Experimental Analysis of Intra-luminal Pressure by Contrast Injection during Mechanical Thrombectomy: Simulation of Rupture Risk of Hidden Cerebral Aneurysm in Tandem Occlusion with Blind Alley.
Authors: Watanabe S, Oda J, Nakahara I, Matsumoto S, Suyama Y, Hasebe A, Suzuki T, Tanabe J, Suyama K, Hirose Y Abstract Mechanical thrombectomy using a retrograde approach is performed for tandem occlusion of the internal carotid artery (ICA). In our patient, a guiding catheter was easily passed by the stenosed lesion despite severe stenosis at the ICA origin. Therefore, we aimed to recanalize the occlusion of the terminal ICA without angioplasty for the stenosed lesion. When contrast was injected, a massive extravasation of contrast from the C2 portion of the ICA was observed. It was speculated that the bleeding ...
Source: Neurologia Medico-Chirurgica - May 27, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Relationship between Flow-mediated Endothelial Vasodilation and the Pulse Wave Velocity, and Cervical Carotid Artery Stenosis.
Authors: Shirokane K, Tamaki T, Kim K, Tsuchiya M, Yamazaki M, Morita A Abstract Carotid artery stenosis is elicited by atherosclerosis and is the main cause of cerebral thrombosis. Flow-mediated endothelial vasodilation (FMD) can be measured noninvasively to assess vascular endothelial function related to atherosclerosis. The pulse wave velocity (PWV) is used to evaluate the vascular media involved in atherosclerosis. We investigated the relationship between these measurements in 75 consecutive patients with atherosclerotic cerebral thrombosis. They were assigned to three equal groups based on the severity of caro...
Source: Neurologia Medico-Chirurgica - May 15, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Frequent Clinical and Radiological Progression of Optic Pathway/Hypothalamic Pilocytic Astrocytoma in Adolescents and Young Adults.
In conclusion, histological diagnoses of OHG before and in AYA were pilocytic astrocytoma or pilomyxoid astrocytoma. Both pediatric and AYA-onset OHPA demonstrate high incidences of tumor progression and visual dysfunctions in AYA, so that long-term follow up is essential after the completion of treatment for pediatric and AYA-onset OHPA. The optimal timing of debulking surgery and radiation therapy should be established to achieve the long-term tumor control and to preserve the visual function. PMID: 32404575 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - May 15, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Submucosal Inferior Turbinectomy to Widen the Surgical Corridor for Endoscopic Endonasal Skull Base Surgery.
Authors: Uozumi Y, Taniguchi M, Umehara T, Nakai T, Kimura H, Kohmura E Abstract The nasal cavity is the exclusive surgical corridor for endoscopic endonasal surgery; however, it is sometimes too narrow to allow extensive surgical maneuvering. Here we show the technique of submucosal inferior turbinectomy (SIT) to widen this surgical corridor. Its effectiveness is evaluated quantitatively by comparing pre- and intraoperative magnetic resonance images. Between March 2015 and October 2018, we performed endoscopic endonasal resection of 57 skull base tumors with 3T intraoperative magnetic resonance imaging (iMRI). Amo...
Source: Neurologia Medico-Chirurgica - May 15, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Ukemi Technique Prevents the Elevation of Head Acceleration of a Person Thrown by the Judo Technique 'Osoto-gari'.
Authors: Murayama H, Hitosugi M, Motozawa Y, Ogino M, Koyama K Abstract Biomechanical analysis was performed to evaluate the effectiveness of mastering ukemi in preventing severe head injury in judo. One judo expert (tori) threw another judo expert (uke) with a skilled break-fall (ukemi) four times. We obtained kinematic data of uke with a digital video camera. Both translational and rotational accelerations were measured with a six-degree-of-freedom sensor affixed to uke's forehead. When Osoto-gari was performed, uke fell backward and his arm made contact with the tatami; the translational and rotational accelerat...
Source: Neurologia Medico-Chirurgica - May 15, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Ergonomics-based Positioning of the Operating Handle of Surgical Microscopes.
Authors: Shimizu S, Kuroda H, Mochizuki T, Kumabe T Abstract Handling surgical microscopes with one hand requires force, especially when gripping the operating handle (OH) to swing the optic axis toward the surgeon and when moving it laterally or medially. These physical issues may be attributable to the non-ergonomic handling of the OH. To optimize the ease of OH handling, we applied ergonomic criteria to the positioning of the OH, i.e. holding the OH at as little ulnar deviation as possible and at abduction to strengthen the grip and ease arm rotation. Of eight male surgeons holding the OH of a mechanically count...
