Half-tied Stay Suture Technique for Cerebrovascular End-to-side Anastomosis: A Technique to Expand the View of the Hidden Ostium.
Authors: Shimizu S, Osawa S, Kuroda H, Koizumi H, Mochizuki T, Kumabe T Abstract In cerebrovascular end-to-side anastomosis, thick, hard donor arteries overlying thin recipient arteries impair the view of the ostium, and may result in occlusion of the anastomosis. To improve the intraoperative view, we modified the stay sutures. After performing standard recipient arteriotomy and placing the first stay suture, we half-tied the second stay suture to leave a loop: half-tied stay suture (HSS). The thread of the HSS was secured with a clip to avoid slippage. For suturing side A, the clip pulling on the HSS was gently m...
Source: Neurologia Medico-Chirurgica - June 8, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Safety and Feasibility of Neuroendovascular Therapy for Elderly Patients: Analysis of Japanese Registry of Neuroendovascular Therapy 3.
Authors: Arimura K, Iihara K, Satow T, Nishimura A, Tokunaga S, Sakai N, JR-NET investigators Abstract Japan has a rapidly aging population and the application of neuroendovascular therapy (NET) for cerebrovascular diseases among elderly patients has increased, but feasibility and safety of NET for elderly patients are still debated. Therefore, this study aimed to elucidate feasibility and safety of NET by analyzing the Japanese nationwide database, the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET 3). In total, 35,972 patients in the JR-NET 3 were analyzed retrospectively. "Elderly patients" w...
Source: Neurologia Medico-Chirurgica - May 29, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Long-term 4 Years Follow-up Study of 482 Patients Who Underwent Shunting for Idiopathic Normal Pressure Hydrocephalus -Course of Symptoms and Shunt Efficacy Rates Compared by Age Group.
Authors: Takeuchi T, Yajima K Abstract A total of 482 operated idiopathic normal pressure hydrocephalus (iNPH) patients were divided into those aged
Source: Neurologia Medico-Chirurgica - May 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Energy Intake at Admission for Improving Activities of Daily Living and Nutritional Status among Convalescent Stroke Patients.
Authors: Nishiyama A, Wakabayashi H, Nishioka S, Nagano A, Momosaki R Abstract Our aim was to clarify the nutritional status and energy intake needed for activities of daily living (ADL) improvement among convalescent stroke patients. This retrospective cohort study of stroke patients used data from the Japan Rehabilitation Nutrition Database. Mean energy intake per ideal body weight was 26 kcal/kg/day at 1 week after hospitalization. Patients were divided into two groups according to energy intake: ≥26 kcal/kg/day (high) and
Source: Neurologia Medico-Chirurgica - May 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Psychogenic Pseudo-responses in an Electrical Cortical Stimulation.
Authors: Tamada T, Enatsu R, Suzuki Y, Yokoyama R, Suzuki H, Ochi S, Mikuni N Abstract An electrical cortical stimulation provides important information for functional brain mapping. However, subjective responses (i.e. sensory, visual, and auditory symptoms) are purely detected by patients' descriptions, and may be affected by patients' awareness and intelligence levels. We experienced psychogenic responses in the electrical cortical stimulation of two patients with intractable epilepsy. A sham stimulation was useful for differentiating pseudo-responses from real responses in the electrical cortical stimulation. In...
Source: Neurologia Medico-Chirurgica - May 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Preoperative Left Ventricular Diastolic Dysfunction Is Associated with Pulmonary Edema after Carotid Endarterectomy.
Authors: Shigematsu K, Iwashita K, Mimata R, Owaki R, Totoki T, Gohara A, Okawa J, Higashi M, Yamaura K Abstract This retrospective study was aimed to investigate the association between preoperative left ventricular (LV) cardiac function and the incidence of postoperative pulmonary edema (PE) in patients undergoing carotid endarterectomy (CEA). Most patients undergoing CEA for carotid artery stenosis have concomitant heart diseases, leading to hemodynamic instability that can cause postoperative cardiac complications such as cardiac heart failure. LV diastolic function has recently been recognized as an independen...
Source: Neurologia Medico-Chirurgica - May 22, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Morphological Pattern and Classification of the Superficial Middle Cerebral Vein by Cadaver Dissections: An Embryological Viewpoint.
