Search PubMed⌕ Search

Biomedical subjects

K Suematsu

Publications and source records attributed to K Suematsu.

At least 37 records · Page 2Linked to original sources
PubMed1991

[A case of cerebral arteriovenous malformation revealed at repeated subcortical hematoma with initially normal angiogram].

An 18-year-old male admitted to our hospital suffered left temporal subcortical hemorrhage. No abnormality was demonstrated on carotid or vertebral angiography at that time. On the day following the onset, left frontotemporal craniotomy was performed and the subcortical hematoma was evacuated. No vascular malformation was found despite careful investigation. On 30th day after the onset, the repeat cerebral angiography was performed but failed to show any vascular abnormalities. After discharge he was in good health, and had had some follow up, CT were normal except for the hematoma cavity. Just two years after the first operation he suffered a second left temporal hemorrhage. Cerebral angiography was repeated and a temporal arteriovenous malformation (AVM) was found with feeding vessels from the M-1 and M-2 portion of the left middle cerebral artery and from the left anterior choroidal artery, and draining veins to vein of Rosenthal and the straight sinus. One month after the second hemorrhage, left frontotemporal craniotomy was performed and complete excision of the AVM was carried out. Only five cases of AVMs in patients with normal angiograms several years before have been reported previously in the literature. But there are no cases in which surgery has been performed. Differently to those cases, in this case it was investigated operatively whether there was a vascular abnormality at the first hemorrhage. We didn't think, however, that the AVM demonstrated at the second hemorrhage had developed spontaneously because there had been a hemorrhage of unknown origin previous to it. It was assumed that a small angiographically occult AVM connected to the hematoma cavity existed at the time of the first hemorrhage but it was too small to be found even during surgical procedure. Such an angiography occult AVM had been growing for two years, and its growth had probably been facilitated by the presence of the hematoma cavity left after the first operation.

Adult↗
PubMed1990

Computed tomography guided stereotactic aspiration of pontine hemorrhages.

Computed tomography-guided stereotactic aspiration has been carried out in 20 patients with hypertensive pontine hemorrhage. A Komai computed tomography-guided stereotactic apparatus and a suboccipital transcerebellar approach were used. The entire operative procedures were performed under local anesthesia or neuroleptanalgesia in the semilateral position. Of 20 patients, the outcome was assessed as good in 9, fair in 4, and poor in 7. No patient deteriorated after the operation. The relationship between the preoperative clinical features and the outcome in comparison with the conservative treatment is presented.

Adult↗
PubMed1989

[Monitoring of somatosensory evoked potentials during extracranial revascularization].

Intraoperative somatosensory evoked potentials (SEPs) were measured in 17 patients during 21 extracranial revascularization and related procedures. The operations included 13 carotid endarterectomies (CEAs), two cervical internal carotid ligations, one vertebral artery (VA) clipping, one VA-common carotid artery (CCA) transposition, and four temporary balloon occlusion tests (TBOTs). Three of the 13 CEAs (23%) showed reduced amplitude and delayed latency of primary cortical SEPs during clamping of the carotid artery, followed by their recovery after emplacement of the internal shunt. Flattening of SEPs during clamping of the CCA was observed in the case of VA-CCA transposition; however, SEPs returned to normal immediately after insertion of a balloon indwelling shunt into the CCA. One of the four TBOTs showed alteration of SEPs during balloon occlusion of the subclavian artery proximal to the origin of the VA. In the others, SEPs remained stable during the entire procedure. Only one transient intraoperative ischemic complication was encountered among the cases of CEA. It was detected through flattening of SEPs, which led to the discovery of an internal shunt obstruction. Carotid stump pressure was also measured in 12 CEAs and two TBOTs, and seven of these 14 had pressure less than or equal to 50 mmHg. Four of the seven had carotid stump pressure less than or equal to 30 mmHg, and three of these four also showed altered SEPs. SEPs remained stable if the collateral flow was sufficient during vascular occlusion and showed obvious alteration when the blood flow was reduced to below the threshold. The authors conclude that monitoring of SEPs during extracranial revascularization is very useful.

Adult↗
PubMed1988

[Immunohistochemical study of developing rat embryo--localization of vimentin, GFAP, neurofilament protein within rat embryo central nervous system].