Source: Neurologia Medico-Chirurgica - May 15, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Immediate Effects of Vagus Nerve Stimulation in Intractable Epilepsy: An Intra-operative Electrocorticographic Analysis.
This study showed the reduction of epileptogenic spikes and spread areas of the spikes by VNS as immediate effects, electrophysiologically. PMID: 32295979 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Analysis of Puncture Site-related Complications in Japanese Registry of Neuroendovascular Therapy (JR-NET)3.
Authors: Sato M, Matsumaru Y, Sakai N, JR-NET study group affiliations Abstract A subgroup analysis of puncture site-related complications listed in the Japanese Registry of NeuroEndovascular Therapy 3, based on retrospective studies, was performed. Puncture site-related complications occurred in 315 (0.73%, average age: 65.2) of 36,708 patients out of all 43,303 registered cases. Carotid artery stenting (CAS, 95 patients, 1.1%, P
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Is the Postoperative Horizontal Decubitus Position Following Transection of a Tight Filum Terminale in Pediatric Patients Necessary? - A Retrospective Cohort Study.
Authors: Kanematsu R, Hirokawa D, Usami K, Ogiwara H Abstract After untethering surgery of a tethered spinal cord of a tight filum terminale, patients are usually kept in the horizontal decubitus position to prevent cerebrospinal fluid (CSF) leakage. However, the optimal period for keeping these patients in this position has not been established yet. Surgical results in two groups of pediatric patients with a tight filum terminale were retrospectively analyzed. Group A was maintained in the horizontal decubitus position for 72 h and group B was managed without being kept in this position postoperatively. A total of...
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Endovascular Therapy for Intracranial Artery Stenosis: Results from the Japanese Registry of Neuroendovascular Therapy (JR-NET)3.
Authors: Izumi T, Nishibori M, Imamura H, Iihara K, Sakai N, JR-NET investigators Abstract A total of 907 patients enrolled in the Japanese Registry of Neuroendovascular Therapy (JR-NET)3, a surveillance study in Japan, who underwent intracranial percutaneous transluminal angioplasty (PTA)/stenting for intracranial stenosis during the period from 2010 to 2014 were investigated. Technical success was achieved in 97.5% of the patients, and 6.8% had a residual stenosis of ≥50%. The incidence rates of ischemic and hemorrhagic complications were as low as 5.3% and 3.1%, respectively, and the mortality rate was 1.9%. ...
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Assessment of Geometric Reliability of Conventional Trajectory of Ventriculostomy in a Three Dimensional Virtual Model and Proposal of a New Trajectory.
Authors: Park B, Han S, Byoun HS, Han S, Choi SW, Lim J Abstract Ventriculostomy is a common neurosurgery procedure performed for many purposes. Kocher's point is most often used as the ventriculostomy entry point. But the accuracy of a cannula's trajectory into the ventricles from entry at Kocher's point is controversial. In this paper we attempt to evaluate the accuracy of the conventional sagittal trajectory, which uses Kocher's point, and evaluate a new trajectory by creating virtual ventriculostomy simulations from computed tomography images of the brain. About 66 patients without brain and skull pathology in ...
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Subaxial Cervical Pedicle Screw for Cervical Spine Diseases: The Review of Technical Developments and Complication Avoidance.
This study aimed to review information on the subaxial cervical pedicle screw (CPS) including recent anatomical considerations, entry points, placement techniques, accuracy, learning curve, and complications. Relevant literatures were reviewed, and the authors' experiences were summarized. The CPS is used for reconstruction of unstable cervical spine and achieves superior biomechanical stability compared to other fixation techniques. Various insertion and guidance techniques are established, among which, lateral fluoroscopy-assisted placement is the most common and cost-effective technique. Generally, placement under imagi...
Source: Neurologia Medico-Chirurgica - April 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Japan Neurosurgical Database: Overview and Results of the First-year Survey.
Authors: Iihara K, Tominaga T, Saito N, Suzuki M, Date I, Fujii Y, Hongo K, Houkin K, Kato A, Kato Y, Kawamata T, Kim P, Kinouchi H, Kohmura E, Kurisu K, Maruyama K, Mikuni N, Miyamoto S, Morita A, Nakase H, Narita Y, Nishikawa R, Nozaki K, Ogasawara K, Ohata K, Sakai N, Sakamoto H, Shiokawa Y, Sonoda Y, Takahashi JC, Ueki K, Wakabayashi T, Yamamoto T, Yoshida K, Kayama T, Arai H, Japan Neurosurgical Society Abstract The Japan Neurosurgical Database (JND) is a prospective observational study registry established in 2017 by the Japan Neurosurgical Society (JNS) to visualize real-world clinical practice, promote scie...
