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Neurologia Medico-chirurgica

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https://www.readbyqxmd.com/read/29142154/the-choroid-plexus-of-the-lateral-ventricle-as-the-origin-of-csf-pulsation-is-questionable
#1
Ken Takizawa, Mitsunori Matsumae, Naokazu Hayashi, Akihiro Hirayama, Fumiya Sano, Satoshi Yatsushiro, Kagayaki Kuroda
The advent of magnetic resonance imaging (MRI) enables noninvasive measurement of cerebrospinal fluid (CSF) motion, and new information about CSF motion has now been acquired. The driving force of the CSF has long been thought to be choroid plexus (CP) pulsation, but to investigate whether this phenomenon actually occurs, CSF motion was observed in the ventricular system and subarachnoid space using MRI. Eleven healthy volunteers, ranging in age from 23 to 58 years, participated in this study. The MRI sequences used were four-dimensional phase-contrast (4D-PC) and time-spatial labeling inversion pulse (t-SLIP)...
November 16, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29142161/treatment-and-outcomes-of-carcinoma-of-the-external-and-middle-ear-the-validity-of-en-bloc-resection-for-advanced-tumor
#2
Takuma Matoba, Nobuhiro Hanai, Hidenori Suzuki, Daisuke Nishikawa, Eiji Tachibana, Takeshi Okada, Shingo Murakami, Yasuhisa Hasegawa
Carcinoma of the external and middle ear is a very rare disease. Despite the various treatment modalities available, its prognosis is still poor. We aimed to analyze the treatment modalities, outcomes, and validity of surgical approaches, especially in advanced tumors in the ear. Twenty-five patients with carcinoma of the external and middle ear were retrospectively analyzed. The modified Pittsburgh staging system was used for staging of the patients. Overall and disease-free survival was estimated using of Kaplan-Meier method...
November 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29142153/prognostic-impact-and-post-operative-evaluation-of-volumetric-measurement-of-the-cerebellopontine-cistern-in-trigeminal-neuralgia-using-3-tesla-magnetic-resonance-imaging
#3
Yoshiki Obata, Yoshihisa Kawano, Yoji Tanaka, Taketoshi Maehara
The aim of this study was to evaluate the importance of pre- and post-operative volumetric measurement of the cerebellopontine angle (CPA) using 3 Tesla (3T) magnetic resonance imaging (MRI). Between April 2012 and December 2015, a total of 87 consecutive patients underwent microvascular decompression (MVD) for trigeminal neuralgia (TN), of whom 51 with primary TN caused by arterial compression were enrolled in this study. Bilateral CPA cistern volume was evaluated using 3T MRI before and after surgery; the Cistern Deviation Index was used to represent the degree of deviation of the CPA cistern...
November 14, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29129882/plasticity-in-glioma-stem-cell-phenotype-and-its-therapeutic-implication
#4
Yasuo Iwadate
The marked heterogeneity in glioblastoma (GBM) may be induced through dynamic differentiation and dedifferentiation process of glioma cells. The hypothesis that environmental stimuli induce these phenotypic changes, including dedifferentiation into the stem cell phenotype which contributes to the high invasiveness and resultant poor outcome in GBM patients, is recently being proven. In the process of cancer invasion and metastasis, the phenotypic change has also been described as epithelial-mesenchymal transition (EMT)...
November 13, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29129841/genetic-risk-assessment-of-elastin-gene-polymorphisms-with-intracranial-aneurysm-in-koreans
#5
Jin Pyeong Jeon, Eun Pyo Hong, Jeong Eun Kim, Eun Jin Ha, Won-Sang Cho, Young-Je Son, Jae Seung Bang, Chang Wan Oh
Elastin encoded by elastin gene (ELN) is a crucial extracellular matrix protein responsible for arterial resilience. The objective of this study was to identify single nucleotide polymorphisms (SNPs) of ELN gene susceptible to intracranial aneurysm (IA) in Korean population. Two SNPs of ELN gene, rs2071307 (Gly422Ser) and rs2856728 (intron), were genotyped in 90 patients with IA and 90 age and frequency matched controls. Fisher's exact test was conducted to evaluate allelic association with IA. Of the two SNPs in ELN gene, T allele of rs2856728 (intron) showed statistically significant association with increased development of IA (odds ratio [OR]: 2...
