Search PubMed⌕ Search

Biomedical subjects

H Tanji

Publications and source records attributed to H Tanji.

At least 55 records · Page 3Linked to original sources

The treatment of dural AVM by embolization with aron alpha (ethyl-2-cyanoacrylate).

The authors report four cases of dural arteriovenous malformation (AVM) treated by a modified technique of embolization. Three cases had posterior fossa dural AVM and one had bilateral supratentorial dural AVM. The authors think that the best way to treat dural AVM is to close its nidus completely. This could be achieved by a safe and easy technique of embolization. The material used for embolization should intimately adhere to the vascular network and should not become fragmented. We used aron alpha (Ethyl-2-cyanoacrylate). This is a biological glue and it sets in a solid membranous form instantaneously on coming into the contact with an ionic medium. It does not get fragmented. Aron alpha was injected into the nidus of the AVM through a cannula inserted only into the main feeding artery in four cases of dural AVM reported here. Postoperative angiography showed complete obliteration of the AVM's, they did not fill either from the treated artery or from the untreated feeding arteries. The technique is easy and safe. There was no operative or postoperative complication. All the patients have remained asymptomatic to date, i.e. 2, 2, 6 and 7 1/2 years after the procedure.

Adult↗

[A personal point of view to EC-IC bypass surgery in completed stroke after the co-operative study].

The role of EC-IC bypass surgery has become a very controversial issue recently. EC-IC anastomosis was performed in 132 patients of stroke in our institute. Thirty six of them which could be followed up completely had a completed stroke and ten of these showed a significant clinical improvement by the next day of surgery. We studied the angiograms, CT scans and dynamic CT studies of all 36 patients to determine the common factors responsible for a significant clinical improvement in these ten patients. It was found that patients with occlusion of middle cerebral arteries and with good collateral circulation fared better than those with other lesions and good cross circulation. Site of low density on CT revealed patient with watershed low density did well. Characteristic of low density area was found to be a significant factors. If the low density area was homogeneous and well defined in an arterial territory, it was invariably associated with no improvement after surgery. Patients showing an improvement had scattered or irregular low density areas. Dynamic CT studies were not found to be significant.

Brain↗

[Surgery of acoustic neurinoma in a hemodialyzed patient].

Successful surgical treatment of acoustic neurinoma in a case of hemodialyzed patient is reported. A 42-year-old female patient, who had been treated by hemodialysis, was diagnosed as having a C-P angle tumor by CT scan. She was refered to our clinic on June 24, 1983. Laboratory examinations on admission showed severe anemia and renal dysfunction. Every possible treatment was done in order to improve the laboratory data preoperatively. Another big problem in this case of hemodialyzed patient was brain edema and bleeding tendency. In order to cope with brain edema, intravenous administration of glycerol and slow hemodialysis for three days were performed preoperatively. These treatments were thought to be effective to reduce bleeding tendency also. During operation, however, heavy swelling of the cerebellum forced us to resect one third of the hemisphere to remove the tumor totally. In addition to this, postoperative mild bleeding in the cavity after tumor resection, subcortical hemorrhage around the shunt tube and oozing from the wound were observed. The patient was discharged from the hospital four months after surgery without any neurological deficit. The way of recovery, however, was not uneventful, because the patient developed various kinds of postoperative complications as mentioned above. In the postoperative managements, we felt almost as if we were treading on thin ice. Neurosurgical management in hemodialyzed patients is not yet very common. We should improve the postoperative management by adding new experience with similar cases.

Adult↗

[A case of chondromyxoid fibroma of the frontal bone].

A case of chondromyxoid fibroma of the skull is reported. A 20-year-old boy visited our clinic on December, 1982 because of a recurrent forehead tumor. He had a 4 X 4 X 1.5 cm tumor on the right side of forehead and a 3 X 3 X 0.5 cm tumor on the left. Neurological examination showed no abnormalities. Skull X-ray film showed a large round radiolucent area with clear sclerotic margin in the frontal bone and right orbit. Right carotid angiogram showed marked posterior displacement of the anterior cerebral artery, but no tumor stain. Plain CT scan showed a mass with iso to low density area in the frontal region. It was markedly and irregularly enhanced with contrast media. Surgery was performed entirely in the epidural space, and the tumor was completely removed. The post-operative clinical course was uneventful. Histologically, the three components of chondroid, myxomatous and fibrous tissues in this tumor led to the diagnosis of "chondromyxoid fibroma."

Adult↗

[An autopsy case of intracranial multiple meningiomas associated with extracranial multiple neurinomas].

An autopsy case of intracranial multiple meningiomas associated with extracranial multiple neurinomas was presented. A 55-year-old woman, who had received surgical treatment for right parasagittal meningioma 20 years ago, gradually showed the sign of increased intracranial pressure and disturbance of the lower cranial nerves. Brain CT scan demonstrated numerous intracranial tumors. At autopsy 124 intracranial meningiomas, and neurinomas in her left cervical and right axillar portion were found. Meningiomas showed the transitional and fibroblastic type, histopathologically, and axillary and cervical tumors were the Antoni A type neurinomas. It is suggested that this case had a tendency of heterogenous and multiple origination of tumors.

Brain Neoplasms↗

[Direct surgical obliteration of a persistent trigeminal artery aneurysm].

