文献一覧: Masaru Hirohata (著者)

24 0 0 0 OA Venous Anatomy of the Cavernous Sinus and Relevant Veins

著者: Shuichi Tanoue Masaru Hirohata Yasuharu Takeuchi Kimihiko Orito Sosho Kajiwara Toshi Abe
出版者: The Japanese Society for Neuroendovascular Therapy
雑誌: Journal of Neuroendovascular Therapy (ISSN:18824072)
巻号頁・発行日: vol.14, no.12, pp.547-557, 2020 (Released:2020-12-20)
参考文献数: 30
被引用文献数: 2

The cavernous sinus (CS) is a dural sinus located on each side of the pituitary fossa. Neoplastic and vascular lesions, such as arteriovenous fistulas, frequently involve the CS. This sinus plays a role as a crossroad receiving venous blood flow from the facial, orbital, meningeal, and neural venous tributaries. The relationship between these surrounding relevant veins and the CS, as well as the CS itself, varies anatomically. For safe and effective surgical and endovascular treatment of lesions involving the CS, knowledge of the anatomy and variations of the CS and the relevant surrounding veins is highly important. In this section, the anatomy and variations of the CS and the relevant surrounding veins are outlined.

2023-12-25 23:41:41
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2 0 0 0 OA Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia

著者: Sosho KAJIWARA Yu HASEGAWA Tetsuya NEGOTO Kimihiko ORITO Takayuki KAWANO Munetake YOSHITOMI Kiyohiko SAKATA Nobuyuki TAKESHIGE Yukako YAMAKAWA Hirofumi JONO Hideyuki SAITO Nobuhisa HIRAYU Osamu TAKASU Masaru HIROHATA Motohiro MORIOKA
出版者: The Japan Neurosurgical Society
雑誌: Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日: vol.61, no.9, pp.528-535, 2021 (Released:2021-09-15)
参考文献数: 21
被引用文献数: 3

This study aimed to examine the beneficial effects of a novel prophylactic barbiturate therapy, step-down infusion of barbiturates, using thiamylal with normothermia (NOR+sdB), on the poor outcome in the patients with severe traumatic brain injuries (sTBI), in comparison with mild hypothermia (MD-HYPO). From January 2000 to March 2019, 4133 patients with TBI were admitted to our hospital. The inclusion criteria were: a Glasgow coma scale (GCS) score of ≤8 on admission, age between 20 and 80 years, intracranial hematoma requiring surgical evacuation of the hematoma with craniotomy and/or external decompression, and patients who underwent management of body temperature and assessed their outcome at 6–12 months. Finally, 43 patients were included in the MD-HYPO (n = 29) and NOR+sdB (n = 14) groups. sdB was initiated intraoperatively or immediately after the surgical treatment. There were no significant differences in patient characteristics, including age, sex, past medical history, GCS on admission, type of intracranial hematoma, and length of hospitalization between the two groups. Although NOR+sdB could not improve the patient’s poor outcome either at discharge from the intensive care unit (ICU) or at 6–12 months after admission, the treatment inhibited composite death at discharge from the ICU. The mean value of the maximum intracranial pressure (ICP) in the NOR+sdB group was <20 mmHg throughout the first 120 h. NOR+sdB prevented composite death in the ICU in patients with sTBI, and we may obtain novel insights into the beneficial role of prophylactic barbiturate therapy from suppression of the elevated ICP during the first 120 h.

2021-12-24 07:35:01
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1 0 0 0 OA Visual Outcomes and Surgical Approach Selection Focusing on Active Optic Canal Decompression and Maximum Safe Resection for Suprasellar Meningiomas

著者: Kiyohiko SAKATA Satoru KOMAKI Nobuyuki TAKESHIGE Tetsuya NEGOTO Jin KIKUCHI Sosho KAJIWARA Kimihiko ORITO Hideo NAKAMURA Masaru HIROHATA Motohiro MORIOKA
出版者: The Japan Neurosurgical Society
雑誌: Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日: pp.2021-0142, (Released:2023-07-10)
参考文献数: 54

The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension. Optic canal decompression and exploration were performed as key surgical procedures. Simpson grade 1 to 3 resection was achieved in 80% of cases. Among the 26 patients with pre-existing visual dysfunction, vision at discharge improved in 18 patients (69.2%), remained unchanged in six (23.1%), and deteriorated in two (7.7%). Further gradual visual recovery and/or maintenance of useful vision were also observed during follow-up. We propose an algorithm for selecting the appropriate surgical approach to a suprasellar meningioma based on preoperative radiologic tumor characteristics. The algorithm focuses on effective optic canal decompression and maximum safe resection, possibly contributing to favorable visual outcomes.

