Suzuki Stage VI Unilateral Moyamoya Disease Presenting With Massive Intraventricular Hemorrhage.

Moyamoya disease (MMD) is characterized by stenosis of the terminal portion of the internal carotid artery (ICA) and the development of collateral vessels. In late Suzuki stage MMD, ICA almost disappears, and the moyamoya vessels gradually regress. We report a case of late Suzuki stage unilateral MMD presenting with intraventricular hemorrhage.

RNF213 p.Arg4810Lys Wild Type is Associated with De Novo Hemorrhage in Asymptomatic Hemispheres with Moyamoya Disease.

Clinical implications of RNF213 genetic variants, other than p.Arg4810Lys, in moyamoya disease (MMD), remain unclear. This study aimed to investigate the association of RNF213 variants with clinical phenotypes in MMD.

Genome-Wide Association Study of Intracranial Artery Stenosis Followed by Phenome-Wide Association Study.

The genetic background of intracranial artery stenosis (ICAS), a major cause of ischemic stroke, remains elusive. We performed the world's first genome-wide association study (GWAS) of ICAS using DNA samples from Japanese subjects, to identify the genetic factors associated with ICAS and their correlation with clinical features. We also conducted a phenome-wide association study (PheWAS) of the top variant identified via GWAS to determine its association with systemic disease.

Initial evaluation of a novel electrocardiography sensor-embedded fabric wear during a full marathon.

Sudden cardiac accident (SCA) during a marathon is a concern due to the popularity of the sport. Preventive strategies, such as cardiac screening and deployment of automated external defibrillators have controversial cost-effectiveness. We investigated the feasibility of use of a new electrocardiography (ECG) sensor-embedded fabric wear (SFW) during a marathon as a novel preventive strategy against SCA.

Changes in the Risk of Stroke in Dialysis Patients: A Retrospective Analysis over the Last 40 Years.

The stroke incidence in hemodialysis (HD) patients is high, but the associated factors remain largely unknown. This study aimed to analyze stroke incidence in HD patients and changes in risk factors. Data of 291 patients were retrospectively analyzed.

Hemorrhagic Onset Intracranial Artery Dissection of Middle Cerebral Artery Followed by Progressive Arterial Stenosis with Genetic Variant RNF213 p.Arg4810Lys (rs112735431).

Background: Intracranial arterial dissection (IAD) is known to exhibit various patterns of arterial imaging features such as stenosis and dilation; however, the genetic background of IAD has not been elucidated so far. RNF213 was recently identified as a susceptibility gene for moyamoya disease (MMD) and intracranial artery stenosis (ICAS). More recently, RNF213 p.

Risk Factors and Outcomes of Cerebral Stroke in End-Stage Renal Disease Patients Receiving Hemodialysis.

Objective: Dialysis patients have a higher incidence of stroke, and outcomes are often poor. Diabetic nephropathy (DN) is a stroke risk-factor, but the importance is unclear in dialysis patients. This study investigated the stroke features and risk factors in hemodialysis (HD) patients.

A Bezoar Composed of Bilirubin Calcium, Calcium Carbonate, and Fatty Acid Calcium.

A 68-year-old Japanese man was diagnosed with bezoar in the stomach, which was endoscopically retrieved. The bezoar was composed of bilirubin calcium, calcium carbonate, and fatty acid calcium. Due to the presence of bilirubin calcium in the bezoar, we performed imaging studies of the bile duct; gallstones and common bile duct stones were identified.

A case of conservative management for left ventricular giant pseudoaneurysm without ST segment changes.

Left ventricular (LV) rupture after myocardial infarction (MI) occasionally results in formation of LV pseudoaneurysm (LVPA) which is prone to rupture because of its thin wall. However, cases of LVPA without ST changes including segment elevation in electrocardiogram (ECG) are rare. In this case, we describe a patient who had relatively mild symptoms and giant LVPA with no specific ECG changes following MI with a confirmed diagnosis via transthoracic echocardiography.

Genetic Analysis of Ring Finger Protein 213 (RNF213) c.14576G>A in Intracranial Atherosclerosis of the Anterior and Posterior Circulations.

Background: Intracranial atherosclerosis of the anterior circulation (anterior ICAS) and intracranial atherosclerosis of the posterior circulation (posterior ICAS) are thought to involve different pathogeneses and risk factors. Recently, we identified a genetic variant that has a significant association with ICAS. The variant was ring finger protein 213 (RNF213) c.

[A fundamental proposal to establish an investigative system for medical accidents].

