Publications by authors named "Taku Sugiyama"

Article Synopsis
  • * These aneurysms often need complex surgical interventions, such as skull base techniques and bypass procedures, rather than standard methods like clipping or coiling used for more common types.
  • * The review discusses the clinical aspects, surgical history, and reconstruction techniques for these aneurysms, and includes a case study and video demonstrating current microsurgical practices.
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Article Synopsis
  • Mechanical thrombectomy is effective for acute ischemic stroke but can be challenging in about 10% of cases due to type III aortic arches, which complicate procedures.
  • This study evaluated 203 patients and focused on 23 with type III aortic arches, comparing the effectiveness of two catheter types (Simmons vs. JB-2) during thrombectomy.
  • Results showed that using a Simmons catheter significantly reduced the time from puncture to recanalization, suggesting that proper catheter selection can enhance outcomes for patients with challenging aortic anatomies.
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Objective: Microsurgical interventions involve the interaction of numerous variables, making objective analysis of skill proficiency challenging. This difficulty is even more pronounced in low-resource contexts. Continuous improvement methodologies such as Kaizen-planning, doing, checking, acting (PDCA) and micromovements science (MMS) can address this issue.

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Continuous and careful management is necessary after revascularization surgery for moyamoya disease (MMD). The postoperative information has been shared in person or by telephone and emails among doctors; however, this is not always efficient. We aimed to describe the feasibility of remote diagnosis and text chats using a smartphone application on postoperative MMD management.

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Vertebrates possess a biomechanical structure with redundant muscles, enabling adaptability in uncertain and complex environments. Harnessing this inspiration, musculoskeletal systems offer advantages like variable stiffness and resilience to actuator failure and fatigue. Despite their potential, the complex structure presents modelling challenges that are difficult to explicitly formulate and control.

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Background: Visual impairment due to delayed optic neuropathy is a rare complication of the endovascular treatment of paraclinoid aneurysms. An inflammatory response induced in the treated aneurysm wall is a known mechanism underlying this pathophysiology. The authors describe a case with severe and progressive optic neuropathy leading to neuronal degeneration and severe visual dysfunction.

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Article Synopsis
  • The study focuses on improving microvascular surgery by developing a deep learning algorithm to assess changes in vessel area during surgical procedures, which is crucial for avoiding damage to delicate blood vessels.
  • The algorithm was trained using videos of expert surgeons performing anastomosis, and showed high accuracy in segmentation, allowing for objective comparisons between expert and novice surgeons.
  • Results indicated that expert surgeons minimized vessel area changes and tissue deformation errors, completing tasks more efficiently, highlighting the algorithm's potential to enhance surgical training and patient safety in the future.
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Purpose: It is difficult to precisely predict indirect bypass development in the context of combined bypass procedures in moyamoya disease (MMD). We aimed to investigate the predictive value of magnetic resonance angiography (MRA) signal intensity in the peripheral portion of the major cerebral arteries for indirect bypass development in adult patients with MMD.

Methods: We studied 93 hemispheres from 62 adult patients who underwent combined direct and indirect revascularization between 2005 and 2019 and genetic analysis for RNF213 p.

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Article Synopsis
  • The study looked at the systemic immune-inflammation index (SII) to see if it could help doctors understand a brain condition called dural arteriovenous fistula (DAVF).
  • Researchers tested 28 patients undergoing treatment for DAVF and found that a higher SII was linked to worse symptoms and complications.
  • After treatment, patients with improved symptoms had lower SII levels, suggesting that SII could be a useful tool for tracking how serious the condition is and how well the treatments work.
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Objective: The objective was to assess the performance of a context-enriched large language model (LLM) compared with international neurosurgical experts on questions related to the management of vestibular schwannoma. Furthermore, another objective was to develop a chat-based platform incorporating in-text citations, references, and memory to enable accurate, relevant, and reliable information in real time.

Methods: The analysis involved 1) creating a data set through web scraping, 2) developing a chat-based platform called neuroGPT-X, 3) enlisting 8 expert neurosurgeons across international centers to independently create questions (n = 1) and to answer (n = 4) and evaluate responses (n = 3) while blinded, and 4) analyzing the evaluation results on the management of vestibular schwannoma.

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Background: Local vasogenic edema induced after direct revascularization in moyamoya disease (MMD) is associated with blood-brain barrier dysfunction, potentially leading to postoperative cerebral hyperperfusion (CHP) or delayed intracerebral hemorrhage. This phenomenon allows the leakage of fluids, proteins, and other substances from the blood vessels into the extracellular compartment. Typically, such edema is observed postoperatively rather than intraoperatively.

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Arterial spin-labeling magnetic resonance imaging (ASL-MRI) is widely used for evaluating collateral development in patients with acute ischemic stroke (AIS). This study aimed to characterize the findings of multiphase ASL-MRI between embolic and atherosclerotic large vessel occlusion (LVO) to aid in the differential diagnosis. Among 982 patients with AIS, 44 who were diagnosed with acute, symptomatic, and unilateral occlusion of the horizontal segment of the middle cerebral artery (MCA) were selected and categorized into embolic stroke (ES) and atherosclerosis (AT) groups.

