巻号一覧
42 巻, 4 号
選択された号の論文の8件中1～8を表示しています
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Original Article
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Fumi NAKAZATO, Tsuyoshi TADA, Yasuyuki SEKIGUCHI, Kentaro MURAKAMI, Sh ...2002 年 42 巻 4 号 p. 151-157
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスPatients with subarachnoid hemorrhage (SAH) who later suffer hydrocephalus show persistently high levels of transforming growth factor-β1 (TGF-β1) in the cerebrospinal fluid after the onset of SAH. Recombinant TGF-β1 induces hydrocephalus in mice. This study examined the spatial learning ability of rats after intraventricular administration of TGF-β1. Thirteen-week-old Wistar rats were treated with 0.8 or 8.0 μg of human recombinant TGF-β1 by direct injection or via osmotic pump. Three months later, their spatial learning ability was evaluated with a Morris water maze. Ventricular size, ultrastructural features, and sodium-potassium-adenosine triphosphatase (Na+,K+-ATPase) activity of the subarachnoid space were examined. All three TGF-β1-treated groups clearly exhibited impaired spatial learning ability, but they did not exhibit ventricular dilation. Histological examination revealed subarachnoid fibrosis and deactivation of Na+,K+-ATPase in the arachnoid cells. These findings are similar to those of our previous experiments involving injection of TGF-β1 in mice. The present and previous studies suggest that subarachnoid fibrosis is an important factor in the disturbance of the spatial learning ability of rats, whereas ventricular size is less important.
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Case Reports
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—Case Report—Tatemi TODAKA, Jun-ichiro HAMADA, Shigetoshi YANO, Yutaka KAI, Motohir ...2002 年 42 巻 4 号 p. 158-161
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 55-year-old male presented with a ruptured distal posterior inferior cerebellar artery (PICA) aneurysm manifesting as subarachnoid hemorrhage. Angiography demonstrated a saccular aneurysm arising from the lateral medullary segment of the left PICA and located on the medial side of the left vertebral artery (VA) and the anterior surface of the medulla oblongata. A transcondylar fossa approach was used to ensure a sufficient operating field and to obtain adequate visualization of the aneurysm, the parent artery, and the perforating arteries to the medulla oblongata. The aneurysm dome protruded medially at the hairpin curve, and was located on the medial side of the left VA and on the anterior surface of the medulla oblongata. There was no vessel branches in the vicinity of the aneurysm. The aneurysm was successfully clipped with minimum retraction of the cerebellar hemisphere and medulla oblongata. Distal PICA aneurysms can be located at various sites in the posterior fossa. The exact location of the aneurysm must be established to select the best surgical approach.
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—Case Report—Ketan DESAI, Trimurti NADKARNI, Rajendra BHAYANI, Atul GOEL2002 年 42 巻 4 号 p. 162-165
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 22-year-old female presented with a cerebellopontine angle epidermoid tumor manifesting as a rare combination of hemifacial spasm, trigeminal neuralgia, and tinnitus. Magnetic resonance imaging demonstrated the tumor distorting the brainstem and the fourth ventricle. The tumor was almost completely resected and the seventh-eighth cranial nerve complex was decompressed by mobilizing the anterior inferior cerebellar artery loop. No arterial loop was related to the trigeminal nerve. The patient was completely relieved of the “tic convulsif” and tinnitus after the surgery. The inflammatory nature of epidermoid tumor may be involved in the etiology of the syndrome. Microvascular decompression may be needed in addition to tumor removal in such cases.
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—Case Report—Hideo TAKESHIMA, Takashi KAWAHARA, Hiroyuki UCHIDA, Hirofumi HIRANO, Y ...2002 年 42 巻 4 号 p. 166-169
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 70-year-old woman presented with a rare brain surface ependymoma with repeated intratumoral hemorrhage. She was admitted with progressive dementia. Two years earlier, a diagnosis of subcortical hematoma in the right frontal lobe had been made following a fall. On admission, magnetic resonance imaging showed a huge right frontal mass lesion with multiple hemorrhagic cysts. She underwent gross total resection. The tumor was located on the surface of the frontal lobe, and was sharply demarcated from the surrounding brain tissue with no attachment to the ventricular wall. The histological features were consistent with an ependymoma forming perivascular pseudorosettes. Immunohistochemistry showed positive staining for glial fibrillary acidic protein. Electron microscopy showed microvilli and zonula adherens. This case demonstrates the natural course of malignant progression of ectopic ependymomas. Ependymoma should be included in the differential diagnosis of tumors associated with repeated subcortical hematomas, even if located on the brain surface and distant from ventricles.
