A case of intravascular lymphoma presenting with a lesion in the splenium of the corpus callosum.

Intravascular lymphoma (IVL) is difficult to diagnose because its clinical presentation and laboratory and imaging findings are nonspecific. Herein, we report a case of IVL presenting as a lesion in the splenium of the corpus callosum. A 52-year-old man attended the emergency department with a 2-week history of progressively worsening abnormal behavior and gait disturbance.

[Stent-assisted percutaneous transluminal angioplasty for intracranial vertebral and basilar artery stenosis: two case reports].

We report two cases of patients who underwent stent-assisted percutaneous transluminal angioplasty for intracranial vertebral artery (VA) and basilar artery (BA) stenosis. They presented with sudden onset of vertigo and right hemiparesis. Vertebral angiographies revealed severe proximal BA stenosis (case 1) and intracranial VA stenosis (case 2).

Recurrence of convexity meningiomas: tumor cells in the arachnoid membrane.

Background: It remains open to debate why totally removed benign meningiomas recur. Two recurrent cases forced us to reconsider something corresponding to their recurrence that we had overlooked during Simpson grade I surgery.

Methods: This study is based on 24 recent and 9 earlier cases in which benign convexity meningiomas were totally removed by Simpson's grade I surgery.

Warning from Nagano: increase of vulvar hematoma and/or lacerated injury caused by snowboarding.

Background: On the basis of the number of women snowboarders whose vulvar injuries we have recently treated, we believe that the cases of vulvar hematoma and lacerated injuries caused by snowboarding have been increasing. To analyze the causal relation between snowboarding and vulvar injuries, we investigated how women were injured during snowboarding.

Methods: During the last three ski-ing seasons at the five hospitals near the ski resorts in Nagano Prefecture, Japan, the clinical charts of all patients with vulvar injuries during snowboarding were reviewed for the number of patients treated, the condition of the patients at diagnosis, and the characteristics of vulvar injuries.

Saccular cerebral aneurysms in young adults.

Background: The formation and rupture of cerebral aneurysms has been controversial. In order to clarify their nature, this study investigates the size and location of ruptured and unruptured aneurysms in young adults and the results of surgery.

Methods: The subjects of this study are 35 patients with ruptured and two with unruptured aneurysms.

Secretory granules of pituitary adenomas: quantitative study of hormonal antigenicity.

Ultrastructurally, the antigenicity of major pituitary hormones in secretory granules was quantitatively investigated in five growth hormone (GH)-secreting adenomas, five prolactin (PRL)-secreting adenomas and eight clinically non-functioning (CN-F) adenomas. Sparsely granulated cells with a few or several small secretory granules (60-100 nm) exhibiting little or only weak antigenicity of various biochemically unrelated hormones were commonly observed in CN-F adenomas and occasionally in GH- and PRL-secreting adenomas. GH- or PRL-secreting adenomas consisted of many densely granulated cells with medium-sized (200-250 nm) or large (over 250 nm) secretory granules and a few or several sparsely granulated cells with small secretory granules.

Bleeding risk in unruptured and residual cerebral aneurysms--angiographic annual growth rate in nineteen patients.

Whether and when unruptured aneurysms or aneurysmal rests following incomplete surgery result in subsequent bleeding are major concerns for neurosurgeons. By calculating the annual growth rate of aneurysms in long-term follow-up angiography (partly supplemented with MR-imaging and/or MR-angiography), we attempted to determine the surgical indications for these aneurysms. Long-term follow-up angiography ranging from one to 20 years was carried out on five patients whose ruptured aneurysms had been incompletely occluded, six patients with multiple aneurysms, of which the ruptured ones had been completely obliterated at operation and the small unruptured aneurysms, missed or misdiagnosed, and eight patients with unruptured aneurysms which were asymptomatic or symptomatic.

The multihormonal character of pituitary adenomas: immuno-electron microscopic studies.

This study investigates the multihormonal character of pituitary adenomas at the ultrastructural level. The growth hormone (GH)- and prolactin (PRL)-secreting adenomas under study consisted of many moderately or densely granulated cells and a few sparsely or slightly granulated cells. The GH-secreting adenomas showed well-developed cytoplasmic organelles and many large (250 nm or more) or medium-sized (200 nm) secretory granules, as well as a few small (70-150 nm) secretory granules.

[Shearing injuries of parasagittal white matter, corpus callosum and basal ganglia: possible radiological evidences of hemiplegia in diffuse axonal injury].

The relationship between spastic hemiplegia in diffuse axonal injury (DAI) and neuroradiological findings was studied in 100 cases. These cases were prospectively collected from the files of Automobile Insurance Rating Organization in Japan between 1993 from to 1996. Requirements for entry to this study were as follows: presence of initial unconsciousness after head injury without any lucid interval.

[Diffuse ventricular enlargement outlines the late outcome of diffuse axonal brain injury].

Clinical significance of ventriculomegaly after severe head trauma has not been fully explored yet. We analyzed hospital records of 53 cases of diffuse axonal injury and 7 cases of brain concussion together. The follow-up periods ranged from 6 months to 8 years (average 25 months).