Source: Neurologia Medico-Chirurgica - April 4, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Feasibility of Robot-assisted Rehabilitation in Poststroke Recovery of Upper Limb Function Depending on the Severity.
In this study, we evaluated the effectiveness of the HAL-SJ exoskeleton in improving upper limb function in the subacute phase after a stroke, as a function of the severity of arm paralysis. Our analysis was based on a retrospective review of 35 patients, treated using the HAL-SJ exoskeleton in the subacute phase after their stroke, between October 2014 and December 2018. The severity of upper limb impairment was quantified using the Brunnstrom recovery stage (BRS) as follows: severe, BRS score 1-2, n = 10; moderate, BRS 3-4, n = 12; and mild, BRS 5-6, n = 13. The primary endpoint was the improvement in upper limb function...
Source: Neurologia Medico-Chirurgica - March 18, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Expanding Cyst of the Septum Pellucidum - Endoscopic Observations on the Mechanism of Development and Results of Treatment.
Authors: Sagan L, Limanówka B, Herbowski L, Poncyljusz W, Gi┼╝ewska M Abstract Cysts of the septum pellucidum (CSP) are usually asymptomatic; however, in some cases they can begin expanding and cause neurological deterioration. The mechanism leading to the formation of an expanding cyst of the septum pellucidum (ECSP) is not known. Based on observations made during endoscopic treatment of ECSP we analyzed intraoperative findings in respect to cyst formation mechanism and treatment prognosis. A group of 31 patients was studied. Only cases with bulging cyst walls occupying the frontal horns observed on imaging...
Source: Neurologia Medico-Chirurgica - March 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Is the Vertebral Posterior Line a Safety Landmark for Cervical Posterior Screw Insertion? - Radiological Study of the Vertebral Artery in the Cervical Spine.
Authors: Kim K, Nariai M, Kawauchi M, Morimoto D, Iwamoto N, Isu T, Morita A Abstract At posterior cervical fixation, iatrogenic injury of the vertebral artery (VA) must be avoided. As the VA is usually located in front of the posterior line of the vertebral body, intraoperative lateral fluoroscopy is used to identify the line. We investigated in how many of 105 patients (210 VAs) this line is a safe marker. We also inspected the original cervical magnetic resonance angiograms (MRA) of 105 consecutive patients who had been treated for other than cervical spine diseases to study some anatomical characteristics of th...
Source: Neurologia Medico-Chirurgica - March 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Other Hospital-onset Acute Ischemic Stroke Due to Large Vessel Occlusion Treated by Mechanical Thrombectomy after Inter-hospital Transfer.
In conclusion, the other hospital-onset patients required additional time for their initial management and inter-hospital transfer although arrival-to-puncture time was shorter. Favorable outcomes were observed less frequently in them. Improving inter-hospital cooperation systems and to educate the medical staff in a thrombectomy-incapable hospital concerning stroke management is important measures for other hospital-onset stroke with LVO. PMID: 32132345 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - March 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Molecular Aberrations Associated with Seizure Control in Diffuse Astrocytic and Oligodendroglial Tumors.
Authors: Suzuki H, Mikuni N, Sugita S, Aoyama T, Yokoyama R, Suzuki Y, Enatsu R, Akiyama Y, Mikami T, Wanibuchi M, Hasegawa T Abstract Diffuse astrocytic and oligodendroglial tumors are frequently associated with symptomatic epilepsy, and predictive seizure control is important for the improvement of patient quality of life. To elucidate the factors related to drug resistance of brain tumor-associated epilepsy from a pathological perspective. From January 2012 to October 2017, 36 patients diagnosed with diffuse astrocytic or oligodendroglial tumors were included. Assessment for seizure control was performed accordi...
Source: Neurologia Medico-Chirurgica - February 5, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Changes in Real-world Practice Patterns of Antiepileptic Drugs for Status Epilepticus: A Nationwide Observational Study in Japan.
