Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Mar 2002
Case ReportsBlade crossing of a pure titanium clip applied to a cerebral aneurysm--case report.
Titanium aneurysm clips are superior to cobalt clips in radiological features, biocompatibility, and hypoallergenicity, but the mechanical characteristics are less advantageous. A 56-year-old man was referred to our department due to dizziness and slurred speech. ⋯ After application of the clip, the clip blades crossed and nearly sheared the wall of the aneurysm. The mechanical characteristics of titanium aneurysm clips require careful consideration because of possible clip malfunction.
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Neurol. Med. Chir. (Tokyo) · Feb 2002
Case ReportsNeuroendoscopic treatment of idiopathic occlusion of the foramen of Monro in adults--two case reports.
Two adults presented with hydrocephalus due to idiopathic obstruction of the bilateral foramina of Monro, manifesting as clinical signs of chronically elevated intracranial pressure. No inflammation was present. The primary surgical treatment was neuroendoscopic reconstruction of the right foramen of Monro. ⋯ The biopsy specimens showed no evidence of malignancy in either case. Neuroendoscopic intervention is an alternative treatment in the management of hydrocephalus due to idiopathic obstruction of the foramen of Monor. The procedure is less invasive than open microsurgical reconstruction and can even avoid ventriculoperitoneal or ventriculoatrial shunting.
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Neurol. Med. Chir. (Tokyo) · Jan 2002
Case ReportsNovel intraoperative cerebral blood flow monitoring by laser-Doppler scanner.
Laser-Doppler (LD) flowmetry was used to measure tissue perfusion non-invasively and continuously during neurosurgical operations using an LD scanner. Scanning was usually completed in 20 seconds. Measurements were processed in software to provide a color-coded image of the tissue perfusion. ⋯ No physical contact was necessary between the scanning device and the exposed brain tissue. The imager provided two-dimensional microvascular flow maps non-invasively and quantitatively during brain operations, and could show the CO2 reactivity in the vessels. LD scanning flowmetry is a promising intraoperative monitoring method for cerebral blood flow changes.
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Neurol. Med. Chir. (Tokyo) · Jan 2002
Case ReportsRuptured aneurysm associated with partially duplicated posterior communicating artery--case report.
A 65-year-old woman presented with a ruptured saccular aneurysm associated with a rare variation of the posterior communicating artery (PcoA), partially duplicated PcoA. The PcoA with this variation forked just distal to the aneurysmal neck, and the two branches independently merged into the posterior cerebral artery. ⋯ A curved Yasargil clip was used to clip the aneurysm and preserve the PcoA and branches. Careful observation of this PcoA variation is needed because the arterial structures may be hidden by the thickened arachnoid membrane.
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Neurol. Med. Chir. (Tokyo) · Dec 2001
Case ReportsIntracerebral hematoma due to ruptured nontraumatic middle meningeal artery aneurysm--case report.
A 77-year-old woman suddenly lost consciousness and presented with right hemiparesis. Computed tomography showed a large subcortical hematoma in her left frontal lobe associated with subarachnoid hemorrhage. The first impression was hemorrhage due to a ruptured aneurysm of the middle cerebral or the internal carotid artery on the left. ⋯ Emergent surgical intervention confirmed that the hematoma was due to ruptured MMA aneurysm. Nontraumatic MMA aneurysm should be recognized as a possible causative lesion of intracranial hemorrhage despite the extremely low incidence. External carotid angiography should be performed in patients with intracranial hemorrhage in whom no vascular cause can be detected in the internal carotid system.