In this study, we used 45 adult cadaveric cerebral hemispheres to investigate the anatomical classification of the superficial middle cerebral vein (SMCV) based on the number of stems, course, and anastomosis at the distal portion. We classified the SMCVs into five types based on embryological concept. Type A (18 cases, 40.0%) is that the frontosylvian veins (FSVs) merge with the vein of Trolard (VT) and the vein of Labbé (VL) at the distal portion of the sylvian fissure. Type B (5 cases, 11.1%) is that the temporosylvian veins (TSVs) merge with the VT and the VL at the distal portion. Type C (13 cases, 28.9%) is th...
Source: Neurologia Medico-Chirurgica - May 15, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Macrophage Imaging of Intracranial Aneurysms.
Authors: Shimizu K, Kushamae M, Aoki T Abstract Considered with a poor outcome of subarachnoid hemorrhage due to rupture of intracranial aneurysms (IAs), treatment interventions to prevent rupture of the lesions are mandatory for social health. As treatment option is limited to surgical manipulations, like microsurgical clipping, endovascular coiling or deployment of flow diverter, and these surgical interventions have a potential risk of complications in nature, a proper selection of rupture-prone IAs among ones incidentally found is essential. Today, a rupture risk in each case is estimated by several factors lik...
Source: Neurologia Medico-Chirurgica - May 15, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Time Course Observation of Outcomes between Minimally Invasive Transforaminal Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion.
In conclusion, this study indicates that MIS-TLIF is comparable to O-PLIF in terms of fusion rates and clinical outcomes in single-segment degenerative lumbar diseases. In addition, compared with O-PLIF, MIS-TLIF has the advantages of lesser blood loss, faster recovery, and lower incidence of ASD. PMID: 31068542 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Surgical Treatment of Lumbar Spinal Discal Cyst: Is It Enough to Remove the Cyst Only without Following Discectomy?
Authors: Park JW, Lee BJ, Jeon SR, Rhim SC, Park JH, Roh SW Abstract Discal cysts are a rare cause of low back pain and radiculopathy with unknown pathophysiologic mechanism. Associated symptoms are difficult to distinguish from those caused by extruded discs and other spinal canal lesions. Most discal cysts are treated surgically, but it is unclear whether the corresponding intervertebral disc should be excised along with cyst. We conducted a retrospective clinical review of 27 patients who underwent discal cyst excision at our institution between 2000 and 2017. The mean follow-up period was 63.6 months. We record...
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Clinical Significance of the CSF Pulsation Flow Sign in the Foramen of Monro on FLAIR in Patients with Aneurysmal SAH -Preliminary Report.
In this study, whether CPF-M can be used as a neuroradiological finding related to pathological conditions in patients with acute aneurysmal subarachnoid hemorrhage (aSAH) was investigated. CPF-M-related clinical features were retrospectively evaluated in 147 aSAH patients who underwent adequate serial MRI examinations without massive intraventricular hemorrhage (IVH) of the lateral ventricle within 48 h of ictus. The frequency of the CPF-M in the control group was 32% (57/178), 33% (40/123), and 38% (45/117) for the normal control, chronic cerebral infarction, and deep white matter lesion (WML) groups, respectively. In aS...
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Questionnaire Survey Regarding Prevention of Surgical Site Infection after Neurosurgery in Japan: Focus on Perioperative Management and Administration of Surgical Antibiotic Prophylaxis.
Authors: Matsuda S, Ikawa F, Ohba H, Yoshiyama M, Hidaka T, Kurisu K, Miyamoto S, Date I, Nakase H Abstract Various guidelines regarding surgical site infection (SSI) have recently been established. However, perioperative management of the wound and use of antibiotics have never been standardized completely in departments of neurosurgery in Japan. This survey investigated current perioperative management and administration of surgical antibiotic prophylaxis (SAP) and compared with guidelines intended to reduce SSI associated with neurosurgery in Japan. Questionnaires were distributed to members of the conference on...
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Changing Paradigms of Periprocedural Antithrombotic Therapy in Neuroendovascular Therapy: Analysis of JR-NET 3.
Authors: Enomoto Y, Mizutani D, Yoshimura S, Sakai N, Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators Abstract To evaluate the changing paradigms of periprocedural antithrombotic management in neuroendovascular therapy in Japan, we analyzed the details of the current periprocedural antithrombotic therapy and compared it with those of the previous generations. We retrospectively analyzed the data from the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey in Japan for neuroendovascular therapy between January 2010 and December 2014. A total of 26,233 patients underwe...
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Anterior Odontoid Screw Fixation for the Treatment of Type 2 Odontoid Fracture with a Kyphotic Angulation or an Anterior Down-slope: A Technical Note.
