Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Search
Advanced search
OR
Browse
Search
Volume 48, Issue 1
Displaying 1-11 of 11 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Original Articles
  • Mechanism of Injury to the Corpus Callosum, With Particular Reference to the Anatomical Relationship Between Site of Injury and Adjacent Brain Structures
    Hideki SHIRAMIZU, Akihiko MASUKO, Hideo ISHIZAKA, Masayoshi SHIBATA, H ...
    2008 Volume 48 Issue 1 Pages 1-7
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.1
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    The location of corpus callosum injury was investigated using magnetic resonance imaging in 92 patients. The anatomical relationships in the region around the corpus callosum were also evaluated to clarify involvement in the mechanism of corpus callosum injury in 20 normal volunteers. Lesions in the posterior half of the corpus callosum accounted for 80% of corpus callosum injuries. The falx was increasingly elongated toward the posterior portion of the corpus callosum and the corpus callosum was thinnest at the body-splenium junction in the normal volunteers. The mechanism of corpus callosum injury apparently involves the following factors. The posterior half of the falx is closer to the corpus callosum than the anterior half. Therefore, the anterior part of the corpus callosum easily moves with lateral movement of the cerebral hemispheres, and the strain is likely to be concentrated in the posterior half of the corpus callosum, because the falx greatly limits lateral movement of the hemisphere in the posterior region. The corpus callosum is easily distorted at the thinnest part of the body-splenium junction. Therefore, corpus callosum injury predominantly occurs in the posterior half of the corpus callosum.
    View full abstract
    Download PDF (339K)
  • Three Column Stabilization Through Posterior Approach Alone: Transpedicular Placement of Distractable Cage With Transpedicular Screw Fixation
    Giyas AYBERK, Mehmet Faik OZVEREN, Naci ALTUNDAL, Hakan TOSUN, Zekai S ...
    2008 Volume 48 Issue 1 Pages 8-14
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.8
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    The combination of anterior and posterior instrumentation provides the most stable repair for burst fractures of the thoracolumbar spine. However, the use of both approaches on a trauma patient may increase morbidity. Stabilization of three columns through only one approach can provide an effective outcome. We treated eight patients with burst fracture involving the thoracic or lumbar vertebrae by the application of anterior and posterior stabilization instruments through only the posterior approach. The desired stabilization was obtained in all patients. The advantages are the absence of the risks of the anterior approach, facilitation of the placement of anterior and posterior stabilization devices through only one approach, preserving the unity of the anterior longitudinal ligament, the effect of the anterior corpus in preventing displacement of the cage, application of compression on the pedicle screw system to both decrease the kyphosis angulation due to collapse of vertebra and to help the stabilization of the cage, repair of the dural tears at the posterior side, prevention of cage displacement by distraction and thus leaning on the endplates, and ease of performance by a neurosurgeon alone.
    View full abstract
    Download PDF (289K)
  • Posterior Instrumentation Surgery for Thoracolumbar Junction Injury Causing Neurologic Deficit
    Joji INAMASU, Bernard H. GUIOT, Masashi NAKATSUKASA
    2008 Volume 48 Issue 1 Pages 15-21
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.15
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    Thoracolumbar junction (TLJ) injury is one of the most common spine injuries. TLJ injury manifesting as neurologic deficit usually requires surgery because of the underlying spinal instability and/or neural compression. The objectives of surgical treatment are to restore biomechanical stability of the spine and/or to achieve neural decompression. The short-term outcomes were evaluated of 32 patients with symptomatic TLJ (T11-L2) injury who underwent posterior instrumentation surgery in the acute stage between 2000 and 2004. Seventeen patients had unstable burst fracture and 15 patients had either flexion-distraction or fracture-dislocation injury of the TLJ. Fifteen patients had American Spinal Injury Association (ASIA) classification Grade-A, eight had Grade-B, seven had Grade-C, and two had Grade-D preoperative neurologic deficits. All patients underwent posterior instrumentation surgery using pedicle screws and connecting rods, fixed to two vertebral levels above and below the injured segment. No patient experienced neurologic deterioration perioperatively. Postoperative recovery evaluated 3 months after discharge heavily depended on the preoperative neurologic status: patients with ASIA Grade-A deficits usually had limited neurologic recovery, whereas some with Grade-C or D became ambulatory. Complications occurred in five patients, but none suffered death or permanent morbidity. Posterior instrumentation surgery is a safe and efficacious treatment for patients with symptomatic TLJ injury. Long-term efficacy of the posterior instrumentation surgery is less clear, because of the limited duration of the follow-up period.
