No shinkei geka. Neurological surgery
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Review
[Subarachnoid hemorrhage in 'Vital Statistics of Japan', 1993-1995: variability with age and sex].
The incidence and death rate of subarachnoid hemorrhage (SAH) varies with age and sex. Female preponderance in the incidence of SAH is a well-known fact. However, the degree varies with age. ⋯ For males over the age of forty, AMA victims are more than those from SAH. However, conversely females' deaths from SAH occur three times frequently as those from AMAs. The fact should be taken into consideration when screening for unruptured aneurysms.
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Excellent results of multiple burr-hole operation (MBHO) for child moyamoya disease are reported in this study. Three patients of moyamoya disease had MBHO. After MBHO, transient, ischemic attacks disappeared in a patient despite progressing stenosis of the major cerebral arteries, and remarkable neurological improvement was recognized in a patient who had encephaloduroarteriosynangiosis. ⋯ N-isopropyl-p-[123I] iodoamphetamine (IMPSPECT) findings also improved in all patients. There was no mortality or morbidity, and no new neurological deficits or bleedings developed during the follow up period. The authors recommend the MBHO as the surgical treatment of choice for not only adult but also child moyamoya disease because of its safety and effectiveness, and also report the usefulness of MBHO for the patients who have already received other bypass operations.