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H Okudera

Publications and source records attributed to H Okudera.

At least 55 records · Page 3Linked to original sources
PubMed1993

[CT guided transsphenoidal surgery: report of nine cases].

We have developed a Computed Tomography system for use in the operating room and applied this CT system to intraoperative monitoring during transsphenoidal surgery. This system includes Toshiba TCT-300 CT system, mobile CT scanner gantry, digitally controlled operating table and head fixation system. Between June 1989 and Dec. 1989, CT guided transsphenoidal surgery was carried out in 9 cases in our department. The suprasellar masses were visualized directly during transphenoidal surgery and were removed safely and efficiently. Under this CT monitoring system the surgeon can obtain accurate information about the location and volume of residual tumor as well as about the important surrounding deeper structure. Another advantage of this system is that the digitally controlled operating table makes it possible to keep the patient in a head-up position, which lessens oozing from the parasellar region during transsphenoidal surgery. We believe the best application of this method is that for pituitary tumor with moderate suprasellar extension. Nine cases were reported in this paper which were operated on using this system. To our knowledge, this is the first report of use of intraoperative CT monitoring during transsphenoidal surgery.

Adenoma↗
PubMed1992

Introduction of high definition television system to neurosurgical documentation.

The high definition television (HDTV) system is introduced to microneurosurgery. Five cases with intracranial lesions: three cerebral aneurysms (giant aneurysms of the anterior communicating artery and internal carotid artery, aneurysm of the basilar artery), one acoustic neurinoma and one skull base meningioma, were operated on under the microscope using the HDTV system. The surgical procedures of each case were relayed and recorded by the system. In two of the five cases, we used two sets of HDTV system to produce stereoscopic projection. The HDTV system provided us with images of superior quality with a distinctly greater resolution than ordinary video systems.

Adult↗
PubMed1992

Suprachiasmal carotid-ophthalmic artery aneurysm--report of two cases.

Two rare suprachiasmal carotid-ophthalmic artery aneurysms, one large and one giant, were discovered incidentally. The patients had no visual disturbances. Angiography showed superomedial projection of the sac. The aneurysms were clipped via an ipsilateral pterional approach. A suprachiasmal carotid-ophthalmic artery aneurysm is indicated when preoperative angiography reveals a superomedial carotid-ophthalmic artery aneurysm without visual disturbances. Direct surgery to clipp a suprachiasmal aneurysm should be carried out to prevent rupture of these frequently large aneurysms.

Aged↗
PubMed1992

A newly designed puncture needle for suction decompression of giant aneurysms. Technical note.

A newly designed puncture needle for aspirating large or giant aneurysms is described. This puncture needle represents a modification of an intravenous catheter with an internal needle. It is designed to prevent blood from leaking when the internal needle is removed and has a lateral tube for aspiration. Following aneurysm puncture with the parent artery temporarily trapped, the catheter is positioned on the head frame with a brain spatula and a self-retaining retractor. Blood is suctioned through the lateral tube with a syringe or the suction system normally used in the operating room.

Equipment Design↗
PubMed1991

Fatal meningitis due to Staphylococcus cohnii. Case report.

We report a case of fatal meningitis due to Staphylococcus (S.) Cohnii in a 63-year-old male. S. Cohnii is often isolated from farm animals and known to be less pathogenic in humans. To our knowledge, S. Cohnii has not yet been reported to cause infection of the central nervous system in humans.

Humans↗
PubMed1991

Development of the operating computerized tomographic scanner system for neurosurgery.

A computerized tomographic (CT) scanner system for intraoperative imaging is presented. The system consists of the following: 1) CT scanner with a mobile gantry, 2) digitally controlled operating table with central processing unit (CPU) and encoder unit; the table can be controlled by the scanner computer as accurately as the scanner bed, and 3) exclusively designed head fixation devices. It allows us to scan the patient on the operating table in the operating room pre-operatively, intra-operatively and immediately after surgery.

Computer Systems↗
PubMed1991

[Computerized tomography immediately after surgery in the neurosurgical operating theater].

