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Surgery for Cerebral Stroke最新文献

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Clinical Features and Surgical Management of Aneurysms at the Proximal Segment (A1) of the Anterior Cerebral Artery 大脑前动脉近段(A1)动脉瘤的临床特征及手术治疗
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.292
Hiromasa KOBAYASHI, Shintarou YOSHINAGA, Hironori FUKUMOTO, Toshiyuki ENOMOTO, Kenji FUKUDA, Takashi MORISHITA, Masani NONAKA, Hiroshi ABE, Mitsutoshi IWAASA, Tooru INOUE
{"title":"Clinical Features and Surgical Management of Aneurysms at the Proximal Segment (A1) of the Anterior Cerebral Artery","authors":"Hiromasa KOBAYASHI, Shintarou YOSHINAGA, Hironori FUKUMOTO, Toshiyuki ENOMOTO, Kenji FUKUDA, Takashi MORISHITA, Masani NONAKA, Hiroshi ABE, Mitsutoshi IWAASA, Tooru INOUE","doi":"10.2335/scs.51.292","DOIUrl":"https://doi.org/10.2335/scs.51.292","url":null,"abstract":"前大脳動脈近位部（A1）動脈瘤はまれな疾患で全脳動脈瘤の1-2％の頻度と報告され，多くは穿通枝分岐部に発生するため治療の難易度は高い．今回，当院で施行した10例のA1動脈瘤について後方視的に検討を行い，臨床的特徴とさまざまな形態による治療戦略に関して報告する．当院で治療を行った脳動脈瘤症例1,520例を対象とし，A1動脈瘤は10例（0.6％）であった．9例が未破裂，1例が破裂脳動脈瘤で，発生位置はA1上のdistal 6例，proximal 3例，middle 1例であった．発生部位はmedial LSA分岐部 3例，orbito-frontal artery分岐部 2例，accessory MCA分岐部 1例であった．治療はclipping 4例，coil塞栓 4例，wrapping 1例で，巨大血栓化動脈瘤に対してはSTA-STA-A3 bypass＋trappingを行った．全例で穿通枝障害含め合併症はなかった．A1動脈瘤に対しては，穿通枝温存のためにも直視下でのclippingが理想的と考えるが，近年では血管内治療の報告も散見される．巨大血栓化動脈瘤に関しては瘤の根治性を高めるためにbypassを駆使した治療戦略も求められる．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135911218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Septic embolism後に複数菌が関与した感染性脳動脈瘤の破裂を認めた1例 Septic embolism后确认多菌群参与的感染性脑动脉瘤破裂的1例
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.330
Yujiro MATSUSHIMA, Hiroshi OGAWA, Masao MOTOMOCHI, Masao SATO, Kazuo NAGASHIMA, Manabu KINOSHITA
{"title":"Septic embolism後に複数菌が関与した感染性脳動脈瘤の破裂を認めた1例","authors":"Yujiro MATSUSHIMA, Hiroshi OGAWA, Masao MOTOMOCHI, Masao SATO, Kazuo NAGASHIMA, Manabu KINOSHITA","doi":"10.2335/scs.51.330","DOIUrl":"https://doi.org/10.2335/scs.51.330","url":null,"abstract":"感染性脳動脈瘤は感染性心内膜炎の合併症の1つとして知られているが，複数種類の菌体が関与していることが明らかとなった感染性脳動脈瘤破裂はまれである．報告症例は75歳の男性で，9年前に未破裂右中大脳動脈に対する根治的頚部クリッピング術を行われていた．感染性心内膜炎によるseptic embolismの診断のもと，大動脈弁置換術を行った1週間後に意識障害および右共同偏視と左片麻痺をきたし，頭部CTで右側頭葉，頭頂葉から脳室内にわたる脳出血を発症した．頭部CT血管造影検査で過去にクリッピング術が施行されている右中大脳動脈M1-M2分岐部の近傍に直径7mm大の囊状動脈瘤の形成を認めた．緊急開頭血腫除去および頚部クリッピングを施行し，術中所見で動脈瘤に凝血塊を認める破裂瘤であった．切除した動脈瘤の中膜は解離しており，解離腔内にCryptococcus，瘤壁の内膜から中膜にAspergillusを認め，脳実質にGram positive cocciのコロニー形成を認めた．感染性脳動脈瘤破裂によるくも膜下出血の診断となったが，責任病原体の同定について示唆に富む症例だと考え，文献的考察を加えて報告する．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135911473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
頚部頚動脈狭窄症に対する年代別の内頚動脈内膜剝離術の治療成績と臨床的特徴 颈动脉内膜剥离术对颈动脉狭窄症的治疗成绩及临床特点
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.286
Akiko MARUTANI, Tomonori YAMADA
{"title":"頚部頚動脈狭窄症に対する年代別の内頚動脈内膜剝離術の治療成績と臨床的特徴","authors":"Akiko MARUTANI, Tomonori YAMADA","doi":"10.2335/scs.51.286","DOIUrl":"https://doi.org/10.2335/scs.51.286","url":null,"abstract":"内頚動脈狭窄症に対する血行再建術として，一般的にCEAやCASが行われる．CEAはCASとの比較試験において有効性が高いが，80歳以上の高齢者を含むCEA高リスク群におけるCASの非劣性がSAPPHIRE試験において示され，侵襲性の低いCASが選択されることが多い．当施設では高齢者を含めた内頚動脈狭窄症に対してCAS高リスク症例（高度石灰化，不安定プラーク，近位あるいは遠位屈曲，アクセス不能例）のうち，割合の多い不安定プラークに対しても積極的にCEAを行っている．当施設で経験したCEA症例を年代別に分けて，有効性ならびに安全性について治療成績と臨床的特徴を報告する．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135910899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
