Neurologia medico-chirurgica

Biomechanics of Cervical Spine Surgery for Tumor and Degenerative Diseases

Edward C. BENZEL

1997 Volume 37 Issue 8 Pages 583-593
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.583

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Thallium-201 Single Photon Emission Computed Tomography Imaging of Meningioma Cells in Hyperostosis

Kentaro MORI, Kajin CHO, Kikuo SUDA, Sumio ISHIMARU, Minoru MAEDA

1997 Volume 37 Issue 8 Pages 594-599
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.594

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Hyperostosis is a well-known bony reaction associated with meningioma. However, it is difficult to determine preoperatively whether meningioma cells have invaded the bone, and if so, the extent of tumor invasion. Preoperative thallium-201 chloride single photon emission computed tomography (²⁰¹Tl SPECT) was performed in four patients with meningioma and hyperostosis. The presence of meningioma cells in bone biopsy specimens was also investigated using standard histological techniques. ²⁰¹Tl SPECT revealed increased uptake in three of the four patients. Biopsy specimens from these three patients revealed invasion of the bony lesions by meningioma cells in accordance with the ²⁰¹Tl SPECT findings. ²⁰¹Tl SPECT found no abnormal uptake in the other patient, in which there was also no histological evidence of tumor invasion of bone. Preoperative ²⁰¹Tl SPECT can provide information on bone invasion by meningioma, which will facilitate preoperative planning of the extent of bony resection required at meningioma surgery.

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Regeneration of Hemisectioned Spinal Cords With and Without Supporting Materials

Hiroshi K. INOUE, Satoshi KOBAYASHI, Katsumi OHBAYASHI

1997 Volume 37 Issue 8 Pages 600-605
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.600

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Nerve regeneration in hemisectioned spinal cords with and without supporting materials was examined in rats. Cell migration and newly formed capillaries surrounded by laminin-positive materials appeared at the lesioned site 7 days postoperatively. Reactive astrocytes increased at the lesioned site and extended into the spinal cord within 3 weeks. However, cell reactions decreased by 4 weeks and a cavity formed at the lesioned site in all animals. Regenerated axons were found only proximal to the lesioned site at 4 to 8 weeks. In the presence of supporting material (sciatic nerve containing proliferated Schwann cells or membrane filter), no cavity formed in the spinal cord and glial reactions were modest around the supporting material. Regenerated axons with growth cones were observed in the supporting material. However, no regenerated axons penetrated into the distal part of the spinal cord. Spinal cord axons can regenerate in the presence of supporting materials, but appropriate microenvironments, such as those found in the injured sciatic nerve, are required for spinal axons to traverse a lesion and penetrate into the spinal cord.

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Chromosome 22q Allelic Losses at Microsatellite Loci in Human Astrocytic Tumors

A. K. M. Ghulam MUHAMMAD, Toshiki YOSHIMINE, Motohiko MARUNO, Koji TOK ...

1997 Volume 37 Issue 8 Pages 606-611
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.606

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Common regions of deletion(s) on chromosome 22q and the correlations between loss of heterozygosity and patient survival were analyzed in 19 deoxyribonucleic acid samples from astrocytic tumors (3 astrocytomas, 5 anaplastic astrocytomas, and 11 glioblastomas) and matched normal brain tissues. The polymerase chain reaction products using five microsatellite markers were electrophoresed on polyacrylamide gels and the ethidium bromide stained bands were photographed. Loss of heterozygosity was observed in 14 (74%) of 19 samples, with similar incidences in astrocytomas, anaplastic astrocytomas, and glioblastomas (67%, 60%, and 82%, respectively). The locus D22S300 (q12.1-q13.1) was most frequently involved, with loss of heterozygosity in eight (80%) of 10 informative glioblastomas at this locus. Increased loss of heterozygosity during tumor progression or recurrence was seen in two patients at the D22S300 (q12.1-q13.1) and TOP1P2 (q11.2-q13.1) loci. No correlation between loss of heterozygosity on chromosome 22 and the postoperative survival was found. These findings suggest that loss of heterozygosity on chromosome 22q probably occurs quite frequently in astrocytic tumors. The chromosome segment 22q12.1-q13.1, around the D22S300 locus, may be the common region of deletion in glioblastomas.

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Non-aneurysmal Subarachnoid Hemorrhage Associated with Basilar Artery Dissection —Autopsy Case Report—

Tsuneaki OGIICHI, Shunro ENDO, Keiichiro ONIZUKA, Michiyasu TAKABA, Ak ...

1997 Volume 37 Issue 8 Pages 612-615
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.612

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A 60-year-old male presented with subarachnoid hemorrhage (SAH) of unknown origin and died of peritonitis 2 months after the ictus. Computed tomography on admission revealed localized hemorrhage at the interpedunclar cistern and sedimentation in both posterior horns. Repeat angiography could not detect any aneurysm. Postmortem histological examination revealed disruption of the wall associated with intramural hemorrhage at the top of the basilar artery, and subintimal hemorrhages of the lower basilar artery and the left vertebral artery. Arterial dissection of the vertebrobasilar system may be a cause of SAH of unknown origin including perimesencephalic hemorrhage.

