著者

FODSTAD Harald

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.22, no.7, pp.577-581, 1982-07-15

被引用文献数

3

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Cart Peter Thunberg (1743-1828), a student of the famous Swedish botanist Cart Linne, visited Nagasaki and Edo in 1775-76. During his stay in Japan, he collected and named numerous plants and so has been called the father of Japanese botany. But he also taught western medicine to Japanese colleagues and introduced mercury in the treatment of syphilis. More than any person before him, he introduced Japan to the outside world. Thunberg deserves the credit of being the pioneer of occidental medicine and science in Japan.

著者

今泉 俊雄 SOHMA Tsutomu HOTTA Haruhiko TETO Ichiro IMAIZUMI Hitoshi KANEKO Mitsuo

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica = 神経外科 (ISSN:04708105)

巻号頁・発行日

vol.35, no.6, pp.385-391, 1995-06-15

参考文献数

10

被引用文献数

4 28

---

Traumatic AOD 11例(交通外傷9例)の来院時所見は, 呼吸停止全例, 心停止9例であった. 合併外傷は, 椎骨動脈損傷による上位頸椎周囲の血腫9例, 環軸椎脱臼4例, 環椎骨折3例, 延髄-頸髄移行部からのくも膜下出血9例, 頭蓋骨々折4例, 下顎骨折3例及びその他の顔面外傷10例, 重症胸部外傷8例, 腹腔内出血2例で, 致死的外傷が多かった. 顔面, 頭部, 胸腹部へ外力が頸部過屈曲伸展を起こし, 頭蓋頸椎移行部への引き抜き力となりAODが発生したと考えられた. AOD発生と同移行部により近い部位の損傷との関連が考えられた. 重篤な外傷であっても出血量は少なく, 低血圧, 心停止による影響と思われた. 最終的予後は10例が死亡, 1例が植物状態であった.

著者

OI Shizuo YAMADA Hiroshi KIMURA Mitsuru EHARA Kazuo MATSUMOTO Satoshi KATAYAMA Kazuaki MOCHIZUKI Matsuto UETANI Yoshiyuki NAKAMURA Hajime

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.30, no.7, pp.456-461, 1990

被引用文献数

2 14

---

Twenty hydrocephalic patients diagnosed in the third trimester of fetal life were evaluated and followed during a 7-year period. The factors affecting the prognosis, including the type of hydrocephalus, underlying conditions, associated anomalies, time of diagnosis and delivery, fetal period after diagnosis, head circumference and degree of ventriculomegaly at birth, and age at treatment, were comprehensively analyzed. The difference between final outcomes as assessed by developmental quotient (DQ) or intelligence quotient (IQ) were statistically tested with computation by means of STAX packages in an NEC 9801 VX. Hydrocephalus as an isolated defect occurred in six cases (30%), was associated with other central nervous system anomalies in nine (45%), and was secondary to intrauterine intraventricular hemorrhage or brain tumor in five (25%). The average age at the time of diagnosis was 33.9 weeks of gestation (range, 27-40 weeks). One fetus was treated by transabdominal cephalocentesis, but the majority of patients underwent ventriculoperitoneal shunt postnatally. The final IQ or DQ scores ranged from 20 to 120 (mean score, 50.6). The data analyses revealed that the only significant factor affecting outcome was the fetal period after diagnosis of hydrocephalus (r = -0.5076, p < 0.01). Our data supports the fact that the results of an on-going hydrocephalic state may become irreversible during fetal life. It is emphasized that establishment of a more precise pathophysiological evaluation, and a less invasive but more reliable decompressive technique for fetal hydrocephalus, is urgent.