Authors: Oh YG, Lee BJ, Jeon SR, Roh SW, Rhim SC, Park JH Abstract Anterior odontoid screw fixation (AOSF) is difficult and challenging to perform in patients with type 2 odontoid fracture with a kyphotic angulation or an anterior down-slope. To demonstrate two surgical techniques to resolve kyphotic angulation or difficult fracture direction issues. Anterior odontoid screw fixation was performed in two patients with type 2 odontoid fracture with a kyphotic angulation or an anterior down-slope. This technique can avoid sternal blocking using a percutaneous vertebroplasty puncture needle, and can reduce the kyphotic...
Source: Neurologia Medico-Chirurgica - May 11, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Predictive Factors Associated with Pain Relief of Spinal Cord Stimulation for Central Post-stroke Pain.
Authors: Tanei T, Kajita Y, Takebayashi S, Aoki K, Nakahara N, Wakabayashi T Abstract The efficacy and predictive factors associated with successful spinal cord stimulation (SCS) for central post-stroke pain (CPSP) have yet to be definitively established. Thus, this study evaluated the rates of pain relief found after more than 12 months and the predictive factors associated with the success of SCS for CPSP. The degree of pain after SCS in 18 patients with CPSP was assessed using the Visual Analog Scale preoperatively, at 1, 6 and 12 months after surgery, and at the time of the last follow-up. After calculating the...
Source: Neurologia Medico-Chirurgica - May 9, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

A Single-center Retrospective Study with 5- and 10-year Follow-up of Carotid Endarterectomy with Patch Graft.
This study evaluated the 5- and 10-year outcomes following CEA with patch graft closure in our institution. Between January 2000 and March 2013, 134 patients, who underwent CEA with patch graft closure were investigated in the current retrospective study. Among these patients, 102 CEAs in 97 patients were followed up for 5 years and 66 CEAs in 61 patients were for 10 years after the procedure. Restenosis was defined as>50% recurrent luminal narrowing at the endarterectomy site. In 5 years, symptomatic restenosis exhibited minor stroke in one patient at 58 months after CEA (restenosis rate 1.0%). The ipsilateral minor st...
Source: Neurologia Medico-Chirurgica - May 9, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Anterior and Posterior Segmental Decompression and Fusion for Severely Localized Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Technical Note.
This study investigated five patients with severely localized OPLL with an occupying ratio more than 60%. Extended ACDF comprising a modified technique with a trans-unco-discal approach and partial oblique corpectomy was first attempted to achieve neural decompression of the spinal cord and nerve roots at the most prominent level of the OPLL. The OPLL was partially resected to reduce the axial occupying ratio or ensure that the OPLL did not exceed the imaginary line between the midpoint between C2 and C7 on sagittal images. PCDF was then performed to achieve satisfactory decompression of neural elements and cervical stabil...
Source: Neurologia Medico-Chirurgica - May 9, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Vessel Wall Magnetic Resonance Imaging in a Case of Post-traumatic Multifocal Striatocapsular Hemorrhagic Infarction.
Authors: Kim E, Kim MS, Kim Y Abstract Post-traumatic striatocapsular infarction is extremely rare and has been described only within the vascular territory of the perforating arteries originating from the middle cerebral artery (MCA). We recently encountered a patient presenting with unilateral multifocal striatocapsular hemorrhagic infarctions following mild head injury. This 25-year-old female was admitted to our trauma center after a motorcycle accident. Initial brain computed tomography and magnetic resonance (MR) imaging showed multifocal acute hemorrhagic infarctions with a clustering in the right caudate he...
Source: Neurologia Medico-Chirurgica - April 19, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Usefulness of [11C] Methionine PET in the Differentiation of Tumefactive Multiple Sclerosis from High Grade Astrocytoma.
Authors: Hashimoto S, Inaji M, Nariai T, Kobayashi D, Sanjo N, Yokota T, Ishii K, Taketoshi M Abstract Tumefactive multiple sclerosis (tumefactive MS) is an atypical variant of MS characterized by a large isolated demyelinating lesion. Because tumefactive MS mimics high grade astrocytoma clinically and radiologically, it is difficult to distinguish between the two using only traditional diagnostic modalities, such as routine magnetic resonance imaging. [11C] methionine positron emission tomography (MET PET) has been known as a useful diagnostic tool for glioma. However, it has not been established as a diagnostic t...
