Nō to shinkei = Brain and nerve
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We used diffusion tensor imaging (DTI) to assess wallerian degeneration of the pyramidal tract after the onset of supra-tentorial stroke, and correlation of the extent of Wallerian degeneration with the motor function at 3 months after stroke. Twenty eight patients with supra-tentorial acute stroke were examined, two weeks and one month after stroke by DTI. We measured fractional anisotropy(FA) of affected side/ unaffected side (FA ratio) in the cerebral peduncle. ⋯ When FA ratio was over 0.8 at 2 weeks after stroke, motor function at 3 months after stroke showed good recovery (mRS 0 to 3) expect for three elderly patients. With the use of DTI, Wallerian degeneration could be detected in the corticospinal tracts at midbrain level during the early phase of supra-tentorial stroke. We conclude that DTI may be useful for early prediction of motor function prognosis in patients with supra-tentorial acute stroke.
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Review Case Reports
[A rare case of aqueductal stenosis due to venous angioma].
Aqueductal stenosis is induced by widely various causes. These causes include congenital stenosis, tumor or inflammation. Among them vascular malformation is a very rare cause. ⋯ Although venous angioma is congenital, all five cases had been symptomatic at adult stage. Detailed evaluation of pre-and post-operative MRIs suggest that aqueductal stenosis induced enlargement of the lateral and third ventricles, which led narrowing of the suprachiasmatic cistern and the peri-mesencephalic cistern, and downward displacement of medulla and tonsil into the foramen magnum. As a result, hydrocephalus is aggravated gradually.
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Review Case Reports
[Dissecting aneurysm of the middle cerebral artery with subarachnoid hemorrhage undetectable on preoperative neuroradiological findings: case report].
We report a rare case of a dissecting aneurysm (DA) of the middle cerebral artery(MCA) associated with subarachnoid hemorrhage(SAH) undetectable on preoperative neuroradiological findings. A 64-year-old man was admitted to our hospital because of a sudden onset of occipital headache. CT scan showed SAH mainly in the basal cisterns and left sylvian fissure. ⋯ The postoperative course was uneventful and the patient was discharged without neurological deficits. There has been no rebleeding nor new ischemic attack during the ten months since surgery. The 20 reported cases of a DA of the MCA associated with SAH with our case are reviewed and their neuroradiological and clinical features are discussed.
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We describe here successful surgical treatment of a rare case of a rapidly enlarged aneurysm due to Takayasu's arteritis. A 22-year-old woman presented with a 1-month history of hoarseness and left neck pain. Contrast-enhanced computerized tomography showed an unruptured partially thrombosed aneurysm, and angiography revealed a large aneurysm of the common carotid artery. ⋯ Histological examination of the arterial wall showed inflammatory change, destruction of the medial elastic fibers, and granulation with multinucleated giant cells. The postoperative course was uneventful, and no new vascular lesion was observed 3 years after operation. We demonstrated the bilateral extracranial carotid artery aneurysms caused by Takayasu's arteritis, which was the first case to be reported in the literature.