[Case report of traumatic hemorrhage from the anterior choroidal artery].

Traumatic hemorrhage from the anterior choroidal artery is very rare. A 74-year-old male was admitted to our hospital immediately after a traffic accident. CT on admission showed right intracerebral hematomas in the posterior limb of the internal capsule and the upper part of the right cerebral peduncle.

[Isolated trigeminal sensory neuropathy due to pontine infarction of the root entry zone--report of two cases].

Secondary trigeminal neuralgia and isolated trigeminal neuropathy due to ischemic lesion of the pons are very rare. We report 2 patients with pontine infarct transecting the central trigeminal pathways resulting in trigeminal neuropathy and/or neuralgia. Case 1: A 48-year-old female presented with lancinating pain and paresthesia and hypesthesia in the right V2 and V3 distributions.

[Rapid disappearance of acute epidural hematoma by percutaneous aspiration of subperiosteal hematoma--case report].

We present the case of an 8-year-old boy who was injured in a bicycle accident and was admitted with a right frontal skull fracture, an acute epidural hematoma, a right frontal laceration, and a subperiosteal hematoma on admission. After the frontal cutaneous suture, the subperiosteal hematoma was aspirated by the percutaneous needle. Two hours later, a CT scan revealed that the epidural hematoma was disappeared.

[Conjugate deviation in ischemia of medial medullary oblongata--report of three cases].

Medial medullary infarct (MMI) is a rare type of brain stem infarction. Its clinical picture was characterized by contralateral hemiparesis, deep sensory disturbance, and ipsilateral hypoglossal paresis, but conjugate deviation or nystagmus is uncommon as initial symptom. Case 1: A 73-year-old man developed vomiting and vertigo.

[Evaluation of the vocal tract during Japanese vowel production in myasthenia gravis using magnetic resonance imaging].

We report a 65-year-old Japanese female whose primary symptom of myasthenia gravis was related to rhinolalia aperta. The vocal tract during vowel production was evaluated using two-dimensional fast advanced spin echo (2D-FASE) MR images on supine and prone position. Before treatment, MRI on prone position demonstrated anterior shift of the palatine uvula and the tongue during Japanese "a", "u" and "o" production following the gravity, the former suggested the paresis of the sphenosalpingostaphylinus and elevator veli palatini muscle and the latter the paresis of the styloglossal and hypoglossal muscles.

[Delayed epidural bleeding caused by traumatic pseudoaneurysm of the middle meningeal artery: case report].

A 16-year-old man who presented with delayed bleeding of epidural hematoma is reported. Computed tomography (CT) on admission demonstrated a small amount of right epidural hematoma and a small fracture of the right lateral orbital wall. He was treated conservatively.

[Case report of Rosai-Dorfman disease mimicking pachymeningitis].

Rosai-Dorfman disease (RDD) is a rare idiopathic histioproliferative disease affecting the lymph nodes. Extranodal sites may be involved and occasionally represent the initial or sole manifestation of the disease. Central nervous system manifestations especially are exceedingly rare.

[Rapid improvement of callosal edema by thiamine administration in Marchiafava-Bignami disease: a case report].

Marchiafava-Bignami disease (MBD) associated with chronic alcoholism is a fatal disorder characterized by demyelination of the corpus callosum. A 62-year-old Japanese man, a heavy drinker for his last over 10 years, was admitted to our hospital because of acute onset of speech disturbance. The first MR images showed abnormal signal intensity of the corpus callosum, which was a typical finding of MBD, but no signal abnormality on diffusion-weighted images.

Delayed, transient neurological deterioration after mild head injury--case report.

A 16-year-old boy presented with delayed, transient neurological deterioration 18 days after mild head injury. Left hemiparesis and left homonymous hemianopsia appeared after right frontal contusional and mild subdural hematomas subsided. Neuroimaging examinations including cerebral angiography, magnetic resonance imaging, and single photon emission computed tomography showed vasodilation and hyperemia in the right cerebral hemisphere.

Atlas hypoplasia manifesting as myelopathy in a child--case report.

A 14-year-old Japanese boy presented with myelopathy due to atlas hypoplasia with complete posterior arch. Decompressive laminectomy of the atlas produced good neurological recovery, and follow-up T2-weighted magnetic resonance imaging showed disappearance of spinal cord edema. Congenital atlas stenosis may be symptomatic even in children, with no accompanying cervical spondylotic change.