Source: Neurologia Medico-Chirurgica - April 19, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Limitations of Local Brain Cooling on Generalized Motor Seizures from Unknown Foci in Awake Rats.
In this study, we attempted to suppress generalized motor seizures (GMSs) by cooling a unilateral sensorimotor area. GMSs were induced in rats by intraperitoneal injection of bicuculline methiodide, an antagonist of gamma-aminobutyric acid. While monitoring the ECoG and behavior, the right sensorimotor cortex was cooled for 10 min using an implanted device. The number of spikes recorded from the cooled cortex significantly decreased to 71.2% and 62.5% compared with the control group at temperatures of 15 and 5°C (both P
Source: Neurologia Medico-Chirurgica - March 22, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Bilateral Internal Carotid and Left Vertebral Artery Dissection after Blunt Trauma: A Case Report and Literature Review.
We describe a 23-year-old man in previously good health who developed three-vessel cervical arterial dissections due to blunt trauma. He was admitted to our emergency and critical care center after a motor vehicle crash. Computed tomography showed a thin, acute subdural hematoma in the right hemisphere and fractures of the odontoid process (Anderson type III), pelvis, and extremities. He was treated conservatively, and about 1 month later, he developed bleariness. Computed tomography angiography showed bilateral internal carotid and left vertebral artery dissection. Aspirin therapy was started immediately, and then clopido...
Source: Neurologia Medico-Chirurgica - March 20, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Real-world Experience of Carotid Artery Stenting in Japan: Analysis of 8458 Cases from the JR-NET3 Nationwide Retrospective Multi-center Registries.
Authors: Tokuda R, Yoshimura S, Uchida K, Yamada K, Satow T, Iihara K, Sakai N, Japanese Registry of NeuroEndovascular Therapy (JR-NET) investigators Abstract We aimed to clarify the outcomes of carotid artery stenting (CAS) in the Japanese population. For this purpose, we reviewed data from the Japanese Registry of NeuroEndovascular Therapy 3 (JR-NET3), a retrospective, nation-wide, multi-center, observational study of neuroendovascular treatments in Japan. Of the 9207 patients who underwent CAS between January 2010 and December 2014, 8458 satisfied the inclusion criteria for our analysis. The outcome statistics o...
Source: Neurologia Medico-Chirurgica - March 20, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Intracranial Aneurysm as a Macrophage-mediated Inflammatory Disease.
Authors: Shimizu K, Kushamae M, Mizutani T, Aoki T Abstract Subarachnoid hemorrhage (SAH) is mainly attributable to the rupture of intracranial aneurysms (IAs). Although the outcome of SAH is considerably poor in spite of the recent intensive medical care, mechanisms regulating the progression of IAs or triggering rupture remain to be clarified, making the development of effective preemptive medicine to prevent SAH difficult. However, a series of recent studies have been expanding our understanding of the pathogenesis of IAs. These studies have suggested the crucial role of macrophage-mediated chronic inflammation ...
Source: Neurologia Medico-Chirurgica - March 16, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Multi-stage Preparation for the Repair of Complicated Skull Defects.
Authors: Sakamoto Y, Arnaud E Abstract Cranioplasty following decompressive craniectomy is highly associated with complications. Methods for avoiding these complications have been well-documented; however, approaching reconstruction through the previous incision, especially if it was on or very near the bone defect, can sometimes lead to wound dehiscence and infection, with exposure of the artificial bone. For such complicated cases, we propose a multi-staged preparation that includes creating a delayed skin flap for the actual skull reconstruction. Flap was elevated in three stages, with 4 week intervals between e...
Source: Neurologia Medico-Chirurgica - March 16, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Japanese Surveillance of Neuroendovascular Therapy in JR-NET - Part II. Japanese Registry of NeuroEndovascular Treatment 3. Main Report.
This study, following Japanese Registry of NeuroEndovascular Treatment 1 and 2 (JR-NET 1 & 2), shows an annual trend of cases including adverse events and clinical outcomes at 30 days after NET. JR-NET3 was registered by 749 cumulative total number of physicians, certified by the Japanese Society of Neuroendovascular Therapy in 166 centers, between 2010 and 2014. Medical information about the patients was anonymized and retrospectively registered through a website. A total of 40,177 patients were recruited, 632 patients were excluded because data of preprocedural status were not available. So we analyzed 39,545 patient...
Source: Neurologia Medico-Chirurgica - March 9, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Application of a Minimally Invasive Liposuction Technique for Harvesting Fat during Transsphenoidal Surgery: A Technical Note.
