Decrease in glutamate in the jugular vein after head injury.
Explore the source record for details and available documents.
Craniocerebral Trauma↗
Biomedical subjects
A Kitakami
Publications and source records attributed to A Kitakami.
Carbon dioxide gas replacement of chronic subdural hematoma using single burr-hole irrigation.
In order to achieve complete irrigation, reduce air in the hematoma cavity, and obtain rapid reduction of the cavity without drainage, we use burr-hole evacuation of the hematoma followed by irrigation using physiologic saline solution and replacement of the hematoma with carbon dioxide (CO2) gas. We have treated 19 cases between the ages of 41 and 84. With the exception of one case with dementia of 5 years' duration, all cases were asymptomatic postoperatively. Computed tomography (CT) scans obtained immediately postoperatively showed the gas to fill the hematoma cavity, but on the following day, the gas and the hematoma cavity had nearly disappeared. There was no surgical mortality nor morbidity and there were no side effects of the CO2 gas. Recurrence was found in one case (5.3%). By filling the hematoma cavity with CO2, disappearance of the cavity is rapid and drainage is not needed. Moreover, this technique implies no restrictions on postoperative motility, and is thus suitable for elderly patients.
Adult↗
[Two surgical cases of tectal glioma].
Tectal glioma is rare and difficult to diagnose, and the tumor has been known as the tumor that gives no indication of the need for direct surgery because of its anatomical location. At present, MR imaging is available to detect the tumor and its location. We present two patients who underwent direct surgery. Case 1: A 18-year-old female was admitted with headache and nausea. MRI showed signs of stenosis of the aqueduct and a tumor of the tectal region. The tumor was removed partially. Histological examination of this tumor demonstrated a low grade astrocytoma. After surgery, hydrocephalus improved. Case 2: A 12-year-old boy was admitted with hydrocephalus detected by CT. MRI demonstrated a tumor of the midbrain without confirmation. He underwent a V-P shunt for hydrocephalus, and was discharged without any complaints. After 2 years, he was admitted again with shunt malfunction. After shunt revision, his consciousness recovered. However, Parinaud's sign appeared and patency of the shunt was unstable. MRI revealed a tumor of the tectal region and signs of stenosis of the aqueduct of Sylvius. The tumor was removed directly by the occipital transtentorial approach. The aqueduct was opened and a catheter was inserted from the 3rd to the 4th ventricle. Histological examination revealed a low grade astrocytoma. The patient followed a satisfactory postoperative course except for slight Parinaud's sign, and the V-P shunt was no longer necessary.
Adolescent↗
Pineal yolk sac tumor in a 65-year-old man.
A 65-year-old man presented with a case of pure yolk sac tumor in the pineal region. The patient was admitted with a gait disturbance and elevated alpha-fetoprotein levels in serum and cerebrospinal fluid. He underwent total resection of the tumor. Cisplatin-vinblastine-bleomycin therapy was interrupted because of severe syndrome of inappropriate secretion of antidiuretic hormone, and there was recurrence of the tumor. Five months after the operation, he died in spite of carboplatin-etoposide therapy. A review of the literature revealed no previous report of pineal yolk sac tumor in an elderly patient. Problems in the diagnosis and treatment of such cases are discussed.
Aged↗
[Transplantation of embryonal cerebral cortex to the adult rat cerebellum: the fiber connections made by cortical transplants and the cerebellum].
