Biomedical subjects

Akinori Kondo

Publications and source records attributed to Akinori Kondo.

4 recordsLinked to original sources

PubMed2006

Trigeminal neuralgia associated with an anomalous artery originating from the persistent primitive trigeminal artery.

A 31-year-old man presented with typical trigeminal neuralgia caused by an anomalous variant type of anterior inferior cerebellar artery (AICA) directly branching from the primitive trigeminal artery (PTA). Three-dimensional computed tomography angiography, magnetic resonance angiography, and magnetic resonance cisternography disclosed that this anomalous artery originated from the PTA and coursed to the AICA territory of the cerebellum. Microvascular decompression surgery disclosed the trigeminal nerve compressed by this AICA variant together with the superior cerebellar artery. These arteries were successfully transpositioned to decompress the nerve. Careful and thorough inspection around the trigeminal nerve verified that the PTA did not conflict with the nerve. This unusual case was caused by compression of the trigeminal nerve from the AICA directly originating from the PTA, without the more common involvement of the PTA.

Adult↗

PubMed2006

[Microvascular decompression for refractory neurogenic hypertension: case report].

It is noted that the increased central sympathetic nerve activity caused by neurovascular compression at the rostral ventrolateral medulla (RVLM) is closely related to the genesis of neurogenic hypertension. The authors present the case of a 49-year-old female with refractory neurogenic hypertension to be uncontrolled even with all kinds of oral antihypertensive medications. After approval by the Ethical Committee in a hospital, she had received an intravenous introduction of calcium antagonist and beta-blocker at home for three years. The subsequent examination detail showed increased sympathetic nerve activity and compression of the left vertebral artery (VA) at the left RVLM on magnetic resonance imaging, and therefore microvascular decompression (MVD) underwent through a left lateral suboccipital approach. The left VA was seen indenting the left RVLM. To ensure the complete decompression, the distal part of VA was moved away from RVLM to fix to the dura of the petrous bone with a glue. Her blood pressure became normalized afterwards without drugs and remained normotensive for 23 months after MVD. In order to decide the surgical indication for pure neurogenic hypertension due to neurovascular compression, a strict differential diagnosis is necessary.

Decompression, Surgical↗

PubMed2004

Surgically treated aneurysm of the trunk of the persistent primitive trigeminal artery--case report.

A 62-year-old man presented with a very rare cerebral aneurysm arising from the trunk of the persistent primitive trigeminal artery (PPTA) manifesting as subarachnoid hemorrhage. Angiography showed a saccular aneurysm at the curved mid-section of the trunk of the left PPTA of the adult type. The patient underwent surgery via the left subtemporal approach, and the aneurysm was successfully eliminated by clipping without sequelae. Aneurysm formation at this point was probably due to hemodynamic stress. The perforating arteries from the PPTA may be important in supply of the hindbrain, so PPTA patency should be preserved if possible.

Aneurysm, Ruptured↗

PubMed2002

Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients.

OBJECTIVE: To provide the characteristics and long-term surgical results of patients who present with cerebellopontine angle epidermoids and trigeminal neuralgia (TN) or hemifacial spasm. METHODS: A total of 30 patients (23 women, 7 men) who presented with cerebellopontine angle epidermoids and TN (28 patients) or hemifacial spasm (2 patients) between 1982 and 1995 were reviewed, with emphasis being placed on the clinical manifestations, the mechanisms of symptom development, the long-term follow-up results, and the anatomic relationship between the tumor and the surrounding neurovascular structures. RESULTS: The average age of the patients was 37.8 years at symptom onset and 49.3 years at the time of the operation. The tumor-nerve relationships were classified into four types: complete encasement of the nerve by the tumor, compression and distortion of the nerve by the tumor, compression of the nerve by an artery located on the opposite side of the unilateral tumor, and compression of the nerve by an artery on the same side of the tumor. Total resection was achieved in 17 patients (56.7%). Microvascular decompression of the respective cranial nerve was achieved in nine cases of direct arterial compression in addition to tumor removal. The symptom was relieved completely in all cases. In an average follow-up period of 11.5 years, three patients developed recurrent symptoms: two experienced tumor regrowth, and one had arachnoid adhesion. CONCLUSION: Hyperactive dysfunction of the cranial nerves, especially TN, may be the initial and only symptom that patients with cerebellopontine angle epidermoids experience. The occurrence of TN at a younger age was characteristic of TN patients with epidermoids, in contrast to patients with TN due to a vascular cause. The symptom is elicited by compression of the nerve by the tumor per se, by an artery that is displaced to the nerve, or by both. Careful resection of the tumor, whose capsule occasionally is strongly adherent to the neurovascular structures, is necessary, and microvascular decompression to straighten the neuraxis should be performed in some cases to achieve a complete, permanent cure of symptoms with a low rate of recurrence.

Adult↗