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Biomedical subjects

K Kyoi

Publications and source records attributed to K Kyoi.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Carotid-ophthalmic aneurysms and visual abnormalities].

The direct neck clipping for carotid-ophthalmic aneurysm is hazardous and difficult as compared with other intracranial aneurysms because of its location adjacent to the anterior clinoid process, the optic nerve, and the cavernous sinus. The authors discuss the visual abnormalities accompanied by carotid-ophthalmic aneurysm on the basis of our experiences with 30 patients with 33 aneurysms. Ten patients (4 of 14 with ruptured aneurysms, 6 of 16 intact aneurysms) had preoperative visual abnormalities. Of our series of patients, visual acuity and visual field were impaired in one eye. The most common field abnormalities were unilateral inner or upper side defects. In the patients whose aneurysms were intact, visual abnormalities had been slowly progressive over many months. Otherwise, 2 cases with ruptured aneurysm experienced their first visual symptoms at the same time their hemorrhage. According to the projection of aneurysm with respect to internal carotid artery, superomedial and posteromedial projections were common in the patients with visual abnormalities. Seven patients with visual dysfunctions were operated on. Improvement of the visual symptoms was observed in 3 cases. In these cases, complete collapse of the aneurysm with good decompression of the optic nerve was obtained at operation. Two patients deteriorated following surgery; this occurred in relation to attempts to clip the aneurysm neck directly, and optic nerve was probably excessively manipulated. Two patients had no change in visual symptom: one was treated with trapping of internal carotid artery combined with STA-MCA anastomosis, another had direct hemorrhage into the ipsilateral optic nerve.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Histopathological findings of the pituitary gland in cases of subarachnoid hemorrhage].

Histopathological change of the pituitary gland in cases of the central nervous system disorder, especially in the cases of subarachnoid hemorrhage, was studied. Clinical materials were 23 cases who were died from subarachnoid hemorrhage due to aneurysmal rupture in the acute stage. Histopathological change was examined not only of the pituitary gland but also hypothalamus and the change due to increased intracranial pressure (midbrain hemorrhage and uncal herniation). Main histopathological findings of the pituitary gland are anterior pituitary necrosis and they are found in 8 cases out of 23 subarachnoid hemorrhage cases (34.9%). Histopathological changes in hypothalamus were hemorrhage or infarction, and these changes were present in 16 cases (70%). Eight cases with pituitary necrosis had shown hypothalamic lesions. Three cases out of 23 cases (17.4%) showed midbrain hemorrhage and uncal herniation and 3 cases out of these 4 cases had anterior pituitary necrosis. According to the angiographic findings, vasospasm tended to be severe and widespread in cases of anterior pituitary necrosis, meanwhile vasospasm did not tend to be severe or widespread in cases without anterior pituitary necrosis. It was suspected that the mechanism of the development of pituitary necrosis is related not only to the circulatory disturbance of the portal vessels due to mechanical compression on the pituitary stalk and acutely raised intracranial pressure at the moment of aneurysmal rupture, but also circulatory disturbance of the portal vessels due to vasospasm.

Adult↗
PubMed1984

[Clinical study on six cases of subcortical cavernous angiomas].

Cavernous angioma is a rare but important clinical entity because of its potential curability. We experienced with 6 cases of cavernous angiomas located in the subcortical region and summarized with special respect on clinical symptoms, CT scan, angiographic manifestations and operative findings. In all of these 6 cases, the diagnosis is confirmed as cavernous angioma histologically. The age in these cases ranged from 16 to 45 years and sex distribution was 3 males and 3 females. Initial symptoms of 6 cases were long-standing epilepsy in 4 cases and attack of unconsciousness in 2 cases. Plain craniogram revealed calcification in only one patient. On the other hand, plain CT scan showed high density areas in all cases. Among these, 3 patients showed slight contrast enhancement. Perifocal low density areas were noted in all cases and these low density areas extended to the cortical region. The most important lesion to differentiate from cavernous angioma is low-grade astrocytoma with calcification on CT scan. We misdiagnosed in one patient with cavernous angioma as contusional hemorrhage, because the patient fell unconscious and hit the occiput. Angiographically, most cavernous angiomas are represented as avascular masses with displacement of adjacent vessels. In contrast to this general acceptance, 4 out of the present 6 cases showed abnormal findings such as feeding artery, capillary blush and draining vein. The draining veins were encountered in 4 cases. It must be emphasized that these angiographic manifestations are very small and caution has to be paid not to be overlooked. From the operative view, there are several characteristic findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Cerebral schistosomiasis with a huge calcification. A case report].

