巻号一覧
42 巻, 1 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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Hiroyuki NAKASE, Takanobu KAIDO, Shuzo OKUNO, Tohru HOSHIDA, Toshisuke ...2002 年 42 巻 1 号 p. 1-4
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスLaser-Doppler (LD) flowmetry was used to measure tissue perfusion non-invasively and continuously during neurosurgical operations using an LD scanner. Scanning was usually completed in 20 seconds. Measurements were processed in software to provide a color-coded image of the tissue perfusion. Moreover, the measurement data, expressed in LD-units, could be used for statistical data analysis. No physical contact was necessary between the scanning device and the exposed brain tissue. The imager provided two-dimensional microvascular flow maps non-invasively and quantitatively during brain operations, and could show the CO2 reactivity in the vessels. LD scanning flowmetry is a promising intraoperative monitoring method for cerebral blood flow changes.
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Hideki BANDAI, Akira TSUNODA, Hideyuki MITSUOKA, Hajime ARAI, Kiyoshi ...2002 年 42 巻 1 号 p. 5-10
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスThe fast inversion recovery (IR) technique was evaluated for the localization of gliomas. Fast IR imaging with real reconstruction and T1-weighted spin echo (SE) imaging before and after contrast administration were performed in 20 patients with gliomas. The tumor-to-white matter contrast ratio (TWCR), tumor-to-gray matter contrast ratio (TGCR), tumor-to-white matter contrast-to-noise ratio (TWCNR), and tumor-to-gray matter contrast-to-noise ratio (TGCNR) were calculated and compared. Fast IR imaging visualized tumors with significantly higher TWCR, TGCR, TWCNR, and TGCNR values (p < 0.01) than those for T1-weighted SE imaging. In particular, fast IR imaging clearly revealed seven non-enhanced tumors that were poorly visualized on T1-weighted SE imaging. Fast IR imaging showed a similar TGCR and significantly higher TWCR (p < 0.01) compared to T1-weighted SE imaging with contrast medium in 13 enhanced tumors. However, fast IR imaging showed similar TWCNR and lower TGCNR compared to T1-weighted SE imaging with contrast medium. The fast IR technique can discriminate tumors from normal cerebral tissues with high contrast and without the use of contrast medium. This technique is extremely useful for the localization of non-enhanced tumors.
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Masaki KOMIYAMA, Tomoya ISHIGURO, Misao NISHIKAWA, Toshihiro YASUI, To ...2002 年 42 巻 1 号 p. 11-17
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスThe diagnostic accuracy of three-dimensional constructive interference in steady state (CISS) magnetic resonance (MR) imaging was evaluated for the assessment of idiopathic moyamoya disease. Six consecutive patients underwent MR angiography, CISS imaging, and digital subtraction angiography. MR angiography and CISS imaging visualization of the steno-occlusive changes in the distal internal carotid arteries and the development of moyamoya vessels in the basal cistern were compared to the results obtained by digital subtraction angiography. MR angiography revealed the steno-occlusive changes correctly in nine and overestimated the changes in three of 12 hemispheres examined. CISS imaging showed the steno-occlusive changes defined as decreased caliber of the internal carotid artery correctly in two, underestimated the changes in nine, and overestimated the changes in one of the 12 hemispheres. MR angiography detected moyamoya vessels correctly in five and underestimated the vessels in seven of the 12 hemispheres. CISS imaging revealed the moyamoya vessels correctly in 10, underestimated the vessels in one, and overestimated the vessels in one of the 12 hemispheres. CISS imaging can supplement MR angiography in the non-invasive diagnosis of moyamoya disease, especially for the evaluation of moyamoya vessels.
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Case Reports
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—Two Case Reports—Shinya KOHYAMA, Tatsumi KAJI, Aya M. TOKUMARU, Shoichi KUSANO, Shoichi ...2002 年 42 巻 1 号 p. 18-22
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスTwo elderly female patients with carotid-cavernous fistulas (CCFs) were treated by transvenous embolization through a transfemoral superior ophthalmic vein approach via the facial vein. Complete occlusion of CCFs was not achieved with this technique exclusively, but the technique was effective in these cases. This technique provides an alternative to other transvenous approaches for the treatment of CCFs.
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—Case Report—Masanori HASHIMOTO, Eiichirou URASAKI, Satoshi TSUJIGAMI, Akira YOKOTA2002 年 42 巻 1 号 p. 23-26
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスA 65-year-old woman presented with a ruptured saccular aneurysm associated with a rare variation of the posterior communicating artery (PcoA), partially duplicated PcoA. The PcoA with this variation forked just distal to the aneurysmal neck, and the two branches independently merged into the posterior cerebral artery. Initial clipping failed to isolate the aneurysm from one of the two branches, so the aneurysmal dome continued to pulsate and bleed. Temporary clipping of the proximal internal carotid artery revealed the fork of the two branches just distal to the aneurysmal neck. A curved Yasargil clip was used to clip the aneurysm and preserve the PcoA and branches. Careful observation of this PcoA variation is needed because the arterial structures may be hidden by the thickened arachnoid membrane.
