Neurologia medico-chirurgica最新文献_第10页

Effectiveness of Keyhole Clipping of Unruptured Intracranial Aneurysms Detected by "Brain Dock" in Healthy Japanese Adults. “脑码头”检测未破裂颅内动脉瘤锁孔夹闭术在日本健康成年人中的疗效。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-11-08 DOI: 10.2176/jns-nmc.2023-0157

Toru Yoshiura, Satoru Takeuchi, Terushige Toyooka, Arata Tomiyama, Kojiro Wada, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori

{"title":"Effectiveness of Keyhole Clipping of Unruptured Intracranial Aneurysms Detected by \"Brain Dock\" in Healthy Japanese Adults.","authors":"Toru Yoshiura, Satoru Takeuchi, Terushige Toyooka, Arata Tomiyama, Kojiro Wada, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori","doi":"10.2176/jns-nmc.2023-0157","DOIUrl":"10.2176/jns-nmc.2023-0157","url":null,"abstract":"In Japan, brain docking has enhanced the detection of unruptured intracranial aneurysms in healthy adults. At our institution, surgical clipping is the first-line treatment for unruptured intracranial aneurysms (UIA). In this study, the differences in neurological and radiological outcomes, as well as cognitive and psychological results, between standard clipping and keyhole clipping for these aneurysms detected via brain docking were evaluated. The study included 131 aneurysms detected via \"brain dock.\" Of these, 65 were treated with keyhole clipping surgery (keyhole clipping group), and 66 were treated with standard clipping surgery (standard clipping group). Evaluations at 3 months included the National Institutes of Health Stroke Scale, modified Rankin Scale, Mini-Mental State Examination, Hasegawa's Dementia Scale-revised, Beck Depression Inventory, Hamilton Rating Scale for Depression, and radiological abnormalities. The mean operative time and postoperative hospitalization period were significantly shorter in the keyhole clipping group than in the standard clipping group (p < 0.001). Between the groups, no significant differences in postoperative neurological complications or radiological abnormalities were found. The keyhole clipping group demonstrated slightly but significantly better Beck Depression Inventory and Hamilton Rating Scale for Depression scores than the standard clipping group (Beck Depression Inventory, p = 0.046; Hamilton Rating Scale for Depression, p < 0.01). Both the Beck Depression Inventory and Hamilton Rating Scale for Depression scores at 3 months were significantly enhanced (p < 0.001) in the keyhole clipping group. These findings propose that keyhole clipping could be considered a new therapeutic option for small UIA detected via brain docking.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"28-35"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differentiation between Anterior and Posterior Roots Using Compound Muscle Action Potential in Intradural Extramedullary Spinal Tumor Surgery. 利用复合肌动作电位在硬膜内髓外脊柱肿瘤手术中鉴别前后根。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-15 Epub Date: 2023-11-30 DOI: 10.2176/jns-nmc.2023-0135

Naoyuki Harada, Yuki Sakaeyama, Yutaka Fuchinoue, Mitsuyoshi Abe, Sayaka Terazono, Chie Matsuura, Shuhei Kubota, Masataka Mikai, Nobuo Sugo, Kunio Sugiyama, Kosuke Kondo, Masaaki Nemoto

{"title":"Differentiation between Anterior and Posterior Roots Using Compound Muscle Action Potential in Intradural Extramedullary Spinal Tumor Surgery.","authors":"Naoyuki Harada, Yuki Sakaeyama, Yutaka Fuchinoue, Mitsuyoshi Abe, Sayaka Terazono, Chie Matsuura, Shuhei Kubota, Masataka Mikai, Nobuo Sugo, Kunio Sugiyama, Kosuke Kondo, Masaaki Nemoto","doi":"10.2176/jns-nmc.2023-0135","DOIUrl":"10.2176/jns-nmc.2023-0135","url":null,"abstract":"This study aims to determine the cutoff values for the compound muscle action potential (CMAP) stimulus in anatomically identified anterior (motor nerve) and posterior roots (sensory nerve) during cervical intradural extramedullary tumor surgery. The connection between CMAP data from nerve roots and postoperative neurological symptoms in thoracolumbar tumors was compared with data from cervical lesions. The participants of the study included 22 patients with intradural extramedullary spinal tumors (116 nerve roots). The lowest stimulation intensity to the nerve root at which muscle contraction occurs was defined as the minimal activation intensity (MAI) in the CMAP. In cervical tumors, the MAI was measured after differentiating between the anterior and posterior roots based on the anatomical placement of the dentate ligament and nerve roots. The MAIs for 20 anterior roots in eight cervical tumors were between 0.1 and 0.3 mA, whereas those for 19 posterior roots were between 0.4 and 2.0 mA. The cutoff was <0.4 mA for both the anterior and posterior roots, and sensitivity and specificity were both 100%. In thoracolumbar tumors, the nerve root was severed in 12 of 14 cases. All MAIs were determined to be at the dorsal roots as their scores were higher than the cutoff and did not indicate motor deficits. The MAIs of the anatomically identified anterior and posterior root CMAPs were found to have a cutoff value of <0.4 mA in the cervical lesions. Similar MAI cutoffs were also applicable to thoracolumbar lesions. Thus, CMAP may be useful in detecting anterior and posterior roots in spinal tumor surgery.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"36-42"},"PeriodicalIF":1.9,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138461199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum. 勘误。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-01 DOI: 10.2176/jns-nmc.er.2023-0069

