Brain and Nerve最新文献_第8页

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050452

Ryosuke Hanaya

{"title":"[Acute Subdural Empyema].","authors":"Ryosuke Hanaya","doi":"10.11477/mf.188160960780050452","DOIUrl":"10.11477/mf.188160960780050452","url":null,"abstract":"Acute subdural empyema is a severe intracranial infection characterized by purulent accumulation between the dura mater and the arachnoid. It commonly affects children and young adults, typically as a complication of sinusitis, otitis media, or bacterial meningitis. In adults, however, head trauma and postoperative c infections are more common causes. Clinical symptoms include fever, headache, seizures, focal neurological deficits, and altered consciousness, with rapid neurological deterioration due to increased intracranial pressure. Diagnosis relies heavily on magnetic resonance imaging, with diffusion-weighted imaging detecting characteristic high-intensity signals. Although computed tomography may aid in initial evaluation, it is less sensitive for accurate diagnosis. Laboratory findings typically show elevated inflammatory markers, while bacterial cultures are often negative. Treatment involves prompt administration of antibiotics such as third-generation cephalosporins, vancomycin, and metronidazole, followed by adjustment based on culture results. Surgical intervention, via burr hole drainage or craniotomy, is often required for pus evacuation and decompression. Treatment of the primary infection source, such as sinus surgery, may also be necessary. Prognosis depends on the patient's condition at presentation and the speed of intervention. Although outcomes have improved with modern therapies, mortality remains substantial in severe cases, and long-term neurological sequelae are common.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"452-456"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977073","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

[Imported Infectious Diseases of the Nervous System]. [输入性神经系统传染病]。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050432

Hiroyuki Murai

{"title":"[Imported Infectious Diseases of the Nervous System].","authors":"Hiroyuki Murai","doi":"10.11477/mf.188160960780050432","DOIUrl":"10.11477/mf.188160960780050432","url":null,"abstract":"Although sanitary conditions in Japan are generally favorable, pathogens may be introduced by patients who acquire the infections overseas. Dengue fever has a high global incidence, with nearly 200 cases occurring annually in Japan. Most of these infections are acquired in Southeast Asia. As dengue fever is transmitted by mosquitoes, preventive measures against insect bites are important. The incidence of Japanese encephalitis has markedly decreased in Japan owing to widespread vaccination. This disease is mosquito-borne, and only approximately 1% of infected individuals develop symptoms. However, once symptoms appear, the mortality rate is 20-30%. A characteristic clinical feature of this condition is the presence of extrapyramidal symptoms. Rabies is a representative disease transmitted through dog bites. In Japan, its incidence has dramatically declined owing to canine vaccination and the control of stray dogs. Once rabies develops, the fulminant form accounts for 70-80% of cases. Measles is a representative disease that is transmitted between humans. It is highly contagious and requires careful monitoring. During the coronavirus disease-19 pandemic, the number of measles cases decreased. Recently, the trend has reversed, with many patients believed to have been infected in Vietnam.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"432-436"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977196","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

[Cryptococcosis]. (隐球菌)。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050573

Kyoko Numahata, Tomoyuki Miyamoto

引用次数: 0

[Leptospirosis (Weil's Disease)]. [钩端螺旋体病（韦尔氏病）]。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050599

Takashi Tokashiki

{"title":"[Leptospirosis (Weil's Disease)].","authors":"Takashi Tokashiki","doi":"10.11477/mf.188160960780050599","DOIUrl":"10.11477/mf.188160960780050599","url":null,"abstract":"Leptospirosis is a zoonotic infectious disease caused by pathogenic Leptospira species and is characterized by a broad spectrum of clinical manifestations. The disease ranges from a mild, self-limiting illness known as Akiyami to severe Weil's disease, which presents with high fever; jaundice; hemorrhagic tendencies involving the skin, nasal cavity, and lungs; and acute renal failure. Leptospirosis is endemic to many regions of Southeast Asia. In Japan, it occurs most frequently in Okinawa Prefecture. Human infections are primarily acquired through direct or indirect contact with water or soil contaminated with the urine of infected animals. Diagnosis is established using bacterial culture, polymerase chain reaction, and serological testing, which allow accurate detection across different stages of the disease. Treatment typically involves doxycycline for mild-to-moderate cases, whereas penicillin is recommended for severe diseases. Despite advances in its diagnosis and therapy, leptospirosis remains a major public health concern in endemic regions. Therefore, preventive strategies are essential, particularly during the rainy season and following floods or landslides when environmental contamination is more likely to occur. Avoiding unnecessary exposure to potentially contaminated water plays a critical role in reducing the risk of infection.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"599-602"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977213","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

