “definite” moyamoya disease after presenting with “probable” moyamoya disease manifesting as ischemic stroke. Angiography at first presentation demonstrated unilateral involvement with normal contralateral findings. The cases were classified as adult type “probable” moyamoya disease according to the diagnostic criteria. Follow-up angiography demonstrated the occlusive lesions had become bilateral, satisfying the criteria for “definite” cases. Serial angiography is required in adults presenting with “probable” moyamoya disease manifesting as ischemic stroke.
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  • Yoshio MIYASAKA, Akira KURATA, Hirotada SAEGUSA, Izumi YUZAWA, Satoshi ...
    1996 Volume 36 Issue 2 Pages 91-95
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 41-year-old female presented with an uncommon mixed dural-pial arteriovenous malformation (AVM) with unusual venous drainage. Angiography at the initial operation for massive intracerebral hematoma in the parietal lobe showed no vascular malformations. Follow-up angiography 3 years later revealed a mixed dural-pial AVM at the previous surgical site. Unexpectedly, the venous drainage from the AVM was not into the patent superior sagittal sinus, but was retrograde into the contralateral cortical veins in the occipital lobe. No skull fracture or sinus thrombosis was demonstrated. The AVM was resected successfully without neurological deterioration. The pial portion of the lesion may have been a congenital anomaly, and the dural portion acquired. The development of a dural AVM at an earlier surgical site is uncommon, and may indicate the possible pathogenesis of acquired dural AVMs unrelated to sinus occlusion or accidental trauma. Furthermore, there are various possible patterns of venous drainage in vascular malformations.
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  • Tetsuya YAMAMOTO, Akira MATSUMURA, Keishi FUJITA, Yasushi KAWAKAMI, Ka ...
    1996 Volume 36 Issue 2 Pages 96-98
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 54-year-old female presented with a cerebral metastasis of functioning parathyroid carcinoma in the right occipital lobe. After surgical removal of the metastatic tumor, her symptoms of left hemianopsia and hypercalcemia improved. Surgical treatment should be considered in a case of brain metastasis of parathyroid carcinoma associated with secondary hyperparathyroidism to prevent metabolic complications and reduce the mass of the tumor.
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  • Ichiro SUNADA, Tsuyoshi INOUE, Katsuhiko TAMURA, Yoshinori AKANO, Yosh ...
    1996 Volume 36 Issue 2 Pages 99-101
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 75-year-old male presented with bilateral parkinsonism due to chronic subdural hematoma. The hematoma was removed through a small craniotomy. The parkinsonism rapidly improved following operation, suggesting a strong relationship between the hematoma and parkinsonism. We recommend surgical intervention in such cases.
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  • Masanori KURIMOTO, Shunro ENDO, Keiichiro ONIZUKA, Takuya AKAI, Akira ...
    1996 Volume 36 Issue 2 Pages 102-105
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 10-year-old boy with progressive left visual disturbance associated with craniobasal fibrous dysplasia underwent left frontotemporal craniotomy. Dysplastic lesions of the sphenoid ridge, orbital roof, anterior clinoid, and ethmoid sinus were removed through an extradural pterional approach and the optic nerve was completely decompressed. His vision was markedly improved postoperatively. Consecutive follow-up studies for 3 years have shown no deterioration of his visual acuity. Early optic nerve decompression is highly recommended to preserve visual function in patients with craniofacial fibrous dysplasia causing visual disturbance.
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  • Yasser ORZ, Shigeaki KOBAYASHI, Yoshiki ICHINOSE, Yuichiro TANAKA, Kaz ...
    1996 Volume 36 Issue 2 Pages 106-110
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    A 48-year-old male harboring a rare peripheral superior cerebellar artery aneurysm presented with sudden severe headache. Neurological examination on admission revealed no deficit except stiff neck. Computed tomography showed subarachnoid hemorrhage. Left vertebral angiography showed an aneurysm at the anterior pontomesencephalic segment (anterior pontine segment) of the left superior cerebellar artery. The neck of the aneurysm was rather high, 10 mm above the biclinoid line. The aneurysm was clipped through an orbitozygomatic transsylvian approach. His postoperative course was uneventful. We recommend this skull base approach especially for high-positioned aneurysms at this segment.
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  • Tatsuhito YAMAGAMI, Hajime HANDA, Ken-ichiro HIGASHI, Kiyoshi NISHIHAR ...
    1996 Volume 36 Issue 2 Pages 111-116
    Published: 1996
    Released on J-STAGE: April 10, 2006
    JOURNAL FREE ACCESS
    Cervical foraminotomies are performed from the fifth to the eighth cervical nerve roots on both sides. On the side with more marked radiculopathies the laminae are osteotomized to the full extent, but not so completely on the other side. The mass of laminae from C-3 to C-7 is lifted up using the incompletely severed side of the laminae as the fulcrum. The removed spinous processes of C-6 and C-7 are adjusted and fixed between the articular joints and the lifted laminae from C-4 to C-6. This procedure prevents extradural scar formation, there are no complications caused by foreign bodies, postoperative neuroimaging is possible because no metallic artifact is formed, and extensive decompression is achieved for the cervical cord and nerve roots.
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