Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Search
Advanced search
OR
Browse
Search
Volume 49, Issue 2
Displaying 1-11 of 11 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Original Articles
  • Shift of the Pyramidal Tract During Resection of the Intraaxial Brain Tumors Estimated by Intraoperative Diffusion-Weighted Imaging
    Norihiko OZAWA, Yoshihiro MURAGAKI, Ryoichi NAKAMURA, Tomokatsu HORI, ...
    2009 Volume 49 Issue 2 Pages 51-56
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.51
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    The present study evaluated the shift of the pyramidal tract during resection of 17 proximal intraaxial brain tumors. In each case intraoperative diffusion-weighted (iDW) magnetic resonance imaging with a motion-probing gradient applied in the anteroposterior direction was performed using a scanner with a 0.3 T vertical magnetic field. The position of the white matter bundles containing the pyramidal tract was estimated on the coronal images before and after resection of the neoplasm, and both quantitative and directional evaluation of its displacement was done. In all cases iDW imaging provided visualization of the structure of interest. The magnitude of the pyramidal tract displacement due to removal of the neoplasm varied from 0.5 to 8.7 mm (mean 4.4 ± 2.5 mm) on the lesion side and from 0 to 3.6 mm (mean 1.3 ± 1.1 mm) on the normal side (p < 0.001). Tumor location in regards to the pyramidal tract was significantly associated with the direction of the pyramidal tract displacement (p < 0.05). Outward shift occurred in 10 out of 13 cases of the lateral neoplasms, whereas in all 4 superomedial tumors inward shift was marked. In conclusion, the direction of the pyramidal tract displacement during resection of the proximal intraaxial brain tumors is mainly determined by position of the neoplasm, but can be unpredictable in some cases, which necessitates use of subcortical brain mapping and intraoperative imaging, particularly iDW imaging with updated neuronavigation.
    View full abstract
    Download PDF (249K)
  • Effects of Facet Tropism and Disk Degeneration on Far Lateral Lumbar Disk Herniation: Comparison With Posterolateral Lumbar Disk Herniation
    Dong Yeob LEE, Sang-Ho LEE
    2009 Volume 49 Issue 2 Pages 57-61
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.57
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    Differences in facet tropism and disk degeneration were investigated as key factors distinguishing the development of far lateral lumbar disk herniation from that of posterolateral lumbar disk herniation in 46 patients with far lateral lumbar disk herniation individually matched with 46 patients with posterolateral lumbar disk herniation. Preoperative standing body height, body weight, and body mass index were compared. Facet tropism was measured using computed tomography and disk degeneration was evaluated using magnetic resonance imaging. Mean body mass index showed a significant difference between patients with the far lateral and posterolateral lumbar disk herniation (24.9 ± 2.7 vs. 23.7 ± 2.3 kg/m2, p = 0.04). However, no significant differences were found in standing body height and body weight, facet tropism, or disk degeneration between two groups. Neither facet tropism nor disk degeneration are involved in distinguishing the development of far lateral lumbar disk herniation from that of posterolateral lumbar disk herniation.
    View full abstract
    Download PDF (167K)
Case Reports
  • Adult Traumatic Leptomeningeal Cyst
    —Case Report—
    Atsushi SAITO, Takayuki SUGAWARA, Yousuke AKAMATSU, Shigeki MIKAWA, Hi ...
    2009 Volume 49 Issue 2 Pages 62-65
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.62
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 60-year-old man presented with a traumatic leptomeningeal cyst manifesting as local tenderness in the right parietal region and local headache 2 years after head injury. Magnetic resonance imaging showed a small arachnoid cyst under bone defect. Dural and bone plasty were performed. Intraoperative examination found small and round defects of the dura and bone. Progressive headache was relieved after the surgery. This rare case of adult posttraumatic leptomeningeal cyst occurred within an unusually short period after trauma, and was associated with a small and round bone defect and small dural defect usually characteristic of congenital arachnoid cyst.
