Abstract:
:The efficacy and safety of cerebellar hemorrhage evacuation by key hole craniotomy and the importance of thorough evacuation and irrigation of the hematoma in the fourth ventricle to resolve obstructive hydrocephalus were assessed in 23 patients with spontaneous cerebellar hemorrhage (SCH) greater than 3 cm or with brainstem compression and hydrocephalus. A 5-cm elongated S-shaped scalp incision was made, and a 3-cm key hole craniotomy was performed over a cerebellar convexity area. The hematoma was immediately evacuated through a small corticotomy. The hematoma in the fourth ventricle was gently removed through the hematoma cavity, followed by thorough saline irrigation to release obstructive hydrocephalus. Patients classified retrospectively into favorable and poor outcome groups using the Glasgow Outcome Scale (GOS) scores of 4-5 vs. 1-3 showed significant differences with respect to the preoperative Glasgow Coma Scale, hematoma size and volume, and brainstem compression. Only 2 of the 23 patients required ventricular drainage and no postoperative complications were recorded. Patients treated by experienced and inexperienced surgeons showed no significant differences in the hematoma evacuation rate, postoperative GOS, and interval from skin incision to start of hematoma evacuation. Our simplified method of key hole craniotomy to treat SCH was less invasive but easy to perform, as even inexperienced neurosurgeons could obtain good surgical results. Thorough cleaning of the fourth ventricle minimized the necessity for ventricular drainage.
journal_name
Neurol Med Chir (Tokyo)journal_title
Neurologia medico-chirurgicaauthors
Tokimura H,Tajitsu K,Taniguchi A,Yamahata H,Tsuchiya M,Takayama K,Shinsato T,Arita Kdoi
10.2176/nmc.50.367subject
Has Abstractpub_date
2010-01-01 00:00:00pages
367-72issue
5eissn
0470-8105issn
1349-8029pii
JST.JSTAGE/nmc/50.367journal_volume
50pub_type
杂志文章abstract::Late onset cerebrospinal fluid (CSF) leakage, such as rhinorrhea or otorrhea, is a rare complication of closed head injury. We encountered two cases of delayed CSF leakage more than 10 years after head injury. In both cases, surgical treatments were performed using intradural approaches, and the dural defects were clo...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.53.217
更新日期:2013-01-01 00:00:00
abstract::A 35-year-old man presented with a rare case of nevoid basal cell carcinoma syndrome, or Gorlin's syndrome, associated with both medulloblastoma and meningioma, manifesting as visual field constriction due to multiple parasellar tumors. He had undergone resection of a medulloblastoma at the age of 1 year 9 months, fol...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.44.665
更新日期:2004-12-01 00:00:00
abstract::A 16-year-old boy presented with an unusual case of a supratentorial, extraaxial small round blue cell tumor of the central nervous system, which was most likely a primitive neuroectodermal tumor (PNET). Preoperative computed tomography and magnetic resonance imaging showed a large multistage hematoma in the left cent...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.51.441
更新日期:2011-01-01 00:00:00
abstract::Cervical spinal neurinomas are benign tumors that arise from nerve roots. Based on their location, these tumors can also take the form of a dumbbell-shaped mass. Treatment strategies for these tumors have raised several controversial issues such as appropriate surgical indications and selection of surgical approaches ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.ra.2014-0421
更新日期:2015-01-01 00:00:00
abstract::A 61-year-old man presented with a large cerebellopontine angle meningioma manifesting as a 1-year history of deafness on the right side, in whom hearing was restored from the deaf state immediately after tumor resection. Neuroimaging demonstrated a large mass in the right cerebellopontine angle, originating at the re...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.41.352
更新日期:2001-07-01 00:00:00
abstract::The prognostic significance of the variety of changes in the internal auditory meatus (IAM) caused by vestibular schwannoma was retrospectively analyzed in 69 consecutive patients with vestibular schwannoma. Preoperative bone-window computed tomography was used to classify IAM changes into extensive destruction (17%),...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.42.465
更新日期:2002-11-01 00:00:00
abstract::The present detailed radiological study investigated the relationship between petroclival meningiomas and petrosal veins with contrast-enhanced (CE) principles of echo-shifting with a train of observations (PRESTO) imaging to assess the potential contribution of the findings to the surgical strategy. Fourteen patients...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.53.490