The identification of intermediate filaments within immature cells is valuable as a means to investigate neuronal and glial differentiation. The purpose of this study is to investigate the time of appearance of neuron and glia within rat embryo by identifying cell-specific intermediate filaments. Pregnant rat were daily sacrificed from day 9-20 of pregnancy. Rat embryos were fixed with 100% ethanol and then we have made the paraffin section. We have stained the specimens for vimentin in accordance with ABC method and for GFAP in accordance with PAP method. We have performed Bodian stain. The neural plate of day 9 rat embryo is composed with vimentin positive immature cells which are disposed with pseudostratified arrangement. In midbrain of day 13 rat embryo, immature cells and their fibers are vimentin positive which are spanning from ventricular surface to marginal layer. NFP is detectable in immature cells and fibers of marginal layer. But GFAP positive cells and fibers are not identified in the same region. In anterior column of day 18 rat embryo, GFAP positive fibers are detectable. Summarizing of these results, we can display first: immature cells composing of neural plate are vimentin positive at day 9, second: NFP positive fibers and cells appear at day 13, third: NFP positive cells are vimentin positive, too, forth: GFAP positive fibers appear at day 18 and they are vimentin positive, too.

Animals↗
PubMed1987

[Cerebral amyloid angiopathy complicated by multiple cerebral infarcts and intracerebral hemorrhages: case report].

Recently, cerebral amyloid angiopathy is stressed as an unusual and infrequent cause of cerebral infarct or intracerebral hemorrhage. This report described a case of cerebral amyloid angiopathy complicated by multiple cerebral infarcts and multiple intracerebral hemorrhages. This 70-year-old man was admitted to our hospital on November 10, 1984 for evaluation of the gradual onset of dysarthria. Examination showed only slight dysarthria. There was no history of hypertension or dementia. A computed tomography (CT) showed enlarged ventricles with cortical atrophy and multiple low-density lesions, deep in the left frontal, left parietal, right parietal lobes, and in the both basal ganglias. The patient discharged from the hospital with only slight dysarthria. On November 20, 1984, he was admitted to our hospital again, because he was found unresponsive on the floor. He was somnolent but arousable. Examination showed disorientation, impairment of recent memory and impairment of calculation, A CT scan demonstrated three small intracerebral hemorrhages in the left frontal, right parietal lobes and left basal ganglia. On the fifth hospital day he deteriorated acutely, becoming semicomatose and hemiparetic on the right side. A repeated CT scan showed two new intracerebral hemorrhages in the left frontal lobe. Cerebral angiograms showed only minimal changes due to the occupying lesions in the above mentioned area. The hematomas was evacuated via left fronto-parietal craniotomy. The specimens removed with hematoma (stained with hematoxylin-eosin, Congo red and thioflavin T) showed extensive amyloid angiopathy. Postoperatively he made a good recovery, although he had residual mental dysfunctions. He expired by pneumonia on March 30, 1985.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[A case of spontaneous carotid-cavernous fistula disappearing following irradiation].

A case of spontaneous carotid-cavernous fistula, which completely disappeared following irradiation (45 Gy), is reported. A 59-year-old woman was admitted on October 10, 1983, with a history of doplopia and recurrent retrobulbar and occipital pain. On admission, neurological examination showed no neurological deficit, and right cerebral angiography demonstrated a dural internal carotid-cavernous fistula fed by the meningohypophyseal trunk and drained into the inferior petrosal sinus. In spite of the conservative management, right oculomotor palsy and hypesthesia corresponding to the division of ophthalmic branch of the right trigeminal nerve was developed. On November 22, liniac irradiation to the region of fistula (30 days, total dose, 45 Gy) was started. Symptoms and signs gradually improved 3 weeks after irradiation and completely disappeared 3 months after irradiation. Carotid-cavernous fistula was no longer demonstrated by the cerebral angiography 7 months after irradiation. Two years after onset, no recurrence of symptoms was observed.

Arteriovenous Fistula↗
PubMed1986

[Two cases of thrombosis of an aneurysm in the acute stage].

Thrombus formation within aneurysm is common and has generally been proved to be a slowly progressive phenomenon. We report two cases of acute completely thrombosis of aneurysms. The initial angiogram failed to reveal aneurysm and other etiology of subarachnoid hemorrhage. CT revealed diffuse cisternal blood and acute hydrocephalus. We decided to operate on these patients in the acute stage because of the generally-known strict correlation between the amount of cisternal high density on CT and the subsequent development of vasospasm and ischemic event. Case 1. A 68 year-old female was admitted on Day 1 with neurological deterioration of Grade 3 (H & K). Complete angiographic study was done, including the basal view and stereotechnique, but failed to reveal aneurysm. On Day 2 we operated on this patient and discovered a thrombosed aneurysm of the anterior communicating artery (3 X 7 mm in size). Case 2. A 51 year-old male suffering from subarachnoid hemorrhage was transferred to our hospital on Day 0. Emergency angiography gave no information, but the pattern of cisternal clots on CT was suggested the existence of an aneurysm of the right internal carotid artery. The next day we performed angiography once more, at that time 2 X 5 mm internal carotid bifurcated aneurysm was revealed. Shortly thereafter we operated and found the intra-aneurysmal clot. Through consideration of these we have reached the following conclusions. When CT findings in a patient with subarachnoid hemorrhage show the diffuse cisternal clots due to rupture of aneurysm, we should consider immediate surgery even if the angiogram is negative in order to lessen the risk of delayed vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

[Pituitary apoplexy with an unruptured carotid-ophthalmic aneurysm].

