巻号一覧
40 巻, 6 号
選択された号の論文の10件中1～10を表示しています
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Original Articles
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Kiyoyuki YANAKA, Kotoo MEGURO, Keishi FUJITA, Kiyoshi NARUSHIMA, Tadao ...2000 年 40 巻 6 号 p. 295-300
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスCerebellar hemorrhage is regarded as a neurosurgical emergency. However, patients with deteriorating consciousness are very likely to die irrespective of the choice of therapy, and it is not clear if surgical intervention can benefit patients in a deeply comatose state. We reviewed 20 patients with a Glasgow Coma Scale score of 3 at admission to ascertain the salvage rate and determine the prognostic factors. Four patients who were managed conservatively died within 2 days. Sixteen patients underwent decompressive suboccipital craniectomy and hematoma evacuation. At discharge, three patients were moderately disabled, three were severely disabled, four were persistently vegetative, and six had died. The overall mortality was 50%. The mean interval between the onset of symptoms and the operation was 1.67 ± 0.29 hours in patients with favorable outcome, and significantly longer at 2.42 ± 0.49 hours in patients with an unfavorable outcome (p = 0.025). Immediate evacuation of the hematoma reduces morbidity and mortality even in deeply comatose patients, especially if the time interval between the onset and surgery is within 2 hours.抄録全体を表示PDF形式でダウンロード (774K) -
Tatsuya NISHIOKA, Ryosuke OKUMURA, Masatsune ISHIKAWA, Akinori KONDO, ...2000 年 40 巻 6 号 p. 301-309
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスThe pathogenesis of optic neuropathy caused by neurovascular compression or by similar mechanisms is unclear. Thin-slice magnetic resonance (MR) imaging was performed in 69 patients with optic neuropathy without demonstrable ophthalmological lesions (57.0 ± 17.1 years of age) and 102 normal subjects (57.7 ± 13.9 years of age). The MR imaging features were classified into “no compression” by the internal carotid artery (ICA), “compression” by the ICA, “no contact” with the anterior cerebral artery (ACA) or the gyrus rectus, “contact” with either or both, “compression” by the ACA, and “compression” by the gyrus rectus. The Spearman correlation coefficients were calculated between patients or controls, the MR classification, and the age, and the number of patients in each MR classification were evaluated by the χ2 test. Five of the 69 patients with rapidly progressive symptoms were operated on via the frontotemporal approach. The MR imaging feature of “compression” by the gyrus rectus was the best predictor of optic neuropathy (Spearman correlation coefficients ρ = −0.23646, p < 0.0018). This MR imaging feature was observed in 38 of 69 patients and in 32 of 102 controls (p = 0.002). Compression of the nerve by the gyrus rectus or the ACA was confirmed in all five operated cases. Decompression of the nerve was fully achieved in four of the five patients, and their symptoms have not progressed since then. Optic neuropathies due to compression by the prolapsing gyrus rectus are not well understood. Such neuropathies may be detected by MR imaging.抄録全体を表示PDF形式でダウンロード (1480K)
Case Reports
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—Two Case Reports—Masaki KOMIYAMA, Toshie MORIKAWA, Hideki NAKAJIMA, Misao NISHIKAWA, To ...原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 310-314
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスSpontaneous dissection of the extracranial vertebral artery (VA) may cause ischemic stroke in the posterior circulation. A 22-year-old female and a 38-year-old male presented with sudden onset of vertigo and nausea without trauma. Angiography was initially interpreted as normal, but retrospective examination disclosed extracranial VA dissection in the V3 segment in both cases. Arterial dissection resulting in embolic stroke in the territory of the ipsilateral posterior inferior cerebellar artery was highly suspected. Both patients were treated conservatively without sequelae. Careful angiographic interpretation is important for the diagnosis of extracranial VA dissection. Spontaneous extracranial VA dissection should be suspected in young patients presenting with ischemic stroke but without predisposing risk factors or associated trauma.抄録全体を表示PDF形式でダウンロード (1221K) -
—Two Case Reports—Satoshi KURODA, Kiyohiro HOUKIN, Mitsuru NUNOMURA, Hiroshi ABE原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 315-320
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスA 60-year-old female and a 40-year-old male underwent surgical revascularization for moyamoya disease and suffered small infarction in the ipsilateral frontal lobe 3 or 4 days postoperatively. Neuroimaging suggested that the bypass flow had caused rapid progression of occlusive changes in the carotid forks, a diminishing of moyamoya vessels, and flow reduction in the anterior cerebral artery ipsilateral to surgery, leading to critical ischemia in the frontal lobe. Surgical revascularization improves the outcome of patients with moyamoya disease, but postoperative management such as hydration is important to avoid ischemic complications due to frontal lobe infarction.抄録全体を表示PDF形式でダウンロード (1633K) -
—Case Report—Toshitaka ENDO, Kentaro MORI, Minoru MAEDA原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 321-323
