Programmable Valve With Virtual off Function Is Useful for Chronic Subdural Hematoma After Ventriculoperitoneal Shunt Surgery.

Over-drainage after a ventriculoperitoneal (VP) shunt can often lead to chronic subdural hematoma; however, the treatment is unclear. Hematoma drainage is performed after physically stopping the shunt function, such as by ligating or removing the shunt system. However, shunt reconstruction is required after the subdural hematoma improves.

Improvement of Isolated Abducens Nerve Palsy with Hydrocephalus after CSF Diversion: A Possible Evaluative Role of Retroclival-pontomedullary Distance.

Isolated abducens nerve palsy (IANP), caused by secondary communicating hydrocephalus, has been rarely documented; in addition, its mechanism and appropriate treatment are not understood well. This study presents a case of bilateral IANP with hydrocephalus in a 62-year-old man who was successfully treated with cerebrospinal fluid (CSF) diversion to correct an enlarged retroclival space during the follow-up of recurrent brain tumor in the right parieto-occipital lobe. The patient was treated with three resections, temozolomide, and irradiation before developing IANP.

The Role for miR-146b-5p in the Attenuation of Dermal Fibrosis and Angiogenesis by Targeting PDGFRα in Skin Wounds.

As a candidate microRNA antifibrotic effector in skin wounds, miR-146b-5p was upregulated by basic FGF, and PDGFRα was identified as a direct target of miR-146b-5p in fibroblasts. The treatment of fibroblasts with a miR-146b-5p mimic markedly downregulated the expression of PDGFRα and collagen type I. miR-146b-5p mimic transfection in wounds markedly attenuated cutaneous fibrosis, whereas a miR-146b-5p inhibitor strongly promoted fibrosis, with increases in PDGFRα and collagen I levels.

Cell-permeable p38 MAP kinase promotes migration of adult neural stem/progenitor cells.

Endogenous neural stem/progenitor cells (NPCs) can migrate toward sites of injury, but the migration activity of NPCs is insufficient to regenerate damaged brain tissue. In this study, we showed that p38 MAP kinase (p38) is expressed in doublecortin-positive adult NPCs. Experiments using the p38 inhibitor SB203580 revealed that endogenous p38 participates in NPC migration.

Segmental copy-number gain within the region of isopentenyl diphosphate isomerase genes in sporadic amyotrophic lateral sclerosis.

Aims: Sporadic amyotrophic lateral sclerosis (SALS) seems to be a multifactorial disease, the pathogenesis of which may involve both genetic and environmental factors. The present study aims at identifying a possible genetic change that confers risk for SALS.

Methods: We performed whole-genome screening of a copy-number variation (CNV) using a CNV beadchip, followed by real-time quantitative polymerase chain reaction (qPCR) and region-targeted high-density oligonucleotide tiling microarray.

Contrast sensitivity of patients with severe motor and intellectual disabilities and cerebral visual impairment.

We attempt to evaluate the residual visual capacities of nine patients (seven males and two females; age range 4 to 35 years, mean 13.8 +/- 9.98) with cerebral visual impairment coupled with severe motor and intellectual disabilities by their contrast sensitivities to sine-wave gratings.

Sonic hedgehog signal peptide mutation in a patient with holoprosencephaly.

We investigated the molecular basis of holoprosencephaly in a sporadic patient and identified a novel missense mutation in the signal sequence of the sonic hedgehog (Shh) gene. Magnetic resonance imaging of the head showed a lobar type of holoprosencephaly and partial agenesis of the anterior corpus callosum. He was treated for craniosynostosis at 7 months of age.

The peak time difference of time-density curve in intravenous digital subtraction angiography correlates to an asymmetric cerebral blood flow as determined by positron emission tomography.

A time-density curve study in contrast media transit is theoretically possible to evaluate an asymmetric cerebral perfusion. In this study, we confirmed the correlation between the peak time difference in a regional time-density curve and the asymmetry of cerebral blood flow using positron emission tomography (PET). Five patients with a unilateral occlusion of the carotid or middle cerebral artery underwent intravenous digital subtraction angiography and PET on two successive days.

Peak time difference of time-density curve in contrast media transit as an indicator of asymmetric cerebral perfusion.

Time-density curve study in contrast media transit has a theoretical possibility to evaluate asymmetric cerebral perfusion. We studied the right-to-left hemispheric difference of peak time in regional time-density curve. Twenty-seven chronic stroke patients underwent either dynamic CT or intravenous digital subtraction angiography (IVDSA), and single photon emission CT (SPECT).