November 10, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29118304/pediatric-optic-pathway-hypothalamic-glioma
#6
Yasuo Aihara, Kentaro Chiba, Seiichiro Eguchi, Kosaku Amano, Takakazu Kawamata
Optic pathway/hypothalamic gliomas (OP/HGs) are rare astrocytic tumors that appear more commonly among young children and often are unresectable. They comprise approximately 2% of all central nervous system tumors and account for 3-5% of pediatric intracranial tumors. Initial manifestations are often visual disturbances, endocrinopathies and hypothalamic dysfunction such as the diencephalic syndrome, and sometimes hydrocephalus due to cerebrospinal fluid (CSF) outflow obstruction. In many cases, the tumors are diagnosed late in the clinical course because they silently enlarge...
November 9, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29093308/the-current-status-of-microvascular-decompression-for-the-treatment-of-trigeminal-neuralgia-in-japan-an-analysis-of-1619-patients-using-the-japanese-diagnosis-procedure-combination-database
#7
Yoshifumi Mizobuchi, Makoto Ohtani, Junichiro Satomi, Kiyohide Fushimi, Shinya Matsuda, Shinji Nagahiro
Microvascular decompression (MVD) is a widely used, safe, and effective treatment for trigeminal neuralgia (TGN). However, the extent of application of this therapeutic method and its outcomes in Japan are currently unclear. To address these questions, the authors analyzed the use of MVD for the treatment of TGN during the 33-month period from July 2010 to March 2013, using data contained in the Diagnosis Procedure Combination database. The analysis revealed that MVD was used for the treatment of TGN in 1619 cases (608 men, 1011 women), with approximately 1...
November 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29093326/contrast-induced-encephalopathy-following-embolization-of-intracranial-aneurysms-in-hemodialysis-patients
#8
Noriaki Matsubara, Takashi Izumi, Shigeru Miyachi, Keisuke Ota, Toshihiko Wakabayashi
Contrast-induced encephalopathy is a very rare complication associated with endovascular treatment of intracranial aneurysms. Patients with renal dysfunction may be prone to developing contrast medium neurotoxicity as a result of delayed elimination of the contrast medium in renal metabolism. This article focuses on our experience with contrast-induced encephalopathy in patients with end-stage renal disease requiring hemodialysis. The authors retrospectively reviewed five patients diagnosed with contrast-induced encephalopathy who underwent aneurysm coil embolization at their institution from January 2006 to December 2015...
October 31, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29081442/glioblastoma-treatment-in-the-elderly
#9
Masaki Okada, Keisuke Miyake, Takashi Tamiya
Although current treatment advances prolong patient survival, treatment for glioblastoma (GBM) in the elderly has become an emerging issue. The definition of "elderly" differs across articles; GBM predominantly occurs at an age ≥65 years, and the prognosis worsens with increasing age. Regarding molecular markers, isocitrate dehydrogenase (IDH) mutations are less common in the elderly with GBM. Meanwhile, O(6)-methylguanine DNA methyltransferase (MGMT) promoter methylation has been identified in approximately half of patients with GBM...
October 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29046504/radiographic-assessment-on-magnetic-resonance-imaging-after-percutaneous-endoscopic-lumbar-foraminotomy
#10
Yong Ahn, Woo-Kyung Kim, Seong Son, Sang-Gu Lee, Yu Mi Jeong, Taeseong Im
Percutaneous endoscopic lumbar foraminotomy (ELF) is a novel minimally invasive technique used to treat lumbar foraminal stenosis. However, the validity of foraminal decompression based on quantitative assessment using magnetic resonance imaging (MRI) has not yet been established. The objective of this study was to investigate the radiographic efficiency of ELF using MRI. Radiographic changes of neuroforamen were measured based on pre- and postoperative MRI findings. Images were blindly analyzed by two observers for foraminal stenosis grade and foraminal dimensions...
