Updated on 2025/04/18

写真a

 
Kodera Hiroto
 
Affiliation
Nippon Medical School Hospital, Department of Neurology, Assistant Professor
Title
Assistant Professor
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Papers

  • Pathological Findings of Embolus Retrieved by Mechanical Thrombectomy in Cerebral Embolism with Libman-Sacks Endocarditis: A Report of Two Cases.

    Hiroto Kodera, Yuki Sakamoto, Junya Aoki, Ryutaro Kimura, Noriko Matsumoto, Yasuhiro Nishiyama, Shinobu Kunugi, Kazumi Kimura

    Internal medicine (Tokyo, Japan)   2024.7

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    Libman-Sacks endocarditis is an important cause of embolic stroke in systemic lupus erythematosus, although the detailed pathogenesis of stroke remains unclear. We herein report two cases of stroke with Libman-Sacks endocarditis in which the emboli were retrieved by mechanical thrombectomy. The embolus consisted of eosinophilic homogeneous acellular structures, whereas fibrin-platelet thrombi were hardly observed in the embolus. Immunohistochemistry showed immunoglobulin deposits in the embolus, suggesting that immunological mechanisms were involved in the growth of the embolus. A pathological analysis of the embolus retrieved by mechanical thrombectomy provided useful information on the etiology, leading to optimal treatment.

    DOI: 10.2169/internalmedicine.3212-23

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  • Migraine-like headache with aura induced by a small infarct in the parieto-occipital cortex: A case report.

    Hiroyuki Hokama, Yuki Sakamoto, Serika Yamamoto, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Yosuke Fujisawa, Chikako Nito, Kazumi Kimura

    Journal of Nippon Medical School = Nippon Ika Daigaku zasshi   2024.6

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    A 56-year-old right-handed man was referred to our hospital for evaluation of sudden-onset transient quadrantanopia, which was followed by throbbing headache consistent with migraine with aura (MA). Magnetic resonance imaging (MRI) of the right parieto-occipital cortex on admission showed a hyperintense region on diffusion-weighted imaging, which disappeared 7 days later. A small cortical infarct in the parieto-occipital cortex can cause MA-like headache, and the present infarct lesion was only detectable on MRI during the acute phase. Performing MRI for patients with suspected acute MA might help identify the cause of MA-like headache and ensure appropriate management of patients.

    DOI: 10.1272/jnms.JNMS.2025_92-103

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  • FLAMES with Elevated Myelin Basic Protein Followed by Myelitis.

    Hiroyuki Hokama, Yuki Sakamoto, Toshiyuki Hayashi, Seira Hatake, Mizuho Takahashi, Hiroto Kodera, Akihito Kutsuna, Chikako Nito, Shunya Nakane, Hiroshi Nagayama, Toshiyuki Takahashi, Kazumi Kimura

    Internal medicine (Tokyo, Japan)   61 ( 23 )   3585 - 3588   2022.12

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    The pathophysiology of unilateral cortical fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis with seizures (FLAMES) is unclear. A 26-year-old man was referred because of a seizure. FLAIR showed an increased signal intensity and swelling of the right frontal cortex. His symptoms and imaging abnormalities were improved after intravenous methylprednisolone therapy. MOG antibody was detected both in serum and cerebrospinal fluid (CSF). Therefore, the patient was diagnosed with FLAMES. Myelin basic protein (MBP) was elevated in CSF. The high MBP value in the CSF in the present case suggested that demyelination as well as inflammation can occur in some FLAMES patients.

    DOI: 10.2169/internalmedicine.9439-22

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  • [Delayed white matter lesion after mechanical thrombectomy for middle cerebral artery occlusion with Libman-Sacks endocarditis].

