巻号一覧
42 巻, 10 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 Article
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Atsushi FUKUNAGA, Takeshi KAWASE, Haruo KASHIMA, Jun HASHIMOTO, Koichi ...2002 年 42 巻 10 号 p. 419-426
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスPostoperative changes in higher cortical function and cerebral blood flow (CBF) were investigated in patients with unruptured cerebral aneurysms to assess the effect of habitual smoking on the known transient changes after aneurysm surgery. Fifty-six adults with unruptured cerebral aneurysms, including 11 heavy smokers (smoking index ≥600) and 45 non-smokers, were evaluated using three neuropsychological examinations, the Mini-Mental State Examination, the Maze test, and the Kana-hiroi test, and single photon emission computed tomography to measure CBF before and after surgery. Neuropsychological changes were assessed by reliable change indices to take into account the practice effects. The scores of at least one examination decreased in 15 of 56 patients 1 month after surgery. On the Maze test, five of 11 heavy smokers and five of 45 non-smokers deteriorated after surgery, showing a significant difference (p = 0.018). The CBF in heavy smokers often decreased after surgery, but there was no statistically significant difference in logistic regression. Three months after surgery, the neuropsychological scores of 13 of the 15 deteriorated patients recovered to the preoperative level. Higher cortical function in heavy smokers with unruptured cerebral aneurysms often decreases transiently after operation, compared to non-smokers. Therefore, surgery planning for heavy smokers with unruptured cerebral aneurysms should consider this outcome.
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Case Reports
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—Case Report—Mitsunobu IDE, Shinji HAGIWARA, Noriko TANAKA, Hirotsune KAWAMURA2002 年 42 巻 10 号 p. 427-430
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 31-year-old woman presented with bilateral ophthalmic segment “kissing” aneurysms causing subarachnoid hemorrhage manifesting as sudden severe headache and nausea 3 days before admission. Cerebral angiography demonstrated bilateral internal carotid-superior hypophyseal artery aneurysms, both projecting medially from the medial surface of the internal carotid arteries and appearing to touch each other. Both aneurysms had to be clipped in the same operation, because of uncertainty over which aneurysm had bled. She underwent bilateral frontotemporal craniotomy on the day after admission. Intraoperatively, the two aneurysms were in contact with each other in the suprasellar cistern. Each aneurysm was clipped through the ipsilateral approach without any incident. The patient returned home a month after the operation and has since resumed her previous work. Identification of this rare entity of bilateral ophthalmic segment “kissing” aneurysms is important for surgical planning. Closely situated, bilateral ophthalmic segment aneurysms require a modified surgical strategy for proximal arterial control and the approach to each aneurysm.
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—Case Report—Shinya OSHIRO, Masaaki YAMAMOTO, Takeo FUKUSHIMA2002 年 42 巻 10 号 p. 431-434
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 49-year-old man presented with symptomatic cavernous malformation in the ventrolateral portion of the medulla oblongata manifesting as left-sided numbness and gait disturbance. Neurological examination disclosed sensory disturbance on the left, cerebellar ataxia, nystagmus, dysphagia, and right hypoglossal nerve paresis. Magnetic resonance imaging revealed a cavernous malformation with hemorrhage occupying the right paramedian field of the medulla oblongata. The patient underwent complete removal of the lesion through vertical incision of the bulging surface of the ventrolateral medulla, anatomically coinciding with the inferior olive. The neurological deficits improved without additional postoperative deficits. This unusual microsurgical approach through a ventrolateral medullary incision permits direct resection of a subpial intrinsic lesion, even on the ventral medulla.
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—Case Report—Hajime TOUHO2002 年 42 巻 10 号 p. 435-438
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 65-year-old woman presented with moyamoya disease associated with a saccular aneurysm of the posterior cerebral artery. The surgical plan required superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis to be conducted before neck clipping of the aneurysm to provide collateral flow via the STA to prevent ischemia if temporary occlusion of the parent artery of the aneurysm was needed. However, the anastomotic procedure failed because the STA was occluded at the site of temporary clip application. End-to-end anastomosis of the STA was planned after excising the occluded site of the STA, but end-to-end anastomosis could not be performed because the donor artery was too short for anastomosis to the branch of the MCA. Therefore, patch grafting using a piece of wall of the STA was performed to repair the arteriotomy defect in the wall of the MCA, followed by neck clipping of the saccular aneurysm in the posterior circulation via the subtemporal approach. Vascular reconstruction can be recommended if arterial anastomosis between a superficial skin artery and a branch of the MCA is impossible due to an intraoperative accident or technical difficulty and reperfusion is necessary.
