著者
太田 富雄 和賀 志郎 半田 肇 斉藤 勇 馬杉 則彦 竹内 一夫 鈴木 二郎 高久 晃
出版者
一般社団法人 日本脳卒中の外科学会
雑誌
脳卒中の外科研究会講演集 (ISSN:03878031)
巻号頁・発行日
vol.3, pp.61-68, 1975-06-06 (Released:2012-10-29)
参考文献数
15
被引用文献数
1

Disturbance of consciousness in acute stage, so far, has been classified by using a set of technical terms such as coma, stupor, somnolence, confusion and so on. However, the definition of such terms has a different nuance from one clinic to another, and this made the comparison of the data on the same topics incomplete and incorrect. Because of this, it is true in most neurosurgical clinics in Japan that the severity of the disturbance of consciousness has long been described with grades of the responsiveness to different stimuli laden to the patients.In order to obtain an universal classification on this matter, possibility ef quantitative and qualitative gradings has been searched by means of combining the following three factors; arousal, responsiveness to mechanical and verbal stimuli, and the contents of consciousness. Table shows our proposal of quantitative and partially qualitative grading of the disturbance of consciousness in acute stage. Deep coma, coma and semicoma in the contemporary usage belong to grade III in our classification; stupor, lethargy, hypersomnia, somnolence, and drowsiness belong to grade II, and delirium, confusion, and senselessness belong to grade I.Features of this new grading of the disturbance of consciousness in acute stage have been discussed.Table: New grading of level of consciousness in acute stage (So-ocalled 3-3-9 formula) Grade III. The patient is unable to be arousen with any forceful mechanical stimulus, and(300) 3. is not responsive at all except for change of respiratory rhythm,(200) 2. is responsive with slight movements including decerebrate response, or(100) 1. is responsive with combative oropurposeful movements. Grade II. The patient is able to be arousen with mechanical or verbal stimuli, and(30) 3. is barely arousen with repeated mechanical stimuli,(20) 2. is arousen with loud voice or shaking shoulders, or(10) 1. is arousen easily with usual voice. Grade I. The patient is awake without any stimulus, and(3) 3. is quite senseless and cannot tell even his own name or date of birth,(2) 2. is disorientated to time, place, and person, or(1) 1. is seemingly alert but not fully so. “R” and“Inc” are added to the grading in case of restlessness and incontinence.
著者
金谷 春之 湯川 英機 伊藤 善太郎 加川 瑞夫 神野 哲夫 桑原 武夫 水上 公宏
出版者
一般社団法人 日本脳卒中の外科学会
雑誌
脳卒中の外科研究会講演集 (ISSN:03878031)
巻号頁・発行日
vol.7, pp.265-273, 1978

In regard to hypertnsive intracerebral hemorrhage, different neurological gradings for clinical evaluation of the patient and different classifications for hematoma location on computed tomography have been used up to the present. To compare one clinical data to others, however, a standard neurological grading and a classification are required. For this reason, the authors tried to make a standard neurological grading and a classification on computed tomography based on 410 patients who had been treated in 6 different neurosurgical facilities in Japan.<BR>In the course of this study, it was found that the factors such as patient's age, level of consciousness, abnormal size and reaction to light of the pupils, and decerebrate or decorticate rigidity are directly influential to operative results. As to evaluation of the postoperative patient, the activities of daily living (ADL) was described as follows: full work, minimal disability and vegetative state.
著者
府川 修 相原 坦道 石井 完治 菊池 淳 増山 祥二 片山 正文 小暮 哲夫
出版者
一般社団法人 日本脳卒中の外科学会
雑誌
脳卒中の外科研究会講演集 (ISSN:03878031)
巻号頁・発行日
vol.10, pp.36-41, 1981 (Released:2012-10-29)
参考文献数
5

10 cases having abnormal angiographical findings which showed the stenosis or occlusion of middle cerebral artery with moyamoya phenomenon were reported. The characteristics of these cases were summarized as follows. 1) It showed high incidence in female (3 males and 7 females). 2) These patients involved two young cases ranged in age from 4 years to 62 years. 3) Intracranial hemorrhage was cofirmed in 4 cases and onset of symptom in other 6 cases was similar to that of cerebral infarction. 4) 5 cases showed a unilateral occlusion of middle cerebral artery at its origin and 2 cases showed a unilateral stenosis of M1 portion, with moyamoya vessels in this region. 5) Two cases demonstrated bilateral occlusion of middle cerebral artery, and one showed a right stenosis and left occlusion of middle cerebral artery, with moyamoya vessels. 6) On the other hand, we could not find a stenosis on the intracranial internal carotid artery in these cases. 7) These findings suggested that such cases may be different from the so-called“Moyamoya disease”.
著者
滝 和郎 半田 肇 米川 泰弘 三宅 英則 小林 映 新島 京 筏 義人 玄 烝休 鈴木 昌和 清水 幸夫
出版者
The Japanese Society on Surgery for Cerebral Stroke
雑誌
脳卒中の外科研究会講演集 (ISSN:03878031)
巻号頁・発行日
vol.13, pp.159-164, 1984

Fourteen cases of arteriovenous malformations (AVM) of the brain, dura and scalp were embolized with ethyl-cyanoacrylate. Injection of the ethyl-cyanoacrylate was performed either by direct puncture of the feeding arteries or transfemoral catheterization with a detachable and leak balloon catheter. For every injection, 0.3 to 1.0ml of cyanoacrylate was used. With additional surgical removal, eight AVMs were totally eradicated and the remaining AVMs were partially embolized. Among the AVMs, dural AVM was most suitable for the cyanoacrylate embolization, and a high rate (67%) of total embolization without surgical intervention was obtained.