巻号一覧
47 巻, 10 号
選択された号の論文の12件中1～12を表示しています
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Original Articles
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Hiroshi AIKAWA, Kiyoshi KAZEKAWA, Shun-ichi NAGATA, Masanari ONIZUKA, ...2007 年 47 巻 10 号 p. 439-447
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスThis study retrospectively reviewed 227 patients with ruptured solitary cerebral aneurysm who underwent endovascular embolization with detachable coils between March 1997 and March 2006 to establish the incidence of rebleeding after endovascular treatment for ruptured cerebral aneurysm and identify the risk factors. The site and size of the aneurysm, the interval between treatment and rebleeding, and the outcome were investigated in six of the 227 patients (2.6%) who rebled after treatment. Four patients had large or giant aneurysms located on the internal carotid artery at the origin of the posterior communicating artery. The interval between treatment and rebleeding was less than 1 year in four patients (mean 394.2 days). Two patients died, and the survivors had modified Rankin Scale scores of 0, 2, 3, and 4. Re-embolization was performed in four patients and no further bleeding occurred during the mean follow-up period of 1.9 years after re-treatment. Patients with giant aneurysms of the internal carotid artery are at increased risk for rebleeding. Re-treatment should be considered if there is conventional and/or magnetic resonance angiographic evidence of dome filling. Patients with ruptured cerebral aneurysms must be followed up with diagnostic imaging closely during the first 12 months post-embolization because rebleeding frequently occurs within 1 year after initial treatment. Re-embolization is safe and effective in patients with recurrent hemorrhage from aneurysms previously embolized with detachable coils.
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Kouzo MORITAKE, Hidemasa NAGAI, Takeshi MIYAZAKI, Noriko NAGASAKO, Mam ...2007 年 47 巻 10 号 p. 448-452
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA nationwide survey in 2000 investigated the causative and associated central nervous system (CNS) lesions of congenital hydrocephalus in Japan. The etiology and associated diseases in 393 patients with congenital hydrocephalus were analyzed and compared between 193 patients with prenatally diagnosed (fetal) hydrocephalus and 181 with postnatally diagnosed (infantile) hydrocephalus. Of 393 patients of congenital hydrocephalus, 355 (90.3%) had primary hydrocephalus and 28 (7.1%) had secondary hydrocephalus. Of 355 patients with primary hydrocephalus, 85 (23.9%) had simple hydrocephalus associated with no other CNS anomaly and 270 (76.1%) had complicated hydrocephalus associated with other CNS anomalies. Destructive cystic lesions, holoprosencephaly, and agenesis of the corpus callosum were significantly predominant in fetal hydrocephalus. Arachnoid cyst was somewhat predominant in infantile hydrocephalus. The majority of cases of congenital hydrocephalus were primary hydrocephalus and two thirds were complicated hydrocephalus. Several complications showed marked predominance in fetal hydrocephalus.
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Kouzo MORITAKE, Hidemasa NAGAI, Takeshi MIYAZAKI, Noriko NAGASAKO, Mam ...2007 年 47 巻 10 号 p. 453-461
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA nationwide questionnaire survey of congenital hydrocephalus in 2000 investigated the treatment and clinical outcomes for congenital hydrocephalus in Japan to evaluate the factors influencing clinical outcome. Surgical treatment was performed in 341 of 380 patients who survived the early neonatal period. Of 321 patients who had shunt operations, 295 (91.9%) underwent ventriculoperitoneal shunting and nine (2.8%) ventriculoatrial shunting. Programmable valves were used in 83 (33.6%) of the 247 patients at the first shunting and in 97 (39.3%) at the last shunting. The incidence of complications after the first shunting was 55.4% (46 of 83 patients) in the programmable and 61.6% (101 of 164) in the non-programmable valve groups. The types of shunt complication differed significantly between these groups (p < 0.001), as the incidence of shunt infection and malfunction was lower in the programmable valve group. Clinical outcome was generally better with later delivery stage during gestation (p < 0.02). The clinical outcome was statistically significantly better in term patients who underwent early shunt placement than in those who underwent late shunt placement (p < 0.05).
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Ingo FISS, Marco DANNE, Ruediger STENDEL2007 年 47 巻 10 号 p. 462-467
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスThe present study evaluated the hemostatic efficacy and handling of gelatin-thrombin matrix hemostatic sealant during intracranial procedures. A retrospective analysis of 478 consecutive patients undergoing intracranial procedures identified seven patients with acute intense or persistent intraoperative bleeding which could not be arrested in time by standard hemostatic methods. The efficacy of gelatin-thrombin matrix was assessed by determining bleeding severity before and after application, time to hemostasis, amount of gelatin-thrombin matrix necessary, need for additional hemostatic measures, and need for reoperation to control hemorrhage. Immediate hemostasis was achieved in five of seven patients. Two of these five patients had abnormal clotting parameters. Cessation of bleeding was achieved by additionally applying either fibrinogen or gelatin sponge to the bleeding site in the other two patients. No complications attributable to gelatin-thrombin matrix use were recorded. The gelatin-thrombin matrix was ready to use within 1 minute in every case. Gelatin-thrombin matrix appears to be an effective, easy-to-use, and readily available hemostatic agent for cranial neurosurgery. Combination with fibrinogen is recommended in special situations.