A case of cerebral schistosomiasis with a huge calcification and with a long clinical course was reported. A 39-year-old male developed ataxic gait gradually associated with headache and general fatigability. According to the past history, the patient had suffered from severe meningitis with disturbance of consciousness for 2 weeks when he was 10 years of age. Neurological examination revealed positive Romberg's sign and left homonymous hemianopsia. Plain craniogram showed a large calcification occupying the whole right occipital region. This calcification was lobulated in shape and was 11 X 9 X 9 cm in size. CT scan demonstrated calcification and remarkable hydrocephalus. This calcification had no mass effect. Left vertebral angiogram revealed the right parieto-occipital artery to be stretched and slightly displaced toward midline. Hematological analysis disclosed no abnormality except for eosinophilia (10%). Pre-operative diagnosis was an old calcified granuloma of unknown origin. For the purpose of biopsy, a right occipital craniotomy was performed. On reflecting the dura, fibrous adhesion and vascular network were seen between the inner table of the dura and the arachnoid. Subarachnoid space was enlarged and all cortical vessels were narrow in their diameters. By a corticotomy, a whitish-yellow calcified mass was seen in the depth of 2 mm. The yellowish gelatinous content poured out of the mass. A piece of calcification and a small amount of content were taken as specimen. Microscopic study of the calcified tissue showed many egg shells of schistosoma japonica, necrotic tissues and infiltration of small round cells.

Adult↗
PubMed1983

[Value of contrast-enhanced CT scan in prediction of development of contusional hemorrhage].

It is often experienced that even if there are no significant findings on the initial plain CT scan in the patient with cerebral contusion, the patient has thereafter a serious clinical course and requires emergency operation for so-called contusional hemorrhage. In order to predict of the development of contusional hemorrhage we performed contrast-enhanced CT scan at the time of patient's arrival within 12 hours after injury, if there was cerebral contusion on 24 hours after the contrast-enhanced CT scan. If enhancement was demonstrated on the contrast-enhanced CT scan, we predicted the development of contusional hemorrhage and if not demonstrated, we predicted no more development of contusional hemorrhage and then we studied the correlation between the prediction and the plain CT 24 hours after the contrast-enhanced CT scan. The results were as follows: 1) The prediction was correct in 13 cases out of 16 cases in which the development of contusional hemorrhage was observed. In 18 cases where no development of contusional hemorrhage was observed, the prediction was correct without exception. 2) Most of the cases in which enhancement was demonstrated were ones examined not before 3 hours after injury. 3) The extent of enhancement shown on contrast-enhanced CT scan was well consistent with that of contusional hemorrhage on the plain CT scan 24 hours after the contrast-enhanced CT scan. From these results, the contrast-enhanced CT scan in acute stage of head injury was considered to by very useful in prediction of the development of contusional hemorrhage.

Adolescent↗
PubMed1983

[Simultaneous, bilateral hypertensive intracranial hematomas].

The reported incidences of bilateral intracerebral hemorrhages due to systemic arterial hypertension are exceptionally rare in Japan. Unilateral hemorrhages, on the other hand, are less uncommon. Recently, we have examined two patients with bilateral intracerebral hemorrhages due to hypertension. The first case involved bilateral thalamic hemorrhages; and in the other, a contralateral hemorrhage developed postoperatively, subsequent to the evacuation of a primary hematoma. The characteristic neurological manifestation of bilateral intracerebral hemorrhages include quadriparesis, bilateral Babinski's signs, stupor, and coma. Published information regarding the anatomy of intracerebral hemorrhages due to hypertension is inconclusive, but the bilateral basal ganglias are believed to be most frequently involved. One school of thought explains the pathomechanism of bilateral hemorrhages as a symmetrical rupture of cerebral microaneurysm. However, it is possible that an unilateral hematoma was formed by a ruptured microaneurysm, and subsequently, a contralateral hemorrhage developed in relatively short time due to circulatory disturbance. As in the case of general cerebral hemorrhage, a craniotomy is also indicated for hypertensive bilateral intracerebral hemorrhage.