更新日期:2013-01-01 00:00:00
abstract::Hemangioblastoma in the suprasellar region is rare. We present a case of a suprasellar hemangioblastoma that underwent surgical resection using an extended endoscopic transsphenoidal approach. A 64-year-old female patient presented with headache and decreased visual acuity for the last four years, computed tomography ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.cr2011-0016
更新日期:2013-01-01 00:00:00
abstract::The suboccipital transmeatal approach uses packing of a muscle or fat graft into the internal auditory canal (IAC) to prevent postoperative cerebrospinal fluid (CSF) leakage. However, preserved hearing after removal of vestibular schwannomas may decline over time because of the progressive constriction of cochlear vas...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.40.597
更新日期:2000-11-01 00:00:00
abstract::Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins co...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.ra.2016-0030
更新日期:2016-09-15 00:00:00
abstract::The effectiveness of spinal surgery for lumbar canal stenosis was investigated in the elderly. 164 patients with lumbar canal stenosis were surgically treated over 8 years. 125 patients were followed up by letter questionnaire. The outcome and patient satisfaction with the surgical procedures were compared between the...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.39.519
更新日期:1999-07-01 00:00:00
abstract::A 55-year-old male presented with hearing disturbance and tinnitus in the left ear. Computed tomography (CT) and magnetic resonance imaging demonstrated a well-defined, homogeneously enhanced mass in the left cerebellomedullary cistern without extension close to the jugular foramen. A three-dimensional image reconstru...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.35.667
更新日期:1995-09-01 00:00:00
abstract::A 4-month-old girl fell off a table onto the floor. Computed tomography performed 4 hours after the trauma showed a left parietal epidural hematoma (EDH) with an omega-shaped fracture line in the left parietal region. The EDH was enlarged after another 4 hours. However, the EDH showed drainage into the subgaleal space...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.51.854
更新日期:2011-01-01 00:00:00
abstract::The authors report four cases of intracranial hemorrhage associated with nontraumatic disseminated intravascular coagulation (DIC). Two cases demonstrated a sudden onset of intracerebral hemorrhage. The other two showed chronic subdural hematoma initially, followed by acute multiple intracranial hemorrhages or general...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.30.610
更新日期:1990-08-01 00:00:00
abstract::Two patients presented with primary intramedullary spinal cord germinoma (PISCG). Neither diagnosis was correct at initial evaluation, and both underwent surgical verification of the tumor. Based on the histological diagnosis, both patients were treated successfully by combination of chemotherapy and radiotherapy. The...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.49.128
更新日期:2009-03-01 00:00:00
abstract::Three cases of ruptured intracranial aneurysm associated with moyamoya disease are presented. Endovascular treatments were performed successfully in two patients with major artery aneurysms. One patient with a collateral aneurysm was managed conservatively and follow-up angiography 1 year later demonstrated spontaneou...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.51.774
更新日期:2011-01-01 00:00:00
abstract::The relationships between event-related potential (P300), higher brain functions, and regional cerebral blood flow (rCBF) were examined in 31 neurosurgical patients. The P300 latency, evaluated by an acoustic "odd-ball" paradigm, was normal in 14 and prolonged in 17 patients. Fourteen of 17 prolonged P300 patients had...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.33.146
更新日期:1993-03-01 00:00:00
abstract::Immunohistochemical localization of prostaglandin (PG) F2 alpha synthesized during recirculation following experimental forebrain ischemia was studied in Mongolian gerbils. The bilateral carotid arteries were clamped for 5 minutes, and the brains were frozen in situ after 5 minutes of recirculation. Sham-operated gerb...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.30.223
更新日期:1990-04-01 00:00:00
abstract::Invasive evaluations play important roles in identifying epileptogenic zones and functional areas in patients with intractable focal epilepsy. This article reviews the usefulness, methods, and limitations of invasive evaluations for epilepsy surgery. Invasive evaluations include various types of intracranial electrode...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.ra.2015-0319