October 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29021413/cyberknife-stereotactic-radiosurgery-and-hypofractionated-stereotactic-radiotherapy-as-first-line-treatments-for-imaging-diagnosed-intracranial-meningiomas
#11
Yoshihiko Manabe, Taro Murai, Hiroyuki Ogino, Takeshi Tamura, Michio Iwabuchi, Yoshimasa Mori, Hiromitsu Iwata, Hirochika Suzuki, Yuta Shibamoto
Definitive radiotherapy is an important alternative treatment for meningioma patients who are inoperable or refuse surgery. We evaluated the efficacy and toxicity of CyberKnife-based stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hSRT) as first-line treatments for intracranial meningiomas that were diagnosed using magnetic resonance imaging (MRI) and/or computed tomography (CT). Between February 2005 and September 2015, 41 patients with intracranial meningiomas were treated with CyberKnife-based SRS or hSRT...
October 12, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29021412/postoperative-headache-after-undergoing-acoustic-neuroma-surgery-via-the-retrosigmoid-approach
#12
Noritaka Aihara, Hiroshi Yamada, Mariko Takahashi, Akira Inagaki, Shingo Murakami, Mitsuhito Mase
To estimate the duration of postoperative headache after surgery for acoustic neuroma and the effects of age, sex, tumor size, extent of tumor resection, type of skin incision, surgical duration, hearing preservation, and postoperative facial nerve palsy. This retrospective review analyzed clinical data from 97 patients who had undergone surgery for unilateral acoustic neuroma via the retrosigmoid approach >1 year previously. We investigated whether patients had headache at hospital discharge and during attendance at outpatient clinics...
October 12, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28966305/functional-vascular-anatomy-of-the-brain
#13
Michihiro Tanaka
Functional vascular anatomy is the study of anatomy in its relation to the function that figures out the normal and pathological vascularization of the brain and spinal cord. The mechanism of anatomical variations (e.g. fenestration of the basilar artery, persistent primitive trigeminal artery, and aberrant subclavian artery) can be explained according to the embryological development of the cardiovascular system. The most developmental process is common among the species of the vertebrates from the fish to the mammalian in the early phase of embryo...
October 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28966304/the-profile-of-mmp-9-mmp-9-mrna-expression-1562-c-t-polymorphism-and-outcome-in-high-risk-traumatic-brain-injury-the-effect-of-therapeutic-mild-hypothermia
#14
Eko Prasetyo, Andi Asadul Islam, Mochammad Hatta, Djoko Widodo, Ilhamjaya Pattelongi
The aim of this study was to investigate the effect of mild hypothermia therapy (34-36°C) and the alterations of matrix metalloproteinase-9 (MMP-9) in 20 patients with high-risk traumatic brain injury (TBI). The neurologic status and outcome were assessed using Full Outline of UnResponsiveness (FOUR) score and Glasgow Coma Scale (GCS). A prospective randomized control study involved patients with high-risk TBI (FOUR score ≤ 7). Patients were randomized into two groups, with and without mild hypothermia therapy which were investigated within 24 and 72 h...
October 2, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28954945/ischemic-tolerance-of-the-brain-and-spinal-cord-a-review
#15
Masatoshi Yunoki, Takahiro Kanda, Kenta Suzuki, Atsuhito Uneda, Koji Hirashita, Kimihiro Yoshino
Ischemic tolerance is an endogenous neuroprotective phenomenon induced by sublethal ischemia. Ischemic preconditioning (IPC), the first discovered form of ischemic tolerance, is widely seen in many species and in various organs including the brain and the spinal cord. Ischemic tolerance of the spinal cord is less familiar among neurosurgeons, although it has been reported from the viewpoint of preventing ischemic spinal cord injury during aortic surgery. It is important for neurosurgeons to have opportunities to see patients with spinal cord ischemia, and to understand ischemic tolerance of the spinal cord as well as the brain...