著者

植木幸明

出版者

日本脳神経外科学会

雑誌

神経外科

巻号頁・発行日

vol.16, no.1, 1976-01

著者

山内 康雄 高原 街彦 河村 悌夫 松村 浩

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.25, no.2, pp.136-142, 1985

被引用文献数

2 4

---

A 69-year-old male was admitted complaining of gait disturbances and diplopia, 2.5 years after an episode of serous meningitis. Neurological examination on admission disclosed Parinaud's sign, unsteady gait and dysdiadochokinesis on the left side. A striking finding on the computerized tomography (CT) was the left to right shift of the posterior portion of the third ventricle without visualization of the quadrigeminal and ambient cisterns, which were almost completely occupied by an isodense mass accompanied by high dense flecks and a low dense part. Enhanced CT showed positive enhancement in the vicinity of the pineal calcification. By the suboccipital supracerebellar approach, an encapsulated mass containing brownish yellow fluid was subtotally removed and a histological examination of it revealed epidermoid tissue and hemosiderin deposits in the solid portion. Few reports of isodense epidermoid cysts have so far been found in the literature giving a full explanation for this unusual CT attenuation value. Based on the clinical course and histology of this case, the pathogenesis of the unusual density is discussed along the following lines: The mixture of the low dense factor due to cholesterin and the high dense factor due to prior bleeding is believed to result in the isodense attenuation value in the liquid portion. Also, in the solid part, a microscopically mixed texture of deposited hemosiderin and cholesterin clefts in the inflammatory granulomatous tissue could explain its density on the CT scan.

著者

北上 明 KIRIKAE Michihiro KURODA Kiyoshi OGAWA Akira

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica = 神経外科 (ISSN:04708105)

巻号頁・発行日

vol.39, no.2, pp.150-152, 1999-02-15

参考文献数

7

被引用文献数

3 26

---

症例は4歳男児、左眼窩内側にバターナイフを刺し搬送された。ナイフは上眼窩裂を通り錐体骨を貫通し後頭蓋窩に達していた。直ちに脳血管撮影を行い血管損傷のないことを確かめ、pterional, subtemporai, lateral suboccipital approacheを同時に行えるように広く開頭し、ナイフを直視下におきながら抜去した。術後頭蓋内感染はなく左失明、全外眼筋麻痺を残したが、他の神経症状はなく退院した。頭部穿通損傷において血管損傷は致死的であるため早期の脳血管撮影が必要と思われた。

著者

渋井 壮一郎

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.24, no.2, pp.65-72, 1984

被引用文献数

1

---

The antitumor effect of 5'-deoxy-5-fluorouridine (5'-DFUR) against experimental glioma cells was investigated in vitro and in vivo. 5'-DFUR is a newly synthesized masked compound of 5-FU, which is activated only in the presence of pyrimidine nucleoside phosphorylase. This enzyme has been reported to exist much more in malignant tumors, such as Sarcoma 180 and Ehrlich ascites carcinoma, than in normal tissues. The activities analysed in 9L, RG12, and 203GL cells were 24.3, 75.1, and 8.1% respectively of the activity in Sarcoma 180. Normal rat brain showed 22.8% of the activity. Growth curves of cultured 9L and RG12 cells showed a dose-dependent 5'-DFUR antitumor effect when it was used at a concentration of over 10 &mu;gml. The colony forming rate of 9L cells treated with 20 &mu;gml of 5'-DFUR decreased to 10%. The inhibition rate of 203GL cells transplanted subcutaneously into C57BL mice was 52.3% in weight, and that of human glioblastoma cells transplanted subcutaneously into nude mice was 20.9% in size after treatment with 5'-DFUR, 400 mgkgday for ten consecutive days. When 9L cells were transplanted intracranially into CD Fisher rats, their median survival time became four days longer than that of non-treated rats. Flowcytometric analysis of in vitro 9L cells and in vivo 203GL cells showed an accumulation in the cells between the 2C and 4C components after treatment of 5'-DFUR. It seems that a delay in DNA synthesis occurred in the presence of this drug. This newly synthesized antitumor drug is expected to be effective for the treatment of malignant brain tumors.

