著者

Tomoaki Murakami Shingo Toyota Motohide Takahara Kazuhiro Touhara Tatsuya Hagioka Yuhei Hoshikuma Takamune Achiha Takeshi Shimizu Maki Kobayashi Haruhiko Kishima

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.2023-0020, (Released:2023-07-04)

参考文献数

18

---

Objective: Extracranial internal carotid artery aneurysms (ECAAs) are rare. We herein describe a case of overlapped stenting with two double-layer micromesh stents for a giant ECAA.Case Presentation: A 73-year-old man presented to our hospital with an enlarged right posterior cervical mass. A right internal carotid artery (ICA) angiogram revealed a giant aneurysm of 50 × 60 mm. We chose a carotid double-layer micromesh stent for stenting. With the patient under general anesthesia, the first double-layer micromesh stent (CASPER Rx, 10 × 30 mm; Terumo, Tokyo, Japan) was deployed between the ICA distal to the aneurysm and the common carotid artery (CCA). The second stent was also deployed from a site more proximal than the first one. Ten coils were then placed from a microcatheter that had been placed in the aneurysm. A right CCA angiogram after the procedure revealed a flow-diversion effect for the aneurysm. The patient was discharged with no complications. At the 6-month follow-up angiogram, blood flow into the aneurysm had completely disappeared.Conclusion: A flow-diversion effect using overlapped double-layer micromesh stents can result in thrombosis and healing of giant ECAAs.

著者

Kunihiro OGATA Tomoki MITA Takeshi SHIMIZU Nobuya YAMASAKI

出版者

The Institute of Electronics, Information and Communication Engineers

雑誌

IEICE Transactions on Information and Systems (ISSN:09168532)

巻号頁・発行日

vol.E98.D, no.11, pp.1916-1922, 2015-11-01 (Released:2015-11-01)

参考文献数

19

被引用文献数

5

---

Some unilateral lower-limb amputees, have through continued exertion, increase the foot reaction force of the sound leg. The asymmetric gait with a prosthetic leg may thus negatively affect the musculoskeletal health of the leg on the healthy side. Therefore, it is important for these amputees to learn how to adjust the balance of each foot load in training. The aim of this study is to develop a training support system visualizing floor-reaction forces using a color-depth sensor. The pose of the entire body of the amputee is measured by the depth sensor, and the floor reaction force is estimated based on Zero Moment Point (ZMP), which is calculated using the center of mass of the amputee. Evaluation experiments of the proposed method were performed and they confirmed the effectiveness of the estimation method and the training with the visualization of reaction force.

著者

Takufumi YANAGISAWA Ryohei FUKUMA Ben SEYMOUR Koichi HOSOMI Haruhiko KISHIMA Takeshi SHIMIZU Hiroshi YOKOI Masayuki HIRATA Toshiki YOSHIMINE Yukiyasu KAMITANI Youichi SAITOH

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.st.2018-0099, (Released:2018-07-12)

参考文献数

41

被引用文献数

6

---

A brachial plexus root avulsion (BPRA) causes intractable pain in the insensible affected hands. Such pain is partly due to phantom limb pain, which is neuropathic pain occurring after the amputation of a limb and partial or complete deafferentation. Previous studies suggested that the pain was attributable to maladaptive plasticity of the sensorimotor cortex. However, there is little evidence to demonstrate the causal links between the pain and the cortical representation, and how much cortical factors affect the pain. Here, we applied lesioning of the dorsal root entry zone (DREZotomy) and training with a brain–machine interface (BMI) based on real-time magnetoencephalography signals to reconstruct affected hand movements with a robotic hand. The DREZotomy successfully reduced the shooting pain after BPRA, but a part of the pain remained. The BMI training successfully induced some plastic changes in the sensorimotor representation of the phantom hand movements and helped control the remaining pain. When the patient tried to control the robotic hand by moving their phantom hand through association with the representation of the intact hand, this especially decreased the pain while decreasing the classification accuracy of the phantom hand movements. These results strongly suggested that pain after the BPRA was partly attributable to cortical representation of phantom hand movements and that the BMI training controlled the pain by inducing appropriate cortical reorganization. For the treatment of chronic pain, we need to know how to modulate the cortical representation by novel methods.

