著者

矢野 大仁 SAWADA Motoshi SHINODA Jun FUNAKOSHI Takashi

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.35, no.7, pp.450-453, 1995-07-15

被引用文献数

15 26

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症例は27歳男性。突然の激しい頭痛にて発症した。来院時、昏迷状態で軽度の頭痛と右不全麻痺を認めた。CTにてくも膜下出血と左前頭葉に脳内血腫を認めた。左内頚動脈写にてA4に紡錘状の拡張を認め、解離性動脈瘤と診断した。第3病日、動脈瘤の切除術を施行した。動脈瘤は硬くひょうたん型を呈していた。末梢領域に対する血行再建術は行っていない。病理にて中膜-外膜間で解離した解離性動脈瘤と判明したが、原因は不明であった。術後も軽度の右不全身麻痺などを認めたが、次第に改善し、術後約40日で独歩退院した。前大脳動脈に限局した解離性脳動脈瘤の報告は稀で、特に治療方針につき文献的考察を加え報告した。

著者

長尾 省吾 角南 典生 筒井 巧 本間 温 門間 文行 西浦 司 西本 詮

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

vol.24, no.6, pp.396-400, 1984 (Released:2006-09-21)

参考文献数

15

被引用文献数

3 7

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Correlations between changes in wave V of the auditory brain-stem response, intracranial pressure, and neurological signs of uncal herniation as graded by Plum and Posner were investigated in 12 patients with supratentorial mass lesion. In three of the five patients who later showed signs of uncal herniation, the latency of wave V, which presumably originated in the inferior colliculus, was already significantly prolonged. In 6 cases which progressed to the early third nerve stage of uncal herniation, the latency of wave V was prolonged in 5 cases. In 7 cases which progressed to the late third nerve stage or worse, the latency was prolonged in 6 cases and suppressed in one. In four of six attempts (three cases), lowering of the intracranial pressure by 10% glycerol solution resulted in normalization of the latency of wave V without clinical improvement. These results strongly indicate that measurement of wave V can predict the beginning of uncal herniation and can assess the effectiveness of medical or surgical decompression on brain-stem function.

著者

Committee for Guidelines for Management of Aneurysmal Subarachnoid Hemorrhage Japanese Society on Surgery for Cerebral Stroke

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.52, no.6, pp.355-429, 2012 (Released:2012-06-25)

参考文献数

336

被引用文献数

18 34

著者

Satoru OSUKA Shingo TAKANO Shinya WATANABE Eiichi ISHIKAWA Tetsuya YAMAMOTO Akira MATSUMURA

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

vol.52, no.4, pp.186-193, 2012 (Released:2012-04-23)

参考文献数

31

被引用文献数

14 52

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Antiangiogenic strategy is promising for malignant glioma. Histone deacetylase inhibitors (HDACIs) are unique anticancer agents that exhibit antiangiogenic effects. The in vitro and in vivo antiangiogenic effects of HDACIs, valproic acid (VPA), were investigated in malignant glioma in the brain. In vitro, VPA preferentially inhibited endothelial cell proliferation compared to glioma cell proliferation at the optimum concentration in a dose-dependent manner. VPA reduced vascular endothelial growth factor (VEGF) secretion of glioma cells in a dose-dependent manner under both normoxic and hypoxic conditions. VPA was also found to inhibit tube formation in the angiogenesis assay. In vivo, treatment with VPA combined with irinotecan reduced the number of vessels expressing factor VIII in the brain tumor model. VPA inhibits glioma angiogenesis by direct (inhibition of endothelial cell proliferation and tube formation) and indirect (decreased secretion of VEGF by glioma cells) mechanisms. These data suggest a potential role for VPA as an adjuvant therapy for patients with malignant glioma.

著者

市川 昭道 田中 隆一 竹内 茂和 小池 哲雄 石井 鏡二

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.29, no.2, pp.106-112, 1989-02-15

被引用文献数

8 11

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The hemodynamics of the anterior cerebral arteries (ACAs) were studied in 28 children with moyamoya disease. In 39% of 56 cerebral hemispheres, antegrade filling of the ACAs was not verified by preoperative angiography. On the other hand, adequate collateral pathways to the ACA territory were generally not achieved by encephalomyosynangiosis (EMS) or superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The authors have devised new surgical methods for the revascularization of the ACA territory, which they term "encephaloarteriosynangiosis" (EAS) and "encephalogaleosynangiosis" (EGS). In these procedures, one or several burr holes are made in the frontal skull, the dura mater is incised, and either the frontal branch of the STA or the pedicled galea aponeurotica stump is placed on the surface of the frontal cortex. In addition to EMS or STA-MCA anastomosis, these methods were applied to 23 cerebral hemispheres in 14 pediatric patients. In 14 cerebral hemispheres (61%) of 10 patients, postoperative external carotid angiograms showed some cortical branches in the ACA territory, and clinical improvement was achieved in patients with transient ischemic attacks affecting the lower extremities. The results of this study demonstrate that EAS and EGS are simple and useful techniques for revascularization of the ACA territory. In addition, EGS can be applied to the territory of the posterior cerebral artery.