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Moyamoya disease (MMD) is a rare idiopathic cerebrovascular disorder that causes transient ischemic attack (TIA) and ischemic stroke in the pediatric population. Herein, we report an extremely rare case of Moyamoya syndrome (MMS) and late-onset idiopathic aqueduct stenosis, a unique form of non-communicating hydrocephalus. A 17-year-old female presented with an intractable headache and occasional faintness.

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The opportunity to treat older patients with Moyamoya disease (MMD) is increasing. However, the surgical outcomes after combined direct and indirect revascularization for elderly patients with MMD are not fully understood, especially for those ≥60 years old. This retrospective study examined 232 consecutive hemispheres of 165 adults with MMD who underwent combined revascularization.

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Article Synopsis
  • Cell therapy using MultiStem, a multipotent progenitor cell product from bone marrow, is being evaluated for its potential to treat ischemic stroke, which involves a lack of blood flow to the brain.
  • The TREASURE trial, a double-blind, placebo-controlled study conducted at 44 centers in Japan, aimed to determine the safety and efficacy of MultiStem when given to patients within 18-36 hours of stroke onset.
  • Key outcomes were measured through various scales at 90 and 365 days post-treatment, assessing safety and overall recovery, with the study involving 206 patients (104 receiving MultiStem and 102 receiving placebo).
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Purpose: Attaining sufficient microsurgical skills is paramount for neurosurgical trainees. Kinematic analysis of surgical instruments using video offers the potential for an objective assessment of microsurgical proficiency, thereby enhancing surgical training and patient safety. The purposes of this study were to develop a deep-learning-based automated instrument tip-detection algorithm, and to validate its performance in microvascular anastomosis training.

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Delayed foreign body reactions to either or both clipping and coating materials have been reported in several small series; however, studies in the titanium clip era are scarce. This study aims to survey the contemporary status of such reactions to titanium clips and coating materials. Among patients who received a total of 2327 unruptured cerebral aneurysmal surgeries, 12 developed delayed intraparenchymal reactions during outpatient magnetic resonance imaging (MRI) follow-up.

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The pneumatic and hydraulic dual actuation of pressure-driven soft actuators (PSAs) is promising because of their potential to develop novel practical soft robots and expand the range of soft robot applications. However, the physical characteristics of air and water are largely different, which makes it challenging to quickly adapt to a selected actuation method and achieve method-independent accurate control performance. Herein, we propose a novel LAtent Representation-based Feedforward Neural Network (LAR-FNN) for dual actuation.

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Article Synopsis
  • - The study focused on evaluating a non-contrast MRA technique called Time-SLIP for assessing catheter access routes in patients undergoing endovascular thrombectomy for acute ischemic stroke.
  • - Researchers reviewed the imaging results of 31 patients, comparing Time-SLIP MRA to traditional contrast-enhanced MRA, and found that Time-SLIP produced high-quality images without any "non-diagnostic" results.
  • - Time-SLIP MRA showed strong effectiveness in identifying vessel stenosis and aorta shape, making it a viable alternative to CE MRA for patients ineligible for immediate thrombectomy therapy.
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Background And Objectives: Gentle tissue handling to avoid excessive motion of affected fragile vessels during surgical dissection is essential for both surgeon proficiency and patient safety during carotid endarterectomy (CEA). However, a void remains in the quantification of these aspects during surgery. The video-based measurement of tissue acceleration is presented as a novel metric for the objective assessment of surgical performance.

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During microvascular decompression (MVD) for trigeminal neuralgia (TGN), the mastoid emissary veins (MEV) are routinely sacrificed using the suboccipital retrosigmoid approach. The technical nuances when the MEV is an important collateral venous pathway for the obstructive internal jugular vein (IJV) have not been described thus far. Herein, we demonstrate for the first time a modified surgical technique for MVD to preserve the MEV.

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A cortical hyperintensity on fluid-attenuated inversion recovery images (FLAIR cortical hyperintensity (FCH)) is an abnormal finding after revascularization surgery for moyamoya disease. This study aimed to investigate the pathophysiology of FCH through genetic analyses of RNF213 p.R4810K polymorphism and perioperative hemodynamic studies using single-photon emission computed tomography.

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Although postoperative neurological events due to brain compression by the swollen temporal muscle are a rare complication, the chronological volume changes of the temporal muscle pedicle and their clinical impact have not yet been documented. This prospective observational study aimed to investigate the chronological volume changes in the temporal muscle pedicle in Moyamoya disease (MMD). Eighteen consecutive combined revascularization procedures using the temporal muscle were performed for symptomatic MMD in 2021.

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Aneurysms of the recurrent artery of Heubner (RAH) are known to be one of the uncommon cerebral aneurysms, predominantly presenting with bleeding symptoms. Previously, nine cases of the RAH aneurysms have been reported, all of which were treated surgically or endovascularly and most cases developed postoperative cerebral infarct in the ipsilateral caudate nucleus. Herein, we report a man presenting with transient ischemic attack due to diffuse cerebral vasospasm from a minor non-disabling subarachnoid hemorrhage (SAH) from an RAH aneurysm.

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