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Neurologia Medico-chirurgica

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https://www.readbyqxmd.com/read/29998936/meg-bmi-to-control-phantom-limb-pain
#1
Takufumi Yanagisawa, Ryohei Fukuma, Ben Seymour, Koichi Hosomi, Haruhiko Kishima, Takeshi Shimizu, Hiroshi Yokoi, Masayuki Hirata, Toshiki Yoshimine, Yukiyasu Kamitani, Youichi Saitoh
A brachial plexus root avulsion (BPRA) causes intractable pain in the insensible affected hands. Such pain is partly due to phantom limb pain, which is neuropathic pain occurring after the amputation of a limb and partial or complete deafferentation. Previous studies suggested that the pain was attributable to maladaptive plasticity of the sensorimotor cortex. However, there is little evidence to demonstrate the causal links between the pain and the cortical representation, and how much cortical factors affect the pain...
July 12, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29998935/neurosurgical-management-and-outcomes-of-cerebrovascular-disease-in-pediatric-patients-with-heart-disease
#2
Daisuke Maruyama, Hiroharu Kataoka, Tetsu Satow, Hisae Mori, Yoshiro Ito, Eika Hamano, Shunichi Tanaka, Taichi Ishiguro, Hidekazu Chikuie, Jun C Takahashi
Antithrombotic treatment has substantial risks, even in pediatric patients. We retrospectively evaluated the management and outcomes of consecutive pediatric patients who underwent neurosurgical treatment for cerebrovascular disease with cardiovascular disease between 1998 and 2017. Patients were divided into patients with comorbid cardiovascular disease (group I); and patients with cardiovascular disease as a primary disease of intracranial complication, without (group IIa) or with (group IIb) extracorporeal circulations...
July 12, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29998934/flow-alteration-therapy-for-ruptured-vertebral-artery-dissecting-aneurysms-involving-the-posterior-inferior-cerebellar-artery
#3
Yasuhisa Kanematsu, Junichiro Satomi, Masaaki Korai, Toshiyuki Okazaki, Izumi Yamaguchi, Yoshiteru Tada, Masaaki Uno, Shinji Nagahiro, Yasushi Takagi
Surgery for- and endovascular treatment of vertebral artery (VA) dissecting aneurysms involving the origin of the posterior inferior cerebellar artery (PICA) remain challenging. Their ideal treatment is complete isolation of the aneurysm by surgical or endovascular trapping plus PICA reconstruction. However, postoperative lower cranial nerve palsy and medullary infarction are potential complications. We report four patients with VA dissecting aneurysms involving the PICA origin who were treated by occipital artery (OA)-PICA bypass followed by proximal occlusion of the VA and clip ligation of the PICA origin instead of trapping...
July 12, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29998933/pedicle-galeo-pericranial-flap-augmentation-in-salvage-frontotemporal-cranioplasty-additional-neurosurgeon-friendly-reconstruction-technique-of-aesthetic-neurosurgery-in-superficial-temporal-artery-branch-compromised-host
#4
Ichiro Takumi, Masataka Akimoto, Kouhei Hironaka, Koji Adachi, Takashi Kon, Takashi Matsumori, Yuichiro Tanaka, Akio Morita
This technical note aims to demonstrate the usefulness, indications and its limitations of augmentation technique by bipedicle galeo-pericranial rotation flap and by monopedicle galeo-pericranial flap, both in STA (superficial temporal artery) branch compromised hosts in salvage frontotemporal cranioplasty. Although these flaps are not always idealistically vascularized owing to accidental injuries to the STA branches during previous surgeries, they are properly augmenting after salvage frontotemporal craniotomy when infection is not active...
July 12, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29925722/albert-l-rhoton-jr-md-his-philosophy-and-education-of-neurosurgeons
#5
Toshio Matsushima, Shigeaki Kobayashi, Tooru Inoue, Alice S Rhoton, Alexander L Vlasak, Evandro de Oliveira
Dr. Rhoton's key philosophies included "Keep working hard.", "Make surgery more accurate, gentle and safe", "We want perfect anatomical dissections, because we want perfect surgical operations", "Competence without compassion is worthless. Compassion without competence is meaningless", "Neurosurgeons share a great professional gift; our lives have yielded an opportunity to help mankind in a unique and exciting way" and "There is no finish line for this effort"...