A TCT-300 scanner (manufactured by the Toshiba Co., Tokyo) has been installed in the operating room of Shinshu University Hospital since 1986. This neurosurgical operating CT scanner system was developed for obtaining intra- and postoperative CT images in the operating room. We have carried out immediate postoperative CT scanning in 206 cases: 170 were major and 36 were minor operations. A mobile CT scanner gantry has been used in 125 cases since June, 1988. We obtained CT images immediately after surgery on the digitalized operating table, the motion of which can be controlled as with the conventional CT scanner table. Immediate postoperative CT scans showed the extent of removed tumors or hematomas, position of the tip of ventricular or cisternal tubes, injury to the surrounding normal brain caused during the removal of lesions, and postoperative complications such as hemorrhage, brain swelling and surgical patties which had been inadvertently left in the wound. This CT scanner system in the operating room proved to be useful in the postoperative care of neurosurgical patients.

Adult↗
PubMed1991

[A case of divergence palsy associated with bilateral chronic subdural hematoma].

A surgical case of bilateral chronic subdural hematoma presenting with divergence palsy is reported. A 75-year-old female was admitted to hospital for investigation of 2-week history of diplopia. The initial neurological examination demonstrated no abnormal findings except Hess chart suggesting bilateral concomitant strabismus or paresis of lateral rectus on both eyes. Because of the homonymous diplopia disappeared when the object of fixation in brought closer and the patient showed no impairment of gaze movements and following movements, the patient was diagnosed as divergence palsy and referred to the Neurosurgical Service. The physical examination revealed a 75-year-old, alert, fully oriented with diplopia at distant gaze. A computerized tomographic (CT) scan showed bilateral subdural hematoma. Emergency burrhole evacuation was performed and total amount bilateral hematoma was 220ml. Diplopia disappeared postoperatively. Hess chart examined two months after the operation shows no impairment of divergence function. This is the first reported case of divergence palsy associated with bilateral chronic subdural hematoma in CT era.

Aged↗
PubMed1990

Digitally controlled neurosurgical operating table--technical note.

The authors describe a new, digitally controlled operating table for neurosurgery. The apparatus includes a digitally controlled motor for manipulating the table and a rotary encoder with a central processing unit, which calculates and displays the table's position. The table can be operated with any type of digitalized computer system and its position is monitored by the encoder unit in real time.

Neurosurgery↗
PubMed1990

[Adult moyamoya disease with a transcranial internal carotid-external carotid (EC-IC) anastomosis through burr holes].

A case of adult Moyamoya disease, with formation of a transcranial external carotid-internal carotid (EC-IC) anastomosis through burr holes which had been made previously. A 43-year-old male suffered sudden headache and vomiting. Neurological examination revealed mild consciousness disturbance and dysarthria. The computed tomography (CT) scans showed intraventricular hemorrhage, which was drained through burr holes bifrontally. The diagnosis of Moyamoya disease was subsequently made by cerebral angiography. A month later he was discharged with mild gait disturbance and mental retardation. Seven years later he suddenly complained of gait disturbance, dysarthria and sensory disturbance involving the right upper extremity. A CT scan revealed a small hemorrhage in the left putamen. Carotid angiograms disclosed transcranial EC-IC anastomosis through the burr holes which had been made previously. It is suggested that revascularization can be expected after opening burr holes and incising the dura matter for Moyamoya disease in adults as well as, possibly, in children.

Anastomosis, Surgical↗
PubMed1989

Bilateral subdural empyema due to Salmonella enteritidis in an infant.

A case is reported of an infant with bilateral subdural empyema due to Salmonella enteritidis. This Salmonella species is extremely uncommon as a pathogen in a focal infection in the central nervous system. Treatment by early surgical drainage, followed by systemic antibiotics and subdural irrigation, was successful. This is the first case reported of infantile subdural empyema due to S. enteritidis.

Drainage↗
PubMed1988

Giant aneurysms of the vertebral artery. Report of five cases.