In this report, we present a method of harvesting abdominal fat using a minimally invasive liposuction technique to avoid cosmetic issues. Since 2016, we have been using fat harvested from the abdominal wall by suctioning with a dedicated syringe for reconstruction after TSS in selected cases. The liquefied fat obtained by the liposuction technique was wrapped with an oxycellulose sheet and changed its form to what we termed "fatty candy". In this form, the fat maintained its configuration and could be handled almost as easily as a conventional fat graft. In our experienced series, there was no case with wound co...
Source: Neurologia Medico-Chirurgica - March 4, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Ex Vivo Assessment of Various Histological Differentiation in Human Carotid Plaque with Near-infrared Spectroscopy Using Multiple Wavelengths.
Authors: Munemitsu T, Ishii A, Okada E, Chihara H, Yoshida K, Takahashi JC, Takagi Y, Miyamoto S Abstract We previously reported that near-infrared hyperspectral imaging enabled the localization of atherosclerotic plaques from outside the vessels, but not the optical characteristics of each histological component. Therefore, the near-infrared spectrum of each component was collected from the sliced section of the human carotid plaque obtained with endarterectomy and the optical characteristics were confirmed in several wavelengths. Based on this information, we assessed the diagnostic accuracy for ex vivo chemogram...
Source: Neurologia Medico-Chirurgica - March 4, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Changing the Currently Held Concept of Cerebrospinal Fluid Dynamics Based on Shared Findings of Cerebrospinal Fluid Motion in the Cranial Cavity Using Various Types of Magnetic Resonance Imaging Techniques.
Authors: Matsumae M, Kuroda K, Yatsushiro S, Hirayama A, Hayashi N, Takizawa K, Atsumi H, Sorimachi T Abstract The "cerebrospinal fluid (CSF) circulation theory" of CSF flowing unidirectionally and circulating through the ventricles and subarachnoid space in a downward or upward fashion has been widely recognized. In this review, observations of CSF motion using different magnetic resonance imaging (MRI) techniques are described, findings that are shared among these techniques are extracted, and CSF motion, as we currently understand it based on the results from the quantitative analysis of CSF motion, is...
Source: Neurologia Medico-Chirurgica - March 4, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

EGFRvIII Is Expressed in Cellular Areas of Tumor in a Subset of Glioblastoma.
Authors: Nozawa T, Okada M, Natsumeda M, Eda T, Abe H, Tsukamoto Y, Okamoto K, Oishi M, Takahashi H, Fujii Y, Kakita A Abstract Epidermal growth factor receptor variant III (EGFRvIII) is a tumor-specific cell surface antigen often expressed in glioblastoma and has drawn much attention as a possible therapeutic target. We performed immunohistochemistry on histology sections of surgical specimens taken from 67 cases with glioblastoma, isocitrate dehydrogenase-wild type, and evaluated the morphological characteristics and distribution of the EGFRvIII-positive tumor cells. We then evaluated the localization of EGFRvIII...
Source: Neurologia Medico-Chirurgica - February 24, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Watertight Robust Osteoconductive Barrier for Complex Skull Base Reconstruction: An Expanded-endoscopic Endonasal Experimental Study.
In conclusion, WRO-barrier as an osteoconductive watertight robust design for cranial base reconstruction possesses several distinct qualities that might be beneficial for patients with complex skull base tumours. PMID: 30787233 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - February 24, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Surgical Intervention for Osteoporotic Vertebral Burst Fractures in Middle-low Lumbar Spine with Special Reference to Postoperative Complications Affecting Surgical Outcomes.
Authors: Kohno M, Iwamura Y, Inasaka R, Kaneko K, Tomioka M, Kawai T, Aota Y, Saito T, Inaba Y Abstract The purpose of this study was to investigate the clinical and radiological features of osteoporotic burst fractures affecting levels below the second lumbar (middle-low lumbar) vertebrae, and to clarify the appropriate surgical procedure to avoid postoperative complications. Thirty-eight consecutive patients (nine male, 29 female; mean age: 74.8 years; range: 60-86 years) with burst fractures affecting the middle-low lumbar vertebrae who underwent posterior-instrumented fusion were included. Using the Magerl clas...
Source: Neurologia Medico-Chirurgica - February 16, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Can the Latest Computerized Technologies Revolutionize Conventional Assessment Tools and Therapies for a Neurological Disease? The Example of Parkinson's Disease.
