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Biomedical subjects

K Hashi

Publications and source records attributed to K Hashi.

At least 145 records · Page 8Linked to original sources
PubMed1976

[A midline vertebral artery aneurysm operated via transoral transclival approach (author's transl)].

A detail of an unsuccessful trial of transoral transclival operation for an aneurysm arising from the left vertebral artery was reported. The patient was 66 years old male who had bronchial asthma and difficulty in phonation and swallowing. The angiograms showed that the aneurysm, 1.5X1.5X2.0 cm in size, was situated in the midline at the level of caudal one-third of the clivus. A transoral transclival operation was performed following preoperative tracheostomy and gastrostomy to improve his pulmonary and nutritional condition. A midline incision on the palate was followed by the removal of the posterior half of palatal bone. The upper part of incision on the retropharyngeal mucosa was placed approximately 1 cm off the midline to facilitate closure afterwords. A caudal 1/3 of the clivus, anterior arch of the atlas and a part of the odontoid process were removed. The aneurysm, fusiform in shape, was then collapsed by needle puncture after the left vertebral artery was trapped between the posterior inferior cerebellar artery and the vertebro-basilar junction. Closure of the dura with a fascial patch was incomplete due to an extensive incision and coagulation of the dura. Closure of the retropharyngeal mucosa around the orifice of the Eustachian tube was also incomplete in spite of the paramedian incision described above. Postoperative course was complicated by an frequent occurrence of the attack of bronchial asthma causing loss of gastic juice from the gastrostomy and resultant hypoproteinemia, although the recovery of lower cranial nerve palsy was good. There was no signs of infection until the 21st postoperative day when meningitis developed. The patient died in the 28th postoperative day. The importance of complete closure of the dura and retropharyngeal mucosa to prevent meningial infection was discussed. Since the mucosa around the orifice of Eustachian tube was extremely friable and the closure was almost impossible, the risk of meningial infection was considered to be high, especially when the intradural procedure was necessary through transoral high clivotomy.

Aged↗
PubMed1976

[Aneurysm of the great vein of Galen--report of a case (author's transl)].

A case of aneurysm of the great vein of Galen was reported in which craniotomy and clipping of a feeding artery arising from the left posterior cerebral artery was successfully performed. This 5-month-old girl developed progressive hydrocephalus from 2 months after birth. At 5 months the head circumference was 50 cm with tense enlarged fontanelle. Both eye balls were deviated downward. The deep tendon reflexes were hyperactive with bilateral ankle clonus and positive Babinski's sign. Mild cardiomegaly and hepatomegaly were also noted. Cerebral angiograms showed a large aneurysm of the great vein of Galen fed by a single enlarged arterial branch from the left posterior cerebral artery. After the evaluation of systemic circulatory status and under strict control of fluid transfusion craniotomy was performed. The feeding artery was clipped at its entrance to the aneurysm via left parieto-occipital interhemispheric approach. A rise in the mean arterial blood pressure of 20 mmHg was observed immediately following clipping. The postoperative course was satisfactory except for a left subdural fluid collection which required subduro-peritoneal shunt. The aneurysm was completely disappeared on the postoperative angiograms and the child is regaining the normal development. This is the first case of aneurysm of the great vein of Galen successfully operated in Japan. Clinical symptoms and signs, radiological features and operative treatment of the disease were reviewed from a total of 46 cases reported in the world literature.

Brain↗
PubMed1973

Cerebrovascular response to intracarotid injection of serotonin before and after middle cerebral artery occlusion.

The effect of intracarotid injection of serotonin (5-HT) on internal carotid artery flow and oxygen availability (O(2)a) of the cerebral cortex was studied in 10 baboons. Vasoconstriction occurred in the vascular bed of the territory supplied by the injected artery. After one middle cerebral artery was occluded the vasoconstrictor effect of 5-HT was more pronounced, particularly in the non-ischaemic hemisphere. The capacity of the cerebral vessels to provide collateral blood flow was reduced in both ischaemic and non-ischaemic areas of brain. As a result of focal cerebral ischaemia, 5-HT may accumulate in the brain and contribute to the progression of infarction.

Animals↗