著者

INAMASU Joji KIM Daniel H. KLUGH Arnett

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.45, no.9, pp.439-447, 2005-09-15

被引用文献数

3 13

---

The surgical treatment of craniocervical junction (CCJ) instability has recently undergone significant development and change. Posterior instrumentation surgery has been the mainstay of treatment of CCJ instability, and is the focus of this review. For the treatment of atlantoaxial instability, C1-2 transarticular screw fixation has shown good stability, and has been regarded as the "gold standard" procedure. Because of potentially hazardous complications including vertebral artery injury, however, C-1 lateral mass-C-2 pedicle screw fixation is gaining popularity. For treatment of atlantooccipital instability, occipitocervical fixation using screw constructs (combined with either rods or plates) has shown more stability than sublaminar wiring techniques, and has been utilized more frequently. Both innovation in material engineering and in vitro biomechanical studies have contributed significantly to the development of more rigid internal fixation devices, and as a result, many patients who would have been treated conservatively with external orthosis are treated nowadays with instrumentation surgery, resulting in earlier ambulation, shortened hospital stay, and earlier recovery into social activities. New surgical techniques and instruments, however, need to stand the test of time to see whether they are free from long-term adverse events. The rapid turnover of new surgical techniques and hardware has made it difficult for less experienced surgeons to keep up with the latest developments. Conventional techniques can be safer and less technically demanding than newer techniques for those who are not familiar with them.

著者

片平 清昭 須田 滉

出版者

日本脳神経外科学会

雑誌

神経外科 (ISSN:03872572)

巻号頁・発行日

vol.18, no.5, pp.401-407, 1978-07-15

---

The present study was designed to investigate the question whether or not unilateral lesion to the amygdala and its adjacent structures in cats produces significant change in sexual and fire-avoidance behavior. After the unilateral amygdalectomy, both male and female cats showed hyperactivity of sexual behavior, indicating successive estrus which was unobserved in normal cats during the regular mating seasons. Moreover, the anuygda-lectomized subjects did not show the fire-avoidance behavior. This disappearance of fire-avoidance behavior lasted over five weeks. It is considered that this result was due to psychic blindness, or visual agnosia, which Kluver and Bucy mentioned in monkeys after bilateral resection of the temporal lobes. The present finding implies that individual differences in sexual behavior appear to depend on the neural basis of the amygdala in adult cats, supporting an assumption that the amygdala is a controlling center of sexual and emotional behavior which is one of the principal role of the limbic system.

著者

守山 英二 BECK Hiroichi MIYAMOTO Toshihiko

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica = 神経外科 (ISSN:04708105)

巻号頁・発行日

vol.39, no.5, pp.350-357, 1999-05-15

被引用文献数

2 20

---

過去20年間にVL thalamotomyで治療したParkinson病(PD)患者53名の治療成績を分析した。―側手術例44例では、振戦、筋強剛に対する効果は良好で、平均8.8年の追跡期間中効果が持続していた。無動に対しては効果は乏しく、その進行がADL低下の主因であった。両側手術例9例でも同様の傾向で、無動の顕著でない例は長期間良好なADLが維持されていた。重大な合併症は、凝固部位の脳内血腫1例、軽度なものは、一過性麻庫4例、一過性意識障害2例、けいれん発作2例であった。振戦、筋強剛がADL低下の主な原因となっているPD患者はthalamotomyの良い適応であり、他の治療法と組み合わせることによりPD患者の治療予後改善に役立つと考えられた。

著者

貫井 英明 長屋 孝雄 宮城 修 玉田 潤平 金子 的実 佐々木 秀夫 三塚 繁 川渕 純一 河野 徳雄 苅野 忠雄

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.22, no.6, pp.437-445, 1982-06-15

