Differences in mastoid pneumatization between Asians and Caucasians.

Background: Anatomical differences of the mastoid pneumatization in Asian and Caucasian patients must be considered when performing the retrosigmoid craniotomy since it may have implications to avoid specific complications such as cerebrospinal fluid infections or fistula.

Methods: We selected cranial CT scans of 120 Asian and 120 Caucasian patients, who were treated at the Mitsui Memorial Hospital (Japan) and at the Heidelberg University Hospital (Germany). Mastoid pneumatization was classified according to the relationship of the mastoid air cells (MAC) to the sigmoid sinus (Type I - III).

Macrovascular Decompression with the Transposition Method Using Teflon Sling for Trigeminal Neuralgia Caused by the Vertebrobasilar Artery.

Objective: Complete separation of the vertebrobasilar artery (VBA) from the trigeminal nerve by microvascular decompression is technically challenging. This paper evaluates the transposition method using Teflon sling for trigeminal neuralgia (TN) caused by the VBA.

Methods: Retrospective review of 32 patients including 2 patients with tic convulsif.

Infrafloccular approach effectively prevents hearing complication in microvascular decompression surgery for hemifacial spasm.

Objective: The infrafloccular approach in microvascular decompression (MVD) surgery for hemifacial spasm (HFS) was investigated for the prevention of hearing complications.

Methods: Retrospective analysis of 136 patients who underwent MVD for HFS in 2019. The infrafloccular approach for MVD was adopted to resolve the symptom and protect hearing function.

Primary diffuse large B-cell lymphoma of the cranial vault with Trousseau syndrome: a case report.

Background: It is extremely rare for primary non-Hodgkin's lymphomas to occur singly in the cranial vault. One case diagnosed as primary diffuse large B-cell lymphoma is reported, initially misdiagnosed as metastatic skull tumor, complicated with Trousseau syndrome.

Case Description: The patient was a 60-year-old Japanese woman with no particular previous medical history.

Neurofibromatosis type 1 with subarachnoid hemorrhage due to multiple and de novo aneurysms: a case report.

Background: Neurofibromatosis type 1 causes various lesions in many organs including the skin, and the incidence of complications with intracranial aneurysms is 9-11%. Here we report a case of neurofibromatosis type 1 with subarachnoid hemorrhage due to multiple and de novo aneurysms.

Case Presentation: The patient was a 49-year-old Japanese woman with a history of neurofibromatosis type 1.

Microvascular Decompression Surgery for Elderly Patients: A Study Based on Proposals from the Joint Committee of the Japan Gerontological Society and the Japan Geriatrics Society.

The present study evaluated the indications for microvascular decompression (MVD) in elderly patients based on the new classification of the elderly population proposed by the joint committee of the Japan Gerontological Society and the Japan Geriatrics Society in 2017.Retrospective analysis of 171 patients with hemifacial spasm (HFS), trigeminal neuralgia (TN), and glossopharyngeal neuralgia (GPN) who underwent MVD in 2018. Patients were divided into three groups based on the proposal: old group, 75-89 years; pre-old group, 65-74 years; and not-old group, 64 years or younger.

Transposition of the Culprit Artery Passing Between the Facial Nerve and Auditory Nerve in Microvascular Decompression Surgery for Hemifacial Spasm.

Background: Decompression of the culprit artery causing hemifacial spasm (HFS), which passes between the facial nerve (cranial nerve [CN] VII) and the auditory nerve (CN VIII), can be difficult, especially if the artery compresses CN VII right after passing between the 2 nerves. Perforators or small arteries branching from near the compression site to adjacent structures can hinder the decompression process because such vessels can anchor the passing condition. The effect of such perforators or small arteries on the decompression process in such cases was investigated.

Mobilization of the Anterior/Posterior Inferior Cerebellar Artery on the Cerebellar Surface in Microvascular Decompression Surgery for Hemifacial Spasm: Potential Effect on Hearing Preservation.

Background: The infrafloccular approach in microvascular decompression (MVD) for hemifacial spasm (HFS) reduces the risk of postoperative hearing impairment. However, location of the anterior/posterior inferior cerebellar artery (AICA/PICA) on the cerebellar surface in the surgical route requires mobilization to maintain the approach direction for the protection of hearing function.

