Edema and elasticity of a fronto-temporal decompressive craniectomy.

Background: Decompressive craniectomy is undertaken for relief of brain herniation caused by acute brain swelling. Brain stiffness can be estimated by palpating the decompressive cranial defect and can provide some relatively subjective information to the neurosurgeon to help guide care. The goal of the present study was to objectively evaluate transcutaneous stiffness of the cranial defect using a tactile resonance sensor and to describe the values in patients with a decompressive window in order to characterize the clinical association between brain edema and stiffness.

Postoperative quality of life outcome and employment in patients undergoing resection of epileptogenic lesions detected by magnetic resonance imaging.

The long-term postoperative improvement of quality of life (QOL) and employment were investigated in patients undergoing resection of epileptogenic lesions detected by magnetic resonance (MR) imaging to identify the associated preoperative factors. Thirty of 47 patients who underwent lesionectomy between 1987-2001 replied to questionnaires. Patients with extratemporal resection outnumbered those with temporal lobe resection.

Stage-specific effect of inhibition of autophagy on chemotherapy-induced cytotoxicity.

Anticancer therapies can induce autophagy in tumor cells and the role of autophagy in these cells may depend on the type of tumor, the stage of tumorigenesis, and the nature and extent of the insult. Appropriate modification of autophagy, that is, suppression of cell-protective autophagy or enhancement of cell-killing autophagy could augment cytotoxicity caused by anticancer therapy. Imatinib mesylate is an inhibitor of tyrosine kinases and is used for the therapy of patients with tumors including leukemias, but is not effective as a monotherapy for malignant glioma.

Indoleamine 2,3-dioxygenase as a new target for malignant glioma therapy. Laboratory investigation.

Object: Indoleamine 2,3-dioxygenase (IDO), a kynurenine pathway (KP) enzyme catalyzing oxidation of the essential amino acid tryptophan (Trp), is thought to be involved in the immune resistance of malignant tumors through T-cell inactivation caused by Trp depletion and metabolite accumulation. Human malignant gliomas may use this strategy to escape immune attack. The object of this study was to investigate the possibility of IDO-dependent Trp depletion by malignant gliomas and the practicability of using an IDO inhibitor together with anticancer drugs to reserve Trp without decreasing the cytotoxicity of the drugs.

Quantitative analysis of delayed neuronal death in the hippocampal subfields of SHRSP and SHR.

Transient forebrain ischemia and reperfusion induces delayed neuronal death (DND) in the hippocampal Cornu Ammonis 1 (CA1) subfield of stroke-prone spontaneously hypertensive rat (SHRSP). The vulnerability to DND is potentially related to the genetic susceptibility to stroke in this strain. To elucidate the mechanism of DND in SHRSP, however, it is essential to establish a method for quantitative evaluation of DND, which is not available yet.

Long-term seizure outcome in patients undergoing resection of lesions detected by magnetic resonance imaging.

The long-term efficacy of resective surgery was investigated in patients with lesions detected by magnetic resonance (MR) imaging. Thirty of 47 patients who had undergone lesionectomy between 1987-2001 were followed up by questionnaire. Patients with extratemporal resections outnumbered those with temporal lobe resections.

[Quantitative assessment of the usefulness of MR-fusion Tl-SPECT image in the diagnosis of brain tumor].

201Tl-SPECT (single photon emission computed tomography) had a disadvantage of low spatial resolution with a limited ROI (region of interest) setting. Recently, the diagnosis of brain tumors has been improved by fusion-imaging employing MRI (magnetic resonance imaging) with Tl-SPECT. In order to assess the usefulness of MR-fusion Tl-SPECT quantitatively, we have compared non-fusion (NF) and MR-fusion (MR-F) imaging with Tl-SEPCT in patients with brain tumors.

Inhibition of autophagy at a late stage enhances imatinib-induced cytotoxicity in human malignant glioma cells.

Malignant gliomas are common primary tumors of the central nervous system. The prognosis of patients with malignant glioma is poor in spite of current intensive therapy and thus novel therapeutic modalities are necessary. Imatinib mesylate, a tyrosine kinase inhibitor, is effective in the therapy of tumors including leukemias but not as a monotherapy for malignant glioma.

Cutting balloon angioplasty for carotid artery in-stent stenosis supported by three-dimensional rotational angiography with automated vessel analysis software.

In-stent stenosis is a possible long-term complication of carotid artery stenting. A simple and safe technique of cutting balloon angioplasty is described for carotid in-stent stenosis. The stented vessel is imaged by three-dimensional (3D) rotational angiography, the acquired projection images are transferred to a workstation, and the stenotic lesion and implanted stent are reconstructed.

Fungal meningitic hydrocephalus with repeated shunt malfunction.

A 33-year-old female presented with a rare case of fungal meningitis caused by Aspergillus detected for the first time at 15 years after onset. The meningitis repeatedly occurred over a period of 15 years. On admission, cerebrospinal fluid examination found cell count 1340/high-power field, protein 158 mg/dl, and sugar 8 mg/dl, indicating meningitis, although no bacterial or fungal species were detected.

Diagnosis of congenital hydrocephalus and delivery of its patients in Japan.

The study population included 193 patients with prenatally diagnosed (fetal) hydrocephalus and 181 with postnatally (12 or less than 12 months after birth) diagnosed (infantile) hydrocephalus identified by a nationwide questionnaire survey of congenital hydrocephalus performed in 2000. Of 180 patients with fetal, 101 (56.1%) were diagnosed before week 32 of gestation and 18 (10%) were diagnosed week 37 and later of gestation.

