Publications by authors named "Mitsuto Iwanaga"

Pure acute subdural hematomas (ASDHs) due to ruptured aneurysms without subarachnoid or intracerebral hemorrhage are rare. We report the case of a 26-year-old female who presented with a pure ASDH caused by a ruptured distal anterior cerebral artery (ACA). The patient complained of sudden headache and vomiting and was transferred to our hospital.

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Background: 5-aminolevulinic acid (5-ALA) photodynamic diagnosis (PDD) has enabled better identification of malignant tumor cells and real-time intraoperative guidance. Here, we report a reasonable procedure for 5-ALA-guided endoscopic biopsy with a violet light-emitting diode (LED) flashlight for deep-seated malignant gliomas.

Methods: A 63-year-old man presented with a headache and left upper homonymous quadrantanopia.

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Background: Although hematoma expansion (HE) is caused by active bleeding in patients with intracranial hemorrhage in most cases, cerebrospinal fluid (CSF) trapped in the hematoma cavity is not a well-known cause of HE.

Case Description: We present a case of subcortical hemorrhage in an 80-year-old woman who experienced neurological deterioration in the subacute phase because of HE caused by CSF pooling in the hematoma cavity. The patient was transferred to our hospital from a previous hospital for surgical treatment because the consciousness disturbance was likely caused by the perihematomal edema that occurred 4 days after onset.

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Objective: Rupture of blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) may result in fatal subarachnoid hemorrhage (SAH). Open surgery including bypass surgery has been performed to treat the aneurysm. Recently, endovascular treatment is developing for the treatment of cerebral aneurysm.

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Objective: The effects of treatment methods for ruptured aneurysms on the incidence of vasospasm and normal pressure hydrocephalus (NPH) following subarachnoid hemorrhage (SAH) are controversial. We retrospectively examined the Nagasaki SAH registry data, and the complication rates of symptomatic vasospasm and NPH were analyzed based on the treatment methods.

Methods: Between January 2015 and December 2017, 800 SAH patients were registered from 18 hospitals, and their age, sex, World Federation of Neurological Societies (WFNS) grade, Fisher group, size and location of cerebral aneurysms, treatment methods, incidence of symptomatic vasospasm and shunt-dependent hydrocephalus, and prognosis (discharge or 3 months later) were retrospectively analyzed.

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Objective: The causes of restenosis following balloon angioplasty are reported to be vasospasm, thrombosis, and recurrence of atherosclerosis. We report a case of internal carotid artery (ICA) occlusion treated by emergency endovascular renacalization and carotid endarterectomy (CEA) for the restenosis, which revealed that the cause of restenosis was neointimal hyperplasia.

Case Presentation: A 70-year-old man was brought to our hospital because of sudden onset left hemiparesis.

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The accessory middle cerebral artery(AMCA)is an anatomical variant of the MCA. It originates from the anterior cerebral artery, reaches the sylvian fissure, and supplies the territory of the middle cerebral artery. We report a case of embolic infarction associated with the AMCA that was treated using mechanical thrombectomy.

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Objective: Carotid endarterectomy(CEA)is well-established and performed for carotid artery stenosis all over the world. However, some severe complications and pitfalls have been reported. Carotid artery stenting(CAS)in high-surgical-risk patients is considered an effective alternative to CEA.

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Twisted carotid artery bifurcation is a variant in which the internal carotid artery(ICA)courses mediall to the external carotid artery(ECA). Here, we report a case of ICA stenosis, which is a complication of twisted ICA, treated with carotid endarterectomy(CEA). A 75-year-old woman was brought to our hospital with left-sided hemiparesis.

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Hypertrophic pachymeningitis is a chronic inflammatory disease, manifesting as a fibrous thickening of the dura mater. Recently, it was reported that IgG4 is related to the etiology of some diseases, such as pancreatitis. Here, we report a case of hypertrophic pachymeningitis related to infiltration of IgG4 positive plasma cells.

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