引用次数: 0

Guidelines for Awake Surgery. 清醒手术指南。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-01 DOI: 10.2176/jns-nmc.2023-0111

引用次数: 0

Nationwide All-case Survey on the Efficacy and Safety of Flow Diverter: Multicenter Study Conducted by the Japan Neurosurgical Society. 关于血流转向器有效性和安全性的全国性全病例调查：日本神经外科学会开展的多中心研究。

IF 2.4 4区医学

Neurologia medico-chirurgica Pub Date : 2024-01-01 DOI: 10.2176/jns-nmc.2023-0246

Kenji Ohata, Hajime Arai, Masayuki Ezura, Koji Iihara, Hiroyuki Kinouchi, Shigeki Kobayashi, Teiji Tominaga, Kazuo Minematsu, Yuichi Murayama, Naoki Nakayama, Nobuyuki Sakai, Masahiro Yasaka, Yuhei Yoshimoto, Takamasa Kayama

引用次数: 0

Lateral Lumbar Interbody Fusion within Three-level for Patients with Neurological Symptoms due to Vertebral Fragility Fractures in the Lumbar Spine. 腰椎脆性骨折引起的神经系统症状患者的三级腰外侧融合术。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2023-12-15 Epub Date: 2023-10-18 DOI: 10.2176/jns-nmc.2023-0064

Yoshitaka Nagashima, Yusuke Nishimura, Tokumi Kanemura, Nobuhiro Hata, Kotaro Satake, Sho Akahori, Motonori Ishii, Takafumi Tanei, Masakazu Takayasu, Ryuta Saito

{"title":"Lateral Lumbar Interbody Fusion within Three-level for Patients with Neurological Symptoms due to Vertebral Fragility Fractures in the Lumbar Spine.","authors":"Yoshitaka Nagashima, Yusuke Nishimura, Tokumi Kanemura, Nobuhiro Hata, Kotaro Satake, Sho Akahori, Motonori Ishii, Takafumi Tanei, Masakazu Takayasu, Ryuta Saito","doi":"10.2176/jns-nmc.2023-0064","DOIUrl":"10.2176/jns-nmc.2023-0064","url":null,"abstract":"There is a lack of agreement on whether minimally invasive lateral lumbar intervertebral fusion (LLIF) is a suitable treatment option for vertebral fragility fractures (VFFs). Hence, we sought to evaluate the efficacy and safety of LLIF in the management of VFF with neurological deficits in the lumbar spine. Between April 2015 and March 2020, we conducted a retrospective observational study of patients with VFF treated with three-level or less LLIF. The participants had previously received conservative treatment but had not been able to control their neurological symptoms. To assess the outcomes of the LLIF procedures, the patients were followed up for a minimum of 1 year. Clinical and radiological results, which include the timing and location of the bony fusion, were analyzed. The study involved 19 patients with 23 vertebral fracture levels. The residual height of the fractured vertebra was found to be 57.0 ± 12.3% of the height of the adjacent level. The mean Japanese Orthopedic Association score significantly improved postoperatively. Postoperative radiological parameters were significantly maintained at 1 year, and lumbar lordosis was maintained at the last follow-up (45.0 ± 26.7). In total 31 LLIF levels, bone fusion was observed in four levels at 6 months postoperatively, in 16 levels at 1 year, and in 23 levels at the last follow-up. The facet joint had the highest bony fusion location. LLIF within three levels can be safely performed in certain VFF cases with sufficient residual vertebral height.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"548-554"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49680295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term Patency of Retrograde Bypass Using a Distal Stump of the Parietal Superficial Temporal Artery for Moyamoya Disease. 颞浅动脉远端残端逆行转流治疗Moyamoya病的长期专利。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2023-12-15 Epub Date: 2023-09-23 DOI: 10.2176/jns-nmc.2023-0070

