Neurologia medico-chirurgica

Original Articles

Histologically Classified Venous Angiomas of the Brain: a Controversy

Masamitsu ABE, Naoshi HAGIHARA, Kazuo TABUCHI, Akira UCHINO, Yoshio MI ...

2003 Volume 43 Issue 1 Pages 1-11
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.1

JOURNAL OPEN ACCESS

Show abstractHide abstract

The term “venous angioma” (VA) usually refers to a developmental venous anomaly (DVA). However, a group of vascular malformations called VAs shows no venous abnormalities on angiography. The clinical and histological features of histologically classified VAs were studied in eight patients who presented with hemorrhage or seizures to reevaluate these venous anomalies. Angiography showed no venous abnormalities in six patients. Histological study included immunostaining for smooth muscle actin and glial fibrillary acidic protein. Surgical specimens of 10 cases of cavernous angiomas, 10 cases of arteriovenous malformations, and two cases of capillary telangiectasias were studied to compare these types of VAs. Angiographically occult VAs were surgically removed safely, whereas removal of DVAs was complicated by brain swelling and hemorrhagic infarction of the brain. Histological examination found angiographically occult VAs contained malformed and compactly arranged vessels with partly degenerated walls, whereas DVAs had dilated thin-walled vessels that were diffusely distributed in the normal white matter. This study of our cases and a review of the reported cases of VAs suggests that two different clinical and pathological entities are commonly categorized as “VA,” angiographically occult VAs and DVAs. These two entities should be carefully distinguished.

View full abstract

Download PDF (701K)
Detection of Chromosomal Imbalances in Spinal Meningiomas by Comparative Genomic Hybridization

Ali ARSLANTAS, Sevilhan ARTAN, Ülkü ÖNER, Ramazan DURMA ...

2003 Volume 43 Issue 1 Pages 12-19
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.12

JOURNAL OPEN ACCESS

Show abstractHide abstract

Little is known about genetic mutations during the malignant progression of spinal meningiomas. This study investigated genomic changes across the entire genome in spinal meningioma samples to determine possible mechanism(s) of tumorigenesis. Paraffin-embedded tissue sections of 16 spinal meningiomas were analyzed by the comparative genomic hybridization (CGH) technique. Lymphocytes of the patients were evaluated as controls. Genomic change was detected in 11 samples. Complete or partial loss of chromosome 22 was the most commonly seen abnormality in eight cases. Chromosome losses on 1p, 9p, and 10q and gains on 5p and 17q were the other abnormalities. These changes are all frequently seen in meningiomas, but are mostly specific to atypical and anaplastic meningiomas. However, in the present study, copy number changes on chromosomes 9p (3 samples), 17q (2 samples), and 1p (2 samples) were seen even in the benign tumors. Our results suggest that in addition to the neurofibromatosis type 2 tumor suppressor gene, other cancer-related genes located on 1p, 9p, 10q, and 17q might be involved in the etiology of spinal meningiomas.

View full abstract

Download PDF (372K)
Caspase Activation in Neuronal and Glial Apoptosis Following Spinal Cord Injury in Mice

Teruhide TAKAGI, Masakazu TAKAYASU, Masaaki MIZUNO, Masayuki YOSHIMOTO ...