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Orbital Varix Diagnosed by Color Doppler Flow Imaging —Case Report—

Shoichiro KAWAGUCHI, Hiroyuki NAKASE, Hiroshi NOGUCHI, Taiji YONEZAWA, ...

1997 Volume 37 Issue 8 Pages 616-619
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.616

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A 66-year-old male presented with an angiographically occult orbital varix. Angiography and phlebography failed to demonstrate the lesion. Computed tomography angiography showed the varix, but not the vascular flow. Color Doppler flow imaging clearly demonstrated the well-defined varix with slow flow velocity, as well as the precise anatomical location. We recommend color Doppler flow imaging as one of the differential diagnostic tools for intraorbital vascular lesions.

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Secretory Meningioma with Severe Peri focal Edema —Case Report—

Nobusuke TSUZUKI, Hiroya NAKAU, Mutsumi SUGAYA, Keizo HASHIZUME, Susum ...

1997 Volume 37 Issue 8 Pages 620-623
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.620

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An 82-year-old male presented with a small parasagittal meningioma associated with disproportionately severe perifocal edema. Histological examination including immunohistochemical staining and electron microscopy resulted in a diagnosis of secretory meningioma. In addition to tumor size, the edema could not be explained by location, growth rate, vascular involvement, or other factors. We conclude that secretory meningiomas may possess an innate ability to cause brain edema.

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Cerebellopontine Angle Meningioma Causing Asymptomatic Syringomyelia —Case Report—

Shigetaka ANEGAWA, Takashi HAYASHI, Ryuichiro TORIGOE, Kosuke IWAISAKO ...

1997 Volume 37 Issue 8 Pages 624-626
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.624

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A 36-year-old female was admitted with a 3-month history of headache and gait disturbance. Magnetic resonance imaging demonstrated a large tumor in the right cerebellopontine angle and syringomyelia in the upper cervical cord associated with caudal displacement of the cerebellar tonsil. Complete removal of the tumor resulted in disappearance of these associated conditions. Herniation of the cerebellar tonsil and distortion of the brain stem had probably caused disturbance of cerebrospinal fluid flow, which combined with obstruction of the spinal canal, caused the syrinx.

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Intraorbital Subperiosteal Hematoma due to Paranasal Mucocele —Case Report—

Hideo AOKI, Yoshihiro TANAKA, Yoichi NIKI, Kitaro KAMADA, Toyohisa FUJ ...

1997 Volume 37 Issue 8 Pages 627-629
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.627

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A 68-year-old female was admitted with a rare intraorbital subperiosteal hematoma manifesting as sudden orbital pain, progressive blepharoptosis, and diplopia. Computed tomography showed a biconvex high density mass in the superomedial part of the left orbit, which was recognized to be a subperiosteal hematoma intraoperatively. The eroded orbital roof between the frontal sinus and orbit was a result of mechanical compression by the mucocele. Infection extending into the orbit was important in causing the hemorrhage.

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Treatment of Brain Abscess Associated With Ventricular Rupture —Three Case Reports—

Mitsuo ISONO, Yukihiro WAKABAYASHI, Toshihisa NAKANO, Minoru FUJIKI, T ...

1997 Volume 37 Issue 8 Pages 630-636
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.630

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Three patients presented with brain abscess associated with ventricular rupture. The origins of infection were sepsis, congenital heart disease, and unknown, and the organisms were Gram-negative cocci in one and Streptococcus species in two. Ventricular rupture occurred before administration of antibiotics and caused consciousness disturbance in all three patients. Continuous ventricle drainage was begun and antibiotics were directly administered into the ventricles. Aspiration and drainage from the abscess was also performed in two patients. Ventricular irrigation resulted in an excellent effect in one patient. The outcomes were excellent in two patients and fair in one. Aggressive ventricular drainage in the very early stage and direct intraventricular administration of antibiotics are very important to obtain a favorable outcome in patients with brain abscess and ventricular rupture.

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Infected Subdural Effusion Associated with Resolving Subdural Hematoma —Case Report—

Nobuhiko AOKI, Tatsuo SAKAI, Akihiro OIKAWA, Touichiro TAKIZAWA, Tsune ...

1997 Volume 37 Issue 8 Pages 637-639
Published: 1997
Released on J-STAGE: April 10, 2006

DOIhttps://doi.org/10.2176/nmc.37.637

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A 70-year-old male presented with rapid neurological deterioration and fever 3 months after suffering a closed head trauma. He underwent craniotomy for possible subdural empyema based on computed tomography and clinical findings. Dural incision revealed an outer membrane typical of chronic subdural hematoma which covered a clear, yellowish fluid containing Campylobacter fetus. Histological examination confirmed the capsule of the hematoma, with a necrotic focus infiltrated by neutrophiles. Administration of intravenous imipenem and topical tobramycin and cefalothin achieved total resolution of his neurological deficits. Development of the infected subdural effusion was probably secondary to bacterial infection in the pre-existing chronic subdural hematoma in the resolving stage. The presence of the hematoma capsule always carries the risk of development of an infectious focus.

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