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—Case Report—Marion REDDY, Jürgen-V. ANTON, Andreas SCHÖGGL, Brian REDDY, ...2002 年 42 巻 10 号 p. 439-442
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 16-year-old male presented with a massive nasopharyngeal angiofibroma arising in the nasopharynx, nasal cavity, pterygopalatine fossa, and infratemporal fossa, and eroding the pterygoid process of the sphenoid bone. Neuroimaging showed the tumor had infiltrated the parasellar region from the middle cranial fossa and reached the cavernous sinus. The tumor was almost completely removed macroscopically by a modified transbasal approach.
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—Case Report—Masafumi UCHINO, Satoru KITAJIMA, Chikao MIYAZAKI, Iekado SHIBATA, Myo ...2002 年 42 巻 10 号 p. 443-446
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 35-year-old woman presented with a bilateral thalamic glioma manifesting as dysesthesia over the left side of the body and mental deterioration. T1-weighted magnetic resonance imaging revealed enlarged bilateral thalami with homogeneous isointensity and no enhancement after gadolinium administration. Histological examination of a stereotactic biopsy specimen identified anaplastic astrocytoma. Radiotherapy and chemotherapy failed to arrest tumor growth. She subsequently died. Magnetic resonance imaging and clinical findings support the view that bilateral thalamic gliomas represent a distinct clinicopathologic entity among thalamic tumors.
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—Case Report—Shigeki KUBO, Hiroshi TAKIMOTO, Kazuki HOSOI, Shingo TOYOTA, Jun KARAS ...2002 年 42 巻 10 号 p. 447-451
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 52-year-old man complaining of headache and nuchal pain was treated initially under a diagnosis of bacterial meningitis. The meningitis resisted antibiotic therapy, and one week later was complicated by a ruptured retropharyngeal abscess, which led to the correct diagnosis of osteomyelitis of the odontoid process of the axis. His neck was immobilized in a high neck collar and the retropharyngeal abscess was treated by repeated drainage and irrigation. A long course of antibiotic administration finally resolved the infection. Osteomyelitis of the odontoid process is rare and presents with peculiar signs and symptoms. Careful consideration of the differential diagnosis is needed for the early detection of this potentially serious condition.
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—Case Report—Sadahiro NOMURA, Tatsuo AKIMURA, Hirochika IMOTO, Takafumi NISHIZAKI, ...2002 年 42 巻 10 号 p. 452-454
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA 32-year-old man presented with an arachnoid cyst of the posterior fossa manifesting as cervical syringomyelic myelopathy. Magnetic resonance (MR) imaging demonstrated edematous enlargement and T2 prolongation of the cervical spinal cord, indicating a “presyrinx” state. MR imaging showed the inferior wall of the cyst, which disturbed cerebrospinal fluid (CSF) pulsatile movement between the intraspinal and intracranial subarachnoid spaces. The cyst wall was fenestrated with a neuroendoscope. The presyrinx state and the CSF movement improved. Posterior fossa arachnoid cyst, as well as Chiari malformation, can cause CSF flow disturbance at the craniocervical junction and syringomyelia. Endoscopic fenestration is less invasive than foramen magnum decompression and should be the procedure of choice.
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Technical Notes
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—Technical Note—Akira HASHIZUME, Kaoru KURISU, Kazunori ARITA, Ryosuke HANAYA2002 年 42 巻 10 号 p. 455-457
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスA new software program can provide images of electrically equivalent current dipoles and sensor arrays superimposed on three-dimensional magnetic resonance images. The images will be helpful for identifying locations between arbitrary sensors and directly projected brain surfaces, or planning surgical approaches.
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—Technical Note—Ulrich SURE, Ludwig BENES, Thomas RIEGEL, Dirk Michael SCHULTE, Helmut ...2002 年 42 巻 10 号 p. 458-462
発行日: 2002年
公開日: 2005/06/14
ジャーナル オープンアクセスAn automatic image fusion module (BrainLab, Munich, Germany) is used for the fusion of the magnetic resonance (MR) imaging and computed tomography (CT) data sets. The procedure of image fusion takes 5 minutes prior to surgery. The image fusion of CT and MR imaging data visualizes the skull base and tumor margins clearly. Color display of the different data sets allows the tumor and the skull base to be distinguished easily. The fused CT data in bone window mode provides useful additional information on the osseous skull base.
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