Risk assessment of lacunar infarct associated with oral conditions: A case control study focused on radiographic bone loss and Eichner classification.

Purpose: This study aimed to evaluate whether lacunar infarcts can be predicted from occlusal support and periodontal stage on images.

Methods: Seventy patients with lacunar infarcts and 300 participants without lacunar infarcts who underwent cerebral checkups at our university hospital were retrospectively reviewed. Lacunar infarcts were assessed using magnetic resonance images by a neuroradiologist.

Monitoring of filter patency during carotid artery stenting using near-infrared spectroscopy with high time-resolution.

We aimed to evaluate the usefulness of a newly developed, near-infrared spectroscopy (NIRS) device for monitoring hemodynamic changes during carotid artery stenting (CAS), as a means to detect filter obstruction due to distal embolism. We evaluated 16 patients with internal carotid artery (ICA) stenosis during the CAS procedure, using a NIRS system that can monitor not only changes in oxygenation of hemoglobin (Hb), but also the fluctuation of oxyhemoglobin (oxy-Hb) synchronized with heartbeat. The NIRS system detected a marked decrease of oxy-Hb and an increase of deoxyhemoglobin (deoxy-Hb) during ICA occlusion in patients without anterior cross circulation (ACC).

Physiological mechanism of increase in deoxy-hemoglobin concentration during neuronal activation in patients with cerebral ischemia: a simulation study with the balloon model.

Patients with cerebral ischemia or brain tumor have been reported to exhibit an increase of deoxygenated hemoglobin (deoxy-Hb) together with an increase of oxygenated hemoglobin (oxy-Hb). However, the physiological mechanisms underlying this hemodynamic response pattern are unclear. In this study, we performed a simulation using the balloon model (Buxton et al.

Endovascular treatment for ruptured vertebral artery dissecting aneurysms at the acute stage.

Objective: Ruptured vertebral artery dissecting aneurysms (VADA) should be treated promptly because of the high risk of rebleeding. However, it is difficult to treat dissecting aneurysm during the acute stage using microsurgery because of high intracranial pressure or brain edema. Therefore, endovascular treatment of the ruptured VADA may be a better technique.

Monitoring of hemodynamic change in patients with carotid artery stenosis during the tilt test using wearable near-infrared spectroscopy.

Transient ischemic attack (TIA) is a major complication in patients with carotid artery stenosis. Patients with severe stenosis sometimes complain of orthostatic dizziness, such as syncope. The purpose of this study was to examine the usefulness of near-infrared spectroscopy (NIRS) for evaluating cerebral circulation in patients with carotid artery stenosis during head-up tilt test (HUTT).

Comparison between pharmacologic evaluation and repetitive transcranial magnetic stimulation-induced analgesia in poststroke pain patients.

Background: It has been reported that poststroke pain has a complex pharmacologic background and that only about one-half of poststroke pain patients are sensitive to motor cortex stimulation induced by repetitive transcranial magnetic stimulation (rTMS).

Objectives: The relationship between pharmacologic background and effects of rTMS of the primary motor cortex was investigated to clarify the pharmacologic basis of rTMS-induced analgesia in poststroke pain patients.

Methods: Changes in visual analog scale (VAS) score for pain following drug challenge tests using ketamine, morphine, and thiopental were compared with the changes in VAS score following rTMS of the primary motor cortex (frequency 5 Hz, at 100% resting motor threshold, 500 pulses per session) in 20 poststroke pain patients.

Pain intensity and psychosocial characteristics of patients with burning mouth syndrome and trigeminal neuralgia.

This study compared pain intensity and psychosocial characteristics between patients with burning mouth syndrome (BMS) and those with trigeminal neuralgia (TN). Data from 282 patients with BMS and 83 patients with TN were analyzed. Patients reported duration of illness: duration ≤ 6 months was defined as acute illness and > 6 months as chronic illness.

Clivus metastasis from gastric signet ring cell carcinoma after a 10-year disease-free interval--case report.

A 64-year-old male presented with an extremely unusual case of solitary clivus metastasis from gastric cancer manifesting as mild headache and diplopia 10 years after radical excision of the primary tumor. The patient underwent surgical resection using an endoscopic transsphenoidal approach. Histological examination revealed typical signet ring cell carcinoma (SRC) which was identical to that of the previous gastric cancer.

Is the circulating plasma volume sufficiently maintained? Fluid management of an aneurysmal subarachnoid hemorrhage in the acute phase.

Cerebral vasospasm is a well-known cause of mortality and morbidity following aneurysmal subarachnoid hemorrhage (SAH). Prevention of symptomatic cerebral vasospasm is the basic management after SAH. Numerous pharmaceutical therapies and endovascular treatments are available against cerebral vasospasm, but none of them have so far proven to improve the outcome.

Effects of occlusal disharmony on working memory performance and prefrontal cortex activity induced by working memory tasks measured by NIRS.

The effects of artificial occlusal disharmony (AOD) on working memory function and prefrontal cortex (PFC) activity in the elderly were examined. We evaluated working memory function using the modified Sternberg test (ST). We measured activity in the bilateral PFC during ST using near-infrared spectroscopy (NIRS) before and after AOD: the mandibular position was displaced by a splint for 10 min.