Analysis of a nationwide survey on treatment and outcomes of congenital hydrocephalus in Japan.

A nationwide questionnaire survey of congenital hydrocephalus in 2000 investigated the treatment and clinical outcomes for congenital hydrocephalus in Japan to evaluate the factors influencing clinical outcome. Surgical treatment was performed in 341 of 380 patients who survived the early neonatal period. Of 321 patients who had shunt operations, 295 (91.

Nationwide survey of the etiology and associated conditions of prenatally and postnatally diagnosed congenital hydrocephalus in Japan.

A nationwide survey in 2000 investigated the causative and associated central nervous system (CNS) lesions of congenital hydrocephalus in Japan. The etiology and associated diseases in 393 patients with congenital hydrocephalus were analyzed and compared between 193 patients with prenatally diagnosed (fetal) hydrocephalus and 181 with postnatally diagnosed (infantile) hydrocephalus. Of 393 patients of congenital hydrocephalus, 355 (90.

Otogenic tension pneumocephalus complicated by eustachian tube insufflation in a patient with a ventriculoperitoneal shunt. Case report.

Spontaneous tension pneumocephalus (TPC) related to shunt surgery has sometimes been reported with reference to the Valsalva maneuver and osseous defects of the tegmen tympani. Here, the authors report on a case of TPC complicated by eustachian tube (ET) insufflation and a ventriculoperitoneal (VP) shunt. This 78-year-old man had undergone VP shunt insertion 3 weeks before readmission to the hospital with a diagnosis of TPC, a left temporal porencephalic cyst, and air accumulation and late leakage of cerebrospinal fluid (CSF) into the left tympanic cavity.

Symptomatic hemorrhage associated with recurrent pilocytic astrocytoma with granulation tissue--case report.

A 51-year-old woman had been followed up for 10 years for recurrence of pilocytic astrocytoma 5 years after the initial treatment consisting of subtotal resection, chemotherapy, and radiation therapy. The patient presented with sudden onset of headache and vomiting. Computed tomography and T(2)*-weighted magnetic resonance imaging revealed hemorrhage in the tumor located in the right basal ganglia, thalamus, and hypothalamus.

Subarachnoid hemorrhage in the presence of both intracranial dissecting and saccular aneurysms--two case reports.

Two patients presented with subarachnoid hemorrhage (SAH) associated with both intracranial dissecting and saccular aneurysms. Case 1, a 48-year-old woman, had a saccular aneurysm of the right internal carotid artery and dissecting aneurysms of the bilateral vertebral arteries. Case 2, a 52-year-old man, had three saccular aneurysms in the anterior circulation and a dissecting aneurysm of the unilateral vertebral artery.

The role of cerebral cyst formation in the intractability of epilepsy.

Objectives: The aims of the present study were: (1) to examine single focal, intractable epilepsy associated with gliotic changes and (2) to discuss the mechanisms underlying seizure intractability.

Patients And Methods: Records of 34 patients with surgically treated intractable epilepsy were analysed retrospectively. Thirteen out of 34 patients had single epileptic focus histologically identified as a gliotic change.

[Clinical efficacy and cost benefit of oral antimicrobial prophylaxis with levofloxacin on neurological surgery].

Objective: The clinical efficacy and cost benefit of oral antimicrobial prophylaxis with levofloxacin (LVFX) on neurosurgical operation were evaluated.

Patients And Methods: Fifty patients undergone burr hole drainage for chronic subdural hematoma were enrolled into this study. These patients had preoperative intravenous drip infusion of 1.

Heavy water inhibiting the expression of transforming growth factor-beta1 and the development of kaolin-induced hydrocephalus in mice.

Object: The authors investigated the effects of heavy water (D2O) on intrameningeal fibrosis and on the expression of cytokine production in mice with kaolin-induced hydrocephalus.

Methods: Mice in which kaolin was injected into the cisterna magna were divided into two groups: 1) Group H, which had free access to H2O as tap water; and 2) Group D, which had free access to 30% D2O as tap water before and after kaolin injection. A distilled water-injected group, which had free access to H2O as tap water was designated the sham-operated group.

The key to improving prognosis for aneurysmal subarachnoid hemorrhage remains in the pre-hospitalization period.

Background: Despite advances in neurosurgical management, aneurismal subarachnoid hemorrhage (aSAH) still has high mortality and morbidity. This study aimed to clarify how delaying hospital admission after aSAH contributes to worse prognosis even today and to find the possibility for an improvement of its prognosis by early admission.

Methods: Four hundred twenty-one consecutive patients are the basis for this study.

Supratentorial primitive neuroectodermal tumor in an aged patient--case report--.

An 88-year-old woman presented with a supratentorial primitive neuroectodermal tumor (PNET) manifesting as disturbance of consciousness and left hemiplegia. Magnetic resonance imaging showed a large mass lesion in the right frontotemporal region. She underwent biopsy of the lesion that confirmed the diagnosis of PNET.

Unusual progression of pleomorphic adenoma of the lacrimal gland: case report.

A 72-year-old female complained of acute pain on left eye movement followed by progressive exophthalmos. Neuroimaging revealed a large well-demarcated lesion consisting of solid and cystic parts, as well as bone destruction and hemorrhage, within the left orbital cavity. The preoperative diagnosis was pleomorphic adenoma with or without malignant transformation, or cavernous angioma.