We described the patient characteristics and practice pattern of antiepileptic drugs. The analysis conducted for this study examined 31,472 cases. As the second-line therapy, the use of i.v. levetiracetam increased rapidly from 2016; 35% of cases received i.v. levetiracetam in 2017. By contrast, the use of i.v. phenytoin/fosphenytoin decreased from 2016. In-hospital mortality decreased year-by-year. No year-by-year change was observed for deaths within 24 h, length of hospital stay, drug-induced hepatitis, or drug-induced eruption. Although the use of levetiracetam for treatment of SE is not compensated by public health in...
Source: Neurologia Medico-Chirurgica - February 5, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Trends in Endovascular Reperfusion Therapy for Acute Stroke after Introduction of Mechanical Thrombectomy Devices: Japanese Registry of NeuroEndovascular Therapy (JR-NET)3.
Authors: Hayakawa M, Matsumaru Y, Yamagami H, Satow T, Iihara K, Sakai N, JR-NET investigators Abstract In Japan, the era of thrombectomy for acute stroke started when the Merci retriever was approved in 2010 and the Penumbra system in 2011. New-generation Penumbra catheters (MAX series) and stent retrievers were introduced in 2013 and 2014, respectively. The aim of this study was to clarify the general status and trends in endovascular reperfusion therapy for stroke in Japan from 2010 to 2014. We extracted a total of 3705 patients (72.1 ± 12.2 years, 1482 women) from a nationwide study of patients receiving...
Source: Neurologia Medico-Chirurgica - February 5, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Natural History of Meningiomas: Review with Meta-analyses.
Authors: Nakasu S, Nakasu Y Abstract Observation has been a mainstay in asymptomatic meningiomas, but it may increase the risk associated with treatment due to tumor enlargement and the aging of patients. Understanding the natural course of meningiomas is important to provide appropriate treatment. The majority of previous studies investigated factors related to their growth, but failed to demonstrate their relationship with symptomatic progression (sympP) because of its rarity. We reviewed and meta-analyzed 27 studies that investigated natural courses in asymptomatic or untreated meningiomas to find clinico-radiol...
Source: Neurologia Medico-Chirurgica - February 5, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Early Transplantation of Human Cranial Bone-derived Mesenchymal Stem Cells Enhances Functional Recovery in Ischemic Stroke Model Rats.
Authors: Oshita J, Okazaki T, Mitsuhara T, Imura T, Nakagawa K, Otsuka T, Kurose T, Tamura T, Abiko M, Takeda M, Kawahara Y, Yuge L, Kurisu K Abstract We analyzed the cell characteristics, neuroprotective, and transplantation effects of human cranial bone-derived mesenchymal stem cells (hcMSCs) in ischemic stroke model rats compared with human iliac bone-derived mesenchymal stem cells (hiMSCs). The expressions of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF ) as neurotrophic factors were analyzed in both MSCs. hiMSCs or hcMSCs were intravenously administered into ischemic st...
Source: Neurologia Medico-Chirurgica - January 22, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Coil Embolization for Unruptured Intracranial Aneurysms at the Dawn of Stent Era: Results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3.
Authors: Satow T, Ikeda G, Takahashi JC, Iihara K, Sakai N, Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators Abstract Endosaccular coiling is recognized as a feasible method for treating unruptured intracranial aneurysms (UIAs). We retrospectively reviewed cases of UIAs treated by coiling in the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey of NET between 2010 and 2014, the beginning period of intracranial stents in Japan. Data were extracted for 6844 UIAs (6619 procedures) from 40,169 registered records of all NETs in the JR-NET 3 databases. The features of the...
Source: Neurologia Medico-Chirurgica - January 22, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Midline Glioma in Adults: Clinicopathological, Genetic, and Epigenetic Analysis.
We examined adult midline glioma cases for their histological grade, presence of H3K27M mutation, and expression of related factors-enhancer of zeste homolog 2 (EZH2), H3K27me3, p16, and methylthioadenosine phosphorylase. These tumor characteristics were also evaluated for their prognostic value in adult midline glioma. High histological grade, H3K27M-mutant, high EZH2 expression, and high H3K27me3 expression was detected in 12/23 (53%), 11/23 (48%), 9/23 (39%), and 12/23 (52%) cases, respectively. Histological grade and prognosis were significantly correlated (P
Source: Neurologia Medico-Chirurgica - January 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Long-term Outcomes of Carotid Artery Stenting: A Single-center Experience.
This study revealed the safety and long-term efficacy of CAS in a real-world setting. Routine follow-up is also important for detecting carotid artery restenosis. PMID: 31902874 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - January 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Bevacizumab Therapy of Neurofibromatosis Type 2 Associated Vestibular Schwannoma in Japanese Patients.