    View full abstract
    Download PDF (240K)
Case Reports
  • Asymptomatic Carotid Artery Dissection Caused by Blunt Trauma
    —Case Report—
    Takahisa FUSE, Tosikazu ICHIHASI, Naoki MATUO
    2008 Volume 48 Issue 1 Pages 22-25
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.22
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 42-year-old man presented with asymptomatic traumatic carotid artery dissection 3 months after sustaining blunt injury with tracheal laceration. Magnetic resonance imaging performed as a screening procedure for asymptomatic carotid artery injury unexpectedly showed dissection of the carotid artery. Angiography confirmed carotid artery dissection with narrowing of the true lumen. Balloon angioplasty and stent placement were carried out to dilate the true lumen and isolate the false lumen from blood flow. Intravascular ultrasonographic virtual histology defined the precise anatomic structure of the lesion and identified the internal flap as fibrotic. Careful clinical assessment of patients with blunt cervical trauma may permit diagnosis of carotid artery dissection and intervention prior to the development of cerebral ischemic symptoms.
    View full abstract
    Download PDF (419K)
  • Thrombosed Giant Aneurysm of the Pericallosal Artery With Inconclusive Findings of Multiple Neuroimaging Studies
    —Case Report—
    Dong-Hyuk PARK, Yong-Gu CHUNG, Il-Young SHIN, Jang-Bo LEE, Jung-Keun S ...
    2008 Volume 48 Issue 1 Pages 26-29
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.26
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 65-year-old woman presented with a thrombosed giant pericallosal artery aneurysm manifesting as headache and memory loss that developed over a 2-year period. Computed tomography (CT), magnetic resonance (MR) imaging, and conventional and CT angiography could not establish the differential diagnosis. Open craniotomy revealed the mass as thrombosed giant aneurysm from the pericallosal artery. Direct clipping with thrombectomy was performed successfully with an uneventful postoperative course. Thrombosed giant aneurysm of the distal anterior cerebral artery should be considered in the differential diagnosis of an unusual mass in the mid-frontal area, particularly in the presence of inconclusive angiographic and MR imaging findings.
    View full abstract
    Download PDF (281K)
  • Complication Caused by Use of Fibrin Glue in Vessel Transposition for Trigeminal Neuralgia
    —Case Report—
    Mika OHTA, Fuminari KOMATSU, Hiroshi ABE, Seizaburou SAKAMOTO, Hitoshi ...
    2008 Volume 48 Issue 1 Pages 30-32
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.30
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 64-year-old man underwent microvascular decompression of the left superior cerebellar artery (SCA) for left trigeminal neuralgia (TN) using a sling of Teflon tape fixed to the tentorium with fibrin glue. The TN disappeared immediately after surgery, but recurred unusually rapidly at 2 weeks later at the same intensity as before. Second surgery revealed the SCA was suspended from the tentorium, but the trigeminal nerve was stretched and displaced superolaterally because of adhesion to the superior petrosal vein. The adhesion was thought to involve the fibrin glue used during the sling retraction procedure. The nerve was meticulously dissected from the adhesion, and the trigeminal nerve was placed in the correct position. The postoperative course was uneventful, and the TN disappeared completely. We recommend that the smallest amount of the fibrin glue possible be used to avoid adhesion to the surrounding neurovascular elements.
    View full abstract
    Download PDF (177K)
  • Isolated Angiitis in the Hypothalamus Mimicking Brain Tumor
    —Case Report—
    Satoshi TSUTSUMI, Masanori ITO, Yukimasa YASUMOTO, Kazuhiko KANEDA
    2008 Volume 48 Issue 1 Pages 33-36
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.33
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 64-year-old female presented with exaggerating somnolence without contributory medical and lifestyle histories. She was not aware of any preceding infection or headache. Cerebral magnetic resonance imaging demonstrated an isolated enhanced mass in the hypothalamus without meningeal enhancement. Blood and cerebrospinal fluid examinations showed no significant findings except for hypernatremia and hyperprolactinemia. She underwent an open biopsy via the interhemispheric route. Histological examination revealed marked perivascular lymphocytic aggregation with polyclonal immunostaining both for B and T lymphocytes. No findings suggestive of underlying malignancy were recognized. Extensive work-up aiming at systemic vasculitis and lymphoma revealed no signs of extracranial lesion, so the most probable diagnosis was isolated angiitis in the hypothalamus. Angiitis may originate from the hypothalamus and should be considered in the differential diagnosis of hypothalamic lesion mimicking brain tumor on neuroimaging.