The association of pituitary adenoma and adjacent cerebral aneurysm is not uncommon and acute hemorrhage into a pituitary adenoma is also a well recognized condition. However, the simultaneous occurrence of pituitary apoplexy with intracranial aneurysm is very rare. Such a case demonstrates the diagnostic difficulty in distinguishing between pituitary apoplexy and rupture of an aneurysm. We reported a patient with subarachnoid hemorrhage in whom a hemorrhage into the pituitary adenoma and a carotid-ophthalmic aneurysm was proven, and discussed the differential diagnosis and treatment. A 41-year-old man, who developed sudden severe headache with nausea and vomiting, was admitted to our hospital. Examination disclosed a mildly stuporous man with bilateral defects of upper lateral visual fields and lumbar puncture revealed subarachnoid hemorrhage. Plain radiographs of the skull showed an enlarged and eroded sella turcica. Carotid angiography revealed a left carotid-ophthalmic aneurysm. A plain CT scan demonstrated an acute suprasellar hematoma. A transsphenoidal operation was performed and postoperative course was uneventful.

Adult↗
PubMed1984

Completely thrombosed giant aneurysm of the angular artery.

An unusual case of a completely thrombosed giant aneurysm arising from the angular artery is reported. A 69-year-old women developed a subarachnoid hemorrhage with a large intracranial hematoma. Computed tomography scans and cerebral angiography could not detect the aneurysm. The rarity of aneurysms in this position is stressed and the difficulty of diagnosis in this case is discussed.

Aged↗
PubMed1984

[Three cases of infra-optic course of the anterior cerebral artery].

Three cases of rare anomalous cerebral artery originating from internal carotid at the level of ophthalmic artery to join the anterior cerebral artery were presented. Case 1. A 32-year-old woman was admitted following subarachnoid hemorrhages. Cerebral angiography disclosed the anterior communicating artery aneurysm and the anomalous vessel originating at rt. carotid siphon to join anterior cerebral artery. Case 2. A 37-year-old woman was admitted with rt. hemiparesis and aphasia. Cerebral angiography revealed the anomalous vessel originating at rt. carotid siphon to join contralateral anterior cerebral artery. Case 3. A 22-day-old male infant with enlarged head was admitted and cerebral angiography was performed. Anomalous vessel originating from internal carotid at the level of ophthalmic artery joined to the azygos anterior cerebral artery. There were only sixteen reported cases of this anomaly including our three cases. Seven aneurysms were associated in six cases, in which four were located in anterior communicating system. The fact that among the cases of this anomaly, ophthalmic artery used to not have normal stem but be fed from middle meningeal or middle cerebral artery suggested that the anomalous vessel had the common stem with ophthalmic artery at certain embryonic stage. These considerations led us to the conclusion that this anomalous vessel might originate from the remnant of anastomotic loop between primitive dorsal and ventral ophthalmic artery.

Adult↗
PubMed1984

[The immunohistological study of developing human spinal cord--the localization of vimentine, GFAP in radial glial cell].

The morphological changes of radial glial cells in developing human spinal cord have been studied immunohistologically. The specimens extracted from developing human spinal cords, gestational age of 15 weeks, 30 weeks and 35 weeks, were prepared with cryostat for the investigation of anti vimentin mouse monoclonal antibody and of GFAP rabbit serum. We have stained the specimens for vimentin in accordance with ABC method, for GFAP in accordance with PAP method. On gestational age of 15 weeks, the fibers radially oriented from the central canal to pial surface were positive for vimentin and GFAP. Partially, early differentiated astrocytic cells were found. On gestational age of 30 weeks, radially oriented fibers were positive for vimentin and GFAP. They took more tortuous course, branching than those of 15 weeks. More differentiated astrocytic cells were found. On gestational age of 35 weeks, the staining for vimentin was very weak on radially oriented fibers and these fibers were more tortuous, branching than those of 30 weeks. More differentiated astrocytic cells than those of 30 weeks were found in rich amount. From results above, we concluded: 1) Radial glial cells in developing human spinal cord were positive for vimentin and GFAP. 2) The show weaker staining for vimentin in process of gestational age. 3) They differentiate to astrocyte. 4) They appear in earlier stage than suggested by previous reports.

Astrocytes↗