Surgery for Cerebral Stroke最新文献_第8页

内頚動脈狭窄症に対する血栓内膜剝離術時のvirtual histology IVUS解析とプラークの組織学的検討内颈动脉狭窄症的血栓内膜剥离术时的virtual histology IVUS分析和斑块的组织学探讨

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.323

紀之玉川, 達哉石川, 淳太師井, 吉岡正太郎, 達士武藤, 引地堅太郎, 明文鈴木, 信之安井, 元宮田

引用次数: 0

Hemodynamic compromise を有する症例における頚動脈ステント留置術の治療成績颈动脉支架置入术治疗Hemodynamic compromise病例的成绩

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.316

荻野達也, 瓢子敏夫, 片岡丈人, 遠藤英樹, 上山憲司, 譲二中川原, 中村博彦

{"title":"Hemodynamic compromise を有する症例における頚動脈ステント留置術の治療成績","authors":"荻野達也, 瓢子敏夫, 片岡丈人, 遠藤英樹, 上山憲司, 譲二中川原, 中村博彦","doi":"10.2335/SCS.39.316","DOIUrl":"https://doi.org/10.2335/SCS.39.316","url":null,"abstract":"We reviewed the treatment results of cervical carotid artery stenting (CAS) for carotid stenosis with cerebral hemodynamic compromise evaluated by 123I-IMP single photon emission computed tomography (SPECT). We treated 10 cases of carotid stenosis with Stage II hemodynamic cerebral ischemia. Hemodynamic compromise was diagnosed by pre-treatment resting and acetazolamide-activated CBF-SPECT using 123I-IMP. There were 5 cases of symptomatic and 5 cases of asymptomatic carotid stenosis. Post-treatment CBF was evaluated 7 days after the procedure. In all cases, pre-operative Stage II hemodynamic compromise was improved at post-procedure SPECT. There were no cases of hyperperfusion syndrome (HPS), intracerebral hemorrhage or ischemic complications during or after the procedure. In patients with ipsilateral Stage II cerebral ischemia, the peri-operative countermeasure against HPS is very important. And in patients with contralateral side Stage II cerebral ischemia, it is necessary to consider how to cope with bradycardia and hypotension to prevent peri-procedural cerebral infarction.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131061783","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

Surgical Strategy for the Posterior Circulation Aneurysms 后循环动脉瘤的外科治疗策略

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.359

Y. Teranishi, M. Kohno, A. Fukui, S. Nomura, A. Miyakoshi, N. Kanenaka, H. Abe, S. Sora, Hiroaki Sato

引用次数: 0

もやもや病患者における123I-IMZ-SPECTの集積分布に関する統計画像解析を用いた検討关于抑郁患者中123i - imz - spect的集成分布，使用统计图像分析的探讨

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.341

山下安佐美, 敦子阿部, 芳明後藤, 嶋田勢二郎, 直顕藤澤, 掌土屋, 巧中村, 康隆鈴木, 貢司上條, 民樹谷口, 漢秀張, 徹松居

{"title":"もやもや病患者における123I-IMZ-SPECTの集積分布に関する統計画像解析を用いた検討","authors":"山下安佐美, 敦子阿部, 芳明後藤, 嶋田勢二郎, 直顕藤澤, 掌土屋, 巧中村, 康隆鈴木, 貢司上條, 民樹谷口, 漢秀張, 徹松居","doi":"10.2335/SCS.39.341","DOIUrl":"https://doi.org/10.2335/SCS.39.341","url":null,"abstract":"123I-iomazenil (IMZ)-SPECT is used as a tool to detect the viability of neuronal cells. We investigated the distribution of IMZ in the brain of patients suffering from moyamoya disease, comparing it with the images of MRI and the distribution of 123I-N-isopropyl-4-iodoamphetamin hydrochloride (IMP)-SPECT. In the present study, we investigated 5 patients (4 females and 1 male, aged 30 to 61) who received our modified surgery according to our strategy (EC-IC bypass surgery and/or EMS, EDAS) in our institution from July 2008 to November 2009. The initial symptoms were ischemic events in 4 patients, and bleeding in 1 patient. 123I-IMZ-SPECT was started 170 minutes after an injection of 123I-IMZ. The distribution of IMZ or IMP was analyzed by iSSP5 and NEUROFLEXER to obtain Z scores. The revascularization procedures were performed at the sites where cerebral blood flow (CBF) was significantly reduced and poor response to Diamox treatment was seen preoperatively. The uptake of 123I-IMZ-SPECT was lower on the symptomatic side than on the asymptomatic side. Only in the region where 123I-IMZ uptake had been preserved preoperatively, the surgery induced a successful restoration of CBF postoperatively. These results strongly suggest that 123I-IMZ-SPECT is useful for evaluation of preoperative neuronal viability of the patients with moyamoya disease as well as preoperative prediction of surgical efficacy.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133686351","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