Objective: To evaluate the effectiveness of mobilization of the AICA/PICA on the cerebellar surface in the surgical route.

Acute Glaucoma Attack Following Microvascular Decompression Surgery for Trigeminal Neuralgia.

Microvascular decompression (MVD) is widely accepted as an effective surgical method to treat trigeminal neuralgia (TN), but the risks of morbidity and mortality must be considered. We experienced a case of acute angle-closure glaucoma attack following MVD for TN in an elderly patient, considered to be caused by lateral positioning during and after the surgery. A 79-year-old female underwent MVD for right TN in the left lateral decubitus position, and TN disappeared after the surgery.

Supratentorial acute subdural haematoma during microvascular decompression surgery: report of three cases.

Supratentoiral haemorrhage during posterior fossa surgery is very rare. Authors report three cases of acute subdural haematoma occurred during microvascular decompression (MVD). Bleeding was observed in the suboccipital surgical area during operation but the origin of the bleeding was not confirmed intraoperatively in all cases.

Lower cranial nerve palsy after the infrafloccular approach in microvascular decompression for hemifacial spasm.

Background: The infrafloccular approach was introduced as a variation in microvascular decompression (MVD) for hemifacial spasm. However, the rate of postoperative lower cranial nerve (CN) palsy can be high. This study investigated the surgical factors in relation to the occurrence of postoperative lower CN palsy.

Fibrin glue injection into the hematoma cavity for refractory chronic subdural hematoma: A case report.

Background: Repeat burr hole irrigation and drainage has been effective in most cases of recurrent chronic subdural hematoma (CSDH), however, refractory cases require further procedures or other interventions.

Case Description: An 85-year-old male presented with left CSDH, which recurred five times. The hematoma was irrigated and drained through a left frontal burr hole during the first to third surgery and through a left parietal burr hole during the fourth and fifth surgery.

Relationship between Silent Brain Infarction and Amount of Daily Coffee Consumption in Middle Age.

Background: In aging societies such as that of Japan, it is important to characterize lifestyle-related factors that minimize the occurrence of silent brain infarction (SBI) among the middle aged population for preventing vascular dementia in older age. Little is known about the relationship between amount of coffee consumption and SBI.

Methods: To assess the association between the amount of coffee consumption and SBI in middle age, we statistically analyzed magnetic resonance imaging findings and data from questionnaires of consecutive 242 healthy Japanese individuals whose ages were less than 65 years and who participated in a medical brain-screening program at Teikyo University Chiba Medical Center from June 2008 to June 2009.

Safety of microvascular decompression for elderly patients with trigeminal neuralgia.

Objective: The present study compared the safety and efficacy of microvascular decompression (MVD) in groups of elderly patients and non-elderly patients with medically refractory trigeminal neuralgia (TN) and collected detailed perioperative data.

Methods: Retrospective analysis of clinical data was performed in 99 patients who underwent MVD from May 2012 to June 2015. The outcome data from 27 MVD operations for 27 patients aged 70-80 years (mean 74.

Exposure of Titanium Mesh after Cranioplasty for Microvascular Decompression Surgery: Two Case Reports.

Two cases of exposed titanium mesh occurred after implantation for cranioplasty after repeated procedures for microvascular decompression (MVD). Case 1 was a 62-year-old female who underwent MVD for left hemifacial spasm followed by repair of cerebrospinal fluid leak after the surgery, and Case 2 was a 75-year-old female who underwent MVD twice for right trigeminal neuralgia. Both patients visited our hospital again with complaints of postauricular lesion.

Microvascular decompression for hemifacial spasm: how can we protect auditory function?

Objective: The nerve function of the VIIIth nerve is at risk during microvascular decompression (MVD) for hemifacial spasm (HFS). Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) can be useful in decreasing the danger of hearing loss. This study assessed the intraoperative BAEP findings related to the surgical process to clarify the optimum maneuvers of MVD surgery to avoid hearing impairment.

Trigeminal neuralgia caused by a trigeminocerebellar artery.