解離性頚部内頚動脈閉塞に対して追加の高流量バイパスが必要になった1例 解离性颈内动脉阻塞需要额外高流量旁路的1例
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.307
Kosuke MASUDA, Kenichiro HASHIMOTO, Iichiro MATSUURA, Toshihiro YAMAUCHI, Koji SUZUKI, Mitsuhiro AIKAWA, Yorio KOGUCHI, Akihiro MIYATA
{"title":"解離性頚部内頚動脈閉塞に対して追加の高流量バイパスが必要になった1例","authors":"Kosuke MASUDA, Kenichiro HASHIMOTO, Iichiro MATSUURA, Toshihiro YAMAUCHI, Koji SUZUKI, Mitsuhiro AIKAWA, Yorio KOGUCHI, Akihiro MIYATA","doi":"10.2335/scs.51.307","DOIUrl":"https://doi.org/10.2335/scs.51.307","url":null,"abstract":"解離性内頚動脈病変による脳梗塞の急性期治療では血管内治療はいまだ確立されておらず，バイパス術を行う症例も報告されている．行われるバイパス術の多くは低流量バイパスであるが，われわれは低流量バイパスでは流量が足りず高流量バイパスを追加した症例を経験したので報告する．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135911225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Large Intracavernous Internal Carotid Artery Aneurysm with Acute Spontaneous Thrombosis and Parent Artery Pseudo-occlusion 海绵状颈内动脉瘤并发急性自发性血栓形成及母动脉假性闭塞1例
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.302
Ryosuke OTSUJI, Toshiyuki AMANO, Yuichiro MIYAMATSU, Kenta HARA, So TOKUNAGA, Akira NAKAMIZO
{"title":"A Case of Large Intracavernous Internal Carotid Artery Aneurysm with Acute Spontaneous Thrombosis and Parent Artery Pseudo-occlusion","authors":"Ryosuke OTSUJI, Toshiyuki AMANO, Yuichiro MIYAMATSU, Kenta HARA, So TOKUNAGA, Akira NAKAMIZO","doi":"10.2335/scs.51.302","DOIUrl":"https://doi.org/10.2335/scs.51.302","url":null,"abstract":"脳動脈瘤に血栓化が生じることがあるが，親動脈まで血栓が進展し閉塞にいたることはまれである．右内頚動脈海綿静脈洞部大型動脈瘤で内頚動脈偽閉塞をきたした1例を経験した．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135911475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case of Ruptured Middle Cerebral Artery Aneurysm with Cervical Carotid Artery Dissection 脑中动脉瘤破裂合并颈动脉夹层1例
Surgery for Cerebral Stroke Pub Date : 2023-01-01 DOI: 10.2335/scs.51.448
Hajime MAEYAMA, Keisuke IDO, Yutaro FUJII, Akifumi YOKOMIZO, Kenichi MATSUMOTO
{"title":"A Case of Ruptured Middle Cerebral Artery Aneurysm with Cervical Carotid Artery Dissection","authors":"Hajime MAEYAMA, Keisuke IDO, Yutaro FUJII, Akifumi YOKOMIZO, Kenichi MATSUMOTO","doi":"10.2335/scs.51.448","DOIUrl":"https://doi.org/10.2335/scs.51.448","url":null,"abstract":"今回われわれは，くも膜下出血に頚部内頚動脈解離を合併した症例を経験したため報告する．症例は47歳，男性．仕事から帰宅後に後頚部痛を自覚した．翌日に意識障害を呈している状態で発見され，当院に救急搬送された．頭部CTで脳底槽にびまん性のくも膜下出血を認め，3D-CTAでは左中大脳動脈分岐部に囊状動脈瘤を認めた．左中大脳動脈瘤破裂によるくも膜下出血の診断で，開頭クリッピング術を行った．第5病日に施行したMRI検査で左頚部内頚動脈の狭窄を認め，intimal flapを伴っていたことから左内頚動脈解離を疑った．あらためて入院時の3D-CTAを確認したところ左内頚動脈の狭窄があり，来院時にはすでに発症していたと考えた．また，島皮質に脳梗塞があり，頚動脈解離に伴い脳梗塞を発症した可能性が否定できなかった．第11病日に施行した血管造影検査では内頚動脈起始部にstring signがあり，内頚動脈解離と診断した．第22病日に施行した3D-CTAで狭窄の改善がなかったため第32病日に頚動脈ステント留置術を行った．術後の経過に問題なく，第44病日にmodified Rankin Scale（mRS）0で自宅退院とした．意識障害に先行して後頚部痛があった病歴を考慮し，本症例は頚部内頚動脈解離後にくも膜下出血を発症したと考えた．本症例のように病歴の中で頚部痛を伴っていた場合は，頚部動脈解離の合併も考慮する必要がある．","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135913911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rupture of Conservatively Managed Unruptured Intracranial Aneurysms: A Single-center Analysis 保守治疗未破裂颅内动脉瘤的破裂:单中心分析