更新日期:2016-05-15 00:00:00
abstract::The Full Outline of UnResponsiveness (FOUR) score was previously developed for neurological assessment, but has not been validated in neurosurgical patients, so was compared to the Glasgow Coma Scale (GCS) in practice. Four groups of raters, expert clinicians, novice clinicians, experienced nurses, and inexperienced n...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.49.565
更新日期:2009-12-01 00:00:00
abstract::Two nonimmunosuppressed patients with primary intracranial malignant lymphoma demonstrated ring-enhanced lesion on postcontrast CT scans. One patient underwent total removal of the tumor and the other patient biopsy, both followed by whole brain irradiation. Histological examination revealed the tumors contained diffu...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.31.214
更新日期:1991-04-01 00:00:00
abstract::A 38-year-old male presented with a cystic lesion at the foramen magnum due to intracranial dissemination from a pituitary adenoma. The primary tumor had required reoperation for regrowth twice. The tumor at the foramen magnum was removed surgically. Two smaller solid tumors were located in the left parietal convexity...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.39.606
更新日期:1999-08-01 00:00:00
abstract::A 56-year-old man developed subdural effusion after mild head trauma, which remained unchanged in volume and density on computed tomography during a follow-up period of 7 months. However, typical chronic subdural hematoma (CSDH) had developed by 9 months after the head trauma. The CSDH was successfully treated by irri...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.45.41
更新日期:2005-01-01 00:00:00
abstract::A 41-year-old man presented with subarachnoid hemorrhage. Initial digital subtraction angiography showed occlusion of the right vertebral artery (VA), which recanalized immediately, and dissecting aneurysm on the distal part of the right VA. Basiparallel anatomic scanning (BPAS)-magnetic resonance (MR) imaging showed ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.52.87
更新日期:2012-01-01 00:00:00
abstract::A 73-year-old woman presented with diffuse subarachnoid hemorrhage from a ruptured fusiform aneurysm directly arising from the right distal anterior inferior cerebellar artery. Six years before admission, she had undergone stereotactic irradiation for right vestibular schwannoma, under a diagnosis based on neuroimagin...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.49.202
更新日期:2009-05-01 00:00:00
abstract::We classified the results of preoperative auditory brainstem response (ABR) in 121 patients with useful hearing and considered the utility of preoperative ABR as a preliminary assessment for intraoperative monitoring. Wave V was confirmed in 113 patients and was not confirmed in 8 patients. Intraoperative ABR could no...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.oa.2013-0258
更新日期:2014-01-01 00:00:00
abstract::Cerebral arterial dissection is defined as a hematoma in the wall of a cervical or an intracranial artery. Cerebral arterial dissection causes arterial stenosis, occlusion, and aneurysm, resulting in acute infarction and hemorrhage. Image analysis by such methods as conventional angiography, computed tomography, magne...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章,评审
doi:10.2176/nmc.ra.2015-0294
更新日期:2016-09-15 00:00:00
abstract::A 60-year-old woman was admitted to the hospital due to a sudden loss of consciousness. Computed tomography (CT) revealed a thick subarachnoid hemorrhage in almost all of the parachiasmatic cisterns, including the sylvian cisterns, with mild hydrocephalus. Three dimensional (3D)-CT angiography showed an irregularly sh...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.cr2013-0025
更新日期:2014-01-01 00:00:00
abstract::Parent artery occlusion (PAO) is an alternative to surgical clipping or endovascular endosaccular coil embolization for the management of cerebral aneurysms. Most giant and fusiform aneurysms are not amenable to endosaccular coil embolization due to anatomical considerations, such as a broad-neck. However, majority of...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract::A 41-year-old female presented with an uncommon mixed dural-pial arteriovenous malformation (AVM) with unusual venous drainage. Angiography at the initial operation for massive intracerebral hematoma in the parietal lobe showed no vascular malformations. Follow-up angiography 3 years later revealed a mixed dural-pial ...
journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
doi:10.2176/nmc.36.91
更新日期:1996-02-01 00:00:00