This study investigated the therapeutic effects of bevacizumab on NF2-associated vestibular schwannomas in Japanese patients. Bevacizumab appears to be a useful therapeutic choice in NF2 cases to control the growth of VS. Therefore, a randomised control trial to prove this assumption is necessary. PMID: 31902875 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - January 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Endoscopically Observed Outer Membrane Color of Chronic Subdural Hematoma and Histopathological Staging: White as a Risk Factor for Recurrence.
This study aimed to elucidate the relationship between endoscopic findings and CSDH recurrence. Furthermore, it examined the association between Nagahori's histopathological staging of CSDH and outer membrane color. Here, we retrospectively analyzed the operative videos of 70 patients with CSDH. The endoscopic findings were investigated, and their correlations with CSDH recurrence, the reduction ratio of the midline shift, and hematoma thickness on day 30 after the operation were analyzed. The outer membrane was white in 21 cases, yellow in 25 cases, and red in 24 cases. CSDH recurred in three (4.2%) patients, all of whom ...
Source: Neurologia Medico-Chirurgica - January 8, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Prediction of the Cerebral Hyperperfusion Phenomenon after Carotid Endarterectomy Using a Transit Time Flowmeter.
Authors: Matsumura H, Ito Y, Uemura K, Nakai Y, Komatsu Y, Ishikawa E, Matsumaru Y, Matsumura A Abstract The purpose of this study was to investigate the relationship between the cerebral hyperperfusion phenomenon (CHP) and carotid artery flow volume as measured by a transit time flowmeter during carotid endarterectomy (CEA). We retrospectively investigated 74 patients who underwent both transit time flowmetry and single photon emission computed tomography (SPECT). The flow volumes of the internal carotid artery (ICA) before and after the endarterectomy were recorded during surgery as the pre- and the post-ICA (mL/...
Source: Neurologia Medico-Chirurgica - December 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Biomechanical Analysis of the Head Movements of a Person Thrown by the Judo Technique 'Seoi-nage'.
Authors: Murayama H, Hitosugi M, Motozawa Y, Ogino M, Koyama K Abstract The present study examined the kinematics and biomechanical parameters of the head of a person thrown forward by the judo technique 'Seoi-nage'. A judo expert threw an anthropomorphic test device (the POLAR dummy) five times. Kinematics data were obtained with a high-speed digital video camera. Linear and angular accelerations of the head were measured by accelerometers mounted at the center of gravity of the dummy's head. When Seoi-nage was performed, the dummy fell forward accompanied by contacting the anterior parietal regions of the head to...
Source: Neurologia Medico-Chirurgica - December 25, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Surgical Technique and Outcome of Extensive Frontal Lobectomy for Treatment of Intracable Non-lesional Frontal Lobe Epilepsy.
This article provides step-by-step descriptions of our surgical technique for non-lesional FLE. Sixteen patients undergoing eFL were included in this study. The goals were to maximize gray matter removal, including the orbital gyrus and subcallosal area, and to spare the primary motor and premotor cortexes and anterior perforated substance. The eFL consists of three steps: (1) positioning, craniotomy, and exposure; (2) lateral frontal lobe resection; and (3), resection of the rectus gyrus and orbital gyrus. Resection ahead of bregma allows preservation of motor and premotor area function. To remove the orbital gyrus preser...
Source: Neurologia Medico-Chirurgica - December 6, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Guidelines for Intravenous Thrombolysis (Recombinant Tissue-type Plasminogen Activator), the Third Edition, March 2019: A Guideline from the Japan Stroke Society.
Authors: Toyoda K, Koga M, Iguchi Y, Itabashi R, Inoue M, Okada Y, Ogasawara K, Tsujino A, Hasegawa Y, Hatano T, Yamagami H, Iwama T, Shiokawa Y, Terayama Y, Minematsu K PMID: 31801934 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - December 6, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Simple Identification of Cerebrospinal Fluid Turbulent Motion Using a Dynamic Improved Motion-sensitized Driven-equilibrium Steady-state Free Precession Method Applied to Various Types of Cerebrospinal Fluid Motion Disturbance.