2003 Volume 43 Issue 1 Pages 20-30
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.20

JOURNAL OPEN ACCESS

Show abstractHide abstract

The involvement of caspases in apoptosis after spinal cord injury (SCI) was investigated in adult mouse spinal cord after contusion. Sections of spinal cord were processed for staining 7 days after SCI with the fluorescent dye Hoechst 33342, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling (TUNEL), and immunostaining with an antibody (CM1) recognizing activated caspase-3. Caspase-3- and caspase-8-like enzyme activities were measured colorimetrically at 8 hours to 7 days after SCI using the specific substrates Asp-Glu-Val-Asp-p-nitroanilide and Ile-Glu-Thr-Asp-p-nitroanilide, respectively. Hoechst 33342 staining showed small, bright areas in fragmented nuclei. Double labeling with TUNEL plus immunostaining with cell type-specific markers identified TUNEL-positive neurons stained by anti-neuronal nuclear protein/neurons antibody, and TUNEL-positive oligodendrocytes stained by anti-cyclic nucleotide 3'-phosphohydrolase antibody. Double labeling with CM1 and cell-type specific markers similarly identified CM1-positive neurons and oligodendrocytes. Caspase-8-like enzyme activity was increased significantly on days 3 and 7 (p < 0.01), whereas caspase-3-like activity increased on day 7 (p < 0.01). Intraventricular injection of a nonspecific tetrapeptide caspase inhibitor or a specific tetrapeptide inhibitor of caspase-3 just after SCI reduced enzyme activity at 7 days. Apoptotic cells were identified with TUNEL staining in both neurons and oligodendrocytes in mice after SCI, which also showed activated caspase-3. Increased caspase-3- and caspase-8-like activity was detected in the injured spinal cord on days 3 and 7. Caspase protease activities may be involved in delayed neuronal and glial apoptosis after SCI.

View full abstract

Download PDF (336K)

Case Reports

Saccular Aneurysm of the Accessory Middle Cerebral Artery

—Case Report—

Kazunori FUJIWARA, Keiichi SAITO, Tsutomu EBINA

2003 Volume 43 Issue 1 Pages 31-34
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.31

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 30-year-old man presented with a rare ruptured saccular aneurysm located at the junction of the accessory middle cerebral artery and the horizontal portion (A₁ segment) of the anterior cerebral artery. A right frontotemporal craniotomy was performed and the aneurysm was clipped through a transsylvian approach. The postoperative course was uneventful and he was discharged in good condition. The transsylvian approach is the method of choice for such aneurysm.

View full abstract

Download PDF (193K)
Cranial Nerve Pareses Following Wrapping of a Ruptured Dissecting Vertebral Artery Aneurysm: a Possible Complication of Cyanoacrylate Glue

—Case Report—

Takao KUROKI, Kazuya AOKI, Yoshinori AOKI, Akio NEMOTO, Takamasa YAMAZ ...

2003 Volume 43 Issue 1 Pages 35-37
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.35

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 51-year-old female with a ruptured dissecting vertebral artery aneurysm underwent an uneventful wrapping technique using Biobond-soaked gauze through a unilateral suboccipital transcondyle approach. On the 3rd postoperative day, she developed pareses of the ipsilateral VII through XII cranial nerves. Daily intravenous administration of 300 mg of hydrocortisone was started. This treatment was continued and dosage was tapered until the 10th postoperative day. The cranial nerve pareses deteriorated until the 8th postoperative day, but slowly resolved by 3 weeks after surgery. The patient was discharged with slight hoarseness and dysphasia 5 weeks after surgery. She had only slight hoarseness at 6 months. This complication was probably due to a neural toxic response to the Biobond.

View full abstract

Download PDF (127K)
Transcortical Transchoroidal Fissure Approach for Ruptured Distal Posterior Cerebral Artery (P₂-P₃ Junction) Aneurysm Associated With Packed Intraventricular Hemorrhage

—Two Case Reports—

Keisuke ONODA, Shoji TSUCHIMOTO, Daisuke TANIOKA, Hideki KIRIYAMA, His ...

2003 Volume 43 Issue 1 Pages 38-42
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.38

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 56-year-old man with ruptured right P₂-P₃ junction aneurysm and a 66-year-old man with ruptured left P₂-P₃ junction aneurysm of the posterior cerebral artery associated with acute-stage packed intraventricular hemorrhage. The aneurysms were successfully clipped through the transcortical transchoroidal fissure approach. This approach requires less retraction of the temporal lobe, provides a wider surgical field, and the P₂ segment can be easily reached. The present approach is very useful for the treatment of ruptured aneurysms at the P₂-P₃ junction, in particular for acute stage surgery associated with packed intraventricular hemorrhage.

View full abstract

Download PDF (219K)
Ring-enhanced Mass in the Brain of a Woman With Systemic Lupus Erythematosus and Elevated Serum CA19-9 Level: Brain Abscess or Metastatic Tumor?

—Case Report—

Joji INAMASU, Yoshiki NAKAMURA, Ryoichi SAITO, Yoshiaki KUROSHIMA, Kei ...