    View full abstract
    Download PDF (586K)
  • Rapid Reduction of Syrinx Associated With Traumatic Intracranial Hypotension by Direct Surgery
    —Case Report—
    Tatsuya OHTONARI, Nobuharu NISHIHARA, Taisei OTA, Satoshi KOBANAWA, Sh ...
    2009 Volume 49 Issue 2 Pages 66-70
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.66
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A woman in her early twenties presented with cerebellar tonsillar herniation with syrinx in the cervicothoracic spinal cord manifesting as postural headache after suffering trauma to the hip. She was treated under a diagnosis of traumatic intracranial hypotension. Cranial magnetic resonance (MR) imaging demonstrated tonsillar herniation to the upper rim of the C1 lamina, associated with effacement of the basal cisterns and flattening of the pons against the clivus, sagging of the optic chiasm, and protrusion of the pituitary gland into the suprasellar cistern. Spinal MR imaging and computed tomography (CT) myelography showed cervicothoracic syrinx and arachnoid diverticulum. Three applications of epidural blood patches produced no improvement. Surgery identified cerebrospinal fluid leakage from two small holes in the spinal dural sac, slightly proximal from the origin of the left L1 root sleeve, and arachnoid diverticulum. These two holes were sutured and a few sheets of gelatin sponge were placed around the arachnoid diverticulum and sealed with fibrin glue. The cervicothoracic syrinx was reduced significantly and tonsillar herniation disappeared within 10 days. Simple surgical repair of the dural tears may rapidly improve symptoms and imaging findings in patients with tonsillar herniation caused by traumatic intracranial hypotension.
    View full abstract
    Download PDF (399K)
  • Sigmoid Sinus Dural Arteriovenous Fistula With Spinal Venous Drainage Manifesting as Only Brainstem-Related Neurological Deficits Without Myelopathy
    —Case Report—
    Yasushi SUGIURA, Takao NOZAKI, Haruhiko SATO, Kouji SAWASHITA, Hisaya ...
    2009 Volume 49 Issue 2 Pages 71-76
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.71
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 69-year-old woman presented with an extremely rare sigmoid sinus dural arteriovenous fistula (AVF) with venous drainage into a spinal perimedullary vein manifesting only as brainstem dysfunction without myelopathy. Cerebral angiography showed retrograde venous drainage into both the brainstem and spinal cord through the ipsilateral bridging vein from the affected isolated sigmoid sinus. Magnetic resonance (MR) imaging showed a hyperintense lesion in the medulla oblongata and lower pons with increased apparent diffusion coefficient (ADC), and enhancement with contrast material. The dural AVF was successfully treated by transfemoral transvenous embolization from the contralateral side, but the hyperintense area and neurological symptoms persisted after the treatment. The neurological deficits were probably due to venous hypertension associated with accessory retrograde venous drainage into the brainstem. MR imaging enhancement of the lesion may be more closely related to the prognosis of neurological deficits than the ADC value.
    View full abstract
    Download PDF (379K)
  • Giant Serpentine Aneurysm Arising From the Middle Cerebral Artery Successfully Treated With Trapping and Anastomosis
    —Case Report—
    Masaru ABIKO, Fusao IKAWA, Naohiko OHBAYASHI, Takafumi MITSUHARA, Ryo ...
    2009 Volume 49 Issue 2 Pages 77-80
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.77
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 56-year-old man presented with a giant serpentine aneurysm arising from the middle cerebral artery (MCA) manifesting as right hemiparesis and motor aphasia. Magnetic resonance imaging and digital subtraction angiography identified the giant serpentine aneurysm arising from the MCA. The patient was treated surgically. Temporary clipping of the distal channel induced thrombosis in the vascular channel, and the thrombosis was aspirated with an ultrasonic suction device after superficial temporal artery-MCA anastomosis. This case shows that initial occlusion of the distal channel is effective to treat giant serpentine aneurysm.
    View full abstract
    Download PDF (323K)
  • Anterior Inferior Cerebellar Artery Dissecting Aneurysm in a Juvenile
    —Case Report—
    Shintaro FUKUSHIMA, Masaru HIROHATA, Yuji OKAMOTO, Shin YAMASHITA, Shi ...