Authors: Atsumi H, Horie T, Kajihara N, Sunaga A, Sakakibara Y, Matsumae M Abstract The motion of cerebrospinal fluid (CSF) within the subarachnoid space and ventricles is greatly modulated when propagating synchronously with the cardiac pulse and respiratory cycle and path through the nerves, blood vessels, and arachnoid trabeculae. Water molecule movement that propagates between two spaces via a stoma, foramen, or duct presents increased acceleration when passing through a narrow area and can exhibit "turbulence." Recently, neurosurgeons have started to perform fenestration procedures using neuroendosco...
Source: Neurologia Medico-Chirurgica - November 30, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy.
Authors: Chonan M, Saito R, Kanamori M, Osawa SI, Watanabe M, Suzuki H, Nakasato N, Tominaga T Abstract After introduction of levetiracetam (LEV), treatment of seizures in patients with malignant brain tumors has prominently improved. On the other hand, we still experience some cases with LEV-uncontrollable epilepsy. Perampanel (PER) is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoaxazolepropionate acid receptor antagonist that has recently been approved for treating focal epilepsy as a secondary drug of choice. Available literature reporting PER medication in patients with gliomas is still sparse. Here, ...
Source: Neurologia Medico-Chirurgica - November 23, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Efficacy of the Drip and Ship Method in 24-h Helicopter Transportation and Teleradiology for Isolated Islands.
We examined the efficacy of the drip and ship (DS) method for treating patients with acute ischemic stroke (AIS) on these islands, in comparison with patients on the mainland. From 2010 to 2017, we reviewed 98 consecutive patients with AIS who received intravenous recombinant tissue plasminogen activator (IV rt-PA) in our hospital or were transported to our hospital after IV rt-PA. Patients were divided into the Islands group (received IV rt-PA on the islands, DS; 31 cases) and the Mainland group (67 cases). The median transport distance from the islands was 112 km. The rate of patients achieving favorable outcomes was 54....
Source: Neurologia Medico-Chirurgica - November 23, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Beneficial Effect of Carotid Artery Stenting on Cerebral Hemodynamic Impairment and Cognitive Function.
Authors: Hara S, Seida M, Kumagai K, Yamamoto T Abstract The aim of this study was to evaluate the effects of the carotid artery stenting (CAS) procedure on cerebral hemodynamics and cognitive performance in patients with internal carotid artery stenosis. In this prospective observational study, 16 consecutive patients in a single institute were treated with CAS from 2010 to 2011 (71.7 ± 7.3 years old, 12 males, and six left-sided procedures). Before and after the CAS procedure, all patients were evaluated with single photon emission computed tomography using 123I-iodoamphetamine and acetazolamide as well as...
Source: Neurologia Medico-Chirurgica - November 23, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Current Status of Endovascular Treatment for Extracranial Steno-occlusive Diseases in Japan: Analysis Using the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3).
Authors: Yamao Y, Ishii A, Satow T, Iihara K, Sakai N, Japanese Registry of Neuroendovascular Therapy investigators Abstract Endovascular treatment of extracranial steno-occlusive lesions is an alternative to direct surgery. There is no consensus regarding the natural course and standard treatment of these lesions. The aim of this study was to identify the current status of endovascular treatment for extracranial steno-occlusive lesions. A total of 1154 procedures for extracranial steno-occlusive lesions, except for internal carotid artery stenosis, were collected from the Japanese Registry of Neuroendovascular The...
Source: Neurologia Medico-Chirurgica - November 23, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Benefits and Risks of CT Angiography Immediately after Emergency Arrival for Patients with Intracerebral Hematoma.
Authors: Sorimachi T, Atsumi H, Yonemochi T, Hirayama A, Shigematsu H, Srivatanakul K, Takizawa S, Matsumae M Abstract Computed tomography angiography (CTA) immediately after diagnosis of intracerebral hematoma (ICH) on noncontrast CT in the emergency room has benefits, which consist of early diagnosis of secondary ICH and prediction of hematoma growth using the spot sign in primary ICH, but CTA also involves possible risks of acute kidney injury (AKI) and adverse reactions. The purpose of this study was to evaluate the benefits and risks of CTA. A total of 1423 consecutive adult patients diagnosed with ICH who wer...
Source: Neurologia Medico-Chirurgica - November 13, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Clinical Characteristics and Endovascular Treatment for Spinal Dural Arteriovenous Fistula in Japan: Japanese Registry of Neuroendovascular Therapy 2 and 3.
