Neurologia medico-chirurgica
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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
Case ReportsXanthogranuloma of the sellar region--case report.
A 55-year-old woman presented with a rare xanthogranuloma of the sellar region after complaining of severe headache and visual disturbance 3 months previously. Clinical examination showed she was alert with early signs of bitemporal hemianopsia. Endocrinological examination revealed hypopituitarism. ⋯ The histological diagnosis was xanthogranuloma of the sellar region. Her visual symptoms recovered postoperatively although the hypopituitarism remained. Xanthogranuloma of the sellar region is rare, but must be considered in the differential diagnosis of tumors of the sellar region.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsRapid spontaneous resolution of neurological signs and cerebral herniation caused by intracerebral hemorrhage -case report-.
A 47-year-old man presented with sudden consciousness disturbance and left hemiplegia caused by intracerebral hemorrhage. Initial computed tomography (CT) showed a massive subcortical right temporoparietal lobe hematoma and signs of impending uncal herniation. ⋯ Small intracerebral hemorrhages occasionally produce transient symptoms with or without disappearance of the hematoma, but the present patient had a large hematoma that decreased in size within a short time with rapid improvement of the symptoms attributed to the hematoma. The mechanism underlying the diminution of the hematoma may be related to redistribution by cerebrospinal fluid flow.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Preventive effect of aggressive blood pressure lowering on hematoma enlargement in patients with ultra-acute intracerebral hemorrhage.
The preventive effect of aggressive blood pressure lowering on hematoma enlargement was investigated in patients with ultra-acute spontaneous intracerebral hemorrhage (ICH). Retrospective review of 248 patients (145 males, 103 females) with spontaneous ICH treated in our hospital between 2005 and 2008 identified patients with ultra-acute ICH who were directly taken to our institute by ambulance within 3 hours after onset. Patients who could not be assessed twice by computed tomography (CT) within 24 hours after arrival were excluded. ⋯ The time course of SBP change was not significantly different in patients with and without hematoma enlargement. The incidence of hematoma enlargement in patients with ultra-acute ICH in this study was 15.0%, which was lower than that in other series in which blood pressure was not reduced aggressively. This finding suggests that aggressive SBP lowering to below 140 mmHg has a preventive effect on hematoma enlargement in patients with ultra-acute ICH.