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NMC Case Report Journal

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https://www.readbyqxmd.com/read/29725570/a-case-of-suspicious-gangliocytoma-with-heterogeneously-distributed-lesions-in-the-thalamus-and-basal-ganglia
#1
Yohei Miyake, Kazuhiko Mishima, Tomonari Suzuki, Jun-Ichi Adachi, Atsushi Sasaki, Ryo Nishikawa
We report a case of a 24-year-old woman who presented with an uncomfortable feeling in her right foot with a 6-month history of slight weakness in her right hand. Neuroimaging demonstrated irregular shaped lesions in the left thalamus and basal ganglia in addition to spotty lesions in the contralateral thalamus. The MRI showed high-intensity signals on T2-weighted, fluid-attenuated inversion recovery, and diffusion-weighted images. The lesions demonstrated low-intensity signaling on T1-weighted images and were slightly enhanced with gadolinium...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725569/nontraumatic-acetabular-fracture-sustained-during-convulsive-seizure-following-surgery-for-an-unruptured-intracranial-aneurysm-a-case-report
#2
Hirofumi Iwamoto, Kazuhiro Nakamura, Daisuke Watanabe, Kiyoyuki Yanaka, Takeshi Ainoya, Tetsuya Yamamoto
Acetabular fracture usually is related to high-energy traumatic injury or falls from heights and directly caused by seizures without trauma is extremely rare. We report a 71-years-old man who sustained a left acetabular fracture secondary to generalized seizure after clipping of an unruptured aneurysm without trauma and any risk for fracture. The patient had an aneurysm was arising from the bifurcation of the left internal carotid artery and the posterior communicating artery. After the clipping, the patient had three times tonic-clonic seizures for 1 min and resulted in an acetabular fracture...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725568/tiny-falx-meningioma-causing-massive-interhemispheric-subdural-hematoma-a-case-report
#3
Yume Suzuki, Masashi Fujimoto, Fumihiro Kawakita, Fumio Asakura, Hiroto Murata, Yoshito Morooka, Hidenori Suzuki
Bleeding from meningiomas is well known, but massive subdural hemorrhage from a very small meningioma is rare. A 61-year-old woman presented with a sudden-onset headache and slight right hemiparesis without a history of trauma. Computed tomographic scan showed bilateral acute/subacute interhemispheric subdural hematoma, but contrast-enhanced computed tomography (CT) scan, non-enhanced magnetic resonance imaging (MRI) and digital subtraction angiography failed to detect the cause. The hematoma was conservatively treated...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725567/one-stage-stent-assisted-coil-embolization-for-rupture-side-unknown-bilateral-vertebral-artery-dissecting-aneurysms-in-an-acute-stage-a-case-report
#4
Mio Terashima, Yoichi Miura, Fujimaro Ishida, Naoki Toma, Tomohiro Araki, Shinichi Shimosaka, Kenji Kanamaru, Hidenori Suzuki
Bilateral vertebral artery dissecting aneurysms (VADAs) with subarachnoid hemorrhage (SAH) are rare and their management is still challenging. In this report, we successfully performed one-stage stent-assisted coil embolization (SAC) for bilateral VADAs with SAH in an acute stage, because the ruptured side could not be diagnosed. A 47-year-old woman presented with a sudden onset of headache without laterality, and left-side dominant SAH with bilateral VADAs was noted on computed tomography (CT) scans. The size of aneurysmal dome and neck was similar between the two VADAs, and a bleb was observed only on the right VADA...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29725566/superficial-temporal-artery-middle-cerebral-artery-anastomosis-for-ischemic-stroke-due-to-dissection-of-the-intracranial-internal-carotid-artery-with-middle-cerebral-artery-extension
#5
Masashi Ikota, Gen Kusaka, Yuichi Tanaka
A 31-year-old man presented with a sudden-onset headache, right hemiparesis, and dysarthria on day 0 and was diagnosed with acute ischemic stroke due to dissection of the left intracranial internal carotid artery with middle cerebral artery extension. His symptoms progressed despite the institution of treatment, suggesting progression of the dissection. On day 5 after symptom onset, the patient underwent superficial temporal artery-middle cerebral artery anastomosis. No new ischemic stroke event occurred after surgery...