Authors: Tsuruta W, Matsumaru Y, Iihara K, Satow T, Sakai N, Katsumata M, Hosoo H, Sato M, Ito Y, Marushima A, Hayakawa M, Ishikawa E, Matsumura A Abstract A subgroup analysis of spinal vascular lesions registered in the Japanese Registry of Neuroendovascular Therapy 2 (JR-NET2) and JR-NET3 was performed. About 172 analyzable cases of spinal dural arteriovenous fistula (SDAVF) were assessed, including the characteristics, treatment strategy, and treatment outcome. SDAVF was more common in middle-aged and older males. The most commonly affected area was the thoracolumbosacral region (83.7%), and most cases had a non...
Source: Neurologia Medico-Chirurgica - November 13, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Stratification by Multidimensional Approach for Rational Treatment of Asymptomatic Carotid Stenosis (SMART-K Study): Study Protocol.
Authors: Yoshida K, Miyamoto S, SMART-K Study Group Abstract With recent advances in medical treatments for carotid artery stenosis (CS), indications for carotid surgery should be more carefully considered for asymptomatic CS (ACS). Accurate stratification of ACS should be based on the risk of cerebral infarction, and subgroups of patients more likely to benefit from surgical treatment should be differentiated. Magnetic resonance imaging (MRI) offers a non-invasive, accurate modality for characterizing carotid plaque. Intraplaque hemorrhage (IPH) seems the most promising feature of vulnerable plaque detectable by M...
Source: Neurologia Medico-Chirurgica - November 13, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Far-anterior Interhemispheric Transcallosal Approach for a Central Neurocytoma in the Lateral Ventricle.
Authors: Komura S, Akiyama Y, Suzuki H, Yokoyama R, Mikami T, Mikuni N Abstract To describe the far-anterior interhemispheric transcallosal approach for the treatment of a central neurocytoma at the roof of the lateral ventricle. In comparison to the view obtained during the usual anterior transcallosal approach, the far-anterior approach allowed for a higher view of the lateral ventricle to be obtained without further injury or retraction of the corpus callous. Two patients with central neurocytoma in the lateral ventricle were treated with the far-anterior interhemispheric transcallosal approach. Gross-total rese...
Source: Neurologia Medico-Chirurgica - October 29, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Targeted Bypass Strategy for Preventing Hemorrhage in Moyamoya Disease: Technical Note.
Authors: Funaki T, Kataoka H, Yoshida K, Kikuchi T, Mineharu Y, Okawa M, Yamao Y, Miyamoto S Abstract Although direct bypass is effective at preventing intracranial hemorrhage in moyamoya disease, the optimal strategy for achieving this purpose has rarely been addressed. The tailored targeting bypass strategy is a novel technical modification of direct bypass focused on hemorrhage prevention. The strategy is based on the promising theory of periventricular anastomosis, which explains the mechanism of hemorrhage in moyamoya disease. The strategy is defined as the use of multi-imaging modalities to predetermine in a ...
Source: Neurologia Medico-Chirurgica - October 29, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Usefulness of a New Electronic Conductivity Device with a Pedicle Probe and a Multi-axis Angiography Unit for Inserting a C1 Lateral Mass Screw Safely and Tightly: A Technical Note.
This study suggested that the ECD and multi-axis angiography unit are useful for inserting the C1 LMS safely and tightly. PMID: 31656253 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - October 29, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Operating Costs of Full-endoscopic Lumbar Spine Surgery in Japan.
Authors: Manabe H, Tezuka F, Yamashita K, Sugiura K, Ishihama Y, Takata Y, Sakai T, Maeda T, Sairyo K Abstract For full-endoscopic lumbar discectomy, operating costs are also important because expensive equipment are necessary. We surveyed the operating costs of surgical equipment necessary for full-endoscopic surgery together with surgical procedure reimbursement fees. A total of 295 cases of full-endoscopic surgery via a transforaminal approach were retrospectively analyzed. We calculated the frequency of damage and the unit purchase price of devices such as endoscopes, and surgical instruments such as grasping f...
Source: Neurologia Medico-Chirurgica - October 19, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Surgical Indications and Operative Results of Lumbosubarachnoid-Lumboepidural Shunting in 29 Patients with Idiopathic Normal Pressure Hydrocephalus under Local Anesthesia.
This study consisted of 29 patients with idiopathic normal pressure hydrocephalus (iNPH) who underwent lumbosubarachnoid-lumboepidural (L-L) shunting under local anesthesia in accordance with our surgical indications of L-L shunting. (1) CSF absorption within the lumbar epidural space and shunt clearance were confirmed in all patients after operation. (2) Shunt responders (R) were 25 of 29 cases (86.2%) 3 months after surgery. Among the R, symptom exacerbation was confirmed in three patients (12%) within the follow-up period (mean, 25.1 months). In each of these patients, shunt function were maintained and remained unchang...
