Biomedical subjects
Publications and source records attributed to H Handa.
Five cases of sinus pericranii are presented, four congenital and one traumatic. All five cases were successfully treated with extirpation and reinforcement with Gelfoam and silk thread over the skull openings. The literature on this rare symptom-complex is reviewed and a new definition of sinus pericranii proposed.
Skeletal scintigraphy employing the new 99mTc-labelled compounds-99mTc-diphosphonate and 99mTc-polyphosphate-has proved to be a reliable technique for the detection of primary and metastatic tumors as well as non-neoplastic conditions of the skeletal system including the skull and spine. Recent experiences in 26 consecutive neurosurgical patients are reported. The bone scintigraphy seems to be most valuable in the clinical management of patients suspected of harboring metastatic deposit in the nervous system. In patients with malignancies elsewhere, the incidence of bone metastases is unexpectedly high, but the radiographic survey often fails to reveal the lesions in the initial stage. Bone scintigraphy, on the other hand, is highly reliable in detecting the bone metastases in its earliest stage, and the routine use of bone scintigraphy in such cases would be expected to help avoiding the unnecessary surgical intervention, or changing the plan of management, for example, from surgery to the systemic chemotherapy. Futhermore, bone scintigraphy seems to be useful in selecting the suitable site for biopsy, or in determining the targets for radiation treatment.
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Warning signs preceding major hemorrhage were analyzed in 192 patients with intracranial aneurysms. One hundred and thirteen (59 percent) had warning signs. The average interval between the last warning signs and the major attacks was 16.9 ddays with anterior communicating and anterior cerebral aneurysms, 6 days with middle cerebral aneurysms, and 7.3 days with intradural internal carotid aneurysms. The incidence was much higher in aneurysms (69 percent) and with location of the aneurysms. Early recognition of warning signs may protect patients from the devasting effects of major hemmorhage.
The effect of topical and intravenous administration of phenoxybenzamine, an alpha adrenergic blocking agent, on experimental vasospasm was studied in cats. Topical application of phenoxybenzamine prevented the occurence of vasospasm without noticeable systemic alpha adrenergic blocking effect. Intravenous use, however, was ineffective in the dosage with which total systemic alpha adrenergic blockade was obtained. Effects of intravenous administration in much larger dosage seemed to be largely due to the non-specific action of phenoxybenzamine on vascular smooth muscle.
Effects of a new synthetic vasodilator, YC-93, a derivative of 1. 4-dihydropyridine, on experimental cerebral vasospasm, were studies in cats. A topical administration of YC-93 solution was found to rapidly reverse the spasm of the basilar artery induced with a subarachnoi application of fresh blood, serotonin or porstaglandin F2 alpha. Pretreatment of the basilar artery with YC-93 prevented the development of experimental vasospasm with all these agents.
Optic glioma associated with bilateral subdural effusion in a four-month-old male infant is reported. Review of the cases with subdural effusion or hematoma and brain tumor in the world literature was made. When subdural effusion is found in a newborn or an older infant, the possibility of an associated brain tumor must be considered. Care also should be taken to search for an underlying brain tumor and to exclude dural metastasis when we deal with chronic subdural hematoma in an adult.
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The occurrence of medulloblastoma in two brothers is presented. The striking similarities between two cases in the sex, age of onset of symptoms, clinical manifestations and histological findings suggested a possible role of heredity in the etiology of this tumor.
Migration of the whole shunting system of a ventriculo-peritoneal shunt into the lateral ventricle of a three-month-old male infant is presented. This is a very rare complication of ventriculo-peritoneal shunt.
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In 29 consecutive patients, the epidural intracranial pressure (EDP) was continuously measured with a semiconductor strain film transducer, and with a telemetric monitoring system in two patients. Factors affecting the EDP during pre-, intra- and postoperative periods were analyzed and their significance in clinical practice stressed.
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Effects of topical and intravenous administration of phenoxybenzamine (PBZ) on the experimental vasospasm were studied in cats. Cerebral vasospasm was produced by a topical application of blood, prostaglandin (PG) E2 or PGF2alpha to be exposed basilar artery. Topical PBZ caused a significant dilatation of the basilar artery and the occurrence of vasospasm was completely prevented either with blood, PGE2 or PGF2alpha. Intravenous administration of PBZ in the dosage with which the pressor response to phenylephrine was completely blocked, or three times that dosage, failed to show any preventive effect on the vasospasm. From these experimental results, it seems that the antispasmogenic action of topically applied PBZ is due largely to the non-spacific vasodilator action of PBZ and not to its alpha adrenergic blocking action. It is also suggested that the role of alpha adrenergic mechanism in the genesis of vasospasm in this experimental design is not significant.
Dynamics of CSF circulation is often altered in the presence of intracranial pathology especially in hydrocephalus. Most neurosurgeons acknowledge that the status of hydrocephalus often changes regardless of the type of treatment. In the follow-up of hydrocephalic children who under-went shunting operation, not a few hydrocephalic children have been doing well in spite of shunt malfunction for a long period. Interestingly enough, we have experienced the children who need no longer shunt after shunt infection complicated by ventriculitis. These cases differ from so-called spontaneously "arrested hydrocephalus", in that the latter develops in not severe hydrocephalus during the course of natural history or after shunt not complicated by serious infection. Consequently, we define these cases "self-cured hydrocephalus" following ventriculitis. Recently we experienced a similar case as mentioned above at the Kyoto University Hospital. We reported the case and made some inquiry into pathogenesis of "self-cured hydrocephalus". We hope that further inventigation of the similar cases along with experimental studies might give us a key to establish a radical treatment for hydrocephalus.