Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Oct 2005
Case ReportsPeritoneal shunt tube migration into the stomach--case report--.
A 47-year-old man presented with repeated headache and feverishness 3.5 years after undergoing ventriculoperitoneal shunt surgery for normal pressure hydrocephalus secondary to subarachnoid hemorrhage. Abdominal computed tomography revealed that the peritoneal catheter was encased by fibrous tissue and the distal end of the catheter had migrated into the stomach. The diagnosis was spontaneous gastric perforation by the ventriculoperitoneal shunt. The fibrous tissue was expected to seal the very small gastric perforation, so the catheter was successfully extracted through a scalp incision without abdominal surgical intervention.
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Neurol. Med. Chir. (Tokyo) · Oct 2005
Awake surgery for glioma resection in eloquent areas--Zurich's experience and review--.
Awake surgery was performed in a series of 21 patients with gliomas in eloquent areas with the use of intraoperative electrical mapping. Gross total removal was performed in 18 patients. There was no operative mortality. ⋯ Extensive radical resection of gliomas prolongs the overall survival and improves the patient's quality of life. However, surgical resection of gliomas located within the sensorimotor or language areas remains a neurosurgical challenge in reducing eloquent neurological sequelae. Awake surgery with intraoperative functional mapping is a safe approach to maximize the extent of tumor removal and to minimize the resultant neurological deficits in the treatment of glioma involving the eloquent cortex.
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Neurol. Med. Chir. (Tokyo) · Sep 2005
Case ReportsRapid disappearance of acute posterior fossa epidural hematoma.
A 34-year-old man presented with an acute epidural hematoma that resolved within 24 hours after a fall. On admission, neurological examination found no abnormalities. Computed tomography (CT) indicated a linear fracture in the occiput. ⋯ Conservative management with pentothal was performed in the intensive care unit. Follow-up CT 21 hours after the initial injury showed complete resolution of the hematoma and an increase in the CT density of the pericranial soft tissue near the hematoma. The pressure gradient between the subgaleal and epidural space may have been important in the rapid disappearance of this epidural hematoma.
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Neurol. Med. Chir. (Tokyo) · Aug 2005
Review Historical ArticleRole of Japan in the future of neurosurgery in Asia.
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Neurol. Med. Chir. (Tokyo) · Aug 2005
Case ReportsMetastatic renal cell carcinoma mimicking pituitary adenoma: case report.
A 54-year-old man, with a past history of renal cell carcinoma, presented with bitemporal visual field defect, hyponatremia, and diabetes insipidus. Endocrinological examination revealed panhypopituitarism. Computed tomography and magnetic resonance imaging showed an intrasellar mass with suprasellar extension. ⋯ The tumor was decompressed via the transsphenoidal route. Histological examination revealed metastatic renal cell carcinoma. The clinical characteristics of metastatic pituitary carcinoma appear to be panhypopituitarism, and neuroimaging findings of strong enhancement of the tumor and bony destruction without marked sellar enlargement.