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—Two Case Reports—Kazuhiko SUGIYAMA, Kaoru KURISU, Kazunori ARITA, Eiji TANIGUCHI, Tatsu ...2002 年 42 巻 4 号 p. 170-174
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 3-month-old boy and a 29-year-old woman presented with myelodysplastic syndrome (MDS) following therapy for primary malignant brain tumor. Both received intensive alkylating agent doses for induction and maintenance chemotherapy combined with craniospinal or cranial radiation for medulloblastoma and anaplastic astrocytoma, respectively. They developed refractory anemia and pancytopenia. Approximately 9 years after the completion of induction chemoradiotherapy, chromosomal analysis of bone marrow cells resulted in the diagnosis of MDS. The boy died of leukemic evolution 15 months later, the woman died of hematopoietic failure 3 months later. The most common symptom of MDS is refractory anemia, either alone or as part of bi- or pancytopenia. Clonal proliferation with chromosomal analysis of bone marrow cells establishes the diagnosis of MDS. Patients with malignant brain tumors are at risk of the development of MDS as a late complication of chemotherapy based on high cumulative doses of alkylating agents.
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—Case Report—Cahide TOPSAKAL, Serpil BULUT, Fatih Serhat EROL, Ibrahim OZERCAN, Han ...2002 年 42 巻 4 号 p. 175-180
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 44-year-old woman presented with a thoracic chordoma with intrathoracic extension manifesting as complaints of lower extremity weakness, hypesthesia below the levels of T5-6, and sphincter incontinence. Almost total resection combined with anterior interbody fusion and stabilization was possible through a left transpleural transthoracic approach. She suffered recurrence after 2 years and was considered inoperable. Biopsy revealed a malignant chordoma with no sarcomatous differentiation. Chordoma is an uncommon malignant bone tumor originating from remnants of the embryonal notochord, occurring mostly along the axial skeleton, at the extremity of the vertebral spine, and is least common in the thoracic region. Differential diagnosis is problematic and biopsy is helpful particularly if considered inoperable. Thoracic chordomas of the malignant type manifest as cord or root compression. Classical malignant chordomas must be distinguished from chondroid, benign, or other types of chordomas, since the biological behavior and clinical features are distinct. However, the differential diagnosis cannot be based on histological examination, but long-term follow up is required. Most patients have extradural and intraspinal tissue extension at the time of diagnosis, which makes complete resection impossible. Aggressive surgery without violation of surgical borders is the best choice in the treatment of thoracic chordoma. Thoracic chordoma is a recurring neoplasm and is prone to dissemination and sarcomatous differentiation despite its slow-growing nature.
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—Case Report—Hiroyuki IMAMURA, Mikio NOMURA2002 年 42 巻 4 号 p. 181-183
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスA 76-year-old man underwent ventriculoperitoneal shunting for hydrocephalus after subarachnoid hemorrhage. Eighteen days after the shunt operation, fluoroscopy revealed the peritoneal catheter in the heart. Three-dimensional computed tomography demonstrated penetration of the catheter into the internal jugular vein. Under local anesthesia, part of the peritoneal catheter was pulled out through the cervical incision and cut off. The ends of the peritoneal catheter were connected so that the distal end was settled in the right atrium of the heart under fluoroscopic visualization. The migration of the peritoneal catheter into the heart presumably occurred because the subcutaneous wire guide of the shunt catheter perforated the internal jugular vein and the catheter was drawn into the heart through the internal jugular vein by the negative pressure of the vein and thoracic cavity.
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Technical Note
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—Technical Note—Taku SHIGENO, Junichiro KUMAI, Masaru ENDO, Soichi OYA, Shinji HOTTA2002 年 42 巻 4 号 p. 184-190
発行日: 2002年
公開日: 2005/06/19
ジャーナル オープンアクセスRecurrence of trigeminal neuralgia (TN) or hemifacial spasm (HFS) after microvascular decompression (MVD) is not rare. The prosthesis material eventually adheres to the neurovascular structures and again transmits arterial pulsation to the nerve. A snare ligature technique using a Gore-Tex tape can be used for the transposition of the offending artery. No prosthesis is necessary once the transposition is complete. This technique requires introduction of either Gore-Tex tape or thread around the artery and suture over the petrous dura, so an adequate working space as if operating in a shallow basin is essential. Therefore, the osteoplastic craniotomy is a little larger than usual with the scalp flap entirely reflected using a semicircular skin incision. The Gore-Tex tape can be directly snared around the artery and sutured over the petrous dura. If this procedure is difficult, a thread can be attached to both ends of the Gore-Tex tape to pass the tape around the vessel. Seven patients with TN and 13 patients with HFS have undergone this surgery. Although the follow-up period is not yet long enough, there has been no case of recurrence. The present technique for MVD can provide complete and permanent transposition of the offending artery.
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