April 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354337/delayed-postoperative-spinal-epidural-hematoma-after-cervical-laminoplasty
#6
Masato Tomii, Junichi Mizuno, Ken Kazama, Tadao Matsushima, Kazuo Watanabe
A 56-year-old man underwent cervical laminoplasty for cervical spondylosis. On the 7th postoperative day, he suddenly felt severe neck pain, and tetraplegia developed rapidly over 1.5 hrs. Computed tomography demonstrated a huge hematoma compressing the cervical spinal cord. Clot was evacuated 3 hrs after the onset of symptoms. The patient's postoperative course was uneventful. His blood pressure could not be properly controlled in the perioperative period. Surgeons should keep in mind that delayed postoperative spinal epidural hematoma (DPSEH) can occur more than a week after surgery, and meticulous blood pressure control is important for more than a week after a spinal operation...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354336/severe-hypoglycemia-induced-right-hemiparesis-with-reversible-diffusion-restriction-in-the-left-internal-capsule-due-to-combination-therapy-using-disopyramide-and-clarithromycin
#7
Yoshito Sugita, Masaomi Koyanagi, Masashi Oda, Tamaki Kobayashi, Osamu Narumi, Masaaki Saiki
Severe hypoglycemia is known to cause acute focal neurological symptoms. In cases with a medical history of diabetes mellitus (DM), the diagnosis and treatment of hypoglycemia-induced neurological symptoms are simple. However, severe hypoglycemia can occur in patients who are not taking hypoglycemic agents such as insulin or long-acting sulfonylurea drugs. We describe a 95-year-old man with sudden onset of right hemiparesis who showed high signal intensity on diffusion-weighted imaging involving the left internal capsule with corresponding reduced apparent diffusion coefficient hypointensity...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354335/adult-chiari-type-1-malformation-with-holocord-syringomyelia-associated-with-sagittal-synostosis
#8
Masakazu Sano, Junichi Yoshimura, Yukihiko Fujii
Craniosynostosis associated with Chiari malformation (CM) is usually found in infants with an underdeveloped posterior fossa. We here present a case of adult craniosynostosis, CM, and symptomatic syringomyelia caused by the protrusion of the posterior rim of the foramen magnum without a tight posterior fossa. A 22-year-old woman with an abnormal head shape and forearm hypesthesia was given a diagnosis of sagittal suture synostosis with CM and syringomyelia caused by foramen magnum stenosis. She underwent foramen magnum decompression with a C1 laminectomy without cranial vault expansion or duraplasty...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354334/traumatic-pseudoaneurysm-of-the-distal-anterior-cerebral-artery-following-penetrating-brain-injury-caused-by-a-crossbow-bolt-a-case-report
#9
Daiichiro Ishigami, Takahiro Ota
Traumatic intracranial aneurysms are one possible complication after penetrating brain injury. A 25-year-old man with a history of major depression presented with a crossbow bolt penetrating the head. On arrival, Glasgow Coma Scale score was E4V5M6, with no apparent neurological deficit. Computed tomography (CT) of the head showed the crossbow bolt passing near the corpus callosum, with surrounding contusion. Three-dimensional rotational angiography showed no anterior cerebral artery injuries. The crossbow bolt was removed after bifrontal craniotomy, with no postoperative infection...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354333/transvenous-aneurysm-sac-and-rupture-point-coil-embolization-of-direct-carotid-cavernous-fistula-after-pipeline-embolization
#10
Hidenori Oishi, Kosuke Teranishi, Kenji Yatomi, Munetaka Yamamoto, Hajime Arai
A delayed aneurysm rupture after flow diverter therapy is a rare but serious complication. Due to the anatomical specificity, a delayed rupture of a carotid cavernous aneurysm may cause a direct carotid cavernous fistula (dCCF). We present a novel therapeutic approach for treatment of dCCF after flow diverter therapy using the Pipeline embolization device (PED). An 86-year-old woman suffered from dCCF after PED embolization. A microcatheter was advanced through the transvenous approach into the cavernous sinus (CS) and further inserted into the aneurysm sac via the rupture point...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354332/tumor-volume-decrease-via-feeder-occlusion-for-treating-a-large-firm-trigone-meningioma
#11
Takuma Nakashima, Norikazu Hatano, Fumiaki Kanamori, Shinsuke Muraoka, Teppei Kawabata, Syuntaro Takasu, Tadashi Watanabe, Takao Kojima, Tetsuya Nagatani, Yukio Seki