    View full abstract
    Download PDF (485K)
  • Atrial Myxoma Occurring 15 Years After Subtotal Resection of Cerebellar Hemangioblastoma
    —Case Report—
    Youichi YANAGAWA, Hideyuki SHIMAZAKI, Katsuji SHIMA, Susumu ISODA, Tad ...
    2008 Volume 48 Issue 1 Pages 37-39
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.37
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 51-year-old female, with a past medical history of resection of cerebellar hemangioblastoma, presented with an atrial tumor detected by sonography after undergoing a series of examinations for fever of unknown origin and subsequent symptoms of heart failure. After removing the atrial tumor, the histological findings demonstrated myxoma. Immunohistopathological study showed that the tumor cells in both the hemangioblastoma and the myxoma had strong cytoplasmic immunoreactivity for vascular endothelial growth factor. Hemangioblastoma associated with myxoma is extremely rare, and was probably a random occurrence in this case.
    View full abstract
    Download PDF (381K)
  • Acquired Lacunar Skull Deformity Following Ventriculoperitoneal Shunt Placement
    —Case Report—
    Kuniaki NAKAHARA, Satoru SHIMIZU, Shinichi KAN, Hidehiro OKA, Kiyotaka ...
    2008 Volume 48 Issue 1 Pages 40-42
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.40
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A female infant developed hydrocephalus as a result of intraventricular hemorrhage related to premature birth. Radiography showed no sign of lacunar skull deformity (LSD). Lateral and fourth ventricle ventriculoperitoneal shunts were placed. The fourth ventricle shunt required replacement at age 3 years. Radiography and computed tomography showed LSD. Follow-up radiography at age 8 years showed the LSD was becoming unclear. LSD generally appears before birth, and disappears shortly after birth. LSD is most commonly associated with spina bifida cystica or encephalocele. This case of acquired LSD indicates that abnormal disorganized collection of collagen fibers of the skull plates may be triggered by iatrogenic intracranial hypotension even after infancy.
    View full abstract
    Download PDF (166K)
  • Fungal Meningitic Hydrocephalus With Repeated Shunt Malfunction
    —Case Report—
    Reiko KAGAWA, Yoshikazu OKADA, Kouzo MORITAKE
    2008 Volume 48 Issue 1 Pages 43-46
    Published: 2008
    Released on J-STAGE: January 24, 2008
    DOIhttps://doi.org/10.2176/nmc.48.43
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 33-year-old female presented with a rare case of fungal meningitis caused by Aspergillus detected for the first time at 15 years after onset. The meningitis repeatedly occurred over a period of 15 years. On admission, cerebrospinal fluid examination found cell count 1340/high-power field, protein 158 mg/dl, and sugar 8 mg/dl, indicating meningitis, although no bacterial or fungal species were detected. Cerebral computed tomography demonstrated hydrocephalus and cervical computed tomography demonstrated a mass lesion on the ventral side of the spinal cord from C4 to C6. Fungal meningitis was suspected and treated with amphotericin B. Her symptoms improved and she was eventually discharged. She was readmitted for recurrence of meningitis and hydrocephalus 2 months later. Amphotericin B was administered and a ventriculoperitoneal (VP) shunt was placed. Shunt malfunction recurred seven times. Aspergillus was detected for the first time from the atrium side of the ventriculoatrial shunt tube at 15 years after onset. Fluconazole was administered. She had narrowing of the cisterna magna, and underwent foramen magnum decompression. The VP shunt was finally reconstructed. Fluconazole administration was continued. Combination of foramen magnum decompression and long-term administration of fluconazole was effective in this case.
    View full abstract
    Download PDF (360K)
Editorial Committee
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top