著者

卯木 次郎 井上 洋 山崎 弘道 村田 稔 木村 良一 川淵 純一

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

vol.19, no.4, pp.343-354, 1979-04-15

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Prealbumin (PA) and its subfractions were analyzed to find their significance in the central nervous system from ontological and oncological points of view, using 7.5% polyacrylamide gel disc electrophoresis according to Ornstein & Davis. Tissues of 11 cases of normal human cerebrum, ranging from 5 or 6 months gestation to 64 years old, and 26 cases of brain tumor which included 12 gliomas, 8 meningiomas and 6 neurinomas were analyzed. Body fluids of 11 cases of brain tumor cysts, 12 ventricular cerebrospinal fluid with various neurological diseases, and 20 sera from the normal and the diseased were analyzed. 1. Tissue PA was subfractionated into five major peaks in the normal human brain, which we labeled PI through PV from the anodal side to the cathodal. In most of the brain tumors more than five peaks were subfractionated. 2. Concentration of PA subfractions changed in the developmental course in human brain. Among them, PIII and PIV changed remarkably in the fetal brain, namely, higher PIII and lower PIV levels were noted when compared to those of the adult brain. PI and PII showed no change during life. 3. Brain tumor had the same tendency as fetal brain regarding concentration of PIII and PIV subfractions. 4. PA III/IV ratios were compared as an index for showing some similarity in fetal brain and brain tumor tissues, and some tendency between them were observed. 5. PA fraction has been named as "neuronin" by Bowen et al. and as "SPR protein" by Kawakita, and some of its subfractions have been identified, for instance, PI as S 100, PIV as 14-3-2 or antigen α, PV as a sensitive index for hypoxia or neurotubulin protein. PIII as well as PII still have not been identified. Further analysis of these proteins, immunochemically as well as electrophoretically, might answer the question of whether or not therc are oncofetal proteins in the central nervous system.

著者

Mikinobu TAKEUCHI Naoya KUWAYAMA Michiya KUBO Kimiko UMEMURA Yutaka HIRASHIMA Shunro ENDO

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.45, no.9, pp.470-471, 2005 (Released:2005-09-26)

参考文献数

6

被引用文献数

7 10

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A 68-year-old man presented with occlusion of the internal carotid artery (ICA) manifesting as a 6-month history of progressive sensory and motor disturbance of the left lower limb. Angiography clearly demonstrated a collateral arterial network between the ICA and external carotid artery (ECA) through the vidian artery, a small branch of both the ICA and ECA. The vidian artery may form an unusual but important ECA-ICA collateral pathway in patients with occlusive lesion of the ICA.

著者

太田 富雄 KUROIWA Toshihiko KAJIMOTO Yoshinaga

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.39, no.7, pp.548-550, 1999-07-15

参考文献数

11

被引用文献数

2 6

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Flushingとdroppingの機能を備え、さらにjet irrigationも可能な、volume-limited bipolar diathemy forcepsを新しく開発した。Bipolarのfoot switchに同期して作動するroller pumpによって洗浄液が送られ、bipolar両側の先端部から流出する。作動開始時にはflushing機能が働き、これにより出血点が確認できる。直後にdropping機能だけとなり、これにより先端部の焦げ付きを押さえ、そして熱による周囲組織の傷害を防ぐことができる。さらにjet irrigationにより、血腫やdebrisの洗い流しも可能である。これらの選択は、本体で流量を設定しておけば、一つのfoot switchだけですべて可能である。このbipolarは、脳神経外科領域の手術で極めて有用である。

著者

岡 秀宏 SCHEITHAUER Bernd W.

