NO TO HATTATSU
Online ISSN : 1884-7668
Print ISSN : 0029-0831
ISSN-L : 0029-0831
Volume 19 , Issue 5
Showing 1-14 articles out of 14 articles from the selected issue
  • [in Japanese]
    1987 Volume 19 Issue 5 Pages 362
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
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  • Makoto Sasaki, Kunihiro Yoshioka, Toru Yanagisawa, Toshihiko Suzuki, M ...
    1987 Volume 19 Issue 5 Pages 363-370
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    Sonograms of the posterior cranial fossa in 30 newborns and 20 infants were obtained using a real time sector scanner with a 5.0MHz transducer. A correlative study of sonographic images with gross sections of the neonatal brain revealed precise normal anatomy of the posterior cranial fossa.
    Each cerebellar lobule could be identified by the primary fissure and the prepyramidal fissure of the cerebellar vermis, and the postlunate fissure and the great horizontal fissure of the cerebellar hemisphere. The fastigium of the 4th ventricle could be distinguished from the posterolateral (superior posterior) recess of the 4th ventricle lying between the superior cerebellar peduncle and the cerebellar tonsil. The posterior cerebral artery, the vertebral artery, the posterior inferior cerebellar artery and the vein of Galen were clearly displayed in nearly every case. The flocculus, the anterolateral (lateral) recess of the 4th ventricle, the anterior inferior cerebellar artery and torcular Herophili could be hardly visualized in some cases. Coronal sections obtained through the temporal squama displayed well the cerebral aqueduct and the 4th ventricle. Echogenicities of cisterns and internal structures of the brain stem are also discussed.
    Those who are familiar with such anatomy may detect focal lesions of the posterior cranial fossa more accurately.
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  • Hidetsuna Utsunomiya, Takashi Hayashi, Takeo Hashimoto, Sumihiro Nishi ...
    1987 Volume 19 Issue 5 Pages 371-378
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    We reported three cases of trigonocephaly associated with trisomy 13 in neonates. They cvere transferred to our hospital for many dysmorphic features and respiratory disturbance. CT scan revealed the abnormal findings characteristic of trigonocephaly, including keel shaped forehead, hypertrophic bone ridge at the metopic suture and hypotelorism. In any of these cases, no abnormalities of central nervous system were demonstrated except microencephaly. However, at autopsy one patient was found to have arhinencephaly (aplasia of olfactory bulbs and tracts) and agenesis of the corpus callosum. We reviewed the literature and discussed the clinical and neuroradiological features in trigonocephaly as well as chromosomal abnormality and hereditary aspects.
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  • Kou Ichihashi, Sadayuki Yano, Toshihiro Kuramatsu, Masutomo Miyao, Mas ...
    1987 Volume 19 Issue 5 Pages 379-386
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    Bacterial menigitis in infants is often associated with complications despite appropriate antibiotic treatment. Brain CT has proved useful in the detection of the complications. Several ultrasonographic findings of bacterial meningitis have been reported in recent years. We reported three patients with bacterial meningitis associated with various complications.
    Case 1 was a 16-month-old boy with meningitis caused by Hemophilus influenzae. The width of the lateral ventricle was 4 mm on the 6th hospital day, and then increased to the maximum of 10 mm on the 27th hospital day, probably due to cerebral atrophy during the acute stage of meningitis. Case 2 was a 7-month-old boy with meningitis caused by Diplococcus pneumoniae. He had cerebral infarction, which was shown as a hyper-echoic lesion on the 9th hospital day. Echogenicity of the lesion decreased thereafter because of abscess formation. Then the abscess connected to the lateral ventricle, causing ventriculitis shown as foggy echo by ultrasonography. He also had hydrocephalus. Case 3 was a 6-month-old boy with meningitis caused by Hemophilus influenzae. A localized subdural effusion was demonstrated outside the sylvian fissure.
    In conclusion, brain ultrasonography is a useful imaging procedure in the evaluation of complications of bacterial meningitis. We recommend ultrasonography as an initial imaging procedure for the evaluation of the complications.
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  • Yukuo Konishi, Masanori Kuriyama, Masakatsu Sudo, Katsumi Hayakawa, Ya ...