    2009 Volume 49 Issue 2 Pages 81-84
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.81
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 15-year-old girl presented with a distal anterior inferior cerebellar artery (AICA) dissecting aneurysm manifesting as sudden onset of general tonic-clonic convulsion while singing a song. Physical and neurological examinations found headache, vomiting, right perceptive deafness, and right cerebellar ataxia. Cranial magnetic resonance imaging demonstrated a hemorrhagic mass in the brainstem region, and digital subtraction angiography revealed a fusiform dilatation of the anterior pontine segment of the right AICA. The diagnosis was dissecting aneurysm. Endovascular embolization was performed for aneurysm and parent artery occlusion using a Guglielmi detachable coil and 9 TruFill detachable coil systems, respectively, 2 weeks after occipital artery-AICA anastomosis. No ischemic complications were seen, and her neurological deficits completely recovered after the interventional therapy.
    View full abstract
    Download PDF (261K)
  • Multiple Brain Abscesses in Neonate Caused by Edwardsiella Tarda
    —Case Report—
    Hayato TAKEUCHI, Yuri FUJITA, Hiroshi OGAWA, Kozue SHIOMI, Youichi TOY ...
    2009 Volume 49 Issue 2 Pages 85-89
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.85
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A neonate presented with multiple brain abscesses caused by very unusual infection with the Gram-negative bacterium, Edwardsiella tarda. Serial changes in magnetic resonance imaging findings including diffusion-weighted imaging demonstrated the development from the late cerebritis to late capsule stages. The patient was successfully treated by external drainage, and has since reached normal development milestones. Early diagnosis with computed tomography, magnetic resonance imaging, and ultrasound tomography, and prompt external drainage were essential to the good outcome of this case.
    View full abstract
    Download PDF (250K)
  • Progression of Pre-existing Chiari Type I Malformation Secondary to Cerebellar Hemorrhage
    —Case Report—
    Atsuhiro KOJIMA, Keita MAYANAGI, Shunichi OKUI
    2009 Volume 49 Issue 2 Pages 90-92
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.90
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A previously healthy 32-year-old man was surgically treated under a diagnosis of right subcortical hematoma. Magnetic resonance imaging incidentally demonstrated tonsillar herniation. Thirty-two months later, he was readmitted with complaints of occipital, neck, and shoulder pain as well as cerebellar ataxia. Subsequent magnetic resonance imaging demonstrated cerebellar hemorrhage and progression in the downward herniation of the tonsils. Conservative treatment resulted in spontaneous disappearance of the cerebellar hematoma, and the clinical signs and radiological findings improved. Patients with Chiari type I malformation require neuroimaging follow up because the downward herniation of the tonsils can progress in association with subsequent pathophysiological disorders.
    View full abstract
    Download PDF (184K)
  • Acquired Hemophilia First Manifesting as Life-Threatening Intracranial Hemorrhage
    —Case Report—
    Ryota MASHIKO, Tetsuya YAMAMOTO, Masayuki SATO, Shozo NOGUCHI, Akira M ...
    2009 Volume 49 Issue 2 Pages 93-95
    Published: 2009
    Released on J-STAGE: February 25, 2009
    DOIhttps://doi.org/10.2176/nmc.49.93
    JOURNAL OPEN ACCESS
    Show abstractHide abstract
    A 74-year-old man presented with life-threatening intracranial hemorrhage and prolonged activated partial thromboplastin time (APTT). The massive subdural hematoma was removed, but multiple intracranial hemorrhages occurred despite the administration of factor VIII and factor IX concentrates. Subdural hematoma, intracerebral hemorrhage in the left temporal lobe, and thalamic hemorrhage subsequently occurred with further prolongation of APTT. He died of enlargement of the thalamic hemorrhage. Acquired hemophilia was diagnosed caused by factor VIII inhibitor. Acquired hemophilia may cause life-threatening hemorrhage, and should be considered in patients with intracranial hemorrhages associated with unexplained prolongation of APTT.
    View full abstract
    Download PDF (158K)
Editorial Committee
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top