[Distal myopathy with rimmed vacuoles and sudden death--report of two siblings].

We describe two siblings with distal myopathy with rimmed vacuoles, who died suddenly presumably due to fatal arrhythmia. Case 1. A 26-year-old man with a 4 year-history of progressive muscle weakness and wasting was hospitalized in April, 1989.

[A case of adrenoleukodystrophy having progressed from the frontal lobes].

A 12-year-old boy was admitted to our hospital in May 1990. Since two years previously, he became restless and could not adapt himself to his new school mates and teacher. He came to refuse going to school, and his intellectual performance rapidly deteriorated, thereafter.

[Cerebellar atrophy and persistent cerebellar ataxia after acute intoxication of phenytoin].

Chronic intoxication of phenytoin (PHT) is a well known cause of cerebellar atrophy or irreversible cerebellar ataxia. Little attention, on the other hand, is paid for acute PHT intoxication because its clinical signs are believed to be reversible. We here report a patient with acute PHT intoxication, which resulted in irreversible cerebellar ataxia with radiologically definite cerebellar atrophy.

Absence of neurobehavioral disturbance in a focal lesion of the left paracentral lobule.

The case of a right-handed woman with an infarcation confined to the left paracentral lobule and sparing the supplementary motor area (SMA) is reported. She presented with a right leg monoplegia and displayed no mutism. The absence of any associated neurobehavioral disturbances (mutism, forced grasping, reduced spontaneous arm activity or aphasia raises the possibility that the left SMA has discrete neurobehavioral functions.

[Evaluation of cerebral intravascular blood flow by time density curve study of intravenous digital subtraction angiography].

Time density curve (TDC) can be reconstructed from the data of intravenous digital subtraction angiography (IVDSA). We evaluated peak time (PT) and modal transit time (MOTT) of the TDC as the probable indicator of cerebral intravascular blood flow. Cerebral IVDSA and single photon emission CT (SPECT) were performed on 12 patients of ischemic cerebrovascular disease, which consisted of 3 internal carotid artery (ICA) occlusions, one middle cerebral artery (MCA) occlusion, one anterior cerebral artery (ACA) branch occlusion and 7 lacunar infarctions.

Hypergraphia associated with a brain tumour of the right cerebral hemisphere.

Two different neurobehavioural abnormalities have been reported under the term hypergraphia. One has been described in temporal lobe epilepsies and the other in the acute stage of strokes of the right cerebral hemisphere. The latter type of hypergraphia in a patient with a metastatic brain tumour confined to the right hemisphere is reported.

[Single photon emission CT in diagnosis of herpes simplex encephalitis--fronto-parietal hypo-accumulation associated with temporal hyper-accumulation].

Single photon emission CT (SPECT) using 123I-iodoamphetamine and magnetic resonance imaging (MRI) were performed in acute, subacute and chronic stages of a herpes simplex encephalitis (HSE). On the 5th day after onset, SPECT showed left temporal hyperaccumulation associated with decreased accumulation in ipsilateral posterior frontal and anterior parietal lobes. These altered accumulations were normalized on the 26th day, and a broad hypoaccumulation appeared in left temporal and surrounded area on the 91st day.

[Chronic cervical epidural hematoma diagnosed by magnetic resonance imaging].

The clinical picture of spinal epidural hematoma is usually characterized by the sudden onset of pain and acute paraplegia within a few hours. The reports of chronic spinal epidural hematoma above the lumbar level is extremely rare. Here we added one case whose hematoma was at cervical level.

Clinical significance of periodic lateralized epileptiform discharges: relationship with status epilepticus.

A retrospective study was carried out in 147 patients who had been found to have periodic lateralized epileptiform discharges (PLEDs). Clinical, laboratory, radiological, and pathological correlation was performed for all patients. As in previously published works, we found a high correlation with cerebrovascular accidents in our population.

[A case of arachnoid cyst in the middle cranial fossa presenting with trigeminal neuralgia].

A 50-year-old man had been suffering from left trigeminal neuralgia for 30 years. CT scan revealed an arachnoid cyst occupying the anterior two-thirds of the left middle cranial fossa. Cerebral angiography showed elevation of the left middle cerebral artery and medial shift of the left posterior cerebral artery.