2023-07-10 16:11:23
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1 0 0 0 OA Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia

著者: Yusuke OTSU Sosho KAJIWARA Aya HASHIMOTO Kiyohiko SAKATA Tetsuya NEGOTO Yu HASEGAWA Hideo NAKAMURA Masaru HIROHATA Motohiro MORIOKA
出版者: The Japan Neurosurgical Society
雑誌: Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日: pp.2022-0288, (Released:2023-04-06)
参考文献数: 22
被引用文献数: 2

Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable.

2023-04-07 11:41:23
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1 0 0 0 OA Relationship between Transient Cortical Blindness and Contrast Medium Leakage That Occurs after Endovascular Treatment of Posterior Circulation Aneurysms

著者: Kimihiko Orito Sosyo Kajiwara Yasuharu Takeuchi Kiyohiko Sakata Toshi Abe Shuichi Tanoue Yusuke Uchiyama Masaru Hirohata Motohiro Morioka
出版者: The Japanese Society for Neuroendovascular Therapy
雑誌: Journal of Neuroendovascular Therapy (ISSN:18824072)
巻号頁・発行日: pp.oa.2021-0106, (Released:2022-08-10)
参考文献数: 11

Objective: The mechanism of transient cortical blindness after endovascular treatment—a rare phenomenon—has not been elucidated; however, it is assumed to be related to contrast medium leakage (CML). We investigated the relationship between postoperative CML and cortical blindness in patients who underwent endovascular treatment for vascular lesions of posterior circulation.Methods: This retrospective cohort study included 28 patients who underwent endovascular treatment for posterior circulation aneurysms at our hospital between January 2014 and December 2018. Cerebral CT was performed immediately after endovascular treatment and 24 h later. CT images were retrospectively evaluated with special interest in the presence and distribution of leakage of the contrast medium (CM). Patients were classified into the following three groups based on CT findings: Group A, no CML (11 patients); Group B, unilateral CML (5 patients); and Group C, bilateral CML (9 patients).Results: The posterior circulation aneurysms were located in the basilar artery in 13 (52.0%) cases, in the posterior cerebral artery in 1 (4.0%) case, and in the vertebral artery in 11 (44.0%) cases. There was no difference regarding the adjunctive technique used for endovascular treatment between the groups. Patients in Group C used a significantly larger amount of CM than those in the other two groups. A longer operation time was associated with a larger amount of CM used during treatment. VerifyNow assay revealed that the P2Y12 reaction unit was significantly lower in Groups B and C. Cortical blindness was transiently observed in 2 of 9 patients (22.2%) in Group C, both of which showed CML surrounding the bilateral parieto-occipital sulcus.Conclusion: Both patients with cortical blindness showed bilateral CML, both of which showed CML surrounding the bilateral parieto-occipital sulcus. The CM-induced blood–brain barrier disruption may be the cause of cortical blindness.

2022-08-10 08:30:00
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1 0 0 0 OA Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia

著者: Sosho KAJIWARA Yu HASEGAWA Tetsuya NEGOTO Kimihiko ORITO Takayuki KAWANO Munetake YOSHITOMI Kiyohiko SAKATA Nobuyuki TAKESHIGE Yukako YAMAKAWA Hirofumi JONO Hideyuki SAITO Nobuhisa HIRAYU Osamu TAKASU Masaru HIROHATA Motohiro MORIOKA
出版者: The Japan Neurosurgical Society
雑誌: Neurologia medico-chirurgica (ISSN:04708105)
巻号頁・発行日: pp.oa.2021-0097, (Released:2021-06-01)
参考文献数: 21
被引用文献数: 3

2022-02-08 06:01:11
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