Publications by authors named "Osamu Hirai"
Article Synopsis
- Cerebral venous sinus thrombosis (CVST) leads to increased pressure and potential neurological issues due to vein blockage, making early treatment essential for better outcomes.
- The standard treatment involves anticoagulants, primarily intravenous heparin followed by oral medications, with evidence suggesting that direct oral anticoagulants (DOACs) might also be effective and safer.
- A case study is presented where a patient with CVST and worsening neurological symptoms was successfully treated by transitioning from heparin to oral Edoxaban early on, resulting in prompt recanalization of the affected sinus.
Article Synopsis
- * The patient was diagnosed with a dAVF that had complex drainage issues, and an emergency embolization was performed to alleviate her symptoms.
- * Despite a successful reduction in the dAVF post-treatment, the patient experienced a significant cerebral hemorrhage immediately afterward, highlighting the need for careful evaluation of hemodynamics before such procedures.
Article Synopsis
- Pineal parenchymal tumor of intermediate differentiation (PPTID) is a rare type of brain tumor classified by the WHO in 2000, sitting between pineocytoma and pineoblastoma in terms of prognosis and having uncertain management strategies.
- A case study describes a 63-year-old woman who experienced lower-extremity weakness, leading to the discovery of a pineal mass, which was diagnosed as a pineocytoma after surgical resection.
- After two years without treatment following surgery, the patient faced tumor recurrence and leptomeningeal dissemination, which was successfully treated with craniospinal irradiation, highlighting the need for long-term monitoring in PPT patients.
Article Synopsis
- - The study examines the use of the relative apparent diffusion coefficient (ADC) ratio in MRI to assess ischemia and predict the potential for ischemic reversal and the risk of hemorrhage after treatment in patients with acute artery occlusion.
- - An analysis of 56 patients showed that higher ADC ratios were associated with reversible lesions, whereas lower ratios were linked to final infarct lesions, with notable differences in ADC readings between hemorrhagic and non-hemorrhagic regions.
- - Findings suggest that the relative ADC ratio can effectively indicate the likelihood of tissue recovery post-revascularization and help predict complications, regardless of when the ischemic event occurred.
Article Synopsis
- - The study aimed to assess how effective an MRI-based scoring system for disproportionately enlarged subarachnoid space hydrocephalus (DESH) is in predicting recovery outcomes for patients with idiopathic normal pressure hydrocephalus (iNPH) after surgery.
- - The DESH score, ranging from 0 to 10, was determined by a team of medical experts assessing MRI findings and analyzed against various patient improvement measures, including the modified Rankin Scale and Mini-Mental State Examination, one year post-surgery.
- - Results indicated a mean DESH score of 5.58 among 50 patients, with a negative correlation found between DESH scores and improvement in mRS scores, suggesting that lower DESH
OBJECTIVE The study aim was to assess the influence of presurgical clinical symptom severity and disease duration on outcomes of shunt surgery in patients with idiopathic normal-pressure hydrocephalus (iNPH). The authors also evaluated the cerebrospinal fluid tap test as a predictor of improvements following shunt surgery. METHODS Eighty-three patients (45 men and 38 women, mean age 76.
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- Segmental arterial mediolysis (SAM) is a recently recognized condition in neurosurgery that can lead to serious complications, especially in cases involving arterial dissection.
- A case involving subarachnoid hemorrhage from a dissecting aneurysm in the left vertebral artery was successfully treated using an endovascular technique, but it led to an unexpected hemorrhage in the middle colic artery due to SAM.
- Recognizing SAM as a systemic disease is crucial, especially in patients with vascular dissections, as it may lead to additional hemorrhagic complications beyond the central nervous system.
Spontaneous intracerebral hemorrhage represents 20 to 30% of all stroke patients in Japan. However, the treatment strategy of intracerebral hematoma remains controversial. Stereotactic hematoma evacuation is minimally invasive surgery and is beneficial for clot removal with limited tissue damage.
View Article and Find Full Text PDFPituitary apoplexy is defined as a sudden loss of blood supply to the pituitary gland, leading to tissue necrosis and hemorrhage. Its clinical symptoms are characterized by sudden onset of headache, nausea, vomiting, ophthalmic symptoms and hormonal dysfunction. A 65-year-old woman presented with left-sided ptosis and blurred vision.
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