著者

Takuya SUEMATSU Tomoaki MURAKAMI Yoshiko SUDO Tatsuya HAGIOKA Yuhei HOSHIKUMA Takamune ACHIHA Takeshi SHIMIZU Shingo TOYOTA Haruhiko KISHIMA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.329-335, 2022-12-31 (Released:2022-09-23)

参考文献数

21

---

Intimal sarcomas (ISAs) are extremely rare malignant tumors that histologically occur in the tunica intima of large blood vessels of the systemic and pulmonary circulation. Herein, we describe a case of an ISA-based neoplastic aneurysm in the middle cerebral artery (MCA) that resulted in a subarachnoid hemorrhage (SAH). The patient presented to our hospital with severe consciousness disturbance (Glasgow Coma Scale E1V1M2) and anisocoria. On admission, computed tomography (CT) showed a diffuse SAH. At 8 months prior, he presented to a previous hospital with hoarseness. Thoracic CT revealed a threatened rupture of the aorta of the arch. After total arch replacement, he had been diagnosed with ISA from the pathological findings of the resected aorta. Thereafter, he had been treated with adjuvant chemotherapy and radiotherapy without any cerebral vascular imaging studies, before admission at our hospital. Angiogram revealed a multilobar fusiform aneurysm on the right MCA. We performed a superficial temporal artery-MCA anastomosis, trapping, and resection of the affected MCA (including the aneurysm), followed by external decompression. Microscopic hematoxylin-eosin staining showed proliferation of atypical spindle-shaped cells with enlarged nuclei in the lumen of the affected MCA. Immunostaining showed CD31 (±), ERG (+), MDM2 (+), CDK4 (+, slightly), SMA (±), MIB-1 index 13.9%, factor VIII (±), and desmin (−). These pathological findings indicated metastasis of the ISA, which formed the neoplastic aneurysm. An ISA can cause a neoplastic cerebral aneurysm. Therefore, once a patient is diagnosed with an ISA, it is necessary to check periodically the cerebral arteries.

著者

Tatsuya HAGIOKA Takeshi SHIMIZU Shingo TOYOTA Tomoaki MURAKAMI Takamune ACHIHA Motohide TAKAHARA Kazuhiro TOUHARA Yuhei HOSHIKUMA Maki KOBAYASHI Haruhiko KISHIMA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.10, pp.241-245, 2023-12-31 (Released:2023-09-29)

参考文献数

12

---

A 54-year-old man with no medical history presented to our hospital with vomiting, left hemiplegia, and seizures. On arrival, he was experiencing generalized tonic-clonic seizures, which required him to be intubated and deeply sedated. Contrast-enhanced computed tomography revealed extensive venous sinus obstruction from the superior sagittal sinus to the bilateral sigmoid sinus and cerebral edema with intracranial hemorrhage. An intracranial pressure (ICP) monitor was immediately placed intracranially, and mechanical thrombectomy (MT) was performed under ICP monitoring. MT was immediately terminated when the venous sinus was partially recanalized enough to decrease the ICP; then, anticoagulation therapy was initiated. Postoperative follow-up angiography revealed that venous sinus obstruction and intracranial venous perfusion improved over time. Although he had intracranial hemorrhage-induced left hemiplegia and sensory deficits, his condition improved with rehabilitation, and the patient was eventually discharged home. The indication criteria and techniques for MT for cerebral venous sinus thrombosis are yet to be established. As in this case, in patients with impaired consciousness due to intracranial hemorrhage or epilepsy, preoperative ICP monitor placement is deemed useful to evaluate venous perfusion during MT and decide the treatment goal.

著者

Takeshi SHIMIZU Shingo TOYOTA Motohide TAKAHARA Kazuhiro TOUHARA Tatsuya HAGIOKA Yuhei HOSHIKUMA Takamune ACHIHA Tomoaki MURAKAMI Maki KOBAYASHI Haruhiko KISHIMA

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2023-0070, (Released:2023-09-23)

参考文献数

15

---

There have been a number of anastomosis methods of bypass techniques reported for moyamoya disease. However, there are yet no randomized controlled trials conducted on the anastomosis method. Retrograde blood flow of the superficial temporal artery (STA) may be used as one of the donor options. Here, we examined the tolerability of retrograde bypass using a distal stump of the parietal STA (dsPSTA). Anastomosis between the dsPSTA and middle cerebral artery (MCA) was performed for consecutive patients with moyamoya disease whose parietal STA was visualized to be longer than 10 cm using contrast-enhanced computed tomography preoperatively. Retrospectively, we have examined its patency and clinical outcome. Retrograde dsPSTA-MCA bypass was performed in 22 hemispheres of 17 patients. The patency of retrograde dsPSTA-MCA bypass in all 22 anastomoses could be confirmed during follow-up periods (mean: 5.5, range: 2-15 years). No recurrence of ischemic events was observed. The dsPSTA-MCA bypass using retrograde blood flow has been determined as one of the many promising anastomosis methods, and long-term patency was achieved in moyamoya disease.

