著者

Masashi Ito Takashi Izumi Masahiro Nishihori Tasuku Imai Yousuke Tamari Tetsuya Tsukada Mamoru Ishida Asuka Kropp Toshihiko Wakabayashi

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

vol.11, no.12, pp.615-618, 2017 (Released:2017-12-20)

参考文献数

12

被引用文献数

1 2

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Objective: We encountered a patient with lateral medullary infarction during transarterial embolization of the posterior meningeal artery (PMA). We reviewed the anatomic characteristics/imaging findings of this disorder.Case Presentation: A 69-year-old male. Cerebral infarction involving the lateral medulla occurred during transarterial embolization of a dural arteriovenous fistula. It was considered to be a complication related to occlusion of a lateral medulla-penetrating vessel on microcatheter/guidewire operations in the PMA. When examining images in detail, the blood vessel could be confirmed using DSA and 3D angiography.Conclusion: When performing embolization, the presence of a brainstem-penetrating vessel originating from the PMA must be considered.

著者

Masahiro Nishihori Ryo Kawase Takashi Izumi Hiroe Nakase Erina Onishi Ryuta Saito

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.2023-0053, (Released:2023-10-24)

参考文献数

8

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Objective: We verified the usefulness of patient management using a balloon-pressurized belt (Stanch Belt Plus) to prevent puncture site hematomas, which can occur at a specific rate even with hemostatic devices after endovascular neurosurgery.Methods: A total of 113 patients who underwent endovascular surgery with a femoral puncture from April 2019 to September 2020 were divided into two groups: 31 cases using a traditional compression belt and 82 cases using a newly introduced balloon-pressurized belt during this period. The clinical data were analyzed retrospectively. The chi-square test and Mann–Whitney U test were used to test for significant differences.Results: There were no significant differences in treatment procedures or frequency of hemostatic device use, but the balloon-pressurized belt group had a significantly lower incidence of hematomas (2.4% vs 12.9%, p <0.05) and a significantly lower incidence of moderate or higher lumbago (22.0% vs 41.9%, p <0.05). The incidence of epidermal detachment tended to be low; however, no significant difference was observed (3.7% vs. 12.9%, n.s.).Conclusion: Patient management with the newly introduced balloon-pressurized belt may decrease the occurrence of groin hematoma and lumbago among complications after endovascular neurosurgery.

著者

Kuniharu Imai Kento Takeda Keisuke Fujii Chiyo Kawaura Takuya Nishimoto Masaki Mori Yuki Yamamoto Takashi Izumi

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.2022-0041, (Released:2022-10-28)

参考文献数

13

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Objective: Neuroendovascular treatments are less invasive than surgical clipping. However, the number of fluoroscopy runs may be greater when a contrast medium is used than when routine angiography is performed. Several recent studies have suggested that an iodinated contrast medium causes an increase in the radiation dose. Therefore, it is clinically important to identify physical factors causing amplification of the radiation dose. The purpose of this study was to investigate how dilution of a contrast medium with water influences the amplification effect of the radiation dose using simulation analysis.Methods: Three different types of commercially available contrast media, namely, iopamidol, iohexol, and iodixanol, were diluted 1.7–3.3 times with water and placed in the left brain parenchyma of a numerical brain phantom. Using the Monte Carlo simulation method, the phantom was exposed to X-ray beams under constant exposure conditions, and the energy absorbed in the entire region of the left brain parenchyma was estimated. At the same time, the content and volume of a contrast medium in the cerebral vessels were predicted on the basis of pharmacokinetic and fractal analyses.Results: The increase in absorbed energy was attributed to secondary electrons emitted from the contrast medium and varied depending on its content and volume. Interestingly, the amount of energy absorbed increased with increasing dilution of the contrast medium. Furthermore, the amplification effect of the radiation dose varied according to the type of contrast medium used.Conclusion: These results suggest that the amplification effect of the radiation dose is closely related to an increase in the cross-sectional area in which the X-rays interact with the contrast medium, which is caused by increased distribution of contrast medium in the cerebral vessels. When the contrast medium is diluted with water, its spread in the cerebral vessels plays a more important role than its content in the amplification effect of the radiation dose.

著者

Taketo HANYU Masahiro NISHIHORI Takashi IZUMI Kazuya MOTOMURA Fumiharu OHKA Shunsaku GOTO Yoshio ARAKI Kinya YOKOYAMA Kenji UDA Ryuta SAITO

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.289-294, 2022-12-31 (Released:2022-09-15)

参考文献数

23

被引用文献数

1

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In this article, we report a case wherein a brain tumor was suspected based on computed tomography and magnetic resonance imaging findings. We made an initial diagnosis of malignant brain tumor based on methionine-positron emission tomography (PET) findings, but the correct diagnosis was dural arteriovenous fistula (DAVF). The patient was a 45-year-old man with DAVF who developed headache. Methionine-PET imaging showed high methionine uptake in the lesion. Although the tumor was strongly suspected from the findings of methionine-PET, the diagnosis of DAVF could be made correctly only by interpreting digital subtraction angiography and computed tomographic angiography. The findings of methionine-PET, which is considered useful in the diagnosis and denial of brain tumors, made the diagnosis of DAVF more difficult. The increased uptake of methionine-PET in DAVF is an important finding because, to our knowledge, this study is the first to report such finding. The results of this study might be useful for differential diagnoses when the diagnosis is uncertain.