No shinkei geka. Neurological surgery
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We report a case of the development of cavum septi pellucidi and cavum Vergae after head trauma in a 29-year-old female patient. After the accident, cavum septi pellucidi and cavum Vergae gradually expanded. Using magnetic resonance imaging, we followed up the patient for 33 months after the head trauma. ⋯ The volume of the cavum septi pellucidi/cavum Vergae decreased remarkably. In this case, our CSF flow studies revealed that CSF flowed into the posterior part of the cavum Vergae from the third ventricle and did not flow backward to the third ventricle. Therefore, we considered that the development of cavum septi pellucidi/cavum Vergae was related to a one-way valve mechanism between the posterior part of the cavum Vergae and the third ventricle.
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Case Reports
[A case of the traumatic hydrocephalus after large craniectomy for acute subdural hematoma].
Decompressive craniectomy sometimes causes neurological deficits known as 'the syndrome of the sinking skin flap' or 'the symptom of the trephined'. These disorders can be corrected with cranioplasty, but there is no consensus on appropriate treatments. We report a case of successful correction of traumatic hydrocephalus following craniotomy. ⋯ These symptoms and CT findings were not improved after cranioplasty, but were improved with removal of the CSF from the adhered subarachnoid space. The diagnosis was traumatic hydrocephalus, and a cisternoperitoneal shunt was subsequently placed. We report this case to emphasize the necessity for study of CSF circulation, as well as the importance of examination of CBF and ICP after craniectomy.
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The present study was aimed at clarifying the clinical significance of posterior cerebral artery (PCA) stenosis/occlusion in pediatric and adult moyamoya disease. ⋯ The present study showed that the involvement of PCA could increase the risk of TIA and/or cerebral infarction in both anterior and posterior circulation areas, suggesting that the PCA plays an important collateral role in moyamoya disease.