Aged↗
PubMed1983

[Multiple meningioma].

Meningiomas are the most popular benign intracranial tumors, but they are rarely seen as a multiple growth. The incidence of multiple meningiomas, defined by Cushing and Eisenhardt, is about 1 to 2 per cent of all meningioma cases. Though many cases of the multiple meningiomas were reported previously in the world, some of them were concomitant with von Recklinghausen's disease or acoustic neurinoma. Most of the cases of the multiple meningiomas reported showed multiple lesion at the time of operation or after a few years of the initial operation. We have encountered two patients with multiple meningioma without the stigmata of von Recklinghausen's disease in our clinic. Case 1. A 58-year-old female visited the hospital complaining of headache and occasional nausea on February 6, 1980. Plain and enhanced cT confirmed a large tumor in the right parietal region and three small tumor nodules in the right occipital region. Carotid angiogram detected only two tumors of frontal falx. Apparent two tumor stains were seen on the region, and they were fed by meningeal frontal and parietal region, and they were fed by meningeal arteries through the right ophthalmic artery. A large tumor of parietal and a small tumor of frontal region on the right side of falx were removed. Three nodular tumors of right occipital convexity were extirpated at the same time. Histological examination of the tumors disclosed all extirpated tumors were fibroblastic meningioma. Case 2. A 61-year-old male developed convulsive seizure of the right upper limb and right side of the face was diagnosed as having convexity meningioma in the left parietal region.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1982

[Experimental studies of the effect of diltiazem (Ca-antagonist) on cerebral circulation and cerebral arterial spasm].

Polygraphycal studies were carried out in order to evaluate the effects of Diltiazem (Ca-antagonist) on cerebral circulation in cats. In addition to these studies, the inhibitory effect of Diltiazem on incubated blood-, and serotonin-induced vasocontraction of basilar arteries was observed through on operating microscope. Experimental vasospasm were induced by local administration of incubated blood and 10(-5)--10(-6) M serotonin solution. The required dose of Diltiazem, 30-300 micrograms/kg, was injected by one shot intravenously. CBF slightly decreased concomitantly with transiently decreased blood pressure shortly after intravenous injection of Diltiazem. After that, CBF increased for 15-20 minutes and returned to the state similar to that before the administration of Diltiazem. The changes in reactive pattern of CBF depend on the doses of Diltiazem and related to changes of CAR and VAR which were thought to indicate the blood of cardiac output. Vasocontraction induced by incubated blood and serotonin was released 30-35 per cent for 30 minutes after intravenous injection of Diltiazem 100 micrograms/kg. However, by administration of Diltiazem before and after local application of incubated blood and serotonin on basilar arteries, vasocontraction was inhibited completely. These data suggest that administration of Diltiazem (Ca-antagonist) might be useful in the prophylaxis and treatment of vasospasm following rupture of cerebral aneurysm.

Animals↗
PubMed1981

[Bilateral internal carotid artery thrombosis (author's transl)].

Nineteen patients with bilateral internal carotid artery thrombosis were analysed with respect to long term clinical course from first onset to admission. The patients comprised 19.3% of all patients with occlusive cerebral disease treated in past three years at our clinic. In reviewing the symptoms and signs associated with bilateral carotid occlusions and the clinical course, several patterns became evident and in this report the patients are divided into 3 types: Apoplectic type, those who had severe neurological deficit acutely after occlusion, whose angiography showed impaired or absent collateral circulation, and whose CT scan demonstrated bilateral diffuse low density areas; Progressing type, those whose neurological signs and symptoms grew progressively serious, whose angiography showed moderate or adequate retrograde filling with collateral circulation through posterior cerebral arteries and whose CT scan demonstrated low density lesions in the bilateral frontal lobes; TIA . RIND repeated type, those who had transient ischemic attacks or reversible ischemic neurological deficits repeatedly, whose angiography showed good normograde filling of bilateral internal carotid artery with collateral circulation through posterior communicating arteries and whose CT scan demonstrated no abnormal low density areas except findings of brain atrophy.

Adult↗