Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsRecurrence of subarachnoid hemorrhage due to the rupture of cerebral aneurysms in a patient with Sjögren's syndrome. Case report.
A 52-year-old woman with Sjögren's syndrome presented with multiple cerebral aneurysms, which resulted in recurrent subarachnoid hemorrhage (SAH) manifesting as severe headache. Computed tomography (CT) showed SAH. Cerebral angiography revealed aneurysms of the anterior communicating artery and the left middle cerebral artery. ⋯ The internal carotid artery aneurysm was successfully treated with endovascular coil embolization. However, she regained no neurological function and died. Patients with Sjögren's syndrome may develop cerebral aneurysm complicated with SAH.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsCavernous angioma associated with arteriovenous malformation of the brain--case report.
A 61-year-old man presented a rare case of cerebral cavernous angioma associated with cerebral arteriovenous malformation (AVM) manifesting as headache. Magnetic resonance imaging showed an AVM in the right occipital lobe and a cavernous angioma in the left middle fossa. The patient underwent left frontotemporal craniotomy with total resection of the left parasellar intra-axial tumor. ⋯ The histological diagnoses were cavernous angioma and AVM, respectively. Immunostaining for angiogenic growth factors and structural proteins revealed different expression patterns of alpha-smooth muscle actin in these structures. Expression of structural proteins may reflect differences in their pathogenesis.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsGlioblastoma detected at the initial stage in its developmental process -case report-.
A 73-year-old male presented with a glioblastoma that was detected at the initial stage in the developmental process. He suffered cerebral infarction. Follow-up magnetic resonance (MR) imaging showed no abnormality. ⋯ Follow-up MR imaging showed regrowth of the tumor and aggravation of edema. The rapid progression of the tumor ultimately resulted in the patient's death 12 months after the onset of right hemiparesis. Diffusion-weighted imaging is a good method for the early detection of glioblastoma.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsInfraoptic course of the anterior cerebral artery originating from the extradural internal carotid artery associated with contralateral internal carotid artery agenesis and multiple intracerebral aneurysms.
A 63-year-old woman presented with infraoptic course of the anterior cerebral artery (ACA) originating from the extradural internal carotid artery (ICA) associated with contralateral ICA agenesis and multiple intracerebral aneurysms. The extradural origin of the infraoptic course of ACA was identified with constructive interference in steady state magnetic resonance (MR) imaging, and confirmed at surgery. ⋯ The anomalous artery of this rare anomaly almost always arises from the intradural ICA. MR imaging is useful for evaluating the anatomical details of this anomaly.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Retrospective survey of endovascular treatment for ruptured intracranial aneurysm in Japan: Retrospective Endovascular Subarachnoid Aneurysm Treatment (RESAT) study.
Annual retrospective surveys of 20 to 31 medical centers performing endovascular treatment of cerebral aneurysms in Japan from 1997 to 2008 were performed to analyze technical and clinical outcomes of endovascular treatment for ruptured cerebral aneurysm. Patients treated with dome embolization using bare platinum coils within 14 days after onset were retrospectively selected, and clinical features, and technical and clinical outcomes at discharge were studied. Retrospective Endovascular Subarachnoid Aneurysm Treatment (RESAT) 1 covers patients treated from 1997, when the Guglielmi detachable coil was introduced, to 2002, just after International Subarachnoid Aneurysm Trial was reported. ⋯ Procedure-related morbidity was 2.9% and mortality was 0.8%. Despite this survey involving high proportions of aged, posterior circulation, and poor-grade patients, the technical success rate and immediate clinical results were relatively favorable. The patient prognosis and aneurysm changes must be investigated over a longer period, together with the effects of the introduction of new endovascular devices for cerebral aneurysms.