Neurologia medico-chirurgica
-
Neurol. Med. Chir. (Tokyo) · Jan 1990
Study on cases with posterior fossa epidural hematoma--clinical features and indications for operation.
In this retrospective study, 11 cases of posterior fossa epidural hematoma were analyzed in terms of clinical and radiological features, treatment, and outcome. Posterior fossa epidural hematomas accounted for 11.8% of all epidural hematomas encountered during the 7-year period studied. There were eight males and three females ranging in age from 2 to 53 years (mean, 20.7 years). ⋯ At discharge, eight patients showed good recovery and one was moderately disabled. Two patients died. The prognosis for posterior fossa epidural hematoma appears relatively good, if it is not accompanied by severe primary brainstem injury and is diagnosed early, and appropriately and promptly treated.
-
Neurol. Med. Chir. (Tokyo) · Jan 1990
Case Reports[Wide-spread spontaneous spinal subarachnoid hematoma. Case report].
A 56-year-old female experienced sudden excruciating pain extending from the upper neck to the lower back. She had mild disturbance of consciousness, and a lumbar puncture revealed bloody cerebrospinal fluid. The positive neurological findings were meningitis, spastic paraparesis, hyperesthesia of the left L3 dermatome, bilateral Babinski, disappearance of anal reflex, and urinary retention. ⋯ After the hematoma removal, non-pulsating tortuous vessels were observed on the surface of the spinal cord at the L1 level which ran into the intramedullary region. However, there was no further abnormality to define spinal arteriovenous malformation or fistula within the limits of exposure. The postoperative course was uneventful and about 2 months later she was able to walk by herself.
-
Neurol. Med. Chir. (Tokyo) · Jan 1990
Case Reports[Arachnoid cyst of the fourth ventricle. Case report].
A 65-year-old female was admitted because of progressive vertigo, truncal ataxia, and unsteadiness of gait for the past 6 years. Computed tomography (CT) and magnetic resonance imaging revealed a non-enhanced, large midline cyst in the posterior fossa and slightly dilated lateral and third ventricles. Metrizamide CT cisternography showed no communication between the cyst and the subarachnoid space. ⋯ On light microscopic examination, the cyst wall was composed of arachnoid cells and connective tissues. Thus, this lesion was not an epithelial cyst but an arachnoid cyst occupying the fourth ventricle. An arachnoid cyst of the fourth ventricle is extremely rare, and only two cases were previously reported.
-
Neurol. Med. Chir. (Tokyo) · Jan 1990
A two-dimensional, finite element analysis of vasogenic brain edema.
The authors constructed a two-dimensional model of vasogenic brain edema, using the finite element method (FEM). The model incorporates the following physical parameters: cerebrovascular hydraulic conductivity, metabolic water production, tissue hydraulic conductivity and compliance, tissue and plasma osmotic and hydrostatic pressures, cerebrospinal fluid hydrostatic pressure and absorption, intracerebral stress, and shift of brain tissue. ⋯ Computer simulation predicted the changes observed in interstitial pressure, extent of edema, intracerebral stress distribution, and shift of brain tissue. The results indicate that the FEM, applied to a model of vasogenic brain edema, can be used to predict the time course and regional distribution of fluid accumulation and the accompanying regional stress and deformation of brain tissue.