June 20, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29925721/traumatic-basilar-artery-entrapment-without-longitudinal-clivus-fracture-a-case-report-and-review-of-the-literature
#6
Ayumu Yamaoka, Kei Miyata, Naofumi Bunya, Hirotoshi Mizuno, Hideto Irifune, Naoya Yama, Yukinori Akiyama, Takeshi Mikami, Masahiko Wanibuchi, Nobuhiro Mikuni
In blunt cerebrovascular injury, reported traumatic basilar artery occlusions have involved dissection of the basilar artery, distal embolization due to traumatic vertebral artery dissection, or entrapment of the basilar artery into the clivus fracture. To date, however, there are no reports of traumatic basilar artery entrapment without a clivus fracture. Here, we report the first case of traumatic basilar artery occlusion caused by entrapment into an originally existing bone defect. A 67-year-old man with a history of treatment for intracranial aneurysm suffered multiple traumatic injuries in a fall...
June 20, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29925720/clinical-features-and-surgical-treatment-of-superficial-peroneal-nerve-entrapment-neuropathy
#7
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Kazuyoshi Yamazaki, Masanori Isobe
Superficial peroneal nerve (S-PN) entrapment neuropathy (S-PNEN) is comparatively rare and may be an elusive clinical entity. There is yet no established surgical procedure to treat idiopathic S-PNEN. We report our surgical treatment and clinical outcomes. We surgically treated 5 patients (6 sites) with S-PNEN. The 2 men and 3 women ranged in age from 67 to 91 years; one patient presented with bilateral leg involvement. Mean post-operative follow-up was 25.3 months. We recorded their symptoms before- and at the latest follow-up visit after surgery using a Numerical Rating Scale and the Japan Orthopedic Association score to evaluate the affected area...
June 20, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29925719/endovascular-intervention-in-basilar-artery-entrapment-within-the-longitudinal-clivus-fracture-a-case-report
#8
Fumiaki Kanamori, Takashi Yamanouchi, Yuya Kano, Naoki Koketsu
Although vascular complications after head trauma is well recognized, basilar artery entrapment within the longitudinal clivus fracture is rare. A 69-year-old man presented with progressive disturbance of consciousness and right hemiplegia after trauma. Computed tomography scan showed a right-sided acute subdural hematoma and multiple skull fractures, including a longitudinal clivus fracture. Magnetic resonance imaging revealed basilar artery occlusion and a small infarction at the ventral part of the pons...
June 20, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29899179/involvement-of-intracellular-cholesterol-in-temozolomide-induced-glioblastoma-cell-death
#9
Yutaro Yamamoto, Nobuyoshi Sasaki, Kosuke Kumagai, Satoru Takeuchi, Terushige Toyooka, Naoki Otani, Kojiro Wada, Yoshitaka Narita, Koichi Ichimura, Hiroki Namba, Kentaro Mori, Arata Tomiyama
Glioblastoma (GBM) still carries a poor prognosis due to the refractoriness against antitumor drugs. Temozolomide (TMZ), one of the few standard therapy drugs against GBM worldwide, has only limited effect due to acquired TMZ resistance of GBM. Therefore, development of novel therapeutic methods to overcome the TMZ resistance of GBM is urgent. The brain is the most cholesterol-rich organ in the human body, so modulation of cholesterol in tumor cells originating from the brain including GBM may be a tumor-specific therapeutic strategy including enhancement of TMZ effects...
June 13, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29848907/mgmt-expression-contributes-to-temozolomide-resistance-in-h3k27m-mutant-diffuse-midline-gliomas-and-mgmt-silencing-to-temozolomide-sensitivity-in-idh-mutant-gliomas
#10
Hideaki Abe, Manabu Natsumeda, Yu Kanemaru, Jun Watanabe, Yoshihiro Tsukamoto, Masayasu Okada, Junichi Yoshimura, Makoto Oishi, Yukihiko Fujii
Histone H3 mutations are frequently found in diffuse midline gliomas (DMGs), which include diffuse intrinsic pontine gliomas and thalamic gliomas. These tumors have dismal prognoses. Recent evidence suggests that one reason for the poor prognoses is that O6 -methylguanine-DNA methyltransferase (MGMT) promoter frequently lacks methylation in DMGs. This review compares the epigenetic changes brought about by histone mutations to those by isocitrate dehydrogenase-mutant gliomas, which frequently have methylated MGMT promoters and are known to be sensitive to temozolomide...
