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Biomedical subjects

C Kuromatsu

Publications and source records attributed to C Kuromatsu.

15 recordsLinked to original sources

Cavernous hemangioma in the cavernous sinus.

Cavernous hemangioma, a rare vascular hamartoma, in the cavernous sinus is described in this report. This case showed a slowly progressive course, which first involved the right optic nerve, followed by the left optic nerve, and then the right oculomotor, trochlear, abducens, and trigeminal nerves. Cavernous hemangioma should be suspected in the case of mass in the cavernous sinus with a very slowly progressive course. MRI is very useful to help diagnose this hemangioma.

Aged↗

Aneurysm of the posterior cerebral artery: report of eleven cases--surgical approaches and procedures.

Eleven cases of an aneurysm of the posterior cerebral artery are reported. All 11 aneurysms were saccular, and 3 were either giant or large. The aneurysms arose from the P1 segment in three patients, the P1-P2 junction in three patients, the P2 segment in three patients, and from the P3 segment in two patients. In all, 10 patients underwent surgery. All P1 and P1-P2 junction aneurysms were treated with the pterional approach. Three P2 and two P3 aneurysms were managed by the subtemporal approach. Two small aneurysms in the series were treated by coating the aneurysmal dome, two by clipping the afferent artery, and all other saccular type aneurysms were treated by clipping the aneurysmal neck. Seven patients had either an excellent or good outcome; two had poor results; and one patient died. The operative approaches and procedures are also discussed in relation to the anatomy of posterior cerebral artery aneurysms.

Adolescent↗

Hemifacial spasm due to tumor, aneurysm, or arteriovenous malformation.

The authors report eight cases of so-called symptomatic hemifacial spasm. They had gross pathological lesions such as a tumor (one epidermoid, one neurinoma, and two meningiomas), vascular malformation (one medullary venous malformation and two arteriovenous malformations), and aneurysm. In all four cases with a tumor, no artery compressed the facial nerve at the root exit zone. In three of the four cases, the hemifacial spasm disappeared after removal of the tumor in contact with the facial nerve. Compression or encasement of the facial nerve by the tumor was the pathogenesis of the hemifacial spasm in these three cases. The remaining case with tumor (tentorial meningioma) did not have a mass or vessel that directly compressed the facial nerve at the root exit zone. However, the hemifacial spasm disappeared after the removal of the tumor. In a case with a medullary venous malformation with arterial component, an engorged draining vein compressed the root exit zone of the facial nerve. In the remaining three vascular cases--two cases of arteriovenous malformation and a case of saccular aneurysm--enlarged feeding arteries and an aneurysm directly compressed the root exit zone of the facial nerve. Not only arterial or venous but also mass compression can cause hemifacial spasm in some symptomatic cases. Surgical decompression of the facial nerve from the causative organic lesion is the primary choice of treatment.

Adult↗

Diagnosis and surgical treatment of spasmodic torticollis of 11th nerve origin.

Of 22 patients with spasmodic torticollis, 7 were treated by microsurgical decompression of the 11th nerve. In these patients, there was an intermittent horizontal torticollis characterized by aggravation of the symptoms when in a resting posture, presenting with a striking contrast to the torticollis of extrapyramidal origin that was alleviated while in the resting posture and aggravated by postural stress. A tight neurovascular contact was observed at the C1 level, occurring between the principal 11th nerve and the vertebral or posterior inferior cerebellar artery. Nerve decompression was achieved in 2 by transposing the compressing artery and in 5 by sectioning at C1 or C2 the branching root of the 11th nerve that had caused the tight cross contact by locking the nerve trunk to the dura mater. The symptoms had improved after an interval of 1 to 4 weeks. After an average follow-up of 3 years, full or satisfactory relief had been obtained in 5 and some improvement had occurred in 2 patients. Possible neural mechanisms related to torticollis of 11th nerve origin are discussed.

Accessory Nerve↗

Immunohistochemical study of intracranial cysts.

Immunohistochemical characterization of 14 cases of intracranial cysts was performed. Among these 14 cases, five different types of cysts were represented; Rathke's cleft cyst (4 cases), neurenteric cyst (2 cases), colloid cyst (1 case), choroidal epithelial cyst (2 cases) and arachnoid cyst (5 cases). Immunohistochemical evaluation utilized antibodies to glial fibrillary acidic protein (GFAP), S-100 protein, prealbumin, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA). GFAP-positive cells were detected in 1 Rathke's cleft cyst and in 1 choroidal epithelial cyst. S-100-positive cells were detected in 2 Rathke's cleft cysts, in 2 neurenteric cysts, in 1 colloid cyst, and in 2 choroidal epithelial cysts. Prealbumin-positive cells were detected only in the 2 choroidal epithelial cysts. CEA-positive cells were detected in 1 Rathke's cleft cyst and in 2 neurenteric cysts. EMA-positive cells were detected in all cases. Immunohistochemical study of prealbumin and S-100 protein is useful for correct diagnosis of choroidal epithelial cyst and study of CEA is useful for diagnosis of neurenteric cyst. The arachnoid cyst is negative for immunoreactivity to GFAP, S-100, prealbumin, and CEA; this can be helpful in distinguishing this type of cyst from single epithelial cysts, a task that is sometimes difficult with only light microscopy.