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—Two Case Reports—Dattatraya MUZUMDAR, Atul GOEL, Ketan DESAI, Raj BHAYANI, Pravin SHARM ...2002 年 42 巻 1 号 p. 27-30
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスTwo rare cases of subtorcular occipital bone hemangioma occurred in 26-year-old and 30-year-old female patients. Partial resection was performed in both cases because of the proximity to the torcula. No recurrence was seen at follow-up examination at 9 and 12 months.
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—Case Report—Toru MATSUI, Eiharu MORIKAWA, Tadashi MORIMOTO, Takao ASANO2002 年 42 巻 1 号 p. 31-35
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスA 61-year-old man presented with a rare, large trochlear nerve schwannoma manifesting as left-sided weakness and hypesthesia, bilateral bulbar pareses, and trochlear nerve paresis persisting for 3 months. T1-weighted magnetic resonance imaging with gadolinium revealed an intensely enhanced, well-circumscribed lesion with multicystic formation occupying the prepontine and interpeduncular cisterns and compressing the pons and midbrain with greater extension to the right. The mass was completely removed through the presigmoid transpetrosal approach with preservation of the posterior cerebral, superior cerebellar, and basilar arteries and their branches. Neuroradiological examination after 3 years demonstrated no recurrence. Enlargement of a tumor in the cisternal portion is inclined to involve and/or encase the adjacent major arteries and their branches. The presigmoid transpetrosal approach is one of the best surgical routes to remove a large trochlear nerve schwannoma safely and completely.
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—Case Report—Masaru KANDA, Ichiro YUHKI, Yasuo MURAKAMI, Yuzuru HASEGAWA, Toshinori ...2002 年 42 巻 1 号 p. 36-39
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスA 28-year-old man presented with monostotic fronto-orbital fibrous dysplasia associated with convulsions. Signs of meningeal irritation were observed. Computed tomography (CT) showed right frontal sinusitis, and destruction from the inner to outer table with expansion of the diploic space. T1- and T2-weighted magnetic resonance imaging showed an abnormal low-intensity mass, with heterogeneous gadolinium enhancement. Although the meningitis resolved, signs of infection continued for 2 months due to sinusitis. Treatment of the right frontal sinusitis was undertaken, accompanied by open biopsy. The histological diagnosis was fibrous dysplasia. Once the infection had completely resolved, orbitofrontal reconstruction was undertaken. Cranioplasty was carried out using cranial bone cement. Three-dimensional CT was valuable to show the likely postoperative result.
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—Case Report—Yuzuru OHTA, Hideo SHICHINOHE, Kazuo NAGASHIMA2002 年 42 巻 1 号 p. 40-43
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスA 69-year-old woman with a 14-year history of polycythemia vera suffered progressive paraparesis due to epidural involvement of hematopoietic tissue. Magnetic resonance (MR) imaging demonstrated extensive epidural masses. Decompressive surgery and radiotherapy were performed and she made an almost complete clinical recovery. Serial MR imaging showed no regrowth of the other epidural masses.
Extramedullary hematopoiesis occurs in patients with various hematologic disorders involving a chronic increase in the production of red blood cells, and is often associated with thalassemia, but is less common with polycythemia vera. The most frequent sites are the spleen, liver, and kidney. Extramedullary hematopoietic tissue occurring within the spinal canal and causing cord compression is very rare. Total surgical excision is not usually feasible because of the diffuse nature of extramedullary hematopoietic tissue and the possibility of recurrence, but acute neurological deterioration does require emergency surgery. Extramedullary hematopoiesis is radiosensitive and displays a rapid response to low dosages, so radiation therapy is recommended for residual tumors. Considering the possibility of central nervous system extramedullary hematopoiesis in patients with polycythemia vera, an early diagnosis is necessary for a favorable prognosis.
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—Case Report—Cahide TOPSAKAL, Metin KAPLAN, Fatih EROL, Hasan CETIN, Ibrahim OZERCA ...2002 年 42 巻 1 号 p. 44-50
発行日: 2002年
公開日: 2005/06/20
ジャーナル オープンアクセスA 67-year-old woman was admitted to our clinic with symptoms of normal pressure hydrocephalus, lower cranial nerve pareses, and pyramidal and cerebellar signs associated with respiratory disturbances. Computed tomography (CT) and magnetic resonance imaging revealed a 4.7 × 5.4 cm quadrigeminal arachnoid cyst causing severe compression of the tectum and entire brain stem, aqueduct, and cerebellum, associated with moderate dilation of the third and lateral ventricles. Emergency surgery was undertaken due to sudden loss of consciousness and impaired breathing. The cyst was totally removed by midline suboccipital craniotomy in the prone position. Postoperatively, her symptoms improved except for the ataxia and impaired breathing. She was monitored cautiously for over 15 days. CT at discharge on the 18th postoperative day revealed decreased cyst size to 3.9 × 4.1 cm. Histological examination confirmed the diagnosis of the arachnoid cyst of the quadrigeminal cistern. The patient died of respiratory problems on the 5th day after discharge. Quadrigeminal arachnoid cysts may compress the brain stem and cause severe respiratory disturbances, which can be fatal due to apneic spells. Patients should be monitored continuously in the preoperative and postoperative period until the restoration of autonomous ventilation is achieved.
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