[Herpes Simplex Encephalitis]. [单纯疱疹脑炎]。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050487

Akihiko Morita

{"title":"[Herpes Simplex Encephalitis].","authors":"Akihiko Morita","doi":"10.11477/mf.188160960780050487","DOIUrl":"10.11477/mf.188160960780050487","url":null,"abstract":"Herpes simplex encephalitis (HSE) is the most common cause of sporadic viral encephalitis and is associated with severe mortality and morbidity. No clinical features are pathognomonic for HSE. The gold standard for diagnosing HSE is a herpes simplex virus (HSV) DNA polymerase chain reaction (PCR) test on cerebrospinal fluid (CSF). Treatment with optimal intravenous aciclovir (ACV) can improve outcomes. After the first episode of HSE, neurological relapses or worsening of deficits occur in nearly 30% of patients. If the HSV DNA PCR on CSF is positive, the possibility of ACV-resistant HSE should be considered, and the addition of foscarnet to the ACV treatment may be warranted. If the HSV PCR in CSF is negative, autoimmune encephalitis (AE) post-HSE is considered. All patients with AE post-HSE are tested for one or more neuronal cell-surface and synaptic antibodies, primarily anti-N-methyl-d-aspartate receptor (NMDAR) antibodies, in serum or CSF. The clinical manifestations of AE post-HSE include choreoathetosis and seizures in children, while adults may experience altered consciousness and NMDAR-like symptoms. Most cases of AE post-HSE respond to first-line immunotherapies, which include corticosteroids, intravenous immunoglobulin or plasma exchange. If necessary, treatment can be escalated to second-line immunosuppressants such as rituximab and cyclophosphamide.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"487-494"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977261","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

[Infection or Autoimmunity: Key Imaging Points for Differential Diagnosis]. [感染或自身免疫：鉴别诊断的关键影像点]。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050409

Keita Watanabe, Kei Yamada

{"title":"[Infection or Autoimmunity: Key Imaging Points for Differential Diagnosis].","authors":"Keita Watanabe, Kei Yamada","doi":"10.11477/mf.188160960780050409","DOIUrl":"10.11477/mf.188160960780050409","url":null,"abstract":"Differentiating infectious encephalitis from autoimmune encephalitis remains a major diagnostic challenge in clinical practice because their magnetic resonance imaging (MRI) findings frequently overlap. Moreover, prior treatment with antimicrobial agents or corticosteroids may alter imaging appearances, obscure typical radiological patterns and further complicate interpretation. This review summarizes the key MRI features of infectious and autoimmune encephalitis, with emphasis on imaging patterns before treatment. Infectious encephalitis typically demonstrates meningeal enhancement, diffusion restriction, hemorrhagic or vascular changes, and infection-related complications. In contrast, autoimmune encephalitis more often presents with relatively mild or nonspecific signal abnormalities and limited contrast enhancement. Particular discriminating features include lesion distribution, symmetry, and temporal evolution on follow-up imaging. We also discuss important diagnostic pitfalls, including radiological lag after antiviral therapy, secondary autoimmune encephalitis following herpes simplex encephalitis, steroid-responsive lesions that mimic inflammatory disease, and reversible postictal changes. Rather than relying on imaging alone to establish a binary diagnosis, radiologists should integrate MRI findings with clinical and laboratory data while recognizing both the strengths and limitations of imaging. Understanding typical patterns and their variations supports more accurate diagnostic reasoning and treatment strategies in patients with suspected encephalitis.","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"78 5","pages":"409-416"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977223","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

[Neurocysticercosis]. (脑囊尾蚴病)。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050621

Hajime Hisaeda

引用次数: 0

[Use of Corticosteroids in Neurological Infections]. [皮质类固醇在神经系统感染中的应用]。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050437

Satoshi Kamei

引用次数: 0

[Mucormycosis]. 毛霉菌病。

Brain and Nerve Pub Date : 2026-05-01 DOI: 10.11477/mf.188160960780050589

Fukumi Nakamura-Uchiyama