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Case Reports
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—Case Report—Hiroya NAKAU, Hitoshi NAGATANI, Reiko NAKAU, Toshio AMETANI2007 年 47 巻 10 号 p. 468-470
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 63-year-old woman presented with a ruptured aneurysm which apparently spontaneously thrombosed. She was admitted after sudden onset of severe headache. Computed tomography (CT) demonstrated subarachnoid hemorrhage (SAH) in the pontine and interpeduncular cisterns. Initial three-dimensional CT (3D-CT) angiography revealed an aneurysm (diameter, 9 mm) near the origin of the left superior cerebellar artery. However, angiography 3 hours later failed to show the aneurysm. Total thrombosis was thought to have occurred in the aneurysm. The patient returned home with no deficit 1 month after admission. T1- and T2-weighted magnetic resonance imaging 75 days after the SAH demonstrated the thrombosed aneurysm as an isointense mass lesion. 3D-CT angiography showed no recanalization of the aneurysm 9 months after the SAH.
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—Case Report—Hideo SAITO, Kuniaki OGASAWARA, Yoshitaka KUBO, Masayuki SASO, Yasunar ...2007 年 47 巻 10 号 p. 471-474
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 54-year-old man presented with a rare ruptured distal middle cerebral artery (MCA) aneurysm manifesting as subarachnoid hemorrhage. Cerebral angiography demonstrated a fusiform aneurysm in the central artery of the left MCA. The patient underwent anastomosis between the superficial temporal artery and the central artery distal to the lesion followed by trapping and excision of the lesion. The postoperative course was uneventful. Histological examination of the excised specimen revealed a saccular aneurysm and absence of bacteria, inflammation, or neoplasm. The present case shows that a spontaneous saccular aneurysm can develop at the cortical segment of the MCA, and can be successfully treated with bypass surgery combined with trapping.
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—Case Report—Junji KOYAMA, Koji IKEDA, Yoshiteru SHOSE, Mitsuru KIMURA, Yoshiro OBO ...2007 年 47 巻 10 号 p. 475-478
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 35-year-old woman presented with a non-functioning pituitary adenoma manifesting as amenorrhea and impaired visual acuity in 1984. The tumor was grossly totally resected through a right frontotemporal craniotomy. The patient underwent surgery for three recurrences in the next 5 years. She was treated with gamma knife surgery for the residual tumor in 1994. Follow-up magnetic resonance (MR) imaging revealed a tumor in the right frontal base in 1999, and the left middle fossa in 2002. Total removal of these tumors was performed. Follow-up MR imaging showed regrowth of the primary pituitary tumor in 2003, which was partially excised. Histological examination of the specimens from the last three surgeries revealed typical pituitary adenoma without malignant transformation. Pituitary carcinomas have a poor prognosis. However, the present patient survived for 22 years from onset and 6 years from the first dural metastasis. Distant lesions should be removed for histological evaluation to assist the subsequent management.
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—Case Report—Yoshifumi TSUBOI, Nakamasa HAYASHI, Masanori KURIMOTO, Shoichi NAGAI, ...2007 年 47 巻 10 号 p. 479-482
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 54-year-old woman presented a midline clival tumor manifesting as right abducens palsy in May 1997. Magnetic resonance (MR) imaging revealed a midline clival tumor. She underwent surgery twice with the transsphenoidal approach and gamma knife surgery for residual tumor. The histological diagnosis was chordoma. MR imaging revealed that the tumor had extended to the right cerebellopontine angle, with spinal seeding in February 2002. She underwent partial removal of the right cerebellopontine angle tumor. The histological diagnosis was chordoma with slight nuclear atypism. She died 5 years and 5 months after the first gamma knife surgery. Autopsy revealed multiple areas of spinal seeding. Histological examination confirmed malignant transformation with unique epithelial characteristics, possibly caused by gamma knife surgery.
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—Case Report—Yoshikazu OGAWA, Teiji TOMINAGA2007 年 47 巻 10 号 p. 483-485
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 38-year-old woman presented with repeated episodes of meningitis. She had undergone transsphenoidal tumor removal followed by gamma knife irradiation in 1994. Complete remission was achieved. Intermittent cerebrospinal fluid (CSF) leakage began in 2004, and transsphenoidal surgery was performed for direct repair of the skull base defect. Operative findings showed that the sellar floor was uncovered, and CSF continuously escaped through the cyanoacrylate polymer framework of the previous repair. Reconstruction used autologous muscle pieces and cyanoacrylate polymer adhesive. The CSF leakage was presumably due to delayed radiation damage to the mucous membrane of the skull base. Several methods for reconstruction of the sellar floor have been proposed, which all rely on tissue regeneration including the arachnoid, dura mater, and mucus membrane of the sphenoidal sinus. Preservation of the arachnoid membrane and minimizing removal of the mucous membrane are essential, especially if postoperative irradiation is anticipated.
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—Case Report—Yuzo TERAKAWA, Naohiro TSUYUGUCHI, Katsuyuki NUNOMURA, Naoaki MURAYAMA ...2007 年 47 巻 10 号 p. 486-488
発行日: 2007年
公開日: 2007/10/25
ジャーナル オープンアクセスA 63-year-old man presented with hypoglycemia-induced hemiparesis manifesting as diffusion-weighted magnetic resonance (MR) imaging changes in the splenium of the corpus callosum and internal capsule which disappeared after glucose administration. Clinicians should be aware that hypoglycemia can cause reversible splenium abnormalities on MR imaging, although the underlying mechanism still remains unclear, as this may be helpful in the differential diagnosis of hypoglycemia-induced hemiparesis and stroke.
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Erratum
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2007 年 47 巻 10 号 p. 490
発行日: 2007年
公開日: 2007/12/15
ジャーナル オープンアクセスPDF形式でダウンロード (103K)
Editorial Committee
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2007 年 47 巻 10 号 p. EC19-EC20
発行日: 2007年
公開日: 2013/03/25
ジャーナル オープンアクセスPDF形式でダウンロード (49K)
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