Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Search
Advanced search
OR
Browse
Search
Volume 42, Issue 7
Displaying 1-9 of 9 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Original Article
  • Diagnosis of Acute Ischemic Stroke Based on Time-To-Peak and Diffusion-Weighted Magnetic Resonance Imaging
    Keisuke MARUYAMA, Tsuneyoshi EGUCHI, Shigeo SORA, Masafumi IZUMI, Hiro ...
    2002 Volume 42 Issue 7 Pages 281-288
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.281
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    Rapid and accurate diagnosis of the hemodynamics of the brain is essential for the treatment of acute ischemic stroke. This study investigated whether time-to-peak and diffusion-weighted magnetic resonance (MR) imaging are useful for predicting the course of stroke. Fourteen patients with non-lacunar acute ischemic stroke underwent emergent MR imaging within 24 hours from the onset followed by cerebral angiography and xenon-enhanced computed tomography (CT). Serial CT was obtained to monitor changes in the size and nature of the infarct. Volumes of the abnormal lesions demonstrated on time-to-peak (VT) or diffusion-weighted (VD) images were measured, and the ratio of VT to VD was calculated. Based on this ratio, patients were classified into three groups: Group 1 (VT/VD 0.5-1.5, n = 9), Group 2 (VT/VD > 1.5, n = 3), and Group 3 (VT/VD < 0.5, n = 2). The size of the infarct detected as a low-density area on serial CT scans did not change significantly throughout the course in Group 1 patients, but showed enlargement in all three patients in Group 2. Two patients in Group 3 had major trunk occlusion followed by spontaneous reperfusion, and both developed hemorrhagic transformation. Our study showed that classification of ischemic stroke based on the VT/VD ratio was predictive of the time course of the infarct, and may be useful in selecting the initial therapeutic procedure immediately after the onset of stroke.
    View full abstract
    Download PDF (365K)
Case Reports
  • Traumatic Arteriovenous Fistula of the Vertebral Artery
    —Case Report—
    Marion REDDY, Andreas SCHÖGGL, Walter SARINGER, Brian REDDY, Chri ...
    2002 Volume 42 Issue 7 Pages 289-292
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.289
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 22-year-old woman sustained a stab wound injury of the right vertebral artery. Initial treatment with endovascular embolization using platinum coils in a local hospital could not stop the bleeding. The patient was transferred to our department in hypovolemic shock. Further angiography revealed an arteriovenous fistula. Open surgical revision occluded the vertebral artery and the patient recovered without neurological deficit.
    View full abstract
    Download PDF (144K)
  • Severe Papilledema Identified 3 Weeks After Head Injury
    —Case Report—
    Shoko M. YAMADA, Akira TERAMOTO, Shokei YAMADA, Yayoi C. HOSHIAI
    2002 Volume 42 Issue 7 Pages 293-296
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.293
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 62-year-old woman presented with rapidly developed visual disturbance without associated headache or nausea 3 weeks after head injury. Ophthalmologic examination revealed bilateral severe papilledema with retinal hemorrhage, and intracranial pressure (ICP) was 17.5 cmH2O estimated by lumbar puncture. Computed tomography and magnetic resonance (MR) imaging showed no evidence of increased ICP, except dilation of the subarachnoid space around the optic nerves with distortion of the nerves. Her visual acuity remarkably improved after steroid and glycerol treatment, and optic fundus examination revealed bilateral clear optic papillae without atrophic changes. Follow-up MR imaging demonstrated that the bilateral optic nerves had regained the normal appearance. These results indicate that the bilateral papilledema was caused by increased subarachnoid pressure around the bilateral optic nerves. We conclude that papilledema can occur with a mildly increased ICP and trapped subarachnoid cerebrospinal fluid around the optic nerves, and papilledema may progress after the ICP is normalized. Papilledema is a warning sign for increased ICP, associated with future visual loss from retinal hemorrhage. Therefore, repeated funduscopic investigation is necessary for the early diagnosis and treatment of papilledema.
    View full abstract
    Download PDF (189K)
  • Intracranial Hemangiopericytoma With Extracranial Metastasis Occurring After 22 Years
    —Case Report—
    Hisashi SUZUKI, Yasushi HAGA, Keiji OGURO, Souji SHINODA, Toshio MASUZ ...
    2002 Volume 42 Issue 7 Pages 297-300
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.297
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 65-year-old man developed pancreatic and pubic tumors 22 years after craniotomy for a left sphenoid ridge tumor. The histological finding of the primary sphenoid ridge tumor was meningotheliomatous meningioma. The histological appearance of the biopsy specimen of the pubic tumor was hemangiopericytoma. The recurrent intracranial tumor was treated by radiosurgery, and the metastatic tumors were treated by conventional irradiation. Intracranial tumors rarely metastasize outside the central nervous system, except for meningeal hemangiopericytomas. This case indicates that meningeal hemangiopericytoma may metastasize many years after the initial onset and requires long-term follow up.
    View full abstract
    Download PDF (263K)
  • Pineal Region Tumor Manifesting Initially as Hearing Impairment
    —Case Report—
    Md. Shafiqul ISLAM, Kenichiro ASANO, Hidefumi TABATA, Hiroki OHKUMA, S ...
