Brain and nerve = Shinkei kenkyū no shinpo
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Beta blockers (beta-adrenoceptor blockers) are known to be used for the prophylactic treatment of migraine. The improvement of migraine in the patients who recieved propranolol for angina pectoris revealed the effectiveness of propranolol in migraine prophylaxis. Many clinical trials have confirmed that propranolol is effective in the prophylactic treatment of migraine. ⋯ In contrast, several beta blockers with intrinsic sympathetic activity (ISA), such as alprenolol, oxprenolol, pindolol and acebutolol, have not been demonstrated to be effective in migraine prophylaxis. In this review, we have descrived the pharmacologic background and pharmacokinetics of the beta blockers that demonstrated a prophylactic effect for migraine will be described. We have also reviewed the results of clinical trials of beta-blocking drugs for migraine.
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Review Case Reports
[Case of ruptured middle cerebral artery bifurcation aneurysm presenting as putaminal hemorrhage without subarachnoid hemorrhage].
Ruptured aneurysms typically present as subarachnoid hemorrhage (SAH); however, they can also cause intracerebral hemorrhage (ICH) that can be mistaken for hypertensive hemorrhage. We report a rare case of a ruptured middle cerebral artery bifurcation aneurysm presenting as putaminal hemorrhage without subarachnoid hemorrhage (SAH). A 47-year-old man, with a past history of hypertension, presented with a decreased level of consciousness. ⋯ We performed aneurysmal clipping and hematoma evacuation. The postoperative course was uneventful. This case suggested that ruptured aneurysms situated on the middle cerebral artery can present as putaminal hemorrhage without SAH.
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Case Reports
[Rupture of a small aneurysm originating from an infundibular dilatation--case report].
Infundibular dilatations (IDs) are funnel-shaped enlargements of the origin of cerebral arteries. Usually IDs occur at the junction between posterior communicating artery and the internal carotid artery. Progression from an ID of the posterior communicating artery to an aneurysm has previously been described, but it is unclear whether an ID is a pre-aneurysmal state or a normal anatomical variant. ⋯ An ID of the posterior communicating artery can develop into an aneurysm and subsequently rupture. The development of an aneurysm from the ID may be influenced by hemodynamic stress and hypertension. Thus patients with the pre-aneurysmal ID should be carefully followed up for a long time.