    1987 Volume 19 Issue 5 Pages 387-391
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    Twenty-five patients (aged from two days after birth to twelve years) were studied. The contrast material was injected into a vein in 21 patients and into an artery in the other 4. Amipaque (2mg/kg) followed by 4ml of saline was injected intravenously. We recorded the digital subtraction angiography images on videotape and analyzed them with a Nexus Image Processor and a Vak-11/750 computer. The region of interest (ROI) was set at the supraclinoid portion of the internal carotid and sinus confluence. Time-density curves were obtained for two ROIs, and cerebral circulation Time (CCT) was measured as the time from the carotid peak to the sinus peak.
    Images of the diagnostic value were obtained in 16 patients in whom the contrast material was injected into the carotid artery, superior vena cava or peripheral vein at the elbow. The images obtained in patients in whom the contrast material was injected into the peripheral vein on the hand were of no value. No advers effects were seen when the total injection volume was limited to 4ml/Kg. CCT was measured in 14 patients. In 9 patients, no cerebrovascular disease was disclosed, the mean CCT in this group was 4.3±0.54 sec with a range of 3.73 to 5.06 sec. The prolongation of CCT was found in patients with superior sagittal sinus thrombosis, moyamoya disease and frontal hematoma. The mean CCT in this group was 6.1±2.48 sec.
    DSA was useful for diagnosing cerebrovascular diseases in neonates and children. In addition, measurement of CCT was very useful for quantitating the cerebral circulation in pediatric patients.
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  • Yasuyuki Futagi, Jiro Abe, Junko Tanaka, Nobuhiko Okamoto
    1987 Volume 19 Issue 5 Pages 392-396
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    The Babkin reflex was first described by Babkin in 1956. He stated that the reflex disappears within the first three or four months of life in most of normal infants.
    In order to evaluate the diagnostic value of the reflex, we examined the Babkin reflex in 258 normal infants, 22 infants with cerebral palsy and 29 with mental retardation, and compared the results obtained from pathological groups to that from normal controls. In normal infants, this reflex could be elicited until the fourth month of life. The result in normal preterm infants, expressed as their corrected ages, was not different from that in normal fullterm infants. The relationship between the reflex activity and the elapsed time after the last feeding in normal infants was assessed. In infants less than two months of age, the mean reflex activity examined over an hour after feeding was greater than that examined within an hour after feeding.
    In some of the infants with cerebral palsy, the reflex activity persisted through the first year of life, while it declined rapidly after five months of life in infants with mental retardation. In case that the Babkin reflex can be elicited after five months of age in an infant, a careful observation for the appearance of neurological symptoms is required.
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  • Ren Hasegawa, Junichi Hata, Takashi Nakamura, Noriko Hasegawa, Hiroo M ...
    1987 Volume 19 Issue 5 Pages 397-401
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    The patient was a 2, 808g female infant delivered vaginally following an uneventful pregnancy at 38 weeks of gestation. Apgar score at five minutes was 9, but rigidity of the extremities was found immediately after birth. At admission on day 3, initial physical examination revealed a poorly active infant showing tremulousness, and markedly regid extrmities, and poor traction response suggesting truncal hypotonia. Primitive reflex such as the Moro reflex and sucking reflex were absent throughout her life. She had no minor anomalies. Laboratory examination presented no abnormalities except for hyperbilirubinemia. The karyotype was 46XX, normal female.
    The baby died of respiratory failure associated with apnea and atelectasis of the lung on the 165th day of life. Autopsy revealed “cerebellar hypoplasia (granular type)” and secondary hypoxic changes of the cerebral cortex.
    It was concluded that the cerebellar hypoplasia in this case was caused prenatally during the intrauterin period due to lack of the granular layer of the cerebellar cortex.
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  • Megumu Tojo, Norio Sakuragawa, Ikuya Nonaka, Masahisa Sato
    1987 Volume 19 Issue 5 Pages 402-407
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    A 13-year-old girl of atypical juvenile myasthenia gravis (MG) who presented mainly with generalized muscle atrophy, bulbar signs and joint contracture was reported. She had not almost presented generalized muscle weakness and ptosis.