    2002 Volume 42 Issue 7 Pages 301-304
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.301
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    An 18-year-old male presented with a pineal region germinoma with hearing impairment as the chief complaint. Magnetic resonance image demonstrated a well-enhanced multi-cystic tumor extending into the upper fourth ventricle and wall of the bilateral lateral ventricles. Audiometry revealed bilateral mild hearing impairment in the low frequencies. Auditory brainstem response recording showed low amplitudes in all waves (IV-V/I ratio < 1) with prolong latencies (I-V and III-V) on the right but no discernable wave at 60 dB clicks on left. Hearing impairment and audiometric findings were improved after ventriculoperitoneal shunt operation. The hearing impairment appeared to be a mixed (conductive and sensorineural) type. The tumor was responsible for the sensorineural deafness because of invasion and compression of the central auditory structures. The inferior brachium was maximally compressed anterolaterally by the dilated bilateral lateral ventricles and posteromedially by the tumor. Hydrocephalus caused conductive deafness by halting or arresting the footplate of stapes movement, as a consequence of high-pressure transmission through the cochlear aqueduct.
    View full abstract
    Download PDF (225K)
  • Chordoma in the Sella Turcica
    —Case Report—
    Yoshiteru KAKUNO, Takashi YAMADA, Hiroshi HIRANO, Hiroshi MORI, Isamu ...
    2002 Volume 42 Issue 7 Pages 305-308
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.305
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 75-year-old man presented with a rare case of chordoma in the sella turcica of the skull base. He had been treated for hypertension and chronic renal failure since 1990. Computed tomography detected a tumor in the sella turcica in 1994, but the patient had no clinical complaints and the serum pituitary hormone levels were normal. He died of disseminated intravascular coagulation, myocardial infarction, pulmonary infection, and multiple cerebral infarctions in 2000. At autopsy, the tumor in the sella turcica was 3.1 cm in greatest diameter and had compressed the pituitary gland posteriorly. Histological examination found oval cells and vacuolated short spindle-shaped cells which showed morphological changes similar to myxoma cells. The tumor was lobulated by narrow connective tissues. The tumor did not contain any cartilaginous tissue components, and was stained positively for epithelial membrane antigen but negatively for S-100 protein. The final diagnosis was chordoma. There was no association between the tumor and the cause of death.
    View full abstract
    Download PDF (314K)
  • Pontine Glioblastoma Multiforme Initially Presenting With Leptomeningeal Gliomatosis
    —Case Report—
    Yasushi MOTOYAMA, Shirei OGI, Sachio NABESHIMA
    2002 Volume 42 Issue 7 Pages 309-313
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.309
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 49-year-old female presented with diffuse leptomeningeal gliomatosis as the initial manifestation of pontine glioblastoma. Magnetic resonance imaging initially revealed diffuse leptomeningeal enhancement caused by metastatic deposits, predominantly along the basal cistern and bilateral sylvian fissures. The primary pontine lesion appeared as hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, but with no enhancement by gadolinium-diethylenetriaminepenta-acetic acid. There was no diffuse enlargement of the pons. The patient died 11 months after the initial presentation. The primary lesion in the pons was histologically confirmed at autopsy. Diffuse enhancement of leptomeningeal dissemination may occur as the initial manifestation of non-enhanced pontine glioblastoma.
    View full abstract
    Download PDF (293K)
  • Surgical Strategy for Spondylodiscitis Due to Candida Albicans in an Immunocompromised Host
    —Case Report—
    Tsutomu TOKUYAMA, Shigeru NISHIZAWA, Naoki YOKOTA, Seiji OHTA, Tetsuo ...
    2002 Volume 42 Issue 7 Pages 314-317
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.314
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 44-year-old woman receiving systemic chemotherapy for cerebellar medulloblastoma developed thoracolumbar spondylodiscitis due to Candida albicans associated with abscesses in the bilateral psoas muscles. As long-term medical therapy with fluconazole was not effective, radical removal of the affected lesions and anterior bone grafting were performed. Corpectomy of the infected vertebra with autologous bone grafting and removal of the psoas muscle were performed via the right transthoracic retroperitoneal approach. Additional posterior instrumentation was not used. Two years after the operation, the patient was doing well, and systemic chemotherapy for medulloblastoma has restarted. Corpectomy with radical resection of surrounding infectious tissues for C. albicans spondylodiscitis in an immunocompromised host should be performed when conservative medical treatment is not successful. Further instrumentation surgery might be necessary to prevent further deformity of the spine as the second surgery.
    View full abstract
    Download PDF (150K)
Technical Note
  • Less-Invasive Sublabial Unilateral Transseptal Approach for Transsphenoidal Surgery
    —Technical Note—
    Shozo YAMADA, Kouji TAKADA, Masaaki USUI
    2002 Volume 42 Issue 7 Pages 318-322
    Published: 2002
    Released on J-STAGE: June 17, 2005
    DOIhttps://doi.org/10.2176/nmc.42.318
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A less-invasive sublabial approach was developed to overcome the disadvantages associated with the conventional sublabial approach. The basic differences between this modified sublabial approach and the conventional approach are: a smaller incision (1-1.5 cm long) and almost midline vertical skin incision underneath the upper lip; minimal development of an inferior tunnel; no widening of the maxillary rim of the piriform aperture; and a strictly unilateral approach. This less-invasive approach uses a slim and small nasal speculum originally designed for the transnasal approach. This modified sublabial approach was applied to 41 of 133 patients who underwent transsphenoidal surgery between August 1998 and the end of 2000. These cases confirmed that this approach is a simple, rapid, and less-invasive technique with significantly fewer mucosal complications compared to the conventional approach. We conclude that this modified sublabial approach offers a good alternative to the conventional standard sublabial approach.
    View full abstract
    Download PDF (198K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top