著者

Tatsuya HAGIOKA Takeshi SHIMIZU Kazuhiro TOUHARA Motohide TAKAHARA Yuhei HOSHIKUMA Takamune ACHIHA Tomoaki MURAKAMI Maki KOBAYASHI Shingo TOYOTA Haruhiko KISHIMA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.343-347, 2022-12-31 (Released:2022-10-13)

参考文献数

18

---

A 72-year-old man who had undergone a lumboperitoneal shunt for idiopathic normal pressure hydrocephalus was admitted to our emergency department with fever and disturbance of consciousness 8 days after placement. Computed tomography scan showed pneumocephalus and a right-sided temporal porencephalic cyst with a small bone defect in the right petrous bone. Shunt valve pressure was raised from 145 mmH2O to "virtual off" setting. After 2 weeks, follow-up computed tomography showed improvement of pneumocephalus, and the shunt valve pressure was lowered to 215 mmH2O. Since that time, the patient has a good clinical course without recurrence.Tension pneumocephalus following shunt placement for idiopathic normal pressure hydrocephalus is rare and has never been reported in the early postoperative stage after lumboperitoneal shunt, except for the present one. Temporary raising shunt valve pressure is effective in improving the pneumocephalus. Preoperative screening for congenital bone defects by thin-slice computed tomography may be useful for selecting types of shunt valve and determining postoperative pressure setting.

著者

Toshifumi Nanjo Takaomi Fukuhara Naoko Kameshima Daijiro Yanagisawa Shino Shimizu Takeshi Shimizu Akihiko Shiino Hiroyasu Akatsu Takayuki Yamamoto Ikuo Tooyama

出版者

Japan Brain Science society

雑誌

脳科学誌 (ISSN:13415301)

巻号頁・発行日

vol.44, pp.5-23, 2014-12-30 (Released:2017-06-01)

---

Previous studies have reported that β-amyloid peptides (Aβ) are observed in the nasal mucosa of postmortem human samples. In a mouse model of Alzheimer's disease (AD), nasal Aβ levels positively correlate with insoluble Aβ levels in the brain. However, it is difficult to measure Aβ content in human nasal smears. Here we report a novel and sensitive method of measuring Aβ42 content in the human nasal cavity and its application in normal human volunteers. We collected nasal smears by cotton swab from the mucosa of the inferior nasal concha and common nasal meatus of 26 normal volunteers with an age range of 23-78 years. The swabs were placed in microtubes and extracted with pure water. Extract solution was removed from each sample for protein assay and the remaining sample was added with formic acid, incubated at 70℃ for one hour, and then centrifuged in a centrifugal filter device to remove larger protein complexes and cellular debris. The filtrates were concentrated and then buffered before Aβ42 concentrations were measured using a commercially available ELISA kit. Samples from five volunteers were also assayed for Aβ42 content without pretreatment. Our novel method for collecting and assaying nasal mucosal smears enabled us to measure Aβ42 content in both the inferior nasal concha and the common nasal meatus of all cases examined, despite the levels being under detection limits (0.1 pmol/L) without pretreatment. There was significantly more Aβ42 content per gram of total protein in the inferior nasal concha (12.37 ± 5.98 pmol/g) than in the common nasal meatus (3.58 ± 1.94 pmol/g; P < 0.001). Thus, this method would be useful for AD screening.

