Publications by authors named "Kensho Okamoto"
Article Synopsis
- A 78-year-old man experienced fatigue, loss of appetite, double vision, and trouble walking, which led to investigations revealing issues with his pituitary gland.
- MRI scans showed an enlarged pituitary stalk and gland, while PET-CT indicated abnormal uptake in the pituitary and nearby lymph nodes.
- The diagnosis pointed towards IgG4-associated hypophysitis, which significantly improved after steroid treatment, highlighting the importance of recognizing this condition in older patients who may have various health issues.
Article Synopsis
- - A 23-year-old woman was admitted to the hospital for severe breathing difficulties and was diagnosed with status asthmaticus; she needed mechanical ventilation initially but was later extubated.
- - After extubation, her respiratory condition worsened, leading to re-intubation, and neurological exams revealed symptoms like droopy eyelids and muscle weakness.
- - The patient was ultimately diagnosed with myasthenia gravis through a positive edrophonium test and the presence of specific antibodies, and she received successful treatment with neostigmine and corticosteroids.
Article Synopsis
- - A 27-year-old woman experienced an ischemic stroke during her first trimester of pregnancy, which turned out to be the first sign of moyamoya disease, a rare vascular disorder.
- - After her stroke symptoms worsened despite treatment, an artificial abortion was performed, leading to an immediate halt in her neurological decline and significant recovery.
- - The case suggests that combining artificial abortion and antithrombotic therapy can effectively manage moyamoya disease-related strokes in pregnant patients by stabilizing blood flow and preventing further neurological damage.
Article Synopsis
- Spastic paraplegia type 4 (SPG4) is the most common hereditary form of spastic paraplegia, caused by mutations in the SPAST gene.
- A Japanese patient with SPG4 was found to have a new mutation (p.R460L) in the SPAST gene that was not inherited from their parents.
- This case adds to the understanding of SPG4 by providing new clinical and genetic information.
A 49-year-old man had developed gradually personality change, gait disturbance, and hearing loss for five years. On admission, he presented with frontal release signs, stuttering, vertical gaze palsy, sensorineural deafness, muscle rigidity, ataxia, and sensory disturbance with areflexia in the lower extremities. Brain MRI demonstrated atrophy in the cerebellum and midbrain tegmentum as well as cerebral atrophy, predominantly in the frontal lobe.
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- Crowned dens syndrome is a rare condition characterized by calcification around the odontoid process, which can be diagnosed through specific imaging techniques like CT and MRI.
- A 61-year-old male patient experienced severe headache and neck stiffness, and was found to have significant calcification detected via a CT scan.
- After treatment with oral nonsteroidal anti-inflammatory drugs, the patient's symptoms improved dramatically within five days, indicating the effectiveness of this treatment for the syndrome.
Article Synopsis
- A study was conducted to evaluate the effectiveness of early superficial temporal artery-middle cerebral artery (STA-MCA) double anastomoses in patients suffering from progressing stroke due to atherosclerotic blockages.
- Nine patients, primarily middle-aged men with occlusions, were examined after undergoing the procedure despite receiving maximum medical treatment.
- Results showed that the procedure was safe, led to significant neurological improvement, and is recommended for patients with specific blood flow ratios even in subacute stages.
Introduction: We report a patient treated successfully via endovascular surgery within 24h after intravenous thrombolysis using recombinant tissue plasminogen activator for acute cervical internal carotid artery occlusion.
Presentation Of Case: A 68-year-old man was admitted to our hospital. Neurological examination revealed severe left-sided motor weakness.
Article Synopsis
- A 74-year-old man experienced involuntary levitation and clumsiness in his right arm, which showed a strange tendency to elevate without his control, especially during complex movements.
- MRI and SPECT scans revealed significant brain abnormalities, particularly in the left cerebral cortex and frontal regions, coinciding with his motor disturbances and sensory issues.
- Ultimately, he was diagnosed with Creutzfeldt-Jakob disease after the initial symptoms evolved into rapid dementia and other neurological signs, highlighting how CJD can initially mimic other disorders like corticobasal degeneration.
Article Synopsis
- A 75-year-old man experienced SMA seizures characterized by brief episodes of inability to speak or move, while remaining aware of his surroundings.
- Physical exam revealed symptoms like difficulty with eye movement, stiffness, and trouble walking, alongside a history of discomfort in his head before seizures.
- Brain imaging indicated changes consistent with progressive supranuclear palsy, and seizures resolved after treatment with carbamazepine, highlighting the need for awareness of SMA seizures in older adults.
[A case of Creutzfeldt-Jakob disease with stroke-like episode as an initial symptom].
Nihon Ronen Igakkai Zasshi
September 2009
A 79-year-old woman was admitted to our hospital, due to acute onset of left hemiparesis and disturbance of consciousness. Although her symptoms improved temporarily, she developed gait disturbance and cognitive deterioration 2 months after the onset. After that, she presented with myoclonus and startle response, followed by akinetic mutism within 8 months after the onset.