Surgery for Cerebral Stroke Pub Date : 2017-01-01 DOI: 10.2335/SCS.45.394
Tomoyuki Nakano, T. Sugawara, M. Inaji, Yoji Tanaka, Y. Yoshino, T. Nariai, S. Nemoto, T. Maehara
{"title":"Rupture of Conservatively Managed Unruptured Intracranial Aneurysms: A Single-center Analysis","authors":"Tomoyuki Nakano, T. Sugawara, M. Inaji, Yoji Tanaka, Y. Yoshino, T. Nariai, S. Nemoto, T. Maehara","doi":"10.2335/SCS.45.394","DOIUrl":"https://doi.org/10.2335/SCS.45.394","url":null,"abstract":"Relatively small unruptured intracranial aneurysms (UIAs) are often managed conservatively. However, rupture of UIA during follow-up occurs occasionally in clinical situations. We retrospectively analyzed cases of ruptured UIAs followed in our institution between 2012 and 2016. Four patients presented with subarachnoid hemorrhage caused by ruptured aneurysms during observation. We calculated the rupture-risk score on the basis of two meta-analyses previously reported. However, these were not effective to estimate the rupture risk of relatively small aneurysms in these cases. Meanwhile, aneurysmal growth was detected in all the cases, which also had at least one risk factor for aneurysm growth. Thus, increase in aneurysm size might be an indicator of rupture, and a slight growth in size should be carefully and seriously considered as a risk factor of rupture to prevent the rupture of small aneurysms.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134580591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enterprise stentとcoilを用いた瘤内塞栓術の血栓・塞栓性合併症についての考察 利用Enterprise stent和coil对瘤内栓塞术的血栓和栓塞性并发症的考察
Surgery for Cerebral Stroke Pub Date : 2013-07-31 DOI: 10.2335/SCS.41.247
章代 定藤, 基治 早川, 鉄平 田中, 剛也 渡部, 一英 安達, 庸子 加藤, 雄一 廣瀬
{"title":"Enterprise stentとcoilを用いた瘤内塞栓術の血栓・塞栓性合併症についての考察","authors":"章代 定藤, 基治 早川, 鉄平 田中, 剛也 渡部, 一英 安達, 庸子 加藤, 雄一 廣瀬","doi":"10.2335/SCS.41.247","DOIUrl":"https://doi.org/10.2335/SCS.41.247","url":null,"abstract":"","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125781631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
頚動脈ステント留置術後のステント外残存潰瘍（Residual Ulceration）に関する研究 颈动脉支架置入术后支架外残留溃疡(Residual Ulceration)的研究
Surgery for Cerebral Stroke Pub Date : 2013-07-31 DOI: 10.2335/SCS.41.259
飯星 智史, 宮田 圭, 杉野 寿哉, 小柳 泉, 三國 信啓
{"title":"頚動脈ステント留置術後のステント外残存潰瘍（Residual Ulceration）に関する研究","authors":"飯星 智史, 宮田 圭, 杉野 寿哉, 小柳 泉, 三國 信啓","doi":"10.2335/SCS.41.259","DOIUrl":"https://doi.org/10.2335/SCS.41.259","url":null,"abstract":"","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131308286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
重症くも膜下出血患者における予後予測─CT perfusionの有用性─ 重症蛛网膜下出血患者的预后预测:CT perfusion的有效性
Surgery for Cerebral Stroke Pub Date : 2013-07-31 DOI: 10.2335/SCS.41.269
篤 笹原, 一史 鈴木, 信司 萩原, 英徳 大渕, 健吾 広田, 宏和 小関, 直幸 新井, 康博 黒井, 大洵 花, 英俊 糟谷
{"title":"重症くも膜下出血患者における予後予測─CT perfusionの有用性─","authors":"篤 笹原, 一史 鈴木, 信司 萩原, 英徳 大渕, 健吾 広田, 宏和 小関, 直幸 新井, 康博 黒井, 大洵 花, 英俊 糟谷","doi":"10.2335/SCS.41.269","DOIUrl":"https://doi.org/10.2335/SCS.41.269","url":null,"abstract":"","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130579029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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