著者

Toshifumi Nanjo Takaomi Fukuhara Naoko Kameshima Daijiro Yanagisawa Shino Shimizu Takeshi Shimizu Akihiko Shiino Hiroyasu Akatsu Takayuki Yamamoto Ikuo Tooyama

出版者

Japan Brain Science society

雑誌

脳科学誌 (ISSN:13415301)

巻号頁・発行日

vol.42, pp.5-20, 2013-09-30 (Released:2017-06-01)

---

Previous studies reported that β-amyloid peptides (Aβ) were observed in nasal mucosa of postmortem human samples. In the model mouse of Alzheimer's disease (AD), nasal Aβ levels positively correlate with insoluble Aβ levels in the brain. However, it is difficult to measure Aβ content in human nasal smears. Here we have reported a novel and sensitive method of measuring Aβ42 content in the human nasal cavity. We collected nasal smears by cotton swab from the mucosa of the inferior nasal concha and common nasal meatus of 13 normal volunteers with an age range of 30-78 years. The swabs were put into microtubes and the protein content extracted with 700 μL of 80% formic acid. Ten microliters of the extract solution was removed from each sample to assay protein levels. The remaining 690 μL was incubated at 70℃ for one hour, transferred to a centrifugal filter device, and centrifuged for one hour at 14000 g to remove larger protein complexes and cellular debris. The filtrates were concentrated to 20 μL, and then neutralized by adding 480 μL of 1 M Tris. Finally, the Aβ42 protein concentrations were measured using a commercially available ELISA kit, with the samples from five volunteers assayed for Aβ42 content without pretreatment. Our novel method for collecting and assaying nasal mucosal smears enabled us to measure Aβ42 content in both the inferior nasal concha and the common nasal meatus of all cases examined here, despite the levels being under detection limits (0.5 pmol/L) without pretreatment. The mean levels of Aβ42 per total protein in the inferior nasal concha and common nasal meatus of normal controls were 6.24 ± 3.70 fmol/g and 2.10 ± 0.77 fmol/g, respectively. Thus, there was significantly more Aβ42 content per total protein in the inferior nasal concha than in the common nasal meatus (P<0.01). Thus, this method would be useful for AD screening.

著者

Takuya SUEMATSU Tomoaki MURAKAMI Jumpei TAKAMATSU Takeshi SHIMIZU Shingo TOYOTA Takuyu TAKI

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.157-163, 2022-12-31 (Released:2022-06-15)

参考文献数

24

---

Penetrating neck injury by a crossbow bolt is extremely rare and can be life-threatening. When removing a crossbow bolt from the neck, it is necessary to protect against fatal bleeding from the carotid vessels. We report removing a crossbow bolt penetrating the neck, with an endovascular approach. A 49-year-old woman was shot in the neck by a crossbow and was transferred to our hospital. On presentation, the crossbow bolt totally penetrated the neck from right to left. Her level of consciousness was clear, with no significant neurological deficits except for right peripheral facial palsy. Neck contrast-enhanced computed tomography revealed the crossbow bolt in contact with bilateral external and internal carotid arteries and that the bolt caused dissection of the left main trunk of the external carotid artery. Under general anesthesia, the crossbow bolt was removed under fluoroscopy with the assistance of an endovascular approach. First, we performed coil embolization for the dissected external carotid artery. Second, we prepared for fatal bleeding from the carotid arteries during crossbow bolt removal under protection using guiding catheters placed in bilateral common carotid arteries. The bolt was removed successfully without significant bleeding, and no complications occurred during the procedure. We report the successful removal of a crossbow bolt penetrating the neck. When removing a crossbow bolt penetrating the neck, endovascular assistance may be feasible to protect against fatal bleeding from the carotid arteries.

著者

Kunihiro OGATA Tomoki MITA Takeshi SHIMIZU Nobuya YAMASAKI

出版者

The Institute of Electronics, Information and Communication Engineers

雑誌

IEICE TRANSACTIONS on Information and Systems (ISSN:09168532)

巻号頁・発行日

vol.E98-D, no.11, pp.1916-1922, 2015-11-01

---

Some unilateral lower-limb amputees, have through continued exertion, increase the foot reaction force of the sound leg. The asymmetric gait with a prosthetic leg may thus negatively affect the musculoskeletal health of the leg on the healthy side. Therefore, it is important for these amputees to learn how to adjust the balance of each foot load in training. The aim of this study is to develop a training support system visualizing floor-reaction forces using a color-depth sensor. The pose of the entire body of the amputee is measured by the depth sensor, and the floor reaction force is estimated based on Zero Moment Point (ZMP), which is calculated using the center of mass of the amputee. Evaluation experiments of the proposed method were performed and they confirmed the effectiveness of the estimation method and the training with the visualization of reaction force.