Takeshi Shimizu, Shingo Toyota, Motohide Takahara, Kazuhiro Touhara, Tatsuya Hagioka, Yuhei Hoshikuma, Takamune Achiha, Tomoaki Murakami, Maki Kobayashi, Haruhiko Kishima

{"title":"Long-term Patency of Retrograde Bypass Using a Distal Stump of the Parietal Superficial Temporal Artery for Moyamoya Disease.","authors":"Takeshi Shimizu, Shingo Toyota, Motohide Takahara, Kazuhiro Touhara, Tatsuya Hagioka, Yuhei Hoshikuma, Takamune Achiha, Tomoaki Murakami, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2023-0070","DOIUrl":"10.2176/jns-nmc.2023-0070","url":null,"abstract":"There have been a number of anastomosis methods of bypass techniques reported for moyamoya disease. However, there are yet no randomized controlled trials conducted on the anastomosis method. Retrograde blood flow of the superficial temporal artery (STA) may be used as one of the donor options. Here, we examined the tolerability of retrograde bypass using a distal stump of the parietal STA (dsPSTA). Anastomosis between the dsPSTA and middle cerebral artery (MCA) was performed for consecutive patients with moyamoya disease whose parietal STA was visualized to be longer than 10 cm using contrast-enhanced computed tomography preoperatively. Retrospectively, we have examined its patency and clinical outcome. Retrograde dsPSTA-MCA bypass was performed in 22 hemispheres of 17 patients. The patency of retrograde dsPSTA-MCA bypass in all 22 anastomoses could be confirmed during follow-up periods (mean: 5.5, range: 2-15 years). No recurrence of ischemic events was observed. The dsPSTA-MCA bypass using retrograde blood flow has been determined as one of the many promising anastomosis methods, and long-term patency was achieved in moyamoya disease.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"542-547"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Venous Structures that Are Involved in Transsylvian Approach Using 3D Rotational Venography. 使用三维旋转静脉造影术评估经侧脑室入路中涉及的静脉结构。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2023-12-15 Epub Date: 2023-09-23 DOI: 10.2176/jns-nmc.2022-0361

Yoshiro Ito, Hisayuki Hosoo, Masayuki Sato, Aiki Marushima, Mikito Hayakawa, Yuji Matsumaru, Eiichi Ishikawa

{"title":"Evaluation of Venous Structures that Are Involved in Transsylvian Approach Using 3D Rotational Venography.","authors":"Yoshiro Ito, Hisayuki Hosoo, Masayuki Sato, Aiki Marushima, Mikito Hayakawa, Yuji Matsumaru, Eiichi Ishikawa","doi":"10.2176/jns-nmc.2022-0361","DOIUrl":"10.2176/jns-nmc.2022-0361","url":null,"abstract":"In the transsylvian (TS) approach, as characterized by clipping surgery, the presurgical visualization of the superficial middle cerebral vein (SMCV) can help change the surgical approach to ensure safe microsurgery. Nevertheless, identifying preoperatively the venous structures that are involved in this approach is difficult. In this study, we investigated the venous structures that are involved in the TS approach using three-dimensional (3D) rotational venography (3D-RV) and evaluated the effectiveness of this method for presurgical simulation. Patients who underwent 3D-RV between August 2018 and June 2020 were involved in this retrospective study. The 3D-RV and partial maximum intensity projection images with a thickness of 5 mm were computationally reconstructed. The venous structures were subdivided into the following three portions according to the anatomic location: superficial, intermediate, and basal portions. In the superficial portion, predominant frontosylvian veins were observed on 31 (41%) sides, predominant temporosylvian veins on seven (9%) sides, and equivalent fronto- and temporosylvian veins on 28 (37%) sides. The veins in the intermediate (deep middle cerebral and uncal veins) and basal portions (frontobasal bridging veins) emptied into the SMCV on 57 (75%) and 34 (45%) sides, respectively. The 3D-RV images were highly representative of the venous structures observed during microsurgery. In this study, 3D-RV was utilized to capture the details of the venous structures from the superficial to the deep portions. Presurgical simulation of the venous structures that are involved in the TS approach using 3D-RV may increase the safety of microsurgical approaches.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"555-562"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Significance of Stiffness during Endoscopic Surgery for Intracerebral Hemorrhage: A Retrospective Study. 脑出血内镜手术中僵硬的临床意义：一项回顾性研究。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2023-12-15 Epub Date: 2023-11-08 DOI: 10.2176/jns-nmc.2023-0043