In this study, we used Parkinson's disease (PD) as an example to elucidate how the latest computerized technologies can improve the diagnosis and treatment of neurological diseases. Dopaminergic medication and deep brain stimulation remain the most effective interventions for treating PD. Subjective scales, such as the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stage, are still the most widely used assessments. Wearable sensors, virtual reality, augmented reality, and robot assistant systems are increasingly being used for evaluation of patients with PD. The use of such computerized technologies can re...
Source: Neurologia Medico-Chirurgica - February 16, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

CT Hounsfield Unit Is a Good Predictor of Growth in Meningiomas.
Authors: Nakasu S, Onishi T, Kitahara S, Oowaki H, Matsumura KI Abstract Predicting the growth rate of meningiomas is important in treatment planning. Although calcification may be an important sign of slow growth in meningiomas, the developmental process and its relation to the tumor growth pattern have not been elucidated. We retrospectively examined the location and degree of calcification in 150 meningiomas (131 asymptomatic tumors) using computed tomography (CT) scans and mean Hounsfield units (mHU). Tumor growth was evaluated using serial imaging studies wherein we calculated tumor doubling time (Td) and iden...
Source: Neurologia Medico-Chirurgica - January 30, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Treatment Outcome of Intracranial Tumor Embolization in Japan: Japanese Registry of NeuroEndovascular Therapy 3 (JR-NET3).
Authors: Sugiu K, Hishikawa T, Murai S, Takahashi Y, Kidani N, Nishihiro S, Hiramatsu M, Date I, Satow T, Iihara K, Sakai N Abstract Embolization for intracranial tumor is performed as a standard endovascular treatment. A retrospective, multicenter, observational study was conducted to clarify the nature, frequency, and risk factors of complications in intracranial tumor embolization. Patients were derived from the Japanese Registry of NeuroEndovascular Therapy (JR-NET3) using data taken from January 2010 through December 2014 in Japan. A total of 40,169 patients were enrolled in JR-NET3, of which, 1,545 patients (...
Source: Neurologia Medico-Chirurgica - January 30, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Probability of Soluble Tissue Factor Release Lead to the Elevation of D-dimer as a Biomarker for Traumatic Brain Injury.
Authors: Suehiro E, Fujiyama Y, Kiyohira M, Motoki Y, Nojima J, Suzuki M Abstract d-dimer is a potential biomarker for the detection of traumatic brain injury (TBI). However, the mechanisms that trigger elevation of d-dimer in TBI remain unclear. The purpose of this study was to evaluate the reliability of d-dimer in blood as a biomarker for TBI and to determine the mechanisms involved in regulating its blood levels. Nine patients with moderate to severe isolated TBI (Glasgow Coma Scale [GCS] score 7-13) were admitted to our hospital from May 2013 to June 2014. Blood samples were collected from systemic arteries on...
Source: Neurologia Medico-Chirurgica - January 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Thermal Annuloplasty Using Percutaneous Endoscopic Discectomy for Elite Athletes with Discogenic Low Back Pain.
Authors: Manabe H, Yamashita K, Tezuka F, Takata Y, Sakai T, Maeda T, Sairyo K Abstract The purpose of this study was to assess the usefulness of radiofrequency thermal annuloplasty (TA) using percutaneous endoscopic discectomy/TA (PED/TA) in elite athletes with discogenic low back pain. Twelve patients (11 men, 1 woman; mean age 27.9 years) underwent PED/TA under local anesthesia. Clinical data for these patients (17 affected intervertebral discs), including type of sport played, average duration of low back pain, disc level affected, presence or absence of a high signal intensity zone on magnetic resonance imagin...
Source: Neurologia Medico-Chirurgica - January 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Report of Japan Neurosurgery Registry (2015 - 2017).
Authors: PMID: 30651422 [PubMed - in process] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - January 18, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Effects of Hemosiderosis on Epilepsy Following Subarachnoid Hemorrhage.
Authors: Hirano T, Enatsu R, Iihoshi S, Mikami T, Honma T, Ohnishi H, Mikuni N Abstract Epilepsy after aneurysmal subarachnoid hemorrhage (post-SAH epilepsy) is a critical complication that influences clinical and social prognoses. However, the underlying mechanisms remain unclear. We investigated the relationship between hemosiderosis and the incidence of post-SAH epilepsy. About 50 patients with aneurysmal SAH who were admitted to Sapporo Medical University and Oji General Hospital between April 2010 and June 2016 were enrolled in this retrospective study. Hemosiderosis detected by T2*-weighted magnetic resonance...