September 27, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28954944/design-of-a-locator-for-designing-the-shortest-incision-for-a-polygonal-dural-window
#16
Mutsumi Nagai, Naoki Kaneko, Fumihiro Arai, Gen Kusaka, Mami Ishikawa
When a wide polygonal dural window is created, a short dural incision length is preferred by surgeons because suturing a wastefully long incision line during closure is troublesome. A locator to facilitate making the shortest dural incision when creating a polygonal dural window would be helpful. We geometrically analyzed the shortest incision design for a pentagonal dural window and produced a simple locator for intraoperatively implementing this design. The design for a pentagonal dural window with the shortest incision is the same as the design for a minimum Steiner tree (MST) problem with five vertices...
September 27, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28954963/application-of-ion-beam-implanted-expanded-polytetrafluoroethylene-to-microvascular-decompression-and-the-surgical-outcome
#17
Koichi Kato, Hiroshi Ujiie, Hiroshi Nakano, Shunsuke Nomura, Masanori Nakagawa, Takashi Higa, Shigeru Kadoyama, Akira Teramoto
Accurate and long-term transposition of offending vessels is required in microvascular decompression (MVD) for the treatment of hemifacial spasm (HFS) and trigeminal neuralgia (TN). We created ion-beam implanted of an expanded-polytetrafluoroethylene (i-ePTFE) surface to transpose offending vessels in MVD. In 13 patients with MVD, we concealed and transposed offending vessels with tape-shaped i-ePTFE, and relieved facial and trigeminal nerve compression by attaching the i-ePTFE to the dura with fibrin glue...
September 26, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28931766/differences-in-the-genotype-frequency-of-the-rnf213-variant-in-patients-with-familial-moyamoya-disease-in-kyushu-japan
#18
Yuichiro Takamatsu, Ken Higashimoto, Toshiyuki Maeda, Masatou Kawashima, Muneaki Matsuo, Tatsuya Abe, Toshio Matsushima, Hidenobu Soejima
The p.R4810K (rs11273543, c.14429G > A) variant of the RNF213 gene is associated with increased risk of Moyamoya disease (MMD), which is an idiopathic progressive intracranial vascular steno-occlusive disease, in Asian populations. Numerous variant association studies for this MMD variant have been performed in Japan to date. Since another genetic study that utilized approximately 140,000 single nucleotide polymor (SNPs) has indicated that there still are genetic differences among mainland Japanese, there is a possibility that the variant distribution in patients with MMD and normal individuals varies between different Japanese regions...
September 21, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28845038/treatment-recommendations-for-adult-patients-with-diffuse-gliomas-of-grades-ii-and-iii-according-to-the-new-who-classification-in-2016
#19
Hikaru Sasaki, Kazunari Yoshida
With advanced understanding of molecular background and correlation with therapeutic outcomes, the revised 4th edition of World Health Organization (WHO) classification of central nervous system (CNS) tumors incorporated molecular information into the definition of diffuse gliomas. Indeed, oligodendroglioma and astrocytoma are now defined by molecular signature, with diagnosis of glioblastoma being made by histology. In parallel, numerous clinical trials are underway all over the world, and important findings are being produced every year that have an impact on patient outcomes...
August 25, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28845040/surgical-anatomy-for-the-endoscopic-endonasal-approach-to-the-ventrolateral-skull-base
#20
Kenichi Oyama, Shigeyuki Tahara, Toshio Hirohata, Yudo Ishii, Daniel M Prevedello, Ricardo L Carrau, Sebastien Froelich, Akira Teramoto, Akio Morita, Akira Matsuno
The authors describe the surgical anatomy for the endoscopic endonasal approach (EEA) to the ventrolateral skull base. The ventrolateral skull base can be divided into two segments: the upper lateral and lower lateral skull base. The upper lateral skull base includes the cavernous sinus and the orbit, while the lower lateral skull base includes the petrous apex, Meckel's cave, parapharyngeal space, infratemporal fossa, etc. To gain access to the upper lateral skull base, a simple opening of the ethmoid sinus provides sufficient exposure of this area...
October 15, 2017: Neurologia Medico-chirurgica
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