Kengo Kishida, Daisuke Maruyama, Saki Kotani, Nobukuni Murakami, Naoya Hashimoto

{"title":"Clinical Significance of Stiffness during Endoscopic Surgery for Intracerebral Hemorrhage: A Retrospective Study.","authors":"Kengo Kishida, Daisuke Maruyama, Saki Kotani, Nobukuni Murakami, Naoya Hashimoto","doi":"10.2176/jns-nmc.2023-0043","DOIUrl":"10.2176/jns-nmc.2023-0043","url":null,"abstract":"Studies regarding hematoma stiffness and removal difficulty are scarce. This study explored the association between hematoma stiffness and surgical results of endoscopic hematoma removal for intracerebral hemorrhage. It also aimed to clarify factors associated with hematoma stiffness. We classified intracerebral hematoma as either soft or firm stiffness by retrospectively evaluating operative videos by two neurosurgeons. The interobserver reliability of the classification was assessed by calculating the κ values. We investigated the relationship between hematoma stiffness and surgical results. Favorable hematoma removal (FHR) was defined as a residual hematoma volume of ≤15 mL or removal rate of ≥70%. Furthermore, we compared the background characteristics, imaging findings, and laboratory data between the two groups. Forty patients were included in this study. The mean baseline hematoma volume was 69.9 mL (range, 41.3-97.6 mL). FHR was accomplished in 35 cases (87.5%). Thirty-four patients (85%) were in the soft hematoma group (group S). Six patients (15%) were in the firm hematoma group (group F). Classification of hematoma stiffness demonstrated an excellent degree of interobserver agreement (κ score = 0.91). Patients in group S had a high FHR rate (p = 0.018) and short endoscopic procedure times (p = 0.00034). The island sign was present in group S (p = 0.030). Patients in group F had significantly high fibrinogen levels (p = 0.049) and low serum total calcium (p = 0.032), hemoglobin (p = 0.041), and hematocrit (p = 0.011) levels. Hematoma stiffness during endoscopic surgery for intracerebral hemorrhage correlates with surgical results, including the endoscopic procedure time and accomplishing rate of FHR.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"563-570"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease. 由致病性疾病引起鞘内巴氯芬剂量随时间变化的特征。

IF 1.9 4区医学

Neurologia medico-chirurgica Pub Date : 2023-12-15 Epub Date: 2023-09-23 DOI: 10.2176/jns-nmc.2022-0359

Yuki Kimoto, Satoru Oshino, Naoki Tani, Koichi Hosomi, Hui Ming Khoo, Yuya Fujita, Shimpei Miura, Takamitsu Iwata, Takuto Emura, Takahiro Matsuhashi, Yuji Onoda, Takamasa Ishiuchi, Takufumi Yanagisawa, Masayuki Hirata, Haruhiko Kishima

{"title":"Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease.","authors":"Yuki Kimoto, Satoru Oshino, Naoki Tani, Koichi Hosomi, Hui Ming Khoo, Yuya Fujita, Shimpei Miura, Takamitsu Iwata, Takuto Emura, Takahiro Matsuhashi, Yuji Onoda, Takamasa Ishiuchi, Takufumi Yanagisawa, Masayuki Hirata, Haruhiko Kishima","doi":"10.2176/jns-nmc.2022-0359","DOIUrl":"10.2176/jns-nmc.2022-0359","url":null,"abstract":"Intrathecal baclofen (ITB) therapy effectively treats spasticity caused by brain or spinal cord lesions. However, only a few studies compare the course of treatment for different diseases. We investigated the change in daily dose of baclofen per year and its associated adverse events in patients presenting with the three most common etiologies at our institute: hereditary spastic paraplegia, cerebral palsy, and spinal cord injury. The ITB pumps were implanted from July 2007 to August 2019, with a mean follow-up period of 70 months. In patients with hereditary spastic paraplegia, baclofen dosage was reduced after eight years following ITB introduction, and the treatment was terminated in one patient owing to disease progression. In patients with cerebral palsy, the dosage increased gradually, and became constant in the 11th year. Patients with spinal cord injury gradually increased their baclofen dosage throughout the entire observation period. Severity and adverse event rates were higher in patients with cerebral palsy than in others. The degree and progression of spasticity varied depending on the causative disease. Understanding the characteristics and natural history of each disease is important when continuing ITB treatment.","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"535-541"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0