Source: Neurologia Medico-Chirurgica - October 19, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Lessons from Vessel Wall Imaging of Intracranial Aneurysms: New Era of Aneurysm Evaluation beyond Morphology.
Authors: Matsushige T, Shimonaga K, Mizoue T, Hosogai M, Hashimoto Y, Takahashi H, Kaneko M, Ono C, Ishii D, Sakamoto S, Kurisu K Abstract Recent basic studies have clarified that aneurysmal wall inflammation plays an important role in the pathophysiology of intracranial aneurysms. However, it remains an interdisciplinary challenge to visualize aneurysm wall status in vivo. MR-vessel wall imaging (VWI) is a current topic of advanced imaging techniques since it could provide an additional value for unruptured intracranial aneurysms (UIAs) risk stratification. With regard to ruptured intracranial aneurysms, VWI could...
Source: Neurologia Medico-Chirurgica - October 17, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Neuroendoscopic Evacuation for Spontaneous Cerebellar Hemorrhage Is a Safe and Secure Approach and May Become a Mainstream Technique.
Authors: Atsumi H, Baba T, Sunaga A, Sakakibara Y, Nonaka Y, Sorimachi T, Matsumae M Abstract Patients with spontaneous cerebellar hemorrhage present with rapidly deteriorating neurological symptoms due to a hematoma-induced mass effect in the brainstem. We compared the standard surgical approach of a suboccipital craniectomy with neuroendoscopic surgery for treating spontaneous cerebellar hemorrhage. We performed a retrospective analysis of 41 patients indicated for surgery to treat spontaneous cerebellar hemorrhage. At our hospital, craniectomy was performed until 2010, and neuroendoscopic surgery was performed t...
Source: Neurologia Medico-Chirurgica - October 6, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

The Tight Medial and High Convexity Subarachnoid Spaces Is the First Finding of Idiopathic Normal Pressure Hydrocephalus at the Preclinical Stage.
Authors: Miyazaki K, Ishii K, Hanaoka K, Kaida H, Nakajima K Abstract Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) findings are often reported as characteristic radiological features of idiopathic normal pressure hydrocephalus (iNPH). However, the process of development of DESH remains unclear. The aim of the present study was to determine the dynamic deforming process and pathophysiology of iNPH. All patients>50 years of age who underwent whole body FDG-PET/CT scanning at Kindai University Hospital between May 2017 and April 2018 were included in this retrospective study, and their brain ...
Source: Neurologia Medico-Chirurgica - October 6, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Application of Augmented Reality to Stereotactic Biopsy.
In conclusion, applying AR to stereotactic biopsy is feasible and may improve the safety of the procedure. PMID: 31548442 [PubMed - as supplied by publisher] (Source: Neurologia Medico-Chirurgica)
Source: Neurologia Medico-Chirurgica - September 26, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Zygomatic Anterior Temporal Approach for High-position Upper Basilar Aneurysm.
Authors: Katsuno M, Tanikawa R Abstract Skull base techniques have often required high-position upper basilar aneurysm surgery based on a surgical corridor. Examples are the orbitozygomatic osteotomy for the trans-sylvian approach and zygomatic osteotomy for the subtemporal approach. However, clarity remains to be archived for the additional technique of the anterior temporal approach, including the middle surgical corridor of the trans-sylvian approach and subtemporal approach. In the present study, we describe the methodology and the problems associated with the zygomatic anterior temporal approach for high-posit...
Source: Neurologia Medico-Chirurgica - September 26, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

Computational Fluid Dynamics Analysis of the Offending Artery at Sites of Neurovascular Compression in Trigeminal Neuralgia Using Preoperative MRI Data.
This study aimed to analyze the hemodynamic features of the offending artery at sites of neurovascular compression (NVC) using computational fluid dynamics (CFD). A total of 23 patients who underwent microvascular decompression (MVD) for primary trigeminal neuralgia (TN) between January 2015 and December 2016 were enrolled in this study. The compressing vessel at the NVC site was identified microsurgically in all cases, and patients were divided into two groups based on the intraoperative findings: (1) the arterial NVC group and (2) the non-arterial NVC control group. A 3D surface model of the structures surrounding the NV...
Source: Neurologia Medico-Chirurgica - September 20, 2019 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research