Publications by authors named "Toshihiro Takami"

The etiology of sellar xanthogranuloma (SXG) remains unclear,1-5 and the surgical strategy for treating SXG is debatable. In this study, we present the surgical case of a symptomatic SXG associated with Rathke cleft cyst. The intraoperative decision to prevent postoperative cerebrospinal fluid (CSF) leakage and secure the drainage route is discussed.

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  • The debate about how effective radiotherapy is for treating meningiomas is ongoing and lacks strong evidence, but recent WHO classification updates and molecular diagnostics have improved how we assess the risks of recurrence.
  • While there's a growing understanding of when radiotherapy might be necessary, its effectiveness for high-risk meningiomas remains debated.
  • New techniques, like combining PET imaging with MRI and exploring boron neutron capture therapy, are being recognized as beneficial for targeting tumor cells, especially in cases where meningiomas invade surrounding brain tissue.
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Purpose: Each institution or physician has to decide on an individual basis whether to continue or discontinue antiplatelet (AP) therapy before spinal surgery. The purpose of this study was to determine if perioperative AP continuation is safe during single-level microsurgical decompression (MSD) for treating lumbar spinal stenosis (LSS) and lumbar disc hernia (LDH) without selection bias.

Methods: Patients who underwent single-level MSD for LSS and LDH between April 2018 to December 2022 at our institute were included in this retrospective study.

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  • Metastatic spinal tumors are becoming more common as cancer treatments improve, emphasizing the necessity for better therapies.
  • Boron neutron capture therapy (BNCT) shows potential by targeting tumors and sparing healthy tissue, making it a promising treatment option.
  • In a study on mice with lung adenocarcinoma, BNCT significantly improved survival rates and preserved neurological function compared to untreated and neutron-only groups, while showing no adverse effects.
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Boron neutron capture therapy (BNCT) is a type of targeted particle radiation therapy with potential applications at the cellular level. Spinal cord gliomas (SCGs) present a substantial challenge owing to their poor prognosis and the lack of effective postoperative treatments. This study evaluated the efficacy of BNCT in a rat SCGs model employing the Basso, Beattie, and Bresnahan (BBB) scale to assess postoperative locomotor activity.

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Airway complications that occur after anterior cervical spine surgery pose a life-threatening risk, which encompasses complications including prolonged intubation, unplanned reintubation, and/or necessity of tracheostomy. The present study aimed to identify the surgical risks associated with postoperative airway complications in neurosurgical training institutes. A retrospective, multicenter, observational review of data from 365 patients, who underwent anterior cervical spine surgery between 2018 and 2022, at three such institutes was carried out.

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Preoperative simulation images creates an accurate visualization of a surgical field. The anatomical relationship of the cranial nerves, arteries, brainstem, and related bony protrusions is important in skull base surgery. However, an operator's intention is unclear for a less experienced neurosurgeon.

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  • The objective of the study was to create updated, evidence-based recommendations on lumbar herniated disk (LDH) regarding its epidemiology, clinical diagnosis, and radiographic diagnosis.
  • A systematic literature review analyzed 123 studies between 2012 and 2022, resulting in eleven consensus statements from experts in the WFNS Spine Committee.
  • Key findings included a 1-3% lifetime risk of symptomatic LDH with 60-90% resolving naturally, as well as recommended clinical tests and MRI as the best method for diagnosis.
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  • Preoperative embolization for meningiomas is debated regarding its benefits for reducing surgical blood loss and time, with mixed reports on its effectiveness, especially for larger tumors.
  • A study compared outcomes in patients who underwent craniotomy for meningiomas with and without preoperative embolization, analyzing factors like tumor size and intraoperative bleeding from data collected between January 2015 and April 2022.
  • Results showed that embolization significantly reduced blood loss for larger tumors (≥40 mm), and while complications were low, hypertensive patients without embolization experienced more bleeding during surgery.
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Tarlov cysts (TCs) rarely cause clinical symptoms, such as leg pain, buttock pain, and bladder/bowel dysfunction. Surgery is considered when these symptoms persist despite medical treatments. Among several surgical procedures, microsurgical wrapping (MSW) is a relatively novel, simple technique with few complications, including cerebrospinal fluid leakage.

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Background: In the cervical nerve sheath tumor (NST) surgery with dumbbell extension of Eden type 2 or 3, selection of anterior, posterior, or combined approach remains controversial.

Objectives: This technical note aimed to propose possible advantages of the posterior unilateral approach (PUA). Methods: Six patients who underwent the surgical treatment of cervical NSTs with dumbbell extension of Eden type 2 or 3 were included.