This 31-year-old woman presented with typical right trigeminal neuralgia caused by a trigeminocerebellar artery, manifesting as pain uncontrollable with medical treatment. Preoperative neuroimaging studies demonstrated that the offending artery had almost encircled the right trigeminal nerve. This finding was confirmed intraoperatively, and decompression was completed.

Radiation-induced meningiomas in multiple regions, showing rapid recurrence and a high MIB 1 labeling index: a case report and review of the literature.

Combined chemotherapy and prophylactic cranial irradiation has improved the prognosis of children with acute leukemia. However cranial irradiation carries a latent risk of the induction of secondary intracranial tumors. We encountered a patient who developed multiple intracranial radiation-induced meningiomas (RIMs) 25 years after prophylactic cranial irradiation for the treatment of acute leukemia in childhood.

Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency.

Adult growth hormone (GH) deficiency (AGHD) in Japan is diagnosed based on peak GH concentrations during GH provocative tests such as GHRP-2 stimulation test. In this study, we aimed to evaluate the ability of serum insulin-like growth factor-1 (sIGF-1) and urinary GH (uGH) at the time of awakening to diagnose AGHD. Fifty-nine patients with pituitary disease (32 men and 27 women; age 20-85 y (57.

Tumefactive multiple sclerosis requiring emergent biopsy and histological investigation to confirm the diagnosis: a case report.

Introduction: Tumefactive multiple sclerosis is a demyelinating disease that demonstrates tumor-like features on magnetic resonance imaging. Although diagnostic challenges without biopsy have been tried by employing radiological studies and cerebrospinal fluid examinations, histological investigation is still necessary for certain diagnosis in some complicated cases.

Case Presentation: A 37-year-old Asian man complaining of mild left leg motor weakness visited our clinic.

Ganglioneuroma originating from the trigeminal nerve in the middle cranial fossa. Case report.

A 55-year-old man present with a case of ganglioneuroma manifesting as sudden onset of severe headache. T(1)-weighted magnetic resonance imaging demonstrated a heterogeneously enhanced mass (3 × 3 × 2.5 cm) in the left middle cranial fossa compressing the left cavernous sinus.

A simple and consistent technique for ventricular catheter insertion using a tripod.

Objective: For long-term preservation of ventriculo-peritoneal (VP) shunt function, it is essential to place the ventricular catheter tip above the foramen of Monro. But the free-hand technique for ventricular catheter passage is not consistent.

Methods: Supposing that a convex of skull matches to a sphere, in which the foramen of Monro is the center, a perpendicular direction from the surface of the sphere to inside always directs toward the center.

Isolated recurrence of intracranial and temporal bone myeloid sarcoma--case report.

A 52-year-old man presented with a rare case of isolated recurrence of myeloid sarcoma (MS) manifesting as rapidly growing intracranial and temporal bone masses 5 years after complete remission (CR) of acute myeloid leukemia (AML) (M2 in the French-American-British classification). Magnetic resonance imaging and computed tomography of the head revealed enhanced mass lesions on the superior aspect of the right petrous bone and within the right mastoid air cells, extending into the right middle ear cavity without bone destruction. Peripheral blood testing found no evidence of relapse.

Combination therapy with rituximab and temozolomide for recurrent and refractory primary central nervous system lymphoma.

High-dose methotrexate-based chemotherapy has extended survival in patients with primary central nervous system lymphoma (PCNSL). However, although salvage treatment is necessary in recurrent and refractory PCNSL, this has not been standardized. We herein describe the efficacy of a combination of rituximab and temozolomide (TMZ) in two consecutive patients with recurrent and refractory PCNSL.

Functional molecular morphology of anterior pituitary cells, from hormone production to intracellular transport and secretion.

Combined in situ hybridization (ISH) and immunohistochemistry (IHC) under electron microscopy (EM-ISH & IHC) has sufficient ultrastructural resolution to provide two-dimensional images of subcellular localization of pituitary hormone and its mRNA in a pituitary cell. The advantages of semiconductor nanocrystals (Quantum dots; Qdots) and confocal laser scanning microscopy (CLSM) enable us to obtain three-dimensional images of the subcellular localization of pituitary hormone and its mRNA. Both EM-ISH & IHC and ISH & IHC using Qdots and CLSM are useful for understanding the relationship between protein and mRNA simultaneously in two or three dimensions.