著者

上宮 奈穂子 石原 正一郎 近藤 竜史 掛樋 善明 中館 雅志 徳重 一雄 都築 伸介

出版者

特定非営利活動法人 日本脳神経血管内治療学会

雑誌

脳血管内治療 (ISSN:24239119)

巻号頁・発行日

vol.6, no.4, pp.211-218, 2021 (Released:2021-12-20)

参考文献数

14

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【目的】脳室内出血発症のもやもや病に合併した後脈絡叢動脈末梢部動脈瘤に対し N-butyl-2-cyanoacrylate(NBCA)による塞栓術を施行し,良好な経過を得た 2 例を報告する.【症例 1】 49 歳,女性.経過中に増大傾向を呈した内側後脈絡叢動脈遠位の動脈瘤に対し,NBCA にて塞栓し良好な経過を得た.【症例 2】46 歳,女性.出血源となった外側後脈絡叢動脈末梢動脈瘤に対し,NBCA による塞栓術を施行.神経内視鏡下に脳室内血腫除去術中,塞栓された脳室壁に位置する動脈瘤を確認した.【結論】もやもや病の側副血行路に合併する末梢動脈瘤に対しては,血管解剖を理解し適切なデバイス選択による塞栓術が有効であった.

著者

都築 伸介 豊岡 輝繁 景山 寛志

出版者

一般社団法人日本脳神経外科コングレス

雑誌

脳神経外科ジャーナル (ISSN:0917950X)

巻号頁・発行日

vol.25, no.9, pp.765-771, 2016 (Released:2016-09-25)

参考文献数

27

被引用文献数

2 1

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硬膜下血腫を合併した低髄液圧症候群の病態は複雑で, さまざまな治療法および治療経過が報告されている. その理由は, 硬膜下血腫の病態が単一ではなく, また同一症例であっても治療を行う時期によって血腫の病態が異なるためではないかと推察される. 適切な治療を行うためには, 治療を開始する時点での血腫の病態を正確に把握することが重要である. われわれは血腫の病態を把握する目的で血腫腔内圧モニタリングを試みた. 結果, 血腫の病態が可視化され, これを正確に把握することが可能となり, 適切な治療を行い得た. 本法は保存的治療が無効な, 硬膜下血腫合併低髄液圧症候群に対する治療の選択肢となり得ると思われた.

著者

苗代 弘 魚住 洋一 佐藤 俊一 川内 聡子 小林 弘明 長田 秀夫 大谷 直樹 和田 孝次郎 都築 伸介 島 克司

出版者

一般社団法人 日本脳卒中学会

雑誌

脳卒中 (ISSN:09120726)

巻号頁・発行日

vol.32, no.6, pp.559-562, 2010-11-26 (Released:2010-12-03)

参考文献数

15

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Objectives: It has been reported that near-infrared (NIR) laser irradiation is effective in cerebral ischemia. We examined the effect of 808 nm laser diode irradiation on CBF in mice. The potential of NIR laser irradiation in the treatment of cerebral ischemia was also investigated.Methods: Male C57BL/6J mice were used. An 808 nm CW diode laser was applied to the hemisphere transcranially. CBF was measured with a non-contact laser Doppler blood perfusion imager. We measured directly nitric oxide in the brain tissue during NIR laser irradiation. To confirm the effect of pretreatment by NIR laser irradiation, we conducted the 1.6 W/cm2 NIR laser irradiation to the hemisphere transcranially for 30 minutes before bilateral common carotid artery occlusion (BCCAO). The control mice were also subjected to BCCAO without pretreatment by NIR laser irradiation.Results: Transcranial NIR laser irradiation increased local CBF by 30% compared to control value in mice. NIR laser irradiation also provoked a significant increase in cerebral NO concentration. Pretreatment by NIR laser irradiation improved residual CBF following bilateral carotid occlusion in mice.Conclusions: Our data suggest that targeted increase of CBF is available by NIR laser irradiation and it is concerned in NOS activity and NO concentration. Besides, NIR laser irradiation may have a protective effect for transient ischemia.

著者

都築 伸介 大井川 秀聡 豊岡 輝繁 魚住 洋一 長田 秀夫 鈴木 隆元 宮澤 隆仁 苗代 弘 島 克司

出版者

一般社団法人 日本脳卒中の外科学会

雑誌

脳卒中の外科 (ISSN:09145508)

巻号頁・発行日

vol.37, no.5, pp.375-378, 2009 (Released:2010-04-16)

参考文献数

4

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A 74-year-old man presented with subarachnoid hemorrhage (SAH) and underwent neck clipping of a left middle cerebral artery (MCA) aneurysm 10 years ago. This patient presented with SAH again due to rupture of a de novo aneurysm of the anterior communicating artery (A-com. aneurysm). The A-com. aneurysm was clipped successfully. The “old” left MCA aneurysm was then inspected. A collapsed “old” aneurysmal dome and a previously applied clip were identified. The “old” aneurysmal dome was resected for histopathological examination. The wall of this aneurysmal dome varied in thickness and consisted of a thin layer of fibrous connective tissue. Fibroblasts were scattered in the aneurysmal wall and either the muscular layer or internal elastic lamina was absent. The aneurysmal dome collapsed to a certain degree, but the lumen of the dome was completely intact. In addition, neovascularization of microcapillaries was observed both inside and outside the aneurysmal dome. Some of these microcapillaries were filled with fresh erythrocytes. Thus the aneurysmal wall was apparently “vigorous.” The previous orifice of the aneurysm did not fuse together at all and could be opened widely with ease during preparation for histopathologic examination. We speculated that the clipped aneurysmal dome survived for 10 years for the following reasons: 1) Although the mechanism of neovascularization of the microcapillaries is unclear, the clipped aneurysmal dome may have obtained nourishment from the microcapillaries. 2) The cerebrospinal fluid may have incubated the dome and provided optimal circumstances for its survival. Considering the radical cure for ruptured cerebral aneurysms by neck clipping or coil embolization, the findings described in this report will be valuable for neurosurgeons and neurointerventionists. Regardless of the time since treatment, ruptured aneurysms treated by either neck clipping and/or coil embolization are at risk of recurrent subarachnoid hemorrhage when the blood re-enters the aneurysms in cases such as clip slip-off or coil compaction.