2003 Volume 43 Issue 1 Pages 43-46
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.43

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 70-year-old woman with systemic lupus erythematosus presented with a brain abscess manifesting as progressive monoparesis of the right lower extremity over 4 days. She had had no episodes of fever, and did not complain of headache or exhibit any signs of meningeal irritability. Computed tomography of the brain showed a round, low-density mass with strong ring enhancement in the left frontal lobe. Laboratory examination found a moderately elevated serum level of CA19-9, a marker of some digestive organ cancers. Together with the absence of febrile episodes, headache, and a rise in leukocyte count, the initial suspicion was metastatic brain tumor rather than brain abscess. However, diffusion-weighted magnetic resonance imaging depicted the mass as a very hyperintense area. The neuroimaging diagnosis was brain abscess. After conservative treatment with intravenous antibiotics for 6 weeks, the brain abscess completely resolved, and the patient was discharged without neurological deficits.

View full abstract

Download PDF (195K)
Retroorbital Hemangiopericytoma and Cavernous Sinus Schwannoma

—Case Report—

Atul GOEL, Dattatraya MUZUMDAR, Ketan DESAI, Aadil CHAGLA

2003 Volume 43 Issue 1 Pages 47-50
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.47

JOURNAL OPEN ACCESS

Show abstractHide abstract

An 18-year-old male presented with severe proptosis and blindness in the right eye. Neuroimaging revealed a large and hypervascular tumor in the right retrobulbar region and a large tumor in the left cavernous sinus. Angiography showed the right tumor was extensively vascular, fed by a hypertrophic ophthalmic artery, and the left tumor was moderately vascular, fed by a large middle meningeal artery. Following embolization of the feeder vessels, the right retrobulbar hemangiopericytoma and the left cavernous sinus schwannoma were uneventfully and successfully resected. Such combinations of different pathological lesions present unusual therapeutic challenges.

View full abstract

Download PDF (270K)
Suprasellar Peri-infundibular Ectopic Prolactinoma

—Case Report—

Ryo UEDA, Makoto KATAYAMA, Kazunari YOSHIDA, Takeshi KAWASE

2003 Volume 43 Issue 1 Pages 51-54
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.51

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 21-year-old man presented with bitemporal hemianopia and hyperprolactinemia. Magnetic resonance (MR) imaging showed a suprasellar cystic tumor in contact with the pituitary stalk. The diagnosis was craniopharyngioma. Intraoperatively, there was no clear continuity between the tumor and the tissue of the anterior lobe of the pituitary gland. The pituitary stalk and the diaphragma sellae were intact, and their morphology remained almost completely normal after the tumor was removed. The histological diagnosis was prolactin-producing pituitary adenoma. Postoperatively, the bitemporal hemianopia improved, and the serum prolactin levels returned to normal. The final diagnosis was suprasellar ectopic pituitary adenoma arising in the peri-infundibular region. Follow-up MR imaging at 1 year showed a normal pituitary stalk and pituitary gland, with no evidence of residual tumor.

View full abstract

Download PDF (237K)
Cervical Myelopathy Caused by Hypoplasia of the Atlas and Ossification of the Transverse Ligament

—Case Report—

Wataro TSURUTA, Kiyoyuki YANAKA, Masao OKAZAKI, Akira MATSUMURA, Tadao ...

2003 Volume 43 Issue 1 Pages 55-59
Published: 2003
Released on J-STAGE: May 31, 2005

DOIhttps://doi.org/10.2176/nmc.43.55

JOURNAL OPEN ACCESS

Show abstractHide abstract

A 79-year-old Japanese female presented with symptomatic cervical myelopathy caused by a hypoplastic posterior arch of the atlas and ossification of the transverse ligament. Neuroradiological examination demonstrated a hypoplastic posterior arch of the atlas and ossification of the transverse ligament. The cervical spinal cord was compressed at the level of the atlas by both the hypoplastic posterior arch of the atlas and the ossification of the transverse ligament. The patient underwent C-1 laminectomy, which arrested the progressive myelopathy and resulted in a good recovery. Atlas hypoplasia with ossification of the transverse ligament may be associated with Asian ethnicity.

View full abstract

Download PDF (177K)

Register with J-STAGE for free!