前大脳動脈近位部（A1）動脈瘤の臨床像と治療成績前大脳动脉近位部（A1）动脉瘤の临床像と治疗成绩

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.353

政之金森, 弘樹高沢, 慎悟米澤, 俊介面高, 奉洋川口, 宏緑川, 達也佐々木, 西嶌美知春

{"title":"前大脳動脈近位部（A1）動脈瘤の臨床像と治療成績","authors":"政之金森, 弘樹高沢, 慎悟米澤, 俊介面高, 奉洋川口, 宏緑川, 達也佐々木, 西嶌美知春","doi":"10.2335/SCS.39.353","DOIUrl":"https://doi.org/10.2335/SCS.39.353","url":null,"abstract":"Aneurysms of the proximal anterior cerebral artery (A1) are rare. We investigated the clinical and angiographical characteristics, and treatment outcomes of A1 aneurysms by reviewing a total of 989 cases of ruptured or unruptured cerebral aneurysms treated with surgical clipping or coil embolization in our department and identified 12 cases of A1 aneurysms (1.2%), including 4 ruptured and 8 unruptured aneurysms. Three of the 4 patients with ruptured aneurysm were Grade IV or V in the classification of the World Federation of Neurosurgical Societies. Five of the 8 cases of unruptured A1 aneurysm were identified during examination for subarachnoid hemorrhage due to ruptured aneurysm at other sites. The A1 aneurysms were located on the proximal segment in 9 cases and projected posteriorly or superiorly in 11 cases. Symptomatic complications occurred in 2 of the 10 cases treated by surgical clipping: cerebral infarction of the genu of internal capsule causing transient motor aphasia in 1 patient, and visual field disturbance due to obstruction of a perforator originating from the A1 in the other patient. Considering the anatomical relationship, any perforator originating from the A1 should be carefully manipulated at surgical clipping.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132566151","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

クリッピングおよびコイル塞栓術後に連続して早期再発を繰り返しhigh-flow bypass併用のtrappingを要した破裂脳動脈瘤の１例在消减和线圈栓塞术后，连续反复早期复发，需要trapping合并high-flow bypass的脑动脉瘤破裂病例1例

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.372

剛史渡辺, 学司権藤, 康浩瓜生, 弘之三島

{"title":"クリッピングおよびコイル塞栓術後に連続して早期再発を繰り返しhigh-flow bypass併用のtrappingを要した破裂脳動脈瘤の１例","authors":"剛史渡辺, 学司権藤, 康浩瓜生, 弘之三島","doi":"10.2335/SCS.39.372","DOIUrl":"https://doi.org/10.2335/SCS.39.372","url":null,"abstract":"We report the case of a patient with a ruptured cerebral aneurysm who consecutively repeated early recurrence after clipping and coil embolization and required high-flow bypass-combined trapping. The patient was a 48-year-old female brought to our hospital by ambulance for acute headache. Subarachnoid hemorrhage and aneurysm of the right internal artery (ICA)-posterior communicating artery (PcomA) were observed on CT, and clipping was performed on the admission day. The lesion was a cerebral aneurysm with a very thin wall. Clipping was applied uneventfully, but when a clip applied deeply to the blade root was re-applied at a shallower site, the aneurysm ruptured at the neck. Re-clipping was repeated 5 times, and was finally successful on pressing a weakly curved clip to the ICA. However, recurrence of the aneurysm was observed on angiography performed after 25 days. Coiling was performed the following day, and the recurrent aneurysm was completely filled, but recurrence occurred again after about 3 months. Considering the vulnerability of the neck, high-flow bypass-combined ICA trapping was performed, and the aneurysm could be finally treated. An aneurysm with a thin neck wall requires a careful surgical technique. When aneurysm neck tissue is injured by repeated clipping, the aneurysm may recur early after treatment. For such a recurrent aneurysm, trapping should be selected, not coiling. A lesion that appears to be a common aneurysm with a thin wall may actually be a dissecting aneurysm in some cases, for which high-flow bypass-combined trapping is necessary from the beginning. Techniques and preparation to perform such surgeries at any time are necessary.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125552772","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

Carotid Artery Stenting by GuardWire and Wallstent RP GuardWire和Wallstent RP的颈动脉支架植入术

Surgery for Cerebral Stroke Pub Date : 2011-09-30 DOI: 10.2335/SCS.39.311

Yoshiro Ito, M. Sonobe, N. Kato, M. Oohashi, K. Hashimoto, Hiromichi Kasuya, T. Yamazaki, K. Sugita