The authors report five cases of surgically treated giant vertebral artery aneurysm. Two giant serpentine aneurysms were managed with aneurysmectomy, a giant semifusiform aneurysm with trapping and partial aneurysmectomy, and the other two saccular giant aneurysms with clipping. Surgical results were satisfactory in all cases. In particular, the two patients who underwent complete aneurysmectomy showed remarkable improvement after the second procedure of a two-stage operation that consisted of initial proximal occlusion and secondary evacuation of clots in the aneurysm when advanced thrombosis was identified. Aneurysmectomy in a two-stage operation was the best treatment for these partially thrombosed giant aneurysms which completely concealed the distal artery under a tight thinned medulla.

Aged↗
PubMed1988

[Monostotic fibrous dysplasia of the sphenoidal bone presenting with visual disturbance during pregnancy].

A case of monostotic fibrous dysplasia in the anterior skull base, which presented with visual disturbance during pregnancy, is reported. A 32-year-old female was referred to our department for examination of the progressing right visual disturbance in the third trimester of her second pregnancy. She had experienced the same episode in her first pregnancy, recovering from it after delivery. This time, however, the visual acuity did not change after delivery. Plain craniogram showed sclerotic changes in the right sphenoidal ridge and the right frontal skull base. CT scan showed an isodense mass which was enhanced by contrast medium in the right sphenoidal sinus. Angiography demonstrated no positive findings. RI bone scintigram using 99 m Tc-MDP revealed an abnormal uptake in this region. The patient was operated on in two stages. The first operation was transsphenoidal removal of the tumor in the sphenoidal sinus. The pathological diagnosis was fibrous dysplasia. Transfrontal decompression of the right optic canal and ophthalmic artery was performed at the second operation. The tumor was totally removed and the decompressed orbital roof was reconstructed using an alumina ceramic plate. Visual acuity gradually improved in the follow-up study. To our best knowledge, only one case of fibrous dysplasia with growth during pregnancy have been reported; it was monostotic fibrous dysplasia of the maxilla. From the clinical course of our case, it is suggested that the pregnancy influenced growth of the monostotic fibrous dysplasia; possibly by way of hypothalamic hormonal factor.

Female↗
PubMed1987

Usefulness of ceramic implants in neurosurgery.

The authors have designed various implants made of alumina ceramic for neurosurgical use. They were used for reconstruction of the sellar floor and orbital wall and for cranioplasty to repair bone defects in both the convexity and the suboccipital region. Burr hole and sphenoid buttons were made to prevent postoperative dents in the skin. A ceramic-silicon sponge was developed as a marker prosthesis for neurovascular decompression. There were no untoward side effects such as infection or rejection by recipient tissue in humans or dogs. The advantages and disadvantages of the material are discussed.

Ceramics↗
PubMed1986

[Evaluation of intracranial calcification associated with aging by computerized tomography].

Computerized tomography (CT) scans of 450 standardized normal persons from 5000 consecutive patients were examined to study the relationship between the incidence of intracranial calcification and aging process. The 450 subjects were classified into 9 groups according to age. In people older than 30 years, calcification in the pineal region including pineal body and habenular commissure was found in about 70%. Calcified choroid plexus seems to be characteristic of aging process because the rate of its calcification increased in proportion to aging. Calcification of the falx cerebri was also found to increase in proportion to aging. Calcified cerebral arteries were observed in advanced-aged groups. The fact that people in the ninth decade had a smaller incidence in calcification of the cerebral artery than those in the eighth decade indicates the possibility that longer-lived people had less incidence of cerebral arterial calcification.

Adolescent↗
PubMed1984

A simple three-dimensional display model based on recorded CT scan films for surgical reference technical note.

A simple method of making a three-dimensional display model of recorded computerized tomography (CT) scan films is presented. The reconstructed display model provides useful information as to surgical approaches to intracranial mass lesions. The actual size and three dimensional shape of a lesion and its topographical relationship to surrounding brain structures are easily grasped by directly handling this model.

Adult↗