    Her chief complaints on admission were marked emaciation and persistent moist cough. She was noted to have unclear pronounciation three years prior to admission. Moist cough lasted all day long for the past 10 months. Rarely she developed double vision and ptosis. On admission, she was markedly emaciated (body weight 28kg) with diffuse muscle atrophy including the tongue muscle. Severe emaciation was thought to be due to bulbar signs such as difficulty in swallowing. Her muscle strength was almost within normal limits except for neck flexor muscles. Muscle fatigability was not induced by repetitive exercises such as eye blink and hand-grip tests. Extra-ocular movements on upper and lateral gazes were limited moderately without definite ptosis. Joint contracture which was due to neurogenic muscle atrophy was present in her upper vertebrae. Her chin did not touch to the chest on neck flexion. There was mild scoliosis of vertebral column. Tensilon test did not show constant results. Muscle biopsy demonstrated mild neurogenic changes scattered small angulated fibers, mild variation in fiber size and an increased number of type 2C fibers. We estimated that diffuse muscle atrophy was due to neurogenic change. The anti-acetylcholine receptor (ACh-R) antibody titer was increased to 2.66 pmoles/ml. Prednisolone therapy (80mg every other day) for two weeks resulted in a complete recovery from ophthalmoplegia and a rapid decrease in the anti-ACh-R antibody titer to the normal range.
    Joint contracture caused by neurogenic muscle atrophy are not reported by now in a generalized form of childhood MG. In spite of reduced muscle bulk there were no definite muscle weakness and muscle fatigability. These symptoms were atypical in childhood MG. Although the prognosis of our case was at first thought to be poor because of her muscle atrophy and bulbar signs, a good response to prednisolone therapy was against our initial estimation.
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  • Takao Yokoyama, Tatsuya Ishikawa, Kyoko Ban, Hisako Saitoh
    1987 Volume 19 Issue 5 Pages 408-414
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    We reported a 13-year-old girl who suffered from chorea after treatment for hyperthyroidism. She was diagnosed as having hyperthyroidism in June, 1985, and treated with propylthiouracil, 250mg daily. Two months later she was considered to be euthyroid. In February, 1986, her mother noticed that she had developed restlessness and uncontrollable movements of her left hand and foot, and brought her to our hospital. The remarkable findings on neurological examination were frequent quick and jerky purposeless movement of the left proximal extremities and neck, and consistent with those of chorea. Two or three weeks after the appearance of chorea she began to experience difficulty in speaking, especially in pronouncing nasal sounds, and reading books smoothly. It took about four months for these manifestations to disappear without a special treatment except for a change of propylthiouracil for methimazole.
    It is well known that chorea is a rare, initial manifestation in hyperthyroidism, but to the best of our knowledge, there has been no previous description of chorea during the euthyroid state.
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  • An Electrophysiological Follow-up Study
    Junko Tanaka, Jiro Abe, Yasuyuki Futagi
    1987 Volume 19 Issue 5 Pages 415-419
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
    Electrophysiological follow up studies were carried out on a male suffering from late infantile ceroid lipofuscinosis (CLF) during the ages from 3 to 6 years. In EEG, high voltage slow waves (HVS) and spikes were noted in the occipital area when he was 3 years old, and thereafter they spread diffusely. As the disease progressed, HVS was decreased in voltage, and multiple focal spikes, dominant in the occipital area, appeared. Multimodality evoked potentials (MEPs) were performed when he was 5 years old. Electroretinogram was silent but a giant visual evoked response was obtained. The C-response and a giant somatosensory evoked potential by the median nerve stimulation were present, which were compatible with the findings in cortical reflex myoclonus. The auditory brainstem response remained normal in spite of the atrophy of cerebrum, cerebellum and brainstem observed on CT and prolonged latency of the electrically elicited blink reflex. It was concluded that the brainstem auditory pathway was kept normal although the trigemino-facial pathway was involved. EEG and MEPs were useful for evaluation of the progression of CLF.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    1987 Volume 19 Issue 5 Pages 420-422
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1987 Volume 19 Issue 5 Pages 422-424
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1987 Volume 19 Issue 5 Pages 425-426
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1987 Volume 19 Issue 5 Pages 427-428
    Published: September 01, 1987
    Released: August 10, 2011
    JOURNALS FREE ACCESS
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