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスSuperficial temporal artery (STA) aneurysms are very rare, and usually occur in young adult men due to blunt trauma as pseudoaneurysms. An 85-year-old male presented with two non-traumatic STA aneurysms. The aneurysms were ligated and resected. Histological examination showed arteriosclerotic fusiform aneurysm. The pathogenesis of non-traumatic aneurysm of the STA appears to be arteriosclerotic change and/or hemodynamic stress.抄録全体を表示PDF形式でダウンロード (785K) -
—Case Report—Hiroshi NISHIOKA, Hiroshi ITO, Jo HARAOKA, Takao HASHIMOTO, Yuko KATO原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 324-328
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスA 49-year-old female presented with a ciliated craniopharyngioma manifesting as repeated intratumoral hemorrhage. Histological examination suggested that the hemorrhage originated from the many thin blood vessels in the cyst wall stroma associated with inflammation. Symptomatic hemorrhage in cystic craniopharyngioma may mimic pituitary apoplexy but the etiology is quite different. Minor hemorrhage may recur unless the cyst wall is totally removed.抄録全体を表示PDF形式でダウンロード (1121K) -
—Case Report—Kenichiroh ASANO, Eiji SOBATA, Kazuharu YAMAZAKI, Osami KUBO2000 年 40 巻 6 号 p. 329-334
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスMalignant melanomas arising from the sella turcica or sphenoidal sinus with bilateral invasion of the base of the skull or cavernous sinus are extremely rare. Whether the sella turcica or sphenoidal sinus is the site of origin is difficult to determine based on neuroradiological findings. An 83-year-old Japanese female presented with headache as the initial symptom. She suffered rapid progression of bilateral obstruction of the nasal cavity, left nasal bleeding, and bilateral visual field defects. The preoperative diagnosis was pituitary adenoma, metastatic tumor, or malignant paranasal tumor. Biopsy was performed. The histological diagnosis was malignant melanoma. Postoperatively, the tumor progressed rapidly. She suffered several cranial nerve pareses and hypopituitarism. She died within 6 months. Tumors arising from the sphenoidal sinus cause obstruction of the nasal cavity or nasal bleeding first, and then cause cranial nerve pareses by invasion of the cavernous sinus. This sequence of clinical manifestations can be attributed to the anatomical relationships between the sphenoidal sinus, nasal cavity, and cavernous sinus. Differential diagnosis of the origin in the sella turcica or sphenoidal sinus appears to be relatively easy based on further observation of the clinical course and symptoms.抄録全体を表示PDF形式でダウンロード (3050K) -
—Case Report—Kyoji SAKAI, Takumi TSUTSUI, Mizuho AOI, Hiroshi SONOBE, Hiroshi MURAK ...原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 335-338
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスA 74-year-old female presented with a 3-month history of compression neuropathy of the right ulnar nerve in Guyon’s canal. Magnetic resonance imaging and ultrasonography revealed the location of the mass lesion. Surgical exploration discovered a lipoma pressing against both the ulnar nerve and the ulnar artery. The mass was extirpated. The postoperative course was uneventful with good function recovery.抄録全体を表示PDF形式でダウンロード (871K) -
—Case Report—Hideo TSURUSHIMA, Tsuyoshi HARAKUNI, Atsushi SAITO, Daisuke TOMINAGA, ...原稿種別: Others
専門分野: Others
2000 年 40 巻 6 号 p. 339-341
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスA 48-year-old female presented with vertiginous feeling and behavior disturbance. Computed tomography showed an arachnoid cyst on the left cerebral convexity. Single photon emission computed tomography revealed decreased cerebral blood flow (CBF) in the left frontal lobe. The Wechsler Memory Scale-Revised test demonstrated memory dysfunction. The arachnoid cyst was partially removed. Disturbances in CBF and behavior disappeared postoperatively. Local ischemia induced by compression due to arachnoid cyst may cause memory dysfunction and behavior disturbance. Neuropsychometric examination is useful for the evaluation of such symptoms.抄録全体を表示PDF形式でダウンロード (653K) -
—Three Case Reports—Hideo TSURUSHIMA, Tsuyoshi HARAKUNI, Atsushi SAITO, Akio HYODO, Yoshih ...2000 年 40 巻 6 号 p. 342-344
発行日: 2000年
公開日: 2005/09/02
ジャーナル オープンアクセスProgrammable valves are often used for ventriculoperitoneal (VP) shunts with the shunt valve positioned on the chest wall. Three cases of shunt problems occurred due to placement of the valve on the chest wall. A 43-year-old male was treated with a VP shunt, and suffered shunt malfunction due to dislocation of the ventricular tube. A 21-year-old male was treated with a VP shunt, and suffered shunt malfunction due to disconnection of the shunt tube. A 4-day-old female neonate was treated with a VP shunt, and suffered migration of the shunt valve. The shunt system has two anchor sites on the head and chest wall, with the neck between the two anchor sites. High tension is sometimes caused in the shunt tube between the two points due to movement of the neck or growth, and may induce such dislocation and disconnection of the shunt tube. We recommend a longer shunt tube in such cases.抄録全体を表示PDF形式でダウンロード (594K)
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