    Akihito Kutsuna, Junya Aoki, Hiroto Kodera, Yasuhiro Nishiyama, Toshinari Nakane, Kazumi Kimura

    Rinsho shinkeigaku = Clinical neurology   62 ( 9 )   716 - 721   2022.9

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    A 59-year-old woman presented with right hemiparesis and was transported from outside hospital. MRI revealed acute infarction and the left middle cerebral artery M2 occlusion. Intravenous infusion of recombinant tissue-type plasminogen activator, and mechanical thrombectomy (MT) were performed. The cause of cerebral infarction was diagnosed as Libman-Sacks endocarditis. She discharged without sequelae. After 10 months later, she presented with mild cognitive decline, and MRI showed new white matter lesion in left deep white matter. In magnetic resonance spectroscopy, the lesion showed an increased rate of choline/creatine, and a decreased rate of N-acetylaspartate/creatine, elevated lactate peak. When new higher brain dysfunction presented after recanalization by MT, it might be related to the delayed white matter lesion.

    DOI: 10.5692/clinicalneurol.cn-001749

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Misc.

  • 片側の舞踏運動・バリズムをきたした中大脳動脈狭窄症の1例

    古寺 紘人, 沓名 章仁, 青木 淳哉, 鈴木 亨尚, 西 佑治, 武井 悠香子, 仁藤 智香子, 西山 康裕, 永山 寛, 木村 和美

    臨床神経学   59 ( 4 )   215 - 215   2019.4

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    Language:Japanese   Publisher:(一社)日本神経学会  

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  • 造影CTが診断に寄与した重症筋無力症クリーゼの症例

    氷室 圭一, 古寺 紘人, 大谷 亮, 菊池 猛, 土屋 武弘, 苅田 真, 田中 真人

    交通医学   72 ( 1-2 )   33 - 33   2018.3

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    Language:Japanese   Publisher:日本交通医学会  

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Presentations

  • 抗AChR抗体陽性重症筋無力症における治療前後の抗体価低下と再発率に関する検討

    古寺紘人, 林俊行, 中根俊成, 永山寛, 木村和美

    日本神経学会学術大会プログラム・抄録集  2022 

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    Event date: 2022

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  • ニボルマブ投与後に発症した抗横紋筋抗体陽性の筋炎・心筋炎合併重症筋無力症の剖検例

    古寺 紘人, 林 俊行, 藤澤 洋輔, 永山 寛, 梶本 雄介, 寺崎 泰弘, 峯岸 裕司, 木村 和美

    臨床神経学  2021.9  (一社)日本神経学会

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    Event date: 2021.9

    Language:Japanese  

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  • Alzheimer病が合併したと考えられるParkinson病患者の臨床的特徴の検討

    古寺 紘人, 藤澤 洋輔, 村賀 香名子, 永山 寛, 木村 和美

    臨床神経学  2020.11  (一社)日本神経学会

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    Event date: 2020.11

    Language:Japanese  

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  • てんかん発作によりMRI異常信号を呈し、片麻痺が遷延した症候性局在関連てんかんの1例

    古寺 紘人, 中嶋 信人, 木村 和美

    臨床神経学  2019.11  (一社)日本神経学会

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    Event date: 2019.11

    Language:Japanese  

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  • 片側の舞踏運動・バリズムをきたした中大脳動脈狭窄症の1例

    古寺 紘人, 沓名 章仁, 青木 淳哉, 鈴木 亨尚, 西 佑治, 武井 悠香子, 仁藤 智香子, 西山 康裕, 永山 寛, 木村 和美

    臨床神経学  2019.4  (一社)日本神経学会

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    Event date: 2019.4

    Language:Japanese  

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  • 高度な可動性プラークが塞栓源と考えられた大動脈原性脳塞栓症の1例

    古寺紘人, 沓名章仁, 青木淳哉, 鈴木亨尚, 西佑治, 武井悠香子, 金城よしの, 仁藤智香子, 松本典子, 西山康裕, 木村和美

    日本栓子検出と治療学会プログラム・抄録集  2018 

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    Event date: 2018

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