Neurologia medico-chirurgica

Modulatory Role of Protein Tyrosine Kinase Activation in the Receptor-induced Contractions of the Bovine Cerebral Artery

Mikio WATANABE, Mamoru DOI, Kazuhiko SASAKI, Akira OGAWA

1998 Volume 38 Issue 2 Pages 75-82
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.75

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Changes in contractile force were measured during isometric contraction of the bovine middle cerebral artery caused by stimulation of various receptors and by application of high K⁺, caffeine, and protein kinase C (PKC)-activators. The protein tyrosine kinase (PTK)-inhibitors, such as genistein and tyrphostin, were applied before testing the effect on the contractions or during the maximal plateau of the contraction. The contractions induced by serotonin, prostaglandin F_2α, endothelin-1, and thromboxane A₂ were significantly and dose-dependently depressed by the PTK-inhibitors (IC₅₀ 2-15 μM). In contrast, contractions were significantly augmented by 1 μM pervanadate, an inhibitor of phosphoprotein tyrosine phosphatase. Lineweaver-Burk plotting of the dose-response curves with an increase in inhibitor concentration indicated that the receptor affinity for each agonist remained unchanged in spite of marked depression of the responses. Although the effect was not significant, contractions induced by both high K⁺ and caffeine were also depressed slightly by PTK-inhibitors in the same range of concentrations used for receptor-induced contractions. Contractions induced by PKC-activators, such as 1-oleoyl-2-acetyl-sn-glycerol and phorbol-12, 13-diacetate, were significantly depressed by PTK-inhibitors at concentrations similar to those used for receptor-induced contractions. The results suggest that receptor stimulations which produce sequential activation of phospholipase C and PKC can activate PTK and trigger the so-called “PTK-cascade” causing a sustained or long-lasting contraction similar to the cerebral vasospasm observed clinically.

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Roentgenological Study of the Sagittal Diameter of the Cervical Spinal Canal in Normal Adult Japanese

Takashi SASAKI, Satoru KADOYA, Hideaki IIZUKA

1998 Volume 38 Issue 2 Pages 83-89
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.83

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The sagittal diameter of the cervical spinal canal on roentgenograms in normal adult Japanese aged 15 years or over, 505 males and 492 females, was investigated to define the normal distribution and lower limit. Lateral roentgenograms of cervical spinal canals were taken at a constant focus-film distance of 1.5 m. The mean ± SD magnification coefficient was 1.17 ± 0.02. The mean ± SD sagittal diameters of the cervical spinal canals at each vertebral level were: C-1, 21.0 ± 2.2 mm; C-2, 18.0 ± 1.7 mm; C-3, 15.8 ± 1.5 mm; C-4, 15.2 ± 1.5 mm; C-5, 15.3 ± 1.5 mm; C-6, 15.7 ± 1.5 mm; and C-7, 15.9 ± 1.4 mm. The lowest mean — 2 SD values were: C-1, 16.6 mm; C-2, 14.6 mm; C-3: 12.8 mm; C-4, 12.2 mm; C-5, 12.3 mm; C-6, 12.7 mm; and C-7, 13.1 mm. The smallest diameter was at the C-4 level, but there was no significant difference between values at the C-4 and C-5 levels. Males had significantly larger diameters than females (mean difference 0.8 mm) (p < 0.01). Younger subjects had greater diameters than older subjects. The incidence of spondylotic changes was 40.1% in subjects aged 50-59 years, 57.7% in those aged 60-69 years, and 76.6% in those aged 70-79 years. Males had a higher incidence than females. Ossification of the posterior longitudinal ligament was observed in 2.1% of all subjects. This study suggests that patients with a sagittal diameter in the cervical spinal canal of less than 12 mm have a high risk of cervical myelopathy.

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Third Ventricular Neuroepithelial Cyst Originating from the Massa Intermedia —Case Report—

Yukihiro WAKABAYASHI, Mitsuo ISONO, Shigeaki HORI, Kazunari OKA

1998 Volume 38 Issue 2 Pages 90-94
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.90

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A 47-year-old female presented with a 3-year history of progressive emotional disturbance. Computed tomography and magnetic resonance imaging revealed a cyst in the third ventricle causing hydrocephalus. Endoscopic surgery found the cyst originated at the massa intermedia. Histological examination confirmed the diagnosis of neuroepithelial cyst. Neuroepithelial cyst originating from the massa intermedia may be due to persistence of neuroepithelial crest at this location.