A long-term follow-up study in direct cerebral aneurysm surgery.

A long-term follow-up study covering between one and twenty-two years after surgery was carried out on 177 patients with direct operations for cerebral aneurysms. Rebleeding was detected in five out of 18 patients with incomplete operations; one patient within 6 months and four patients within 5 to 8 years after surgery. The rebleeding rate of incompletely operated patients in the first decade was similar to that of untreated patients with ruptured aneurysms.

Failure of down-regulation of estrogen receptors and progesterone receptors after medroxyprogesterone acetate administration for endometrial hyperplasias.

Background: To determine the biologic difference between normal endometrium and endometrial hyperplasias, the authors assessed the expression of estrogen receptors (ER) and progesterone receptors (PR) in the subjects before and after oral administration of medroxyprogesterone acetate (MPA) (Hysron-H, Kyowa Hakko Kogyo Co., Ltd., Tokyo, Japan).

Immunohistochemical analysis of the peritoneum adjacent to endometriotic lesions using antibodies for Ber-EP4 antigen, estrogen receptors, and progesterone receptors: implication of peritoneal metaplasia in the pathogenesis of endometriosis.

This study was designed to investigate whether or not the pelvic peritoneum exhibits a metaplastic process into müllerian-type epithelium using a marker for epithelial differentiation (Ber-EP4 antigen) and markers that indicate müllerian differentiation (estrogen receptors and progesterone receptors). The peritoneum and/or ovarian surface epithelium adjacent to endometriotic lesions were obtained from 24 patients with endometriosis at operation, and peritoneum and ovarian surface epithelium without any lesions were also obtained from control patients without endometriosis. The specimens were immunohistochemically analyzed using antibodies for epithelial antigen Ber-EP4, estrogen receptor (ER), and progesterone receptor (PR) on frozen sections.

[Parasagittal white matter shearing injury (so-called gliding contusion): possible radiological evidence of spastic hemiplegia in diffuse axonal injury].

Severe head injury or diffuse axonal injury is frequently associated with spastic hemiplegia/paraplegia. However, the causative lesion has not been well elucidated. Especially, the relationship between the gliding contusion and spastic hemiplegia has not been inferred yet.

[Clinical assessment of diffuse brain injury sequelae: with respect to so-called post-traumatic disorder].

Brain injury sequelae were observed in 24 patients who had sustained diffuse brain injury. According to their ability to lead social life, the severity was classified into 6 levels; vegetative, severe, moderate, mild, fair, and good. The severity levels statistically correlated with the length of the initial unconsciousness (Spearman's correlation coefficient r = 0.

A combined extradural-posterior petrous and suboccipital approach to the jugular foramen tumours.

An approach which improves on the conventional suboccipital craniectomy was used to explore a jugular foramen, a hypoglossal neurinoma, and a tentorial meningioma. A postero-medial mastoidectomy supplemented by the conventional suboccipital craniectomy made it possible to expose the entire sigmoid sinus. Subsequent medial retraction of the exposed sigmoid sinus and continuous dura mater and the extradural removal of petrous bone around the jugular foramen exposed the whole extracranial portion of the tumours.

Pontine gliomas causing locked-in syndrome.

The terminal phase of pontine glioma is reportedly characterized by disturbance of consciousness. The authors retrospectively reviewed 8 children who died of pontine gliomas in their hospitals. The hospital records were analyzed specifically in regard to neurological status and terminal case.

The number of proliferating cell nuclear antigen positive cells in endometriotic lesions differs from that in the endometrium. Analysis of PCNA positive cells during the menstrual cycle and in post-menopause.

Immunohistochemical expression of proliferating cell nuclear antigen (PCNA) was studied in the endometrium and in endometriotic lesions during the menstrual cycle and in post-menopausal patients. During the menstrual cycle, in the basal layer of the endometrium, an increase in the number of positive indices (PI) of PCNA was observed in epithelial cells from the menstrual phase. It reached a maximum in the proliferative phase and decreased in the secretory phase.

Bilateral chronic subdural hematomas without communication between the hematoma cavities: treatment with unilateral subdural-peritoneal shunt.

Communication between bilateral subdural hematoma cavities was not demonstrated by metrizamide computed tomography subdurography in three patients with bilateral chronic subdural hematomas. Because unilateral subdural tapping yielded a slack fontanel without untoward neurological findings, patients were treated by the placement of unilateral subdural-peritoneal shunts, resulting in resolution of the bilateral hematomas.

Mixed oligodendroglioma and astrocytoma: fine structural and immunohistochemical studies of four cases.

Four mixed oligodendrogliomas and astrocytomas were investigated by electron microscopy and immunohistochemistry (GFAP, NSE and MBP). GFAP-positive oligodendroglioma cells and their transitional cells to GFAP-negative oligodendroglioma cells were present, suggesting successive morphological changes of astrocytic tumor cells. NSE-positive cells, suggestive of residual neurons, also exhibited round nuclei and perinuclear halos.