Fifteen-day-old embryonic neocortical tissue was transplanted into the mature cerebella of normal adult rats (Fischer 344) heterotopically. After 5-8 months, WGA-HRP was injected into the host inferior olivary nucleus, pontine raphe, pontine nuclei, and neocortical transplants, 0.3 microliter, 0.2 microliter and 0.05 microliter respectively. The animals were sacrificed 48 hours later, and the HRP positive neuron and nerve fibers were examined in the transplants and host brain stem. Other animals were sacrificed for anti-dopamine-beta-hydroxylase immunohistochemical study and electron microscopic observation. Anterograde and retrograde tracing methods with the HRP method revealed on the light microscopic level that the transplants had received afferents from the host's locus coeruleus, and the inferior olivary nucleus. In one case, HRP injected into the host inferior olive was almost limited within the inferior olivary nucleus. Therefore, HRP-labelled fibers in the cerebellum were thought to be climbing fibers. The climbing fibers from the host inferior olivary nucleus entered the transplant from the host cerebellar medullary layers and branched in the transplant. The fiber ingrowth was limited within 300-500 microns for the distance. In another case, HRP injected into the inferior olive extended to the lateral reticular and the pontine nuclei. HRP labelled fibers entered the graft from the host medullary layers and many granular patterns like axon terminals were observed in the graft. In cases, in which HRP was injected into the pontine raphe and pontine nuclei, HRP labelled fibers did not grow into the graft. Retrograde tracing method with HRP injected into the graft showed labelled neurons in the host locus coeruleus.(ABSTRACT TRUNCATED AT 250 WORDS)
Adrenergic Fibers↗
Grafted granule and Purkinje cells can migrate into the mature cerebellum of normal adult rats.
Cerebellar primordia of different ages (embryonic days of 14 to 20) were transplanted into cerebella of normal syngeneic adult rats (Fischer 344). After 1-12 months (mostly 5-6 months), the host brains were examined by light and electron microscopy. In about 80% of our successful experiments, grafted Purkinje and/or granule cells migrated into the host molecular layer. Some granule cells migrated down along host Bergmann glia, reminiscent of their normal developmental migration route. Other granule cells migrated along astroglial processes that ensheathed capillary walls. Some grafted Purkinje cells were also located ectopically in the host molecular layer. They were identified as graft origins autoradiographically. This migration seemed to be encouraged under conditions where the subjacent host Purkinje cells had been lost. Where the grafted Purkinje cells were located on top of the host molecular layer, their primary dendrites faced vertically downwards into the host molecular layer. However, the position of the apical poles of migrated Purkinje cell bodies in the deeper aspect of the molecular layer varied considerably, suggesting that the orientation of the Purkinje cell dendrites is probably determined by the availability of afferent fibers. Thus, the present study has demonstrated that Purkinje and granule cells can migrate from embryonic cerebellar grafts into the molecular layer of the normal, adult host rat cerebellum.
Animals↗
[Two cases of cerebral aspergillosis with intracerebral hemorrhage].
Two patients who had cerebral aspergillosis with massive intracerebral hemorrhage were presented. Case I was a 59-year-old woman who had slight mental retardation. There was swelling in the left forehead, from which mucosal cysts of frontal sinus had been removed 2 years before her admission. She had a diagnosis of subdural abscess and radical operation was performed. Aspergillus was found in the abscess histologically. Three months after the operation, CT scan revealed multiple abscess in bilateral frontal lobe. When she lost consciousness suddenly 4 months after the operation, CT scan showed a huge intracerebral hematoma. Case 2 was a 16-year-old girl who suffered from immunological dysfunction caused by more than 6 months antibiotics-steroid treatment for pneumonitis. She lost her consciousness after complaints of severe headache. CT scan showed a heterogeneous high density area with severe brain edema in the left temporal lobe. The removal of hematoma was performed immediately. The level of her consciousness improved, but she died of the complication of DIC and renal failure 14 days after the hemorrhage. Autopsy revealed a number of aspergillomas in lungs, kidneys, gastrointestinal tract, liver and pancreas. Marked necrosis and a number of aspergillus hyphae which invaded and penetrated the wall of cerebral vessels were found in the brain tissue. It was presumed that such a huge intracerebral hematoma was caused by direct invasion and penetration into the brain of aspergillus from the blood vessels. The diagnosis of cerebral aspergillosis is made mainly by the pathological examination of the tissue obtained at surgery or autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