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Autopsy Findings in a Long-term Survivor With Glioblastoma Multiforme —Case Report—

Shozo YAMADA, Yuzo ENDO, Takanori HIROSE, Koji TAKADA, Masaaki USUI, M ...

1998 Volume 38 Issue 2 Pages 95-99
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.95

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Autopsy detected no tumor tissues in a patient who died 6.5 years after the diagnosis of glioblastoma multiforme. A 54-year-old male developed left hemiparesis one month prior to admission. Computed tomography demonstrated a cystic lesion in the right frontal region with irregular ring-like enhancement. The tumor was extensively removed together with the surrounding tissues followed by irradiation (whole brain 32.4 Gy, local 28.8 Gy), and intravenous administration of interferon-β. Histological examination confirmed the diagnosis of glioblastoma multiforme. He died of accidental head trauma 6.5 years after surgery. Autopsy of the brain detected no evidence of glioblastoma multiforme. The only findings were cerebral edema and hematoma caused by head trauma, as well as histological changes due to radiation damage. This case apparently confirms the histological disappearance of tumor tissue in a long-term survivor with glioblastoma multiforme.

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Facial Spasm and Paroxysmal Tinnitus Associated with an Arachnoid Cyst of the Cerebellopontine Angle —Case Report—

Shingo TAKANO, Tooru MARUNO, Shizuo SHIRAI, Tadao NOSE

1998 Volume 38 Issue 2 Pages 100-103
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.100

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A 59-year-old female presented with a 3-year history of hemifacial spasm and paroxysmal tinnitus associated with an arachnoid cyst of the cerebellopontine angle, which was identified preoperatively by magnetic resonance imaging. Surgical decompression of the cyst and arterial decompression of the facial and acoustic nerves at their root exit zones resulted in complete resolution of the symptoms.

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Magnetic Resonance Imaging of Non-specific Inflammatory Granulation Involving the Skull Base —Two Case Reports—

Akira WATANABE, Ryoji ISHII, Hironari OKAMURA, Teruo SHIRABE

1998 Volume 38 Issue 2 Pages 104-106
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.104

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A 55-year-old male presented with a 20-day history of nuchal pain and hypoglossal nerve paresis on the right. T₂-weighted magnetic resonance (MR) imaging showed an isointense lesion with a small hypointense part in the hypoglossal canal and caudal clivus. A 66-year-old female presented with a long-standing history of left orbital pain. T₂-weighted MR imaging showed a hypointense lesion occupying the orbital apex which on recurrence became isointense. The histological diagnosis of both lesions was non-specific inflammatory granulation. The T₂-weighted MR imaging appearance of this entity is variable, and can change within the clinical course of the same lesion.

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Usefulness of Neuroendoscopy in Treating Supracollicular Arachnoid Cysts —Case Report—

Shigeru FURUTA, Takao HATAKEYAMA, Osamu NISHIZAKI, Shinya FUKUMOTO

1998 Volume 38 Issue 2 Pages 107-109
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.107

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A 12-year-old girl presented with a supracollicular arachnoid cyst manifesting as a compressive headache. Neurological examination on admission revealed no deficit except bilateral papilledema. Stereotactic cyst puncture failed to perforate the cyst wall. The wall was then punctured using microforceps under neuroendoscopic guidance, followed by cystoperitoneal shunting. Her headache disappeared immediately after surgery. Neuroendoscopy is useful in treating a deep-seated arachnoid cyst.

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Surgical Correction of Trigonocephaly: Theoretical Basis and Operative Procedures

Eiji MORIYAMA, Hiroichi BECK, Keiichi ISEDA, Nobuyuki SAITOH, Masaru S ...

1998 Volume 38 Issue 2 Pages 110-115
Published: 1998
Released on J-STAGE: March 30, 2006

DOIhttps://doi.org/10.2176/nmc.38.110

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Trigonocephaly involves premature fusion of both the metopic suture and the sutures in the skull base. Surgical treatment by opening of the prematurely fused metopic suture and expansion of the anterior cranial base by creating “neosutures” was used to treat three children with trigonocephaly. The combination of lateral canthal advancement and radical forehead remodeling achieved excellent results. These procedures can also prevent the development of midface hypoplasia such as hypotelorism. The two younger patients, aged 0 and 6 months, achieved rapid bone growth in the defects and normalization of intercanthal and interpupillary distances. The older patient, aged 8 years, retained some skull defects at follow-up. The optimal age for surgery is 3-6 months, which allows good cosmetic results and minimizes visual repercussions with relatively low perioperative risks.

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