[Subarachnoid hemorrhage due to ruptured dissecting aneurysm of peripheral superior cerebellar artery].

The peripheral superior cerebellar artery (SCA) dissecting aneurysm (DA) is extremely rare, with only 4 cases (including our case) having been reported. Here we report a case of subarachnoid hemorrhage due to ruptured DA of peripheral SCA and summarize the 23 cases of the DA of peripheral arteries in the posterior fossa. A 64-year-old woman was found unconscious at home and was admitted to our hospital on December 12, 1998.

[A case of internal carotid-posterior communicating artery aneurysm presenting pure acute subdural hematoma].

The incidence of acute subdural hematoma (SDH) due to a ruptured intracranial aneurysm varies from 0.5% to 7.9% of all intracranial aneurysms.

[A case of neurofibromatosis type 1 associated with arteriovenous fistula caused by re-bleeding of a vertebral dissecting aneurysm].

We described a dissecting aneurysm of the vertebral artery (VA), which was associated with neurofibromatosis type 1 (NF1). A 41-year-old man was referred to our hospital because of abrupt, severe headache. A CT scan revealed diffuse subarachnoid hemorrhage (SAH) predominantly in the prepontine cistern.

Anatomic study of anterior frontal cortical bridging veins with special reference to the frontopolar vein.

Anatomic variations of the frontopolar vein were investigated in 21 cadaver brains to improve the preservation rate of this vein in interhemispheric surgery for anterior communicating aneurysms. Most of the frontopolar vein has been considered to drain the outer convex side of the frontal lobe, but in reality, the area of its venous drainage was found to cover a large part of the frontal lobe, including its medial and basal surfaces. This observation suggests that sacrifice of the vein during surgery carries a risk of venous infarction.

Serial transcranial Doppler flow velocity and cerebral blood flow measurements for evaluation of cerebral vasospasm after subarachnoid hemorrhage.

Serial transcranial Doppler (TCD) and cerebral blood flow (CBF) examinations were performed in 73 patients with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysm to evaluate cerebral vasospasm. Twenty-six (35.6%) of the 73 patients developed ischemic neurological symptoms associated with cerebral vasospasm, which were reversible in all except four patients (5.

[Renal cell carcinoma metastasizing to choroid plexus of lateral ventricle; a case report].

A rare case of renal cell carcinoma metastasizing to the choroid plexus of the lateral ventricle is reported. A 59-year-old woman was admitted to our institution on November 26, 1987 complaining of left-half headache for one month. She had a past history of right nephrectomy due to renal cell carcinoma 4 years before admission, and of right radical mastectomy due to breast cancer 10 years before admission.

[Ventricular puncture; is it a safe procedure?].

Four hundred and fifty patients underwent 755 ventricular punctures as a procedure for continuous ventricular drainage (CVD), or ventriculoperitoneal/ventriculoatrial shunt (shunt) between April, 1983 and March, 1990. In all patients, postoperative findings on CT scan and related clinical manifestations were studied. Of the total of 755 punctures in 100 cases (13.

Intraoperative anatomical studies in patients with aneurysms of the anterior communicating artery complex.

The intraoperative anatomical findings of the anterior communicating artery (ACoA) complex in 46 patients with anatomical variations were compared to those in an equal number of patients without variations in order to determine the visualization of the elements of the vascular complex. All patients underwent radical surgery for an ACoA aneurysm by one of three different surgical approaches: transsylvian, anterior interhemispheric, or basal interhemispheric. Visualization of the vascular elements was similar in patients with or without anatomical variations.

[Clinical course in poor grade patients with ruptured intracranial aneurysms and extensive subarachnoidal clot].

Three hundred and eight cases with ruptured intracranial aneurysms and variable amounts of subarachnoidal clot were evaluated clinically with special emphasis on the natural course of poor grade patients. Clinical severity was classified according to the Glasgow Coma Scale (GCS); severe cases (score 3-8) and mild cases (score 9-15). Patients were further divided into four groups based on the preoperative clinical course, and on whether radical surgery was performed or not.

[Clinical study of growing up aneurysms: report of 25 cases].

Twenty-five cases of patients with growing up aneurysms are reported. Growth of the aneurysm was confirmed by repeated angiography within 1 month in 11 cases (short-term group), and for over 1 month in the other 14 cases (long-term group) following the initial angiography. Clinical history, shape and growth pattern of aneurysms, as well as hemodynamic factors that effect the growth were investigated in each group.

[A case of adult pilocytic astrocytoma in the right temporal lobe].

A case of adult pilocytic astrocytoma in the right temporal lobe is reported here. The patient was a twenty-four year old man, who came to the neurological division of our hospital on October 6, 1987 because of repeated consciousness-loss attacks accompanied with uncinate fit. He had no neurological deficits.

[Treatment for serious cases of ruptured intracranial aneurysms with severe subarachnoid clot].

Forty-one serious cases of ruptured intracranial aneurysms with severe subarachnoid clot were clinically analyzed, with special emphasis on the prognosis, pathophysiology, and surgical indications. All cases had thick subarachnoid clot without concurrent intracerebral hematoma and/or intraventricular hematoma causing mass signs on the CT scan. In this series, 23 cases underwent radical surgery while in the acute stage, 18 cases were treated conservatively (including 5 cases treated only by continuous ventricular drainage).

[Intraventricular hematomas associated with hypertensive intracerebral hemorrhages: with special reference to third ventricular hematoma].

Intraventricular hematoma (IVH) is often associated with many kinds of intracranial hemorrhage; for example, hypertensive intracerebral hemorrhage, subarachnoid hemorrhage, and so on. In this paper we discuss the clinical significance of IVH in the third ventricle, as well as the effects of surgical treatment. Forty-five patients were treated in our hospital because of massive IVH associated with small or mode-rate-size (hematoma volume less than or equal to 15 ml) thalamic or caudate-head hemorrhage between April, 1983 and April, 1988.

Contrast medium extravasation during cerebral angiography for ruptured intracranial aneurysm--clinical analysis of 26 cases.

Since 1976, the authors performed angiography on 837 patients with ruptured intracranial aneurysm, among which extravasation (EV) of contrast medium occurred in 26. Eleven patients underwent radical surgery within 3 hours after the EV, and four recovered well. The other 15 patients were conservatively treated, and all died.

[Combination of serial transcranial Doppler examinations and cerebral blood flow studies in the management of cerebral vasospasm after subarachnoid hemorrhage].

In 13 patients who had ruptured intracranial aneurysms, serial transcranial Doppler (TCD) and cerebral blood flow (CBF) examinations were performed in order to evaluate the degree of cerebral vasospasm. All patients showed some extent of vasospasm on angiography, which was performed between Day 7 and 10. The flow velocities of either the middle cerebral arteries or the anterior cerebral arteries, measured by TCD, began to increase on post hemorrhage Day 5, and maximum flow velocities were recorded between Day 9 and 13, with normalization occurring within the following 2 weeks.

Early surgery in elderly patients with ruptured intracranial aneurysms--preoperative clinical evaluation and prognosis.

Numerous clinical classification systems have been developed for patients with ruptured intracranial aneurysms. However, most systems do not take age into account and are less reliable in elderly than in younger patients in terms of indications for early surgery and predicting the clinical outcome. The authors have studied this problem using our clinical classification system and, present here the results of 38 elderly patients (greater than or equal to 65 years of age) who underwent neck clipping and implementation of continuous ventricular drainage within 3 days of aneurysm rupture.