引用次数: 0

Accessory anterior cerebral arteryに発生した破裂末梢性前大脳動脈瘤の1症例 Accessory anterior cerebral artery发生的末梢性破裂前大脑动脉瘤1例病例

Surgery for Cerebral Stroke Pub Date : 2011-07-31 DOI: 10.2335/SCS.39.294

一史前田, 隆輔郡, 正之宮園, 勝治亀田, 圭久田, 富男佐々木

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A Case of Cerebral Infarction in the Internal Capsule Following a Resection of AVM in the Trigone of the Lateral Ventricle Fed by the Anterior Choroidal Artery 经前脉络膜动脉供血的侧脑室三角区AVM切除术后内囊性脑梗死1例

Surgery for Cerebral Stroke Pub Date : 2011-07-31 DOI: 10.2335/SCS.39.289

T. Fujimoto, Y. Uchiyama, Y. Ishida, R. Uranishi

{"title":"A Case of Cerebral Infarction in the Internal Capsule Following a Resection of AVM in the Trigone of the Lateral Ventricle Fed by the Anterior Choroidal Artery","authors":"T. Fujimoto, Y. Uchiyama, Y. Ishida, R. Uranishi","doi":"10.2335/SCS.39.289","DOIUrl":"https://doi.org/10.2335/SCS.39.289","url":null,"abstract":"We report a case of cerebral infarction in the internal capsule following a resection of AVM in the trigone of the left lateral ventricle fed by the anterior choroidal artery. A 61-year-old man presented with mild right hemiparesis and seizure. He had had an AVM in the trigone of the left lateral ventricle since 37 years before, and had experienced a seizure and cerebral hemorrhage. Cerebral angiography showed an AVM of Spetzler-Martin’s Grade 2 fed by the anterior choroidal artery in the trigone of the left lateral ventricle. An operation was performed by the transcortical approach using a former hemorrhagic cavity. The left anterior choroidal artery feeding the nidus was cut in the left lateral ventricle, and AVM was removed together with a choroid plexus. Right hemiparesis worsened postoperatively, and MRI revealed cerebral infarction in the left internal capsule. Although it is thought that the cutting of the anterior choroidal artery in the lateral ventricle is safe, care should be taken when cutting the anterior choroidal artery even in the lateral ventricle because the branch(es) originating from the plexal segment of the anterior choroidal artery could penetrate to the cerebral parenchyma and feed the internal capsule.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125173110","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: 1

Functional Prognosis in Patients with Brainstem Hemorrhage 脑干出血患者的功能预后

Surgery for Cerebral Stroke Pub Date : 2011-07-31 DOI: 10.2335/SCS.39.262

Shinichiro Kimura, Kuniaki Koshin, S. Obayashi, K. Masuhara, Katsumi Matsumoto, K. Tsuruzono, S. Oshino, S. Taketsuna

{"title":"Functional Prognosis in Patients with Brainstem Hemorrhage","authors":"Shinichiro Kimura, Kuniaki Koshin, S. Obayashi, K. Masuhara, Katsumi Matsumoto, K. Tsuruzono, S. Oshino, S. Taketsuna","doi":"10.2335/SCS.39.262","DOIUrl":"https://doi.org/10.2335/SCS.39.262","url":null,"abstract":"We evaluated the prognosis of patients 6 months after a brain-stem hemorrhage, based on clinical findings obtained at admission and 1 month after commencement of rehabilitation. Seventeen patients who were admitted to our hospital during the past 2 years with a brainstem hemorrhage were evaluated at admission and 1 month later, based on the National Institute of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), modified Rankin Scale (mRS), motor paralysis, sensory disturbance, ataxia, blood pressure, and swallowing. To retrospectively examine these evaluation items, the patients were divided into 2 groups: patients who became ambulatory within 6 months (Group A) and patients who did not become ambulatory (Group B). Significant differences were confirmed between groups regarding NIHSS, FIM points, motor paralysis, sensory disturbance, and ataxia at admission and regarding motion capability and mRS at 1 month. At admission, Group A had NIHSS of ≤8.5 (lower limit: 16), FIM of ≥60.7 points (24 points), motor paralysis of Stage IV or higher, and normal to mild sensory disturbance. Moreover, they could retain the sitting position within 1 month, with mRS of Grade 3 or higher (Grade 4 or higher), which indicates their motion capability. Many patients with severe ataxia became ambulatory. Based on these findings, 6-month recovery of patients with brain-stem hemorrhage could be determined based on their achievements at 1 month.","PeriodicalId":131030,"journal":{"name":"Surgery for Cerebral Stroke","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130955037","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: 2