May 31, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29848906/elevation-of-autoantibody-in-patients-with-ischemic-stroke
#11
Yoichi Yoshida, Takaki Hiwasa, Toshio Machida, Eiichi Kobayashi, Seiichiro Mine, Jun Matsushima, Masaki Takiguchi, Yasuo Iwadate
Recent clinical research has revealed a significant correlation between atherosclerosis, one of the primary etiologies of ischemic stroke, and the immune system. Assuming that "disease-specific autoantibodies are produced in the sera of patients with ischemic stroke," we investigated multiple arteriosclerosis-related antibodies using the serological identification of antigens by recombinant cDNA expression cloning (SEREX), an established method for identifying antigenic proteins. We either screened a human aortic endothelial cell cDNA library or conducted protein array screening using the sera from patients with ischemic stroke, such as carotid artery stenosis or transient ischemic attack (TIA)...
May 31, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29887547/risk-factors-of-contralateral-microembolic-infarctions-related-to-carotid-artery-stenting
#12
Hidemichi Ito, Masashi Uchida, Taigen Sase, Yuichiro Kushiro, Daisuke Wakui, Hidetaka Onodera, Hiroshi Takasuna, Hiroyuki Morishima, Kotaro Oshio, Yuichiro Tanaka
This study sought to analyze the incidence of contralateral microembolic infarctions (MIs) on diffusion-weighted imaging (DWI) following protected carotid artery stenting (CAS) and compared the difference of risk factors between ipsilateral and contralateral lesions. From April 2010 to March 2017, 147 CASs in 140 patients were performed. All the patients underwent DWI within 1 week before and 24 hrs after the procedures. CAS was successfully completed in 145 (98.6%) of the 147 procedures. Forty-nine (33.8%) patients with new MIs revealed on postprocedural DWI were enrolled...
July 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29877209/endoscopic-endonasal-surgery-for-subdiaphragmatic-type-craniopharyngiomas
#13
Hiroshi Nishioka, Yuichi Nagata, Noriaki Fukuhara, Mitsuo Yamaguchi-Okada, Shozo Yamada
Subdiaphragmatic type craniopharyngiomas are tumors that originate within the sella. They are divided into two types; those localized within an enlarged sella (intrasellar type) and those accompanying a suprasellar extension (suprasellar extended type). The clinicopathological features and the recent outcomes of endoscopic endonasal surgery were retrospectively reviewed in 32 patients, with 11 surgeries for recurrence. These tumors showed a preponderance in young patients (19 patients were younger than 18-year-old) and suprasellar extended type (25 cases), were mostly composed of a large cyst (96...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29780072/late-cerebrovascular-events-and-social-outcome-after-adolescence-long-term-outcome-of-pediatric-moyamoya-disease
#14
Takeshi Funaki, Jun C Takahashi, Susumu Miyamoto
In this article, the authors review the literature related to long-term outcome of pediatric moyamoya disease, focusing on late cerebrovascular events and social outcome of pediatric patients once they reach adulthood. Late-onset de novo hemorrhage is rare but more serious than recurrence of ischemic stroke. Long-term follow-up data on Asian populations suggest that the incidence of de novo hemorrhage might increase at age 20 or later, even more than 10 years after bypass surgery. Social adaptation difficulty, possibly related to cognitive impairment caused by frontal ischemia, continues in 10-20% of patients after they reach adulthood, even if no significant disability is present in daily life...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29780071/symptomatic-remote-cyst-after-bcnu-wafer-implantation-for-malignant-glioma
#15
Hideaki Matsumura, Eiichi Ishikawa, Masahide Matsuda, Noriaki Sakamoto, Hiroyoshi Akutsu, Shingo Takano, Akira Matsumura
A 43-year-old man was operated on for right frontal oligoastrocytoma. 14 years after the surgery, magnetic resonance imaging and positron emission tomography revealed a new lesion near the surgical cavity. He underwent gross total resection of the lesion and implantation of bis-chloroethylnitrosourea (BCNU) wafers after intraoperative pathological diagnosis of recurrent high-grade glioma. A few days after the operation, the level of consciousness gradually worsened and left hemiparesis developed. A computed tomography scan revealed a cyst remote to the surgical cavity which did not exist 3 days prior...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29769453/comparison-of-the-long-term-efficacy-and-safety-of-gamma-knife-radiosurgery-for-arteriovenous-malformations-in-pediatric-and-adult-patients