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.39, no.7, pp.510-518, 1999-07-15

被引用文献数

9 54

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我々は、Medulloblastoma-PNETやgerm cell tumorと鑑別を要する新しい小児中枢神経系腫瘍であるAtypical Teratoid/Rhabdoid Tumor (AT/RT)の臨床病理学的特徴を検討した。AT/RTは組織学的にしばしばrhabdoid, PNET,上皮性あるいは間素系成分等の多様な組織像を示す悪性腫瘍であるため、主にPNET成分で構成されたAT/RTが後頭蓋窩に発生した場合はmedulloblastomaと、大脳半球に発生した場合はPNETと診断が困難な場合がある。一方、組織学的に上皮性あるいは間素系成分を含むgerm cell tumorとの鑑別も重要である。AT/RTの予後はmedulloblastoma-PNETやgerm cell tumorの予後より不良であるため、これらの小児中枢神経系腫瘍からAT/RTを鑑別することは重要と考え報告した。

著者

鐙谷 武雄 上山 博康 村田 純一 布村 充 蝶野 吉美 小林 延光 阿部 弘 斉藤 久寿 宮坂 和男 阿部 悟

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.27, no.12, pp.1195-1200, 1987-12-15

被引用文献数

6 12

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A case of dural arteriovenous malformation (AVM) in the anterior cranial fossa is reported. A 61-year-old male was hospitalized because of sudden onset of severe headache, vomiting, mild hemiparesis, and lethargy. Computerized tomography disclosed left frontal subcortical and fronto-temporal subdural hematomas. Angiography revealed an AVM in the anterior cranial fossa, fed by the bilateral anterior ethmoidal arteries and drained by the left olfactory and left fronto-orbital veins. The latter veins had large, varicose dilatations and drained to the basal vein of Rosenthal. Two weeks after artificial embolization, surgical evacuation of the hematoma and removal of anomalous vessels, including a varicose dilated vein, were carried out. The involved dura at the olfactory groove was coagulated rather than totally removed. According to literature, the dural AVM in this region is fed primarily by the anterior ethmoidal artery and drains via the leptomeningeal veins into the superior sagittal sinus. Varicose dilatation of a draining vessel is considered a characteristic angiographical finding. The high incidence of bleeding from dural AVMs in this region is related to the varicose dilatation. The drainage capacity of the elongated leptomeningeal veins is insufficient, and the high arterial pressure in the AVM leads to the development of varicose dilatation and intracranial hemorrhage.

著者

Shinya MANAKA Buichi ISHIJIMA Yoshiaki MAYANAGI

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.43, no.12, pp.589-600, 2003 (Released:2005-03-23)

参考文献数

85

被引用文献数

36 73

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The risk of epileptic seizures after craniotomy is extremely important but the incidence of postoperative epilepsy varies greatly, depending on the patient's conditions such as primary diseases, severity of surgical insult, and pre-existing epilepsy. Animal studies suggest that neurosurgical insults lead to seizures by two different mechanisms: One mechanism is mediated by free radical generation and the other by impaired ion balance across the cell membrane caused by ischemia or hypoxia. Conventional antiepileptic agents such as phenytoin, phenobarbital, carbamazepine, and valproic acid are promising for the prevention of early seizures, but the effect in preventing postoperative epilepsy is still controversial. Studies on the prophylactic effect of newer antiepileptic agents in craniotomized patients were very limited. Zonisamide, an antiepileptic agent with antiepileptogenic, free radical scavenging and neuroprotective actions in experimental animals, showed promising effects against postoperative epilepsy in a randomized double blind controlled trial. Prophylactic treatment for craniotomized patients significantly prevented the development of partial seizures during the follow-up period. Most recent studies have not supported the prophylactic use of antiepileptic agents in craniotomized patients, but further studies are required.

著者

竹島 秀雄 KAKU Takayuki USHIO Yukitaka

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.39, no.3, pp.242-245, 1999-03-15

被引用文献数

11

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自然退縮を示した神経梅毒(ゴム腫)の1例を報告する。症例は75歳男性、頭痛で発症した。MRIのT1, T2強調画像ともに低信号を示し、Gd投与でリング状に増強される、硬膜と癒着した病変を右後 頭葉に認めた。経過中、ステロイドや抗生物質を投与しなかったにもかかわらず、画像上自然退縮を認めたため、悪性リンパ腫の術前診断で摘出を行った二ところが、組織学的には非特異的肉芽腫で、髄液中のTPHA反応が強陽性、抗生物質の投与にて約4カ月で病変が消失したことよりゴム腫の診断が確定した。近年AIDSの増加とともに神経梅毒は増加しており、硬膜を巻き込んだ腫瘍では自然退縮を認めても、ゴム腫を鑑別診断として考慮すべきである。