Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · May 2004
Case ReportsClinical features and management of intracranial hemorrhage in patients undergoing maintenance dialysis therapy.
The management and outcome were retrospectively investigated in patients with chronic renal failure receiving maintenance blood purification who suffered intracranial hemorrhage. Patients with intracerebral hemorrhage (ICH, n = 36) or subarachnoid hemorrhage (SAH, n = 5) were evaluated. Both groups were initially managed using continuous hemofiltration (HF) after admission, except for two patients with SAH receiving maintenance peritoneal dialysis. ⋯ Ten of the 16 patients with initial GCS < or = 8 and six of the 20 with GCS > or = 9 were diabetic. Therefore, there were significant differences between diabetic and non-diabetic patients (p = 0.05). Poor outcomes in diabetic patients with ICH are caused by primary brain damage, reflected in the initial disturbance of consciousness.
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Neurol. Med. Chir. (Tokyo) · Apr 2004
Practice Guideline GuidelineClinical guidelines for idiopathic normal pressure hydrocephalus.
Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by gait disturbance, dementia, and/or urinary incontinence without causative disorders, and ventricular enlargement due to disturbance of the cerebrospinal fluid (SF) circulation. The number of patients with iNPH will increase with the aging of the population in Japan. However, iNPH is often difficult to differentiate from other senile disorders such as lumbar canal stenosis, parkinsonism, and so on. ⋯ The CSF tap test is a major diagnostic measure because of the simplicity and less invasiveness. Use of the programmable valve is recommended to decrease CSF overdrainage. These guidelines are helpful for the diagnosis and treatment of iNPH.
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Neurol. Med. Chir. (Tokyo) · Apr 2004
ReviewAssociation of paranasal sinus osteoma and intracranial mucocele--two case reports.
Two young adult males presented with paranasal sinus osteoma associated with mucocele. A 20-year-old man presented with headache and seizure, and another 20-year-old man presented with headache, frontal deformity, and visual disturbances. ⋯ The higher aggressiveness of the lesions may be due to the presence of the mucocele. Calcification and ossification of the mucocele probably contributes to the unexpected enlargement of the osteoma.
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Neurol. Med. Chir. (Tokyo) · Mar 2004
Case ReportsSurgical management of high cervical disc prolapse associated with basilar invagination--two case reports.
C3-4 cervical disc prolapse was associated with basilar invagination and short neck in a 21-year-old man and additionally with an extensive Klippel-Feil abnormality and fusion of multiple cervical vertebrae in a 32-year-old man. The transoral surgical route was adopted for cervical discectomy in the latter case and an additional odontoidectomy in the former case. ⋯ Both the patients were relieved of symptoms and remained asymptomatic at follow up. Simultaneous fixation procedure is not mandatory after transoral surgery in patients with basilar invagination.
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Neurol. Med. Chir. (Tokyo) · Feb 2004
Case ReportsIdiopathic interdural hematoma looking like a "Chinese dumpling"--case report.
A 79-year-old man presented with an interdural hematoma manifesting as headache. Computed tomography revealed a right parietal intracranial hematoma. ⋯ Histological examination showed the hematoma had divided the meningeal dura into two layers. This case confirms the location of interdural hematoma.