DOI： 10.4103/ajns.AJNS_261_18

PubMed

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DOI： 10.4103/ajns.AJNS_11_19

PubMed

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Language：English  

Persistent primitive hypoglossal artery is a rare anastomosis between the carotid and basilar arteries, and sometimes associated with cerebral aneurysms. However, association of persistent primitive hypoglossal artery with aneurysms located on arteries other than persistent primitive hypoglossal artery itself or posterior circulation is very rare. An 80-year-old woman suffered from subarachnoid hemorrhage, whose angiography demonstrated aneurysms on the left middle cerebral artery and anterior communicating artery, and the left persistent primitive hypoglossal artery. The middle cerebral artery aneurysm was the origin of hemorrhage. Although repeated craniotomy was necessary for the left middle cerebral artery aneurysm, both aneurysms were successfully clipped. In our case, neither aneurysm was located on an artery related to the persistent primitive hypoglossal artery. There is a possibility that cases of persistent primitive hypoglossal artery are accompanied by cerebral aneurysms on arteries other than the persistent primitive hypoglossal artery or in the posterior circulation.

DOI： 10.14740/jocmr3649

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Language：Japanese   Publisher：(一社)日本脳卒中の外科学会  

橈骨動脈(RA)グラフトの基本手技と連続10症例の結果を報告した。基本手技は浅側頭動脈中大脳動脈(STA-MCA)吻合術を併用したexternal carotid artery(ECA)-RA-M2 bypassで、STA-MCA吻合術はassistとしてよりも灌流圧のモニタリングとして重視している。グラフトの皮下通しでは皮下トンネル作成用のchest tubeに通した糸とクリップに結んだ糸を結紮し引き込むことでグラフトのねじれを防止した。頸部での血管吻合の際にはECA-RA吻合前にRAのねじれをとり、切断は外頸動脈のarteriotomy終了後とし、未破裂例の予定手術では術前から抗血小板剤を用いた。10症例の術後MRIでは症候性虚血性合併症はみられず、術前症候が認められた9例中7例は1ヵ月以内に症状が改善した。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02079&link_issn=&doc_id=20190524130002&doc_link_id=%2Fcp4strok%2F2019%2F004701%2F002%2F0006-0011%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2019%2F004701%2F002%2F0006-0011%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English  

For a case of dissecting vertebral artery aneurysm (DVAA) in a dominant vertebral artery (VA) or posterior inferior cerebellar artery (PICA)-involving lesion, stent-assisted coil embolization (SACE) is an effective technique to preserve blood flow of the VA. A 41-year-old man presented with subarachnoid hemorrhage. Angiography demonstrated DVAA on the left VA just distal to the PICA, and the right VA was thinner than the left. For this case, SACE was performed to preserve the left VA and PICA. On the 10th day, angiography showed recurrence of the dissection. The dissected portion had thickened and extended to both distal and proximal sides involving the PICA origin and proximal portion to the PICA. A second endovascular embolization was performed and the recurrent dissecting aneurysm was embolized including the main VA cavity. In cases of DVAA, there is a possibility of recurrence after SACE, if a dissecting cavity remains unembolized. Therefore, total embolization is necessary under close observation from multiple angles, including the down-the-barrel view.

DOI： 10.14740/jocmr3397w

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications Inc.  

Background: In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods: From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation. The aneurysms were located at the anterior communicating artery and basilar artery in two patients each, and on the internal carotid artery at the bifurcation of the anterior choroidal artery (AChoA) in one. In these patients, the clinical course, radiological findings, and management were retrospectively reviewed. Results: Thrombus formation was observed in the posterior cerebral artery, anterior cerebral artery (A2), AChoA, and middle cerebral artery. The timing of thrombus formation was during coil delivery in four cases, and guiding catheter advancement in one. As for thrombus management, for all patients, administrations of heparin and antiplatelet agents were performed. For four patients, urokinase injection into the affected arteries was added after the completion of embolization. Cerebral infarction was postoperatively identified in two patients, but no hemorrhage was noted. Conclusion: Administrations of heparin and antiplatelet drugs should be performed appropriately during procedures, and close observation of the arterial condition on angiography is necessary. Once thromboembolism occurs during the endovascular embolization of ruptured cerebral aneurysms, adequate heparinization, and antiplatelet therapy should first be performed.

DOI： 10.1177/1591019917739448

Scopus

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Language：English  

Background: An aneurysm of distal lenticulostriate artery is very rare. The natural course and management of this rare aneurysm are not clear. Case Description: An 81-year-old woman developed consciousness disturbance. Computed tomography revealed hemorrhage in the right caudate nucleus and lateral ventricles. Three-dimensional computed tomographic angiography demonstrated only an aneurysm at the basilar artery. On angiography, on the sixth day, an aneurysm at the right lenticulostriate artery was demonstrated. Then, the aneurysm disappeared on three-dimensional computed tomographic angiography on the 15th day. Subsequent radiological examinations revealed no vascular anomaly in the right lenticulostriate artery. Conclusion: An aneurysm at this location can show dynamic changes based on radiological findings. Close radiological observation is necessary.

DOI： 10.4103/sni.sni_126_18

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

In penetrating injuries, woods are known to be difficult to detect with radiological imaging studies, because the wood density are known to be extremely close to the value of air on CT. Adjustment of CT window and reconstruction of a 3D image from CT images allowed us to more accurately distinguish wood from air and to find the fragment of the wooden chopstick. It is particularly useful in transorbital penetrating injury.

DOI： 10.1007/s00381-017-3510-2

Web of Science

PubMed

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：(NPO)日本脳神経血管内治療学会  

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Language：Japanese   Publisher：(NPO)日本脳神経血管内治療学会  

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Language：Japanese   Publisher：(一社)日本脳神経外傷学会  

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：(NPO)日本脳神経外科救急学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：Japanese   Publisher：(公財)大原記念倉敷中央医療機構倉敷中央病院  

偽性副甲状腺機能低下症(以下PHP)は副甲状腺ホルモン(以下PTH)に対する先天的不応性により,電解質異常やそれに伴う症状を呈する疾患であり,日本全国で430名の患者数が推定されている非常にまれな疾患でもある.また,PHPIa,Ic型はAlbright遺伝性骨異栄養症(以下AHO)という特徴的な体型や性質を呈する.今回,AHOを呈するPHPI型の症例を経験したため,報告する.症例は5歳の女児.てんかん発作と精神発達遅滞で小児科フォロー中の患者であったが,低カルシウム血症,高リン血症および血清intact-PTH高値を認めたため,精査目的に入院となった.Ellsworth-Howard試験を行い,PHPI型と診断した.また,精神発達遅滞,円形顔貌,低身長はAHOによるものと思われ,PHPIa型またはIc型と考えられた.甲状腺機能の低下は認めなかった.ビタミンD3製剤の投与を開始し,9ヵ月後には血清電解質濃度は正常域となった.PHPIa型は,PTHだけでなく,他の生体ホルモンに対しても不応性を呈することがある.Ia型とIb型の鑑別にはAHOの有無が有用であり,その鑑別により,他の生体ホルモンへの不応性に対して迅速な診断と治療を行える可能性がある.(著者抄録)

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Poster presentation  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Poster presentation  

File： ポスター pdf.pdf

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Poster presentation  

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