被引用文献数

8 13

---

The authors reported 7 cases that showed development of new aneurysms or enlargement of small aneurysms originally less than 3mm in diameter. New aneurysms of the anterior communicating artery and the right pericallosal artery were found in one case. In this patient with a 5 year history of hypertensiovn, cerebral angiography performed 8 years before following a head trauma had revealed marked arteriosclerosis and a hypoplasia of A1_1, but no aneurysm. Development of an aneurysm from a dilatation at the origin of the right embryonal posterior cerebral artery was found 3 years after the clipping of an aneurysm of the left internal carotid artery in the other case. In 3 cases, a small unruptured aneurysm all originally less than 3mm in diameter previously noted in conjunction with a ruptured aneurysm were found to have enlarged 3 to 13 years after the clipping of the ruptured aneurysm. In these 3 cases, anomalies of the circle of Willis, such as hypoplasia of unilateral A_1, infundibular dilatation at the origin of the posterior communicating artery and the embryonal posterior cerebral artery were revealed. Arteriosclerosis and hypertension were noted in 2 cases. In 2 cases, a small ruptured aneurysm, which had not been recognized at the first subarachnoid hemorrhage, was noted to have enlarged 5 and10 years after the first bleeding. Changes of the arterial wall due to hypertension, arteriosclerosis, etc., and hemodynamic stress caused by anomalies of the circle of Willis seemed to be responsible for the new development of aneurysm and the enlargernent of aneurysm. A small aneurysm less than 3mm in diameter, including an unruptured aneurysm that is found in association with the ruptured aneurysm, have a high incidence of progressive enlargement and rupture. Therefore, even a small aneurysm should be diagnosed and treated precisely.

著者

所 安夫

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.20, no.4, pp.415-424, 1980-04-15

被引用文献数

1 1

著者

YONEKAWA Yasuhiro FANDINO Javier

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.38, no.5, pp.301-303, 1998-05-15

被引用文献数

1

著者

西村 周郎

出版者

日本脳神経外科学会

雑誌

神経外科 (ISSN:03872572)

巻号頁・発行日

vol.16, no.5, pp.377-378, 1976-09

著者

高久 晃 福井 仁士 JUNG Hee-Won HAN Dae Hee O-Ki Kwon CHO Byung-Kyu CHOI Kil Soo 森田 明夫 若井 晋 島 健 端 和夫 早川 徹 桐野 高明

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.38, no.5, pp.305-321, 1998-05-15

著者

杉田 保雄 YONEDA Shigeaki WATANABE Toshinori SHIGEMORI Minoru

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.8, pp.591-593, 1995-08-15

参考文献数

7

被引用文献数

2 6

---

脳動脈破裂によるくも膜下出血と隔たった場所に同時発症した高血圧性脳内出血の一症例について報告した。症例は77歳の女性で高血圧の既往があった。左内頚動脈撮影では左内頚一後交通動脈瘤が認められた。CTでは基底槽から左シルビウス裂にくも膜下出血が認められた。また破裂脳動脈瘤と同側の内包後脚にくも膜下出血とは別個に脳内出血が認められた。発症から3週後にネッククリッピング術が杉田のNo.26の有窓クリップにて施行された。脳内出血の影響による全身血圧の上昇が内頚一後交通動脈瘤の破裂の誘因と考えられた。

著者

NAKASE Hiroyuki OHNISHI Hideyuki TOUHO Hajime MIYAMOTO Susumu WATABE Yasuharu ITOH Tamio YAMADA Keisuke KARASAWA Jun SAKAMOTO Takanori KUREHARA Koukichi SHIMIZU Kiyoshi

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.33, no.9, pp.621-624, 1993-09-15

被引用文献数

1 17

---

Twenty-three patients with epileptic type moyamoya disease are reviewed among 200 moyamoya disease patients. Ten boys and 13 girls aged 5 months to 12 years were followed over 6 months to 17.3 years. Six had generalized seizure and 17 had focal seizure. Operations were performed within 1 year in eight patients, within 1-3 years in five, and more than 3 years after onset in 10. Nineteen patients improved and suffered no seizure without receiving antiepileptic drugs, but four patients developed true epilepsy and three of these suffered cerebral infarction. Multivariate analyses showed that toddlers aged less than 1 year and mild or severe abnormal computed tomographic (CT) findings correlated with a bad outcome. This study showed that epileptic type moyamoya disease has the same clinical features as transient ischemic attack or infarction type. Age under 1 year and CT abnormalities indicate a poor prognosis and necessity for early reconstructive surgery.

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

---

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

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

---

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

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

---

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。