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- * She was treated with intravenous tissue plasminogen activator (t-PA), which significantly improved her neurological symptoms shortly after administration.
- * Following a sudden pulseless arrest just after her treatment, she was revived with advanced life support, underwent mitral valve surgery, and was discharged in good condition 40 days later; this case is notable for the pulseless arrest occurring after t-PA treatment.
We report a 50-year-old man presenting with wall-eyed bilateral internuclear opthalmoplegia (WEBINO) syndrome. He had suffered from progressive double vision and tetraparesis, and been diagnosed as secondary progressive multiple sclerosis (MS). On admission, he presented with bilateral facial nerve palsy, pseudobulber palsy, and spastic tetraparesis, predominantly on the right side.
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- The study investigates the differences in clinical features between vascular parkinsonism (VP) and Parkinson's disease (PD), focusing on the value of pathological reflexes for diagnosis.
- In a sample of 132 PD patients and 55 VP patients, various reflexes were evaluated, showing that most pathological reflexes were significantly more common in VP patients compared to PD patients.
- The snout reflex (SR) and palmomental reflex (PMR) were identified as particularly helpful in distinguishing VP from PD, achieving high sensitivity and specificity rates for accurate diagnosis.
Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.
J Stroke Cerebrovasc Dis
November 2007
Article Synopsis
- A patient experienced a sudden worsening from spastic paraparesis (weakness in the legs) to tetraparesis (weakness in all four limbs) after a stroke, accompanied by a lack of initiative (abulia).
- MRI scans showed new areas of damage (infarctions) in both medial frontal regions of the brain, but no issues in the brainstem or spinal cord.
- The case highlights unique symptoms of anterior cerebral artery syndrome that can resemble issues in the spinal cord or brainstem, emphasizing the complexity of diagnosing stroke-related conditions.
Article Synopsis
- A 65-year-old woman was hospitalized due to a rapid decline in cognitive function, exhibiting significant disorientation and severe impairment on cognitive tests.
- Routine tests showed normal results, but high levels of anti-thyroid antibodies indicated a potential autoimmune issue.
- A brain MRI suggested leukoencephalopathy, leading to a diagnosis of Hashimoto's encephalopathy; treatment with steroids improved her cognitive abilities and MRI findings.
Idiopathic spinal cord herniation was assumed to be a rare disease. However, the incidence of discovering this condition appears to have been increasing recently with advances in neuroradiological diagnosis using magnetic resonance imaging (MRI) and computed tomographic myelogram (CTM). We present herein an operated case of high-aged idiopathic spinal cord herniation.
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- - An adult patient developed acute anterior poliomyelitis (AAP) 28 days after his son received the oral poliovirus vaccine (OPV), revealing a possible connection between the two.
- - Neurological tests indicated that the patient's left lower limb weakness was due to a lower motor neuron disorder, confirmed by MRI showing a lesion in the left anterior horn.
- - The patient's stool tested positive for poliovirus type 3, linked to the vaccine strain, raising concerns about the safety and implications of using OPV in countries where polio is no longer prevalent.
[A clinicoanatomical study of thalamic cheiro-oral syndrome].
Nihon Ronen Igakkai Zasshi
January 2006
Article Synopsis
- Magnetic resonance imaging revealed fresh infarctions in thalamic areas responsible for sensory processing, linked to risk factors like hyperlipidemia and hypertension.
- While most patients experienced residual effects, one fully recovered, emphasizing the need for early diagnosis and intervention to prevent long-term complications.
Article Synopsis
- * MRI scans revealed abnormalities at the C3-4 level, and neurological exams showed impairments in dexterity, sensory disturbance, and difficulty with fine motor skills, particularly on the left side.
- * After receiving steroid treatment, the patient noted gradual improvement, and this case highlights that despite being rare, bilateral useless hand syndrome can occur in multiple sclerosis, emphasizing the role of high cervical regions in fine motor control.
Article Synopsis
- A 72-year-old man was hospitalized for dysuria and frequent fainting, diagnosed with neurogenic bladder and showed symptoms such as blepharoptosis, anisocoria, and sleep apnea.
- Neurological tests indicated sympathetic dysfunction, and MRI revealed lacunar infarctions but no signs of severe brain degeneration.
- Treatment with nasal CPAP improved his sleep apnea, reduced orthostatic hypotension and syncope, suggesting CPAP may help manage these symptoms in neurodegenerative conditions like pure autonomic failure.
[A case of acute measles encephalitis with periodic synchronous discharge on electroencephalography].
Rinsho Shinkeigaku
February 2002
Article Synopsis
- An 18-year-old man's measles diagnosis was confirmed on May 10, 2001, following a skin rash and high fever, but he later developed severe complications, including convulsions and status epilepticus.
- Doctors diagnosed him with acute measles encephalitis based on clinical signs and cerebrospinal fluid analysis, treating him with intravenous immunoglobulin and dexamethasone.
- EEG studies showed significant brain activity patterns, but no viral genes were found, and he fully recovered within a month, highlighting the importance of monitoring EEG changes in cases of measles encephalitis.