Source: Neurologia Medico-Chirurgica - December 22, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Real-time Imaging of an Experimental Intracranial Aneurysm in Rats.
Authors: Miyata H, Shimizu K, Koseki H, Abekura Y, Kataoka H, Miyamoto S, Nozaki K, Narumiya S, Aoki T Abstract Subarachnoid hemorrhage due to rupture of a pre-existing intracranial aneurysm has quite a poor outcome in spite of intensive medical care. Hemodynamic stress loaded on intracranial arterial walls is considered as a trigger and a regulator of formation and progression of the disease, but how intracranial arterial walls or intracranial aneurysm walls behave under hemodynamic stress loading remains unclear. The purpose of this study was to visualize and analyze the wall motion of intracranial aneurysms to d...
Source: Neurologia Medico-Chirurgica - December 19, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Cervical Spondyloptosis Successfully Treated with Only Posterior Short Segment Fusion Using Cervical Pedicle Screw Fixation.
Authors: Kim MW, Lee SB, Park JH Abstract This paper describes two patients with cervical spondyloptosis with severe spinal cord injury treated with cervical pedicle screw (CPS) through a single-stage operation, posterior approach. A 60-year-old male patient with quadriparesis due to trauma 1 day before visited the emergency room. Cervical spine computed tomography (CT) and magnetic resonance imaging showed complete dislocation of the C7 and T1 vertebrae with severe spinal cord compression, disc injury, and disc herniation at the C7-T1 level. Cervical pedicle screw with freehand technique was done on C6 and T1 vert...
Source: Neurologia Medico-Chirurgica - December 19, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Endovascular Therapy for Ruptured Vertebral Artery Dissecting Aneurysms: Results from Nationwide, Retrospective, Multi-Center Registries in Japan (JR-NET3).
In this study, we have extracted 530 ruptured VADA, treated through PAO with EVT, from a nationwide, retrospective, multi-center registration in Japan (JR-NET3), and analyzed factors associated with outcome at 30 days and procedure-related complications. Complete occlusion was achieved in 497 cases (93.8%) and favorable outcome was obtained in 303 cases (59.1%). Older age (≥60 years), male sex, use of general anesthesia, non-specialist as the responsible doctor, and time delay from onset to treatment (≥24 h) were negative factors for favorable outcome in multivariate analysis, although these factors were not associat...
Source: Neurologia Medico-Chirurgica - December 14, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Parent Artery Occlusion for Unruptured Cerebral Aneurysms: Results of the Japanese Registry of Neuroendovascular Therapy 3.
Authors: Nishi H, Ishii A, Satow T, Iihara K, Sakai N, Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators Abstract Although the current standard treatment for unruptured aneurysms comprises surgical clipping or endovascular coiling, these techniques are not suitable for some cases, such as large, giant, and fusiform aneurysms. Endovascular parent artery occlusion (PAO), which includes internal trapping and proximal occlusion, is a well-established alternative treatment for such cases. Here, we retrospectively reviewed PAO cases from the Japanese Registry of Neuroendovascular Therapy 3, a nation-w...
Source: Neurologia Medico-Chirurgica - December 14, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Boron Neutron Capture Therapy Combined with Early Successive Bevacizumab Treatments for Recurrent Malignant Gliomas - A Pilot Study.
Authors: Shiba H, Takeuchi K, Hiramatsu R, Furuse M, Nonoguchi N, Kawabata S, Kuroiwa T, Kondo N, Sakurai Y, Suzuki M, Ono K, Oue S, Ishikawa E, Michiue H, Miyatake SI Abstract Recurrent malignant gliomas (RMGs) are difficult to control, and no standard protocol has been established for their treatment. At our institute, we have often treated RMGs by tumor-selective particle radiation called boron neutron capture therapy (BNCT). However, despite the cell-selectivity of BNCT, brain radiation necrosis (BRN) may develop and cause severe neurological complications and sometimes death. This is partly due to the full-dos...
Source: Neurologia Medico-Chirurgica - November 24, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Endovascular Treatment for Vasospasm after Aneurysmal Subarachnoid Hemorrhage Based on Data of JR-NET3.
Authors: Imamura H, Sakai N, Satow T, Iihara K, JR-NET investigators Abstract Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior ci...
Source: Neurologia Medico-Chirurgica - November 24, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Transient Symptomatic Downregulation of Cortical Neurotransmitter Receptor Function Due to Cerebral Hyperperfusion after Arterial Bypass Surgery for a Patient with Ischemic Moyamoya Disease.