Trigone meningiomas are considered a surgical challenge, as they tend to be considerably large and hypervascularized at the time of presentation. We experienced a case of a large and very hard trigone meningioma that was effectively treated using initial microsurgical feeder occlusion followed by surgery in stages. A 19-year-old woman who presented with loss of consciousness was referred to our hospital for surgical treatment of a brain tumor. Radiological findings were compatible with a left ventricular trigone meningioma extending laterally in proximity to the Sylvian fissure...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29354331/pazopanib-mediated-long-term-disease-stabilization-after-local-recurrence-and-distant-metastasis-of-primary-intracranial-leiomyosarcoma-a-case-report-on-the-efficacy-of-pazopanib-as-a-salvage-therapy
#12
Yasuhiro Kawabata, Tomokazu Aoki, Tetsurou Yamamoto, Hisateru Yasui, Satoru Sawai, Shunichi Fukuda, Satoru Kawarazaki, Tetsuya Tsukahara
Primary intracranial leiomyosarcoma (LMS) is an extremely rare tumor of the central nervous system. Only sporadic case reports have been published, and therefore data regarding long-term prognosis remain scarce. A 76-year-old woman presented with a right parietal mass, which had grown rapidly in the month prior to admission. Neuroimaging showed a resemblance to intraosseous meningioma. Gross total resection of the tumor was achieved, and histological diagnosis confirmed LMS. Because positron emission tomography (PET) with fluorodeoxyglucose (FDG) just after the resection showed no abnormal uptake, we diagnosed the tumor as primary intracranial LMS...
January 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018655/the-involvement-of-sensory-motor-networks-in-reflex-seizure
#13
Hime Suzuki, Rei Enatsu, Aya Kanno, Satoko Ochi, Takashi Murahara, Shogo Yazawa, Hideaki Shiraishi, Nobuhiro Mikuni
Reflex seizures are epileptic events triggered by specific external stimuli, or less commonly, internal mental stimuli. Understanding the characteristics of reflex seizures is important to elucidate the mechanisms underlying network abnormalities in epileptic conditions. This report details a patient with medically intractable reflex seizures provoked by sensory stimuli to the patient's right foot. Single-photon emission computed tomography (SPECT) during the seizure induced by sensory stimulation showed hyperperfusion in broad sensory-motor networks (dorsal column-medial lemniscus pathway, left thalamus, bilateral postcentral gyri and posterior parietal cortices, left supplementary motor area (SMA), and left paracentral lobule) and left caudateputamen...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018654/double-crush-of-l5-spinal-nerve-root-due-to-l4-5-lateral-recess-stenosis-and-bony-spur-formation-of-lumbosacral-transitional-vertebra-pseudoarticulation-a-case-report-and-review
#14
Motoyuki Iwasaki, Masahiko Akiyama, Izumi Koyanagi, Yoshimasa Niiya, Tatsuo Ihara, Kiyohiro Houkin
We present a case of double-crushed L5 nerve root symptoms caused by inside and outside of the spinal canal with spur formation of the lumbosacral transitional vertebra (LSTV). A 78-year-old man presented with 7-year history of moderate paresis of his toe and left leg pain when walking. Magnetic resonance imaging (MRI) revealed spinal stenosis at the L3/4 and 4/5 spinal levels and he underwent wide fenestration of both levels. Leg pain disappeared and 6-min walk distance (6MWD) improved after surgery, however, the numbness in his toes increased and 6MWD decreased 9 months after surgery...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018653/chiari-type-1-malformation-induced-intracranial-hypertension-with-diffuse-brain-edema-treated-with-foramen-magnum-decompression-a-case-report
#15
Toshiki Fukuoka, Yusuke Nishimura, Masahito Hara, Shoichi Haimoto, Kaoru Eguchi, Satoshi Yoshikawa, Toshihiko Wakabayashi, Howard J Ginsberg
Chiari type 1 malformation (CM1) rarely causes papilloedema, which is indicative of high intracranial pressure with or without ventricular dilatation. Furthermore, concomitant brain parenchymal abnormalities have not been reported to date. In this paper, the authors report on a young woman of CM1-induced intracranial hypertension (ICH) with diffuse brain edema with a focus on venous sinus assessment, and discuss the surgical strategy. A 24-year-old woman presented to Nagoya University Hospital complaining of 4-year history of severe occipital headache and blurry vision with slowly progressive worsening...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018652/anastomotic-aneurysm-formation-after-high-flow-bypass-surgery-a-case-report-with-histopathological-study
