著者
Daiichiro ISHIGAMI Satoshi KOIZUMI Satoru MIYAWAKI Hiroki HONGO Yu TERANISHI Jun MITSUI Nobuhito 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.139-144, 2022-12-31 (Released:2022-05-31)
参考文献数
17
被引用文献数
2

Stenotic developmental venous anomalies (DVAs) often present with neurological deficits. In addition, cerebral capillary telangiectasia (CCT) coexisting with DVA is rarely encountered, and its pathophysiology, including the underlying genetics, and appropriate management remain uncertain. A 46-year-old man without any medical history of note was referred to our hospital with gradually worsening cerebellar ataxia. Two months after symptom onset, ataxic dysarthria and gait emerged. Brain magnetic resonance imaging showed CCT occupying the pons and left cerebellar peduncle. Subsequent catheter angiography demonstrated a DVA leading from the mass into the cavernous sinus with marked outlet stenosis and flow stagnation. We hypothesized that venous congestion was the source of gradual neurological deterioration and therefore initiated anticoagulation. Symptoms showed mild improvement, and his neurological status has remained stable as of 1 year after symptom onset. Whole-exome sequencing of germline DNA did not reveal any rare variants in genes previously reported as pertinent to vascular malformations. Anticoagulation may be a useful option in patients with non-thrombotic, stenotic DVA for whom neurological status did not improve under expectant management. Genetic analysis of this patient did not reveal any pathogenic mutations, and further investigation of somatic mutations is necessary to elucidate potential genetic causes.
著者
Tetsushi Murakami Tadashi Yoshida Arata Kurokochi Kimiharu Takamatsu Yu Teranishi Keisuke Shigeta Satoshi Tamaki Shinya Morita Ryuichi Mizuno Mototsugu Oya
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.1945-18, (Released:2019-06-07)
参考文献数
22
被引用文献数
3

Accidental hypothermia is defined as a core body temperature <35°C. Even with the use of multiple active rewarming methods, it has a high mortality rate. No standard treatment strategy for moderate or severe hypothermia in the absence of cardiac arrest has yet been established. We herein report three patients with severe or moderate accidental hypothermia who were treated by hemodialysis in the acute phase. This case report with a literature review describes the usefulness of hemodialysis for the treatment of moderate and severe accidental hypothermia without cardiac arrest.