#16
Hirotaka Hasegawa, Shunya Hanakita, Masahiro Shin, Mariko Kawashima, Wataru Takahashi, Osamu Ishikawa, Satoshi Koizumi, Hirofumi Nakatomi, Nobuhito Saito
It is debated whether the efficacy and long-term safety of gamma knife radiosurgery (GKRS) for arteriovenous malformations (AVMs) differs between adult and pediatric patients. We aimed to clarify the long-term outcomes of GKRS in pediatric patients and how they compare to those in adult patients. We collected data for 736 consecutive patients with AVMs treated with GKRS between 1990 and 2014 and divided the patients into pediatric (age < 20 years, n = 144) and adult (age ≥ 20 years, n = 592) cohorts. The mean follow-up period in the pediatric cohort was 130 months...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29769452/acute-glaucoma-attack-following-microvascular-decompression-surgery-for-trigeminal-neuralgia
#17
Kenichi Amagasaki, Masami Nagayama, Saiko Watanabe, Naoyuki Shono, Hiroshi Nakaguchi
Microvascular decompression (MVD) is widely accepted as an effective surgical method to treat trigeminal neuralgia (TN), but the risks of morbidity and mortality must be considered. We experienced a case of acute angle-closure glaucoma attack following MVD for TN in an elderly patient, considered to be caused by lateral positioning during and after the surgery. A 79-year-old female underwent MVD for right TN in the left lateral decubitus position, and TN disappeared after the surgery. Postoperatively, the patient tended to maintain the left lateral decubitus position to prevent wound contact with the pillow, even after ambulation...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29760312/change-in-cerebral-blood-flow-after-palliative-percutaneous-angioplasty-and-timing-of-second-stage-carotid-artery-stenting-in-staged-angioplasty
#18
Hisashi Nagashima, Kazuhiro Hongo, Alhusain Nagm
The purpose of this study is to elucidate the hemodynamic changes after palliative angioplasty and the timing of second stage carotid artery stenting (CAS) in staged angioplasty for patients with severe hemodynamically compromised carotid artery stenosis. Among consecutive 111 patients with carotid artery stenosis, chronological changes in the cerebral blood flow of all 11 hemodynamically compromised patients treated with CAS were evaluated with single photon emission computed tomogram (SPECT) in each stage of the treatment...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29760311/postoperative-subdural-air-collection-is-a-risk-factor-for-chronic-subdural-hematoma-after-surgical-clipping-of-cerebral-aneurysms
#19
Shuhei Kawabata, Shoichi Tani, Hirotoshi Imamura, Hidemitsu Adachi, Nobuyuki Sakai
The precise mechanism of the development of chronic subdural hematoma (CSDH) as a postoperative complication after aneurysmal clipping remains unclear. The purpose of this study was to identify the independent risk factors for CSDH after craniotomy for aneurysmal clipping and to elucidate the relationship between CSDH and subdural air (SDA) collection immediately after surgery. The medical records and radiologic data of 344 patients who underwent surgical clipping of unruptured aneurysms from July 2010 to July 2016 were retrospectively evaluated...
June 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29710057/efficacy-of-dural-sealant-system-for-preventing-brain-shift-and-improving-accuracy-in-deep-brain-stimulation-surgery
#20
Tatsuya Sasaki, Takashi Agari, Ken Kuwahara, Ittetsu Kin, Mihoko Okazaki, Susumu Sasada, Aiko Shinko, Masahiro Kameda, Takao Yasuhara, Isao Date
The success of deep brain stimulation (DBS) depends heavily on surgical accuracy, and brain shift is recognized as a significant factor influencing accuracy. We investigated the factors associated with surgical accuracy and showed the effectiveness of a dural sealant system for preventing brain shift in 32 consecutive cases receiving DBS. Thirty-two patients receiving DBS between March 2014 and May 2015 were included in this study. We employed conventional burr hole techniques for the first 18 cases (Group I) and a dural sealant system (DuraSeal) for the subsequent 14 cases (Group II)...
May 15, 2018: Neurologia Medico-chirurgica
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