For more than a decade, numerous disputes over medical errors and other safety issues in the healthcare system have occurred and attracted growing interest from society. As a result, through the Model Project for the Investigation of Death Associated with Medical Practice, the Outline Proposal of the Measure to Establish an Investigative Commission on Medical Accidents was proposed by the Japanese Ministry of Health, Labour and Welfare. However, this measure was not finalized.

Symptomatic recurrence of intracranial arterial dissections: follow-up study of 143 consecutive cases and pathological investigation.

Background And Purpose: The frequency and pattern of symptomatic recurrence of spontaneous intracranial arterial dissection (IAD) are unknown.

Methods: A follow-up study of 143 patients (85 men, 58 women; mean age, 50.7 [7-83] years) with spontaneous IADs at The University of Tokyo and affiliated hospitals from 1980 to 2000 was conducted.

Intramedullary recurrence of germinoma in the spinal cord 15 years after complete remission of a pineal lesion.

The authors present a case of germinoma that was initially found in the pineal region and recurred 15 years later in the intramedullary cervical spinal cord after intensive chemo- and radiotherapy and diagnosis of complete remission. This 28-year-old man initially presented with seizures. Hydrocephalus and a pineal tumor were found on radiological examination, and partial resection of the tumor was performed.

Prediction of the incidence of spontaneous intracerebral hemorrhage from meteorological data.

We analyzed the relationship between the incidence of spontaneous intracerebral hemorrhage (ICH) and various meteorological data (daily atmospheric air pressure, air temperature, precipitation, humidity, presence of typhoons, occurrence of the rainy season, wind velocity, and wind direction) for patients at Teraoka Memorial Hospital in Shin-ichi Town, Japan, from January 1, 2001 to December 31, 2003. All data were analyzed by contingency table analysis and multivariate regression analysis. From January 1, 2002 to December 31, 2003, we identified high-risk ICH days as those days for which the preceding 3 days mean recorded air pressure of 1,015 hPa or more and then conducted a statistical comparison of the incidence of ICH on high-risk ICH days with that on the other days.

Relationship between the occurrence of spontaneous intracerebral hemorrhage and holidays and traditionally unlucky days in Fukuyama City, Hiroshima Prefecture, Japan.

To investigate whether calendrical information influences the occurrence of spontaneous intracerebral hemorrhage, we statistically compared the incidence of intracerebral hemorrhage for inpatients at Teraoka Memorial Hospital (164 patients), against various calendrical factors such as the day of the week, national holidays, and RokuYo (a recurring six-day series of lucky and unlucky days in the Japanese traditional calendar) over the period from January 1, 2001 to December 31, 2003. On Japanese national holidays the relative risk of intracerebral hemorrhage is significantly higher than on other days, certainly due to much more alcohol consumption on holidays. During RokuYo, the relative risk of intracerebral hemorrhage is extremely low on the traditionally unlucky days of ButsuMetsu and TomoBiki, as many Japanese people restrain their activities on these days.

Endoscopy-guided removal of spontaneous intracerebral hemorrhage: comparison with computer tomography-guided stereotactic evacuation.

Background And Purpose: Spontaneous intracerebral hemorrhage (ICH) continues to be a major medical and socioeconomic problem. While the surgical procedure failed to show benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. The authors introduced endoscopy-guided evacuation in managing ICH and reports the benefits over the conventional method.

[Relationship between classification of CSDH according to the Internal architecture and hematoma contents].

Background: Based on the finding of temporal changes in the internal architecture on CT scans, we classified CSDH into 4 types: the homogeneous type, the laminar type, the separated type, and the trabecular type. The purpose of this study was to statistically analyze the relationship between the type of CSDH and the hematoma contents.

Methods: This study assessed 45 consecutive CSDH patients.

[Efficacy of dynamic CT perfusion imaging in conjunction with three dimensional CT angiography for the evaluation of acute ischemic stroke].

Background And Purpose: Through the use of a high-speed spiral CT scanner (GEMedical HiSpeedZX/i), CT/P/A technique, where conventional CT, CT perfusion imaging (CTP) and CT angiography (CTA) are consecutively performed, can now be performed with an imaging time of 90 seconds and a total contrast medium volume of 100 ml. A prospective clinical study was performed to ascertain the effectiveness of CT/P/A in diagnosing acute ischemic strokes.

Methods: 29 consecutive patients of Teraoka Memorial Hospital suspected of suffering from the occlusion or constriction of cerebral arteries and who underwent CT/P/A within 3 hours from the onset served as subjects.