Cost-effectiveness analysis of intrathecal baclofen therapy in Japan.

Intrathecal baclofen (ITB) therapy was approved for health insurance coverage in 2005 for the treatment of patients whose spasticity could not be adequately controlled by conventional therapy, and is currently being used to treat around 300 patients nationwide in Japan. Various reports have examined the efficacy and safety of ITB therapy, but no report has evaluated the patient quality of life and medical costs in Japan. A cost-utility analysis of ITB was conducted by time period in six severely spastic patients admitted to our university hospital between 2005 and 2010 for ITB therapy.

Medical care for chronic-phase stroke in Japan.

Stroke leaves serious neurological sequelae, which require long-term medical and social care, imposing financial and mental burdens on the patients and their families, and causing enormous losses to society. It is currently required that medical resources be used efficiently and the cost-effectiveness of treatment be analyzed carefully. We conducted a follow-up survey of stroke patients admitted to the hospital attached to our university in order to build a picture of the current status of chronic-phase stroke medical treatment.

[Case of a giant cervical carotid artery aneurysm with contralateral severe stenosis treated using a covered stent].

We report a case of a cervical carotid artery pseudoaneurysm with contralateral severe stenosis, treated using a covered stent. A 79-year-old man admitted for a splenic artery aneurysm presented a pulsatile mass on the right side of his neck and lower cranial nerve palsy after misinsertion of a central venous line into the right carotid artery. MRI revealed a huge thrombosed aneurysm (30 mm×25 mm) in the right common carotid artery (CCA).

Influence of periodontal afferent inputs for human cerebral blood oxygenation during jaw movements.

Using functional magnetic resonance imaging (fMRI) and near-infrared spectroscopy (NIRS), we examined the role of periodontal afferent inputs on cerebral activation pattern evoked by masticatory muscle activity in twenty-two subjects. Statistical comparisons were used to identify brain regions with significant activation after subtraction of baseline activity from sham teeth-tapping (no periodontal input) and teeth-tapping (periodontal input) activity in an fMRI (N = 14) and NIRS study (N = 8). Both sham teeth-tapping and teeth-tapping significantly activated bilateral sensorimotor cortex and supplementary motor area in the fMRI study.

Report on the international Primary Neurosurgical Life Support course in the eighth Asian Congress of Neurological Surgeons in Kuala Lumpur, Malaysia.

On November 22, 2010, a simulation-based hands-on education course for medical staff in the neurosurgical fields was held in 8(th) Asian Congress of Neurological Surgeons (ACNS) in Kuala Lumpur, Malaysia. The present education course called Primary Neurosurgical Life Support (PNLS) course had been started by the Japan Society of Neurosurgical Emergency since 2008. This report summarizes the international version of PNLS course in 8(th) ACNS.

[Stent-assisted angioplasty using the proximal protection method for intracranial internal carotid artery stenosis].

Percutaneous transluminal angioplasty (PTA) with stenting (PTA/stenting) for intracranial atherosclerotic stenoses is usually performed without any embolic protection devise (EPD). However, we have encountered ischemic complications when performing PTA/stenting without EPD for symptomatic intracranial internal carotid artery stenosis. We report here a case of symptomatic intracranial artery stenosis, which was treated by stenting under proximal protection without ischemic complications.

The Modules for ISLS/PNLS Combined Course as International Version: Report of Workshop in 9 International Conference of Cerebrovascular Surgery.

In Japan, there are two simulation based training systems for neurosurgical diseases, that are ISLS (Immediate Stroke Life Support) and PNLS (Primary Neurosurgical Life Support). Workshop on "First ISLS International Version Trial Task Force" came to a successful conclusion on November 12, 2009, in Nagoya, Japan. More than 30 international participants attended this workshop, organized by the Department of Neurosurgery, Fujita Health University.

Abnormal single-unit activity recorded in the somatosensory thalamus of a quadriplegic patient with central pain.

We have performed single unit analysis of the activity of cells located in the ventral nuclear group of thalamus in a patient with dysesthetic pain below the level of a clinically complete traumatic spinal cord transection at C5. Cells located in the parasagittal plane 14 mm lateral to the midline responded to tactile stimulation in small facial and intraoral receptive fields, which were characteristic of patients without somatosensory abnormality [30]. In this patient the 16 mm lateral parasagittal plane contained cells with receptive fields located on the occiput and neck instead of the upper extremity as would normally be expected.

Thalamic relay nucleus stimulation for relief of intractable pain. Clinical results and beta-endorphin immunoreactivity in the cerebrospinal fluid.

Deep brain stimulation (thalamic relay nucleus, periaqueductal gray and internal capsule) was applied to various cases of intractable pain, and the resulting degree of pain reduction and alteration in beta-endorphin immunoreactivity in the cerebrospinal fluid (CSF) were compared. The following results were obtained. (1) The studies on intractable pain revealed that the levels of beta-endorphin immunoreactivity in the CSF were lower than those in the control group.