#16
Tatsuya Uchida, Masanori Yoshino, Shinji Ito, Takayuki Hara
Bypass surgery is often used in the treatment of large and giant aneurysms. Major complications that often arise during the perioperative period include cranial nerve palsy, ischemic complications, and hyperperfusion. However, there have been a few reports about late onset complications such as anastomotic aneurysms. In particular, anastomotic aneurysm after high flow bypasses has never been reported. A 57-year-old woman who had been suffering from left eye pain was diagnosed with a large aneurysm of the left internal carotid artery (ICA) in the cavernous portion...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018651/a-case-of-vertebral-artery-fusiform-aneurysm-treated-by-flow-alteration-successful-prediction-of-therapeutic-effects-using-computational-fluid-dynamics
#17
Yoichi Miura, Fujimaro Ishida, Yusuke Kamei, Masanori Tsuji, Masato Shiba, Hiroshi Tanemura, Yasuyuki Umeda, Shinichi Shimosaka, Hidenori Suzuki
The treatment of intracranial complicated aneurysms remains challenging. In patients with complicated aneurysms that are neither clippable nor coilable, flow alteration treatment (FAT) with a combined procedure of proximal/distal occlusion or trapping of an aneurysm with bypass surgery has been reported. However, it is difficult to predict whatever FAT can achieve aneurysmal obliteration without ischemic complications. A 69-year-old female was incidentally diagnosed with a left vertebral artery (VA) fusiform aneurysm distal to the left posterior inferior cerebellar artery (PICA)...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018650/surgical-treatment-of-rotational-vertebral-artery-syndrome-induced-by-spinal-tumor-a-case-report-and-literature-review
#18
Shoichi Haimoto, Yusuke Nishimura, Masahito Hara, Yuu Yamamoto, Toshiki Fukuoka, Ryuichi Fukuyama, Toshihiko Wakabayashi, Howard J Ginsberg
Vertebrobasilar insufficiency (VBI) provoked by physiological head rotation is known as rotational vertebral artery syndrome (RVAS) or Bow Hunter syndrome. RVAS most often occurs at C1-2 level with head rotation and presents with symptoms of VBI. Several previously published studies have reported RVAS at subaxial sites (V2 segment), however, tumor-induced RVAS has never been reported. The authors report the first case of RVAS at V2 segment due to compression from a spinal tumor. A 71-year-old man presented with symptoms of dizziness provoked by head rotation or neck extension...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/29018649/rapid-recanalization-using-trevoprovue-through-a-4-2-fr-catheter-without-a-guiding-catheter-via-transbrachial-approach-a-case-report
#19
Susumu Yamaguchi, Nobutaka Horie, Yoichi Morofuji, Kei Satoh, Kazuhiko Suyama
Mechanical thrombectomy with a stent retriever has been reported to achieve high rates of successful recanalization, and reduce disability and mortality in patients with acute ischemic stroke (AIS) due to proximal vessel occlusion. However, in a few cases, the treatment is difficult due to artery tortuosity or other factors. The authors present a case of a 94-year-old man presenting with acute right middle cerebral artery occlusion. We attempted to treat using a stent retriever via transfemoral approach, but failed to advance the guiding catheter into the right internal carotid artery due to femoral artery tortuosity and a type III arch...
October 2017: NMC Case Report Journal
https://www.readbyqxmd.com/read/28840087/posterior-inferior-cerebellar-artery-thrombosed-aneurysm-associated-with-persistent-primitive-hypoglossal-artery-successfully-treated-with-condylar-fossa-approach
#20
Norihiro Saito, Rokuya Tanikawa, Toshiyuki Tsuboi, Kosmo Noda, Nakao Ota, Shirou Miyata, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro Sakakibara, Yu Kinoshita, Takanori Miyazaki, Hiroyasu Kamiyama, Sadahisa Tokuda
A 68-year-old woman presented with generalized seizure due to the left internal carotid artery (ICA) aneurysmal compression of the ipsilateral medial temporal lobe. Computed tomography angiography (CTA) revealed multiple aneurysms of the right persistent primitive hypoglossal artery (PPHA), the right ICA, and the right anterior cerebral artery (ACA). The right PPHA originated from the ICA at the level of the C1 and C2 vertebral bodies and passed through the hypoglossal canal (HC). The PPHA aneurysm was large and thrombosed, which was located at the bifurcation of the right PPHA and the right posterior inferior cerebellar artery (PICA), projecting medially to compress the medulla oblongata...
July 2017: NMC Case Report Journal
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