Adolescent↗

[Relationship between angiographical manifestations and operative findings in 100 cases of hemifacial spasm].

Relationship between angiographical manifestations and operative findings of hemifacial spasm was studied in 100 cases. Vertebral angiography was performed, and Towne, straight AP, and lateral projections were routinely studied. The anterior inferior cerebellar artery (AICA) directly compressed the facial nerve root exit zone in 54 instances, the posterior inferior cerebellar artery (PICA) in 38, and the vertebral artery (VA) in 11. Compressions by multiple vessels were observed in 3 cases. Anatomical variations of the AICA and the PICA were classified into 3 groups according to their origins and their distributions of blood supply: Type I, normal distribution of AICA and PICA; Type II, common trunk anomaly with dominant AICA (basilar artery origin); and Type III, common trunk anomaly with dominant PICA (vertebral artery origin). In our cases, 35% of them showed normal distribution, 34% dominant AICA, and 35% dominant PICA. Analyses of the angiograms revealed significantly increased numbers of common trunk anomalies when compared with normal angiograms studied by Takahashi. In 60 of the 65 cases with common trunk anomalies, facial nerves were compressed by the main trunk or the branches of the dominant artery. There were 35 cases which belonged to Type I anatomical classification. They were subdivided into 2 groups according to the size of the AICA and PICA: 1. AICA greater than PICA, and, 2. PICA greater than AICA. In the AICA greater than PICA subgroup, the AICA was the offending artery in all but one case. In the PICA greater than AICA subgroup, the PICA was responsible in 9 of 17 cases. In 31 cases, angiograms showed a redundant VA with lateral elongation into the cerebellopontine angle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Therapeutic problems in aged patients with intracranial aneurysms].

In a series of 404 patients with intracranial saccular aneurysm, 61 were over 65 years of age. Ten of these aged patients had no surgery. The operative mortality in the aged patients was 11.8%. While the mortality rate in patients below 65 years was 6.1%. The main complication following intracranial surgery for aneurysm consisted of cerebral infarction due to vasospasm, hydrocephalus, intracranial hematoma and general complications. The incidence of angiographical vasospasm was 22.6% in the aged patients and 43.6% in the young patients. There is no significant difference in vasospasm following subarachnoid hemorrhage between the aged and young patients. Cerebral infarction occurred in 27.5% of the aged patients and in 24.6% of the young patients. Severe cerebral infarction was found in 92.9% of the aged patients and in 58% of the young patients. Vasospasm resulted in broad cerebral infarction significantly more frequently in the aged patients, but cerebral infarction proved was non-fatal in the aged patients. Ventricular dilatation detected by CT was found in 33.3% of the aged patients and in 24.2% of the young patients. In patients with ventricular dilatation, 82.4% of the aged patients needed ventriculo-peritoneal shunt (V-P shunt). On the other hand, 39.3% of the young patients had V-P shunt. There was no significant difference for ventricular dilatation detected by CT between the aged and young patients. The aged patients depended on V-P shunt significantly more than did the young patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Recurrent cystic meningioma.

The authors report a case of recurrent meningothelial meningioma with a large cyst. At the first operation, the mural nodule was totally resected and the cyst wall was removed as much as possible. This cystic tumor recurred six years later at the site where the first operation was performed. Histologically, the cyst wall contained islands of the same neoplastic cells as were previously found in the mural nodule. The authors discuss the preoperative diagnosis and mechanism of cyst formation, and emphasize the importance of complete removal of the cyst wall for permanent cure.

Adult↗

Symptomatic choroidal epithelial cyst in the fourth ventricle.

A case of choroidal epithelial cyst in the fourth ventricle is described. The cyst occupied the fourth ventricle almost completely, and produced an intermittent hemiparesis and hemisensory disturbance. After removal of the cyst wall, the patient recovered completely. On light microscopy, a single epithelial layer with a basement membrane lining the cyst wall was observed. An electron microscopic study was also made.

Cerebral Angiography↗

Rathke's cleft cyst.

Two cases of Rathke's cleft cyst which produced symptoms of compression of the optic chiasm are described. The first case has been followed for five years since the operation. No evidence of recurrence has been noticed. The prognosis after a partial removal of the cyst wall seems to be good with this lesion. In the second case, there was clinical and laboratory evidence of hypopituitarism and the CT scan revealed suggestive findings to differentiate the cyst from a pituitary adenoma.

Craniopharyngioma↗