A successful case of ruptured aneurysm of the persistent trigeminal artery (PTA) treated with direct operation is reported. Only 14 cases out of ever-reported 400 cases with persistent trigeminal artery have aneurysms developing from PTA itself or its junction. These aneurysms originate most frequently from the trunk portion of the PTA. In our case, aneurysms are found at the rt. internal carotid-PTA junction and the rt. IC-PC junction. Six out of 14 are associated with another intracranial aneurysms, indicating high multiplicity. Of 14 cases, only 2 including our case are treated by direct surgery. Since the internal carotid-PTA junction aneurysm is located in the cavernous sinus, special consideration is needed during the operation. Surgical keypoints in opening the cavernous sinus under normothermia and getting the landmark for orientation are described.

Carotid Artery Diseases↗

[Case of postoperative subdural tension pneumocephalus].

In this paper, a case with subdural tension pneumocephalus secondary to bifrontal craniotomy and VP shunt for ruptured Acom aneurysm is reported. In this patient, the mechanisms for entry of air into the subdural space and producing mass effect (Tension pneumocephalus) seem to be one way valve mechanism and negative pressure due to excess of CSF drainage owing to shunting system. Only 29 reported cases of tension pneumocephalus following surgery were found in an extensive review of the literature. We discussed about the clinical symptoms and signs, therapy, and especially about the mechanisms leading to this condition, and prevention for it.

Cerebrospinal Fluid Shunts↗

[A case of intracranial mesenchymal chondrosarcoma--changes observed by computed tomography before and after radiotherapy (author's transl)].

Intracranial mesenchymal chondrosarcoma is very rare, only 14 cases being reported in Europe and in the United States of America. Recently we experienced a case in which the follow-up indicating computed tomograms (CT) demonstrated interesting data on the radiosensitivity of this tumor. The patient, a 14-year-old female was admitted to out hospital with the complaint of left hemiplegia which had gradually progressed. CT revealed an area spreading upward from the right median base of the skull and consisted of two components showing (A) a density as high as that of calcium and (B) a density higher than that of surrounding brain tissue, but much lower than that of calcium. Temporoparietal craniotomy was performed to react approximately one-half of the tumor. Histological finding revealed mesenchymal chondrosarcoma. The component-A was though to be a cartilaginous tissue, and-B to be an undifferentiated mesenchymal tissue. Postoperative irradiation of 7,000 rad was initiated. The effect of radiotherapy as seen on computed tomograms is as follows, (1) decrease in the volume of the tumor by 26%, (2) decrease in density and enhancement of the area which is considered to be the undifferentiated mesenchymal cells, (3) mild reduction of the area which is considered to be the cartilaginous tissue, and (4) a very high density of the entire tumor similar in degree to that of the bone one year later. These results suggested that radiotherapy is effective for this tumor.

Adolescent↗

[A case of hypertensive intracerebral hemorrhage associated with cerebral arteriovenous malformation and aneurysm (author's transl)].

A 45-year-old man suddenly developed right hemiparesis and aphasia during work and lost conciousness next day, when he was admitted to us. Lumbar puncture showed bloody C.S.F. with the initial pressure of 220 mm H2O. Physical examination revealed hypertension and arteriosclerosis. Cerebral angiogram revealed an arteriovenous malformation in the left frontoparietal-parasagittal region and a saccular aneurysm at the left internal carotid-posterior communicating artery junction. In addition, the existence of putaminal hematoma was suspected on account of the displacement of the left anterior cerebral artery and the left lenticulostriate arteries. On the fourth day after admission his consciousness returned and the right hemiparesis gradually improved. One month later the disappearance of the displacement of the anterior cerebral artery was demonstrated by cerebral angiogram. A frontoparietal craniotomy was done and no hematoma was found around the arteriovenous malformation and the basis of the aneurysm did not adhere to the temporal lobe. Taking these findings into consideration, it is presumed that the hematoma in putaminal region was due to neither arteriovenous malformation nor aneurysm but was a hypertensive intracerebral hemorrhage.

Cerebral Hemorrhage↗

[Intracranial neurinoma of jugular foramen--report of a case and reference, its clinical manifestations (author's transl)].

This is the 28th case report of jugular foramen neurinoma in the world. A 24-year-old man was admitted to our hospital with complaints of dizziness and impaired balance. Neurological examination revealed IX, XI and XII cranial nerves and cerebellar involvements, e.g., Brun's-Cushing nystagmus, curtain sign on the left, weakness of the left sternocleidomastoid muscle and deviation of the tongue to the left, accompanied with atrophy. Choked discs and other signs of increased intracranial pressure were not recognized. There were no cerebellar symptoms except impaired balance and nystagmus. Lateral view of vertebral angiography showed that the posterior inferior cerebellar artery was displaced backward and upward, the basilar artery was imposed to the clivus, and the superior cerebellar artery was elevated. A-P view of vertebral angiography showed that the posterior inferior cerebellar artery was displaced to the left. Enlargement of the left jugular foramen was revealed especially by tomograms of horizontal section at the level of 0.3 cm below the external acoustic meatus and 0.5 cm behind the external acoustic meatus. The jugular foramen margins were smooth and somewhat sclerotic. We confirmed the diagnosis of the jugular foramen neurinoma on the left. Suboccipital craniectomy confirmed a huge tumor which covered the left jugular foramen and the bulk of which was in the cisterna magna. These findings were supposed to explain that the patient did not show increased intracranial pressure. The tumor was encapsuled with smooth and thin capsule. This tumor was totally removed and the postoperative course was uneventful. Histological diagnosis was neurinoma. We consider that this tumor arose on the IXth or XIth cranial nerve.

Adult↗