著者

Hiroki UCHIKAWA Taichi KIN Satoshi KOIZUMI Katsuya SATO Tatsuya UCHIDA Yasuhiro TAKEDA Tsukasa KOIKE Satoshi KIYOFUJI Shigeo YAMASHIRO Akitake MUKASA Nobuhito SAITO

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2023-0003, (Released:2023-08-23)

参考文献数

30

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Rebleeding from a ruptured intracranial aneurysm has poor outcomes. Although numerous factors are associated with rebleeding, studies on computational fluid dynamics (CFD) on hemodynamic parameters associated with early rebleeding are scarce. In particular, no report of rebleeding in ultra-early phase exists. We aimed to elucidate the specific hemodynamic parameters associated with ultra-early rebleeding using CFD. In this study, the rebleeding group included patients with aneurysmal subarachnoid hemorrhage (aSAH) that rebled within 6 h from the onset. The control group included patients without rebleeding, observed for >10 h following the initial rupture. Clinical images after initial rupture and before rebleeding were used to build 3D vessel models for hemodynamic analysis focusing on the following parameters: time-averaged wall shear stress (WSS), normalized WSS, low shear area, oscillatory shear index, relative residence time, pressure loss coefficient, and aneurysmal inflow rate coefficient (AIRC). Five and 15 patients in the rebleeding and control groups, respectively, met the inclusion criteria. The World Federation of Neurosurgical Surgeons grade was significantly higher in the rebleeding group (p = 0.0088). Hemodynamic analysis showed significantly higher AIRC in the rebleeding group (p = 0.042). The other parameters were not significantly different between groups. There were no significant differences or correlations between SAH severity and AIRC. AIRC was identified as a hemodynamic parameter associated with ultra-early rebleeding of ruptured intracranial aneurysms. Thus, AIRC calculation may enable the prediction of ultra-early rebleeding.

著者

Hirohisa YAJIMA Satoshi KOIZUMI Tomoki KANDA Naoyuki SHONO Taichi KIN Nobuhito SAITO

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.10, pp.41-45, 2023-12-31 (Released:2023-03-15)

参考文献数

24

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Several studies have reported the coexistence of chronic subdural hematoma (CSDH) and dural arteriovenous fistula (DAVF); however, the association between these two entities remains unknown. A case of coexisting CSDH and DAVF that was successfully treated with burr hole surgery and middle meningeal artery (MMA) embolization is reported herein. We visualized the positional relationship between CSDH and DAVF by fusion three-dimensional computer graphics images reconstructed from multimodal imaging studies, which revealed that the shunt point of the DAVF was far from the burr hole and was in contact with the CSDH membrane at the center of the CSDH. Additionally, the chronological development of CSDH in the presence of DAVF and the complete disappearance of both DAVF and CSDH after MMA embolization were also demonstrated. This study suggests a possible association between recurrent CSDH and DAVF.

著者

Masanori YOSHINO Toki SAITO Taichi KIN Daichi NAKAGAWA Hirofumi NAKATOMI Hiroshi OYAMA Nobuhito SAITO

出版者

社団法人 日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.tn.2014-0278, (Released:2015-07-28)

参考文献数

28

被引用文献数

9

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Three-dimensional (3D) computer graphics (CG) are useful for preoperative planning of neurosurgical operations. However, application of 3D CG to intraoperative navigation is not widespread because existing commercial operative navigation systems do not show 3D CG in sufficient detail. We have developed a microscopic optically tracking navigation system that uses high-resolution 3D CG. This article presents the technical details of our microscopic optically tracking navigation system. Our navigation system consists of three components: the operative microscope, registration, and the image display system. An optical tracker was attached to the microscope to monitor the position and attitude of the microscope in real time; point-pair registration was used to register the operation room coordinate system, and the image coordinate system; and the image display system showed the 3D CG image in the field-of-view of the microscope. Ten neurosurgeons (seven males, two females; mean age 32.9 years) participated in an experiment to assess the accuracy of this system using a phantom model. Accuracy of our system was compared with the commercial system. The 3D CG provided by the navigation system coincided well with the operative scene under the microscope. Target registration error for our system was 2.9 ± 1.9 mm. Our navigation system provides a clear image of the operation position and the surrounding structures. Systems like this may reduce intraoperative complications.