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  • Ependymomas are diverse tumors with specific types based on where they occur and their molecular characteristics, with spinal ependymomas (SP-EPN) being the most common type found in the spinal cord of both children and adults.
  • Research revealed limited molecular data on SP-EPN, with known genetic changes including losses on chromosome 22q and mutations in NF2, but this study aimed to fill the gaps by analyzing transcriptomic, epigenetic, genetic, and clinical data from a large cohort.
  • The study identified two subtypes of SP-EPN: subtype A, associated with known NF2 mutations and more severe disease, and subtype B, characterized by different genetic alterations and more stable NF2 expression, helping to
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Purpose: Patients with lumbar spinal stenosis (LSS) require microsurgical decompression (MSD) surgery; however, MSD is often associated with postoperative instability at the operated level. Paraspinal muscles support the spinal column; lately, paraspinal volume has been used as a good indicator of sarcopenia. This study aimed to determine preoperative radiological factors, including paraspinal muscle volume, associated with postoperative slippage progression after MSD in LSS patients.

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We report the case of a 70-year-old woman with metastatic brain tumors who underwent surgical removal of the tumor and radiation necrosis. The patient had a history of colon cancer and had undergone surgical removal of a left occipital tumor. Histopathological evaluation revealed a metastatic brain tumor.

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Objective: Cancers in adolescents and young adults (AYAs) (age 15-39 years) often present with unique characteristics and poor outcomes. To date, spinal cord glioblastoma, a rare tumor, remains poorly understood across all age groups, including AYAs. This comparative study aimed to investigate the clinical characteristics and outcomes of spinal cord glioblastoma in AYAs and older adults (age 40-74 years), given the limited availability of studies focusing on AYAs.

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Malignant glioma is a highly invasive tumor, and elucidating the glioma invasion mechanism is essential for developing novel therapies. We aimed to highlight actin alpha 2, smooth muscle (ACTA2) as potential biomarkers of brain invasion and distant recurrence in malignant gliomas. Using the human malignant glioma cell line, U251MG, we generated ACTA2 knockdown (KD) cells treated with small interfering RNA, and the cell motility and proliferation of the ACTA2 KD group were analyzed.

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Objective: This study aimed to clarify the differences in the perioperative data of patients with extramedullary and intramedullary tumors and estimate the impact of surgery on medical costs.

Methods: This single-center retrospective study included consecutive patients who underwent spinal tumor resection between September 2020 and December 2022. The perioperative medical information and medical costs for individual patients were obtained from their medical records.

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  • - Glioblastoma typically recurs in the brain, with rare cases of extracranial metastases; lymph node involvement is often discovered through symptoms or lymphadenopathy.
  • - The case study presented involves a patient with asymptomatic lymph node metastasis and rising C-reactive protein levels, leading to a diagnosis 9 months later when fever developed without prior signs of infection.
  • - The findings suggest that C-reactive protein levels might be a useful indicator for detecting lymph node metastasis in glioblastoma patients, warranting further investigation.
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High-grade gliomas present a significant challenge in neuro-oncology because of their aggressive nature and resistance to current therapies. Boron neutron capture therapy (BNCT) is a potential treatment method; however, the boron used by the carrier compounds-such as 4-borono-L-phenylalanine (L-BPA)-have limitations. This study evaluated the use of boron-conjugated 4-iodophenylbutanamide (BC-IP), a novel boron compound in BNCT, for the treatment of glioma.

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Background: This retrospective multicenter study aimed to analyze the characteristics and surgical outcomes of intramedullary spinal cord metastasis (ISCM) and to discuss the controversy regarding its surgical indications.

Methods: This study included 29 ISCM patients who underwent surgery between 2009 and 2020. Biopsy cases were excluded from analysis.

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Background: The authors report a case of occult neurohypophyseal germinoma detected in a patient with long-term diabetes insipidus. Central diabetes insipidus is the initial symptom in 95% of cases of neurohypophyseal germinoma. In occult neurohypophyseal germinomas, no abnormalities are seen on magnetic resonance imaging (MRI) at the onset of symptoms.

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Study Design: This was as clinical retrospective study.

Objectives: We sought to evaluate the characteristics of Pediatric intramedullary spinal cord tumors (PISCTs) and to identify differences between pediatric and adult intramedullary spinal cord tumors.

Summary Of Background Data: PISCTs represent a rare clinical entity with limited evidence-base in the literature.

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Objective: Spinal cord cavernous malformation (CM) is an intramedullary vascular lesion that may present with progressive symptoms. Surgery is recommended for symptomatic patients, but optimal timing of surgery is debatable. Some advocate waiting until plateau of neurological recovery and others support emergency surgery.

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Background And Objectives: Ependymoma is the most common spinal intramedullary tumor. Although clinical outcomes have been described in the literature, most of the reports were based on limited numbers of cases or been confined to institutional experience. The objective of this study was to analyze more detailed characteristics of spinal intramedullary ependymoma (SIE) and provide clinical factors associated with progression-free survival (PFS).

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  • * A 74-year-old male presented with several symptoms and had MRI results showing a tumor; preoperative steroid treatment shrank the tumor and reduced pain, but only subtotal resection was possible due to the tumor's adhesion to surrounding tissues.
  • * Post-surgery, the patient's condition improved rapidly, and he received targeted radiation therapy, which resulted in a gradual decrease in tumor size without recurrence over two years, emphasizing the potential benefits of combining surgery with adjuvant therapies.
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