Publications by authors named "Daisuke Shimo"
Vertebral artery stump syndrome (VASS) is a rare condition that can cause posterior circulation ischemic stroke due to occlusion of the ipsilateral vertebral artery (VA) orifice, resulting in blood flow stagnation and embolus formation. Although there is no established treatment for this condition, we observed 3 cases of VASS out of 326 acute ischemic stroke cases at a single institution from April 2021 to October 2022. Despite the best possible antithrombotic treatment, all 3 patients had recurrent ischemic strokes.
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- Cerebral venous sinus thrombosis (CVST) leads to increased pressure and potential neurological issues due to vein blockage, making early treatment essential for better outcomes.
- The standard treatment involves anticoagulants, primarily intravenous heparin followed by oral medications, with evidence suggesting that direct oral anticoagulants (DOACs) might also be effective and safer.
- A case study is presented where a patient with CVST and worsening neurological symptoms was successfully treated by transitioning from heparin to oral Edoxaban early on, resulting in prompt recanalization of the affected sinus.
Article Synopsis
- * The patient was diagnosed with a dAVF that had complex drainage issues, and an emergency embolization was performed to alleviate her symptoms.
- * Despite a successful reduction in the dAVF post-treatment, the patient experienced a significant cerebral hemorrhage immediately afterward, highlighting the need for careful evaluation of hemodynamics before such procedures.
Article Synopsis
- Pineal parenchymal tumor of intermediate differentiation (PPTID) is a rare type of brain tumor classified by the WHO in 2000, sitting between pineocytoma and pineoblastoma in terms of prognosis and having uncertain management strategies.
- A case study describes a 63-year-old woman who experienced lower-extremity weakness, leading to the discovery of a pineal mass, which was diagnosed as a pineocytoma after surgical resection.
- After two years without treatment following surgery, the patient faced tumor recurrence and leptomeningeal dissemination, which was successfully treated with craniospinal irradiation, highlighting the need for long-term monitoring in PPT patients.
Article Synopsis
- - The study examines the use of the relative apparent diffusion coefficient (ADC) ratio in MRI to assess ischemia and predict the potential for ischemic reversal and the risk of hemorrhage after treatment in patients with acute artery occlusion.
- - An analysis of 56 patients showed that higher ADC ratios were associated with reversible lesions, whereas lower ratios were linked to final infarct lesions, with notable differences in ADC readings between hemorrhagic and non-hemorrhagic regions.
- - Findings suggest that the relative ADC ratio can effectively indicate the likelihood of tissue recovery post-revascularization and help predict complications, regardless of when the ischemic event occurred.
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- - The study aimed to assess how effective an MRI-based scoring system for disproportionately enlarged subarachnoid space hydrocephalus (DESH) is in predicting recovery outcomes for patients with idiopathic normal pressure hydrocephalus (iNPH) after surgery.
- - The DESH score, ranging from 0 to 10, was determined by a team of medical experts assessing MRI findings and analyzed against various patient improvement measures, including the modified Rankin Scale and Mini-Mental State Examination, one year post-surgery.
- - Results indicated a mean DESH score of 5.58 among 50 patients, with a negative correlation found between DESH scores and improvement in mRS scores, suggesting that lower DESH
Article Synopsis
- Segmental arterial mediolysis (SAM) is a recently recognized condition in neurosurgery that can lead to serious complications, especially in cases involving arterial dissection.
- A case involving subarachnoid hemorrhage from a dissecting aneurysm in the left vertebral artery was successfully treated using an endovascular technique, but it led to an unexpected hemorrhage in the middle colic artery due to SAM.
- Recognizing SAM as a systemic disease is crucial, especially in patients with vascular dissections, as it may lead to additional hemorrhagic complications beyond the central nervous system.