We report here a case with cerebral hyperperfusion syndrome after arterial bypass surgery for ischemic MMD. Chronological changes of brain perfusion and central benzodiazepine receptor biding potential were observed using single-photon emission computed tomography. A 20-year-old woman with ischemic MMD underwent arterial bypass surgery. Six days later, cerebral hyperperfusion syndrome developed. During this syndrome, contralateral-to-ipsilateral cerebellar asymmetry of blood flow and a decrease in central benzodiazepine receptor binding potential in the area with hyperperfusion were observed. Four months later, these two f...
Source: Neurologia Medico-Chirurgica - October 30, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Microdiscectomy and Foraminotomy in Cervical Spondylotic Myelopathy and Radiculopathy.
This study was to assess the efficacy of microdiscectomy, cage fixation, and right tranuncal foramintomy for the patients suffering from right radiulo-myelopathy. Anterior cervical foraminotomy was reported to be an effective option for the treatment of cervical degenerative radiculopathy but with the problem of recurrence. Since Hakuba reported the method of trans-unco-discal approach in 1976, it was designed as keyhole foraminotomy which was called transuncal approach, transpedicular approach or transvertebral approach. In the anterior approach, we usually use the right-sided approach because most of us are right-handed ...
Source: Neurologia Medico-Chirurgica - October 10, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Flow Diverter Therapy Using a Pipeline Embolization Device for 100 Unruptured Large and Giant Internal Carotid Artery Aneurysms in a Single Center in a Japanese Population.
Authors: Oishi H, Teranishi K, Yatomi K, Fujii T, Yamamoto M, Arai H Abstract Flow diverters (FDs) have been developed for intracranial aneurysms difficult to treat with conventional endovascular therapy and surgical clipping. We reviewed 94 patients with 100 large or giant unruptured internal carotid artery (ICA) aneurysms treated with Pipeline embolization device (PED) embolization from December 2012 to June 2017 at Juntendo University Hospital. The patients' mean age was 63.4 years (range, 19-88), and there were 90 women 89.4%. Aneurysm locations were: C4 (45), C3 (4), and C2 (51) in ICA segments. Mean aneurysm ...
Source: Neurologia Medico-Chirurgica - October 10, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Application of Awake Surgery for Epilepsy in Clinical Practice.
We examined five consecutive patients, in whom we performed lesionectomy for epilepsy with awake craniotomy, with postoperative follow-up> 2 years. All patients showed clear lesions on magnetic resonance imaging (MRI) in the right frontal (n = 1), left temporal (n = 1), and left parietal lobe (n = 3). Intraoperatively, under awake conditions, sensorimotor mapping was performed; primary motor and/or sensory areas were successfully identified in four cases, but not in one case of temporal craniotomy. Language mapping was performed in four cases, and language areas were identified in three cases. In one case with a left pa...
Source: Neurologia Medico-Chirurgica - September 28, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Potential Strategies Overcoming the Temozolomide Resistance for Glioblastoma.
Authors: Jiapaer S, Furuta T, Tanaka S, Kitabayashi T, Nakada M Abstract Glioblastoma (GBM) is a highly malignant type of primary brain tumor with a high mortality rate. Although the current standard therapy consists of surgery followed by radiation and temozolomide (TMZ), chemotherapy can extend patient's post-operative survival but most cases eventually demonstrate resistance to TMZ. O6-methylguanine-DNA methyltransferase (MGMT) repairs the main cytotoxic lesion, as O6-methylguanine, generated by TMZ, can be the main mechanism of the drug resistance. In addition, mismatch repair and BER also contribute to TMZ res...
Source: Neurologia Medico-Chirurgica - September 28, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Method for Placement of an Intraoperative Continuous Facial Nerve Stimulating Electrode in Acoustic Neuroma Surgery: Technical Note.
Authors: Torihashi K, Sora S, Sato H, Kohno M Abstract Preservation of facial nerve (FN) function is the most important goal in acoustic neuroma (AN) surgery. We have been using intraoperative continuous facial nerve monitoring (ICFNm) of evoked electromyography during AN surgery. ICFNm is very useful, and we can identify the real-time functions of the FN. Some surgeons have experienced difficulty with placing the ICFN stimulating electrode (SE). We therefore show how to place the ICFN SE. We mostly perform AN surgery with a retrosigmoid approach (RSA). A craniotomy with four burr holes is performed. We dissect the...
Source: Neurologia Medico-Chirurgica - September 28, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research