[Unusual MR findings of Wernicke encephalopathy with cortical involvement].

We report a 48-year-old chronic alcoholic man, who developed consciousness disturbance, oculomotor paresis, and flaccid tetraplegia. His dietary habit was very poor since one month prior to the present admission and he was drinking alcoholic beverage. On admission on April 19, 1999, he showed disturbance of consciousness, tetraparesis without sensory disturbance, gaze paresis, and vertical nystagmus on downward gaze.

Effect of transcutaneous electrical nerve stimulation (TENS) on central nervous system amplification of somatosensory input.

The effect of transcutaneous electrical nerve stimulation (TENS) on the central nervous system amplification process was investigated focusing on the dorsal column-medial lemniscal pathway, because the dorsal column nucleus was recently shown to receive multiple sources of sensory information, including pain. Short latency somatosensory evoked potentials (SSEPs) were recorded in ten healthy normal volunteers. Amplitude changes in each SSEP component (the N9 brachial plexus potential, the P14 potential that originates from the cervicomedullary junction, spinal N13/P13 generated by the cervical dorsal horn and the cortical N20/P25 potential) were studied at stimulus strengths ranging from the threshold (40% maximum stimulus) to 2.

[Evaluation of neuro-Behçet disease with 99mTc-HMPAO brain SPECT: comparison with MR imaging].

The purpose of this study was to evaluate the brain perfusion of neuro-Behçet disease using 99mTc-HMPAO. In total, nine patients (7 men and 2 women) were evaluated. Seven were in the chronic phase, one was acute and the other was subacute.

Effects of night work on the cognitive function in young and elderly subjects with specific reference to the auditory P300.

To estimate the effects of night work on the human cognitive function, P300 event related potentials (ERPs) evoked with an auditory "oddball" paradigm were recorded for 17 nurses (mean age 27.4 +/- 6.1 years; range 21-41 years) for 3 epochs; after a night of work, after a day of work and on a holiday, and for 12 elderly security guards (mean age 62.

Clinical application of paraspinal somatosensory evoked potentials (PS-SEPs) for the diagnosis of spinal cord lesion.

To evaluate the clinical utility of somatosensory evoked potentials elicited by stimulation of the paraspinal region (PS-SEPs), waveform characteristics and scalp topography were studied in 23 normal controls. PS-SEPs were recorded in 22 patients with spinal lesions, and the relation between the abnormal PS-SEPs and clinico-radiological findings was investigated. 1) The normal control study showed clear waveforms on the scalp elicited by stimulation of the paraspinal region from C7 to the L2 spinous process level, with both bilateral and unilateral stimulation.

P30 and N33 of posterior tibial nerve SSEPs are analogous to P14 and N18 of median nerve SSEPs.

Generator sources of far-field P30 and N33 components produced by posterior tibial nerve stimulation were compared with those of the P14 and N18 components of median nerve stimulated somatosensory evoked potentials. Intracranial spatio-temporal distributions of P30 and N33 were similar to those of the P14 and N18 obtained by median nerve stimulation. In clinical cases, the changes in P30 and N33 were correlated with those in P14 and N18, indicative that P30 and N33 are derived from activities similar to those that produce P14 and N18.

Clival chordoma associated with pathological laughter. Case report.

The case of a 40-year-old man with a clival chordoma who presented with symptoms of pathological laughter and left sixth cranial nerve paresis is reported. Laughing and talking during sleep were noted on polygraphic and videotape recordings of nocturnal sleep. Selective disorganization of sleep was observed, with laughing facial expressions and a lack of muscular atonia.

Origin of subcortical somatosensory evoked potentials in response to posterior tibial nerve stimulation in humans.

To identify the origin of short latency somatosensory evoked potentials (SSEPs) to posterior tibial nerve stimulation, direct recordings were made from the cervical cord, the ventricular system and the frontal subcortex during 8 neurosurgical operations. The origin of each component of SSEPs was also studied in 7 selected patients with various lesions in the central nervous system. In addition, SSEPs to median nerve stimulation were investigated in 4 of 8 surgical cases and all 7 cases of the lesion study group.