著者
Hiroshi MIYABAYASHI Nobuhiko NAGANO Shin HASHIMOTO Katsuya SAITO Risa KATO Takanori NOTO Mari SASANO Koichiro SUMI Atsuo YOSHINO Ichiro MORIOKA
出版者
The Japan Neurosurgical Society
雑誌
Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日
pp.2022-0105, (Released:2022-09-30)
参考文献数
29
被引用文献数
5

In this study, we aimed to evaluate the longitudinal changes in the cranial shape of healthy Japanese infants using a three-dimensional scanner and construct a normal values database for the growth process. Preterm infants (gestational age < 37 weeks), infants with neonatal asphyxia (5-minute Apgar score of <7), and patients who started helmet therapy for deformational plagiocephaly were excluded from this study. The first scan was performed at approximately 1 month of age, followed by two scans conducted at 3 and 6 months of age. The parameters considered were as follows: cranial length, width, height, circumference, volume, cranial vault asymmetry index, and cephalic index. A cranial vault asymmetry index >5% was defined as deformational plagiocephaly. Changes in each parameter were examined using repeated-measures analysis of variance classified by sex and deformational plagiocephaly status. The rate of increase in each parameter was also examined. In total, 88 infants (45 boys and 43 girls) were included in this study. All growth-related parameters were noted to increase linearly with time. Sex differences were observed in all parameters except cranial length. Deformational plagiocephaly was found to have no effect on growth-related parameters. Cranial volume increased by 60% from 1 to 6 months of age. The growth almost uniformly influenced the rate of increase in volume in each coordinate axis direction. Overall, the mean trends in three-dimensional parameters in infants up to 6 months of age were obtained using a three-dimensional scanner. These trends could be used as a guide by medical professionals involved in cranioplasty.
著者
Katsuya Saito Takahiro Miyata Tsubasa Miyauchi Takaki Ichikawa Keita Mayanagi Joji Inamasu Masashi Nakatsukasa
出版者
The Japanese Society for Neuroendovascular Therapy
雑誌
Journal of Neuroendovascular Therapy (ISSN:18824072)
巻号頁・発行日
pp.cr.2022-0009, (Released:2022-07-22)
参考文献数
20

Objective: We describe a rare case report of micro-arteriovenous malformation (micro-AVM) treated by the endovascular approach in addition with literature review.Case Presentation: A 12-year-old boy presenting with a spontaneous intracerebral hematoma in the left occipital lobe underwent conventional diagnostic workups. The results of initial catheter angiography were considered to be equivocal as the AVM. Superselective angiography (SA) demonstrated a micro or small AVM (single feeder and single drainer type) with an aneurysmal dilatation. Immediate transarterial embolization (TAE) might fail to occlude the whole of nidus area completely, and subsequently, we switched to the surgical exploration of AVM lesion. Intraoperative findings demonstrated that the whole of AVM lesion had already been occluded completely, indicating the complete occlusion by TAE only. Pathological findings of the surgical specimen showed an aneurysmal dilatation was a venous aneurysm with vulnerable vascular wall structure, which was certainly the source of bleeding. Based on the above results, the retrospective revaluation of superselective angiogram permitted us to understand that the nidus of AVM was micro nidus type and TAE had resulted in the complete nidus occlusion.Conclusion: SA is the most useful diagnostic modality to clarify the angioarchitecture of micro-AVM and AVM-related aneurysms. If SA is successfully performed and relatively safe TAE is expected to be possible, the subsequent attempt to do curative embolization as a first-line treatment may be worthy of consideration. However, the surgical procedure should be fully reserved for the possible incomplete obliteration and hemorrhagic complications.