Search PubMed⌕ Search

Biomedical subjects

M Jimbo

Publications and source records attributed to M Jimbo.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Cheiro-oral syndrome with pontine infarct--report of a case].

A case of cheiro-oral syndrome presumably due to brain stem infarction was reported. A 41-year-old man suddenly experienced the numbness of the palm and the lips on the left side at 2 p. m. March 30, 1982 and was admitted to our clinic at 5 p.m. on that day. Neurological examination on admission revealed hypesthesia of the palm and the lips on the left side, but pain and temperature sensibilities were preserved. Neither astereognosia nor extinction phenomenon was there. CT scan showed no abnormal findings. At 9 p.m. his speaking became somewhat obscure and he became unable to swallow fluid. And after ten hours or so, he became quadriplegic, anarthric and lost almost all voluntary movement below the eye, while his consciousness was preserved ("Locked-in" syndrome). CT scan taken on the 9th hospital day revealed brain stem infarction. He expired on the 58 th hospital day because of the exacerbation of pneumonia. At autopsy both vertebral arteries and basilar artery were markedly sclerotic. The rostral two-thirds of the basilar artery was occluded by organized thrombus. The serial microscopic sections through the midbrain and the medulla oblongata showed extensive infarction of the basis pontis. The tegmentum pontis remained free, except that a small offshoot of the infarct reached into the medial part of the medial lemniscus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Rathke's cleft cyst. Report of two cases].

Two cases of Rathke's cleft cysts were reported. Case 1. A 57-year-old man was admitted to our hospital on Sep. 29th. 1982, complaining of visual field defect. Visual acuity was 0.7 in the left eye and 0.1 in the right eye. Visual field examination revealed upper temporal quadrantanopsia on the left side and incomplete temporal hemianopia on the right side. He was neurologically free otherwise. Endocrinological study disclosed general hypopituitarism except for elevated serum prolactin level. CT scan showed a high density mass in the enlarged sellar cavity extending to suprasellar area. Right frontal craniotomy was performed on Oct. 26th, 1982, and about 3 ml of reddish-brown colloid substance was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and field defects were improved. Microscopic section of the cyst demonstrated a loose fibrous wall, lined by single layer of ciliated columnar epithelial cells containing secreting vesicles. Histological diagnosis was Rathke's cleft cyst. Case 2. A 43-year-old female was attacked by subarachnoid hemorrhage on Jan. 1st, 1983. Angiography revealed an anterior communicating aneurysm. Operation was performed on Jan. 18th, 1983 and the aneurysm was successfully clipped. During surgery a suprasellar cystic mass was incidentally discovered and the cyst wall was resected. Microscopic section of the cyst demonstrated one layer of cuboidal cells supported by thick connective tissue. Precise check of her early history disclosed that her menstruation had been delayed and visual acuity had been impaired. CT scan was negative as far as the suprasellar region was concerned.

Adult↗
PubMed1984

[Conservative treatment of traumatic intracerebral hematoma].

In the previous report, it was insisted that traumatic intracerebral hematoma should be regarded as a variety of cerebral confusion and that conservative treatment would be therapy of choice in these situations. Adversely, unjudicious operation would sometimes result in more expansion of hematoma by untamponade effect of decompressive craniectomy. In the present investigation, it was attempted to provide therapeutic policy in the management of traumatic intracerebral hematoma. Consecutive thirty two cases of traumatic intracerebral hematomas were selected for this study. Those cases with other hematoma such as epidural or subdural hematoma were excluded. These 32 cases were divided into two groups, operative (15 cases) and non-operative (17 cases). Whether to be operated or not was arbitrarily decided by the surgeons who were faced to the patients. Disturbance of consciousness of the patients were divided into three categories, namely severe (III-100 to 200 level), moderate (II-10 to 30 level), and mild (I-1 to 3 level). They were 8 cases, 5 cases, 1 case in operative cases and 6 cases, 10 cases, 1 case in non-operative cases respectively. Mortality rates were 13.3% (2 cases) in operative cases and none in non-operative ones. Concerning the patients of severely disturbed consciousness, there were no difference in their final outcomes between the two groups. On the other hand, 7 out of 10 cases of moderately disturbed consciousness recovered completely without operation, whereas all operative cases of the same category were, more or less, handicapped.

Adolescent↗
PubMed1984

[Trochlear neurinoma: case report].

A case of solitary neurinoma of the trochlear nerve was reported. The patient was a 37-year-old female, who had a sudden attack of right-sided temporal headache with nausea and vomiting on August 1, 1982. Headache was subsided in a few days but she had complained of diplopia since the episode. Ophthalmological examination revealed right superior oblique muscle palsy. She was neurologically free otherwise. CT scan, taken about three weeks after the onset, showed a solitary enhancing mass in the region of tentorial incisura on the right side. She was admitted to our clinic on August 24, 1982. Extensive work-up including polytomography, cerebral angiography, lumbar puncture, and so forth, revealed no abnormality. There were no cutaneous manifestations of von Recklinghausen's disease. Craniotomy was performed on October 28, 1982 and the tumor was totally removed by way of right subtemporal-transtentorial route. The tumor, size of which was 1.0 X 0.9 X 0.7 cm, was located just underneath the tentorial edge, and was adherent to it. The trochlear nerve was found incorporated in the tumor. Histological diagnosis was neurinoma of Antoni A type. Postoperatively, she was well and fully active, except for diplopia due to the sacrificed trochlear nerve.

Adult↗
PubMed1983

[Histographic analysis of computed tomography of cerebral hemispheric tumors].

The aim of this report is to assess the possibility of digital processing of computed tomography for histological diagnosis of brain tumors. For this purpose, percent histograms of x-ray attenuation value of lesions were analysed in 113 cases of histologically verified hemispheric tumors. Sixteen histograms obtained from normal brain parenchyma served as controls. Histograms were made from the same slices before and after contrast enhancement. The result were as follows; Histograms of benign tumors such as meningiomas and low grade astrocytomas characteristically showed similar pattern with normal subjects, whereas histographic patterns of the more malignant tumors such as malignant astrocytomas, metastases and glioblastomas were more heterogeneous with lower peak and wider curve. Displacement of the histogram to the higher density following contrast material administration was important clue in histographic analysis. The most prominent displacement was observed in meningiomas, followed by metastases with nodular type enhancement and malignant astrocytomas. Displacement in low grade astrocytomas and oligodendrogliomas was very slight and less than that of normal brain. Tumors showing ring enhancement such as glioblastomas and brain abscesses had wide histogram curve with twin peaks. Conclusively, it is possible to detect histological nature of cerebral tumors through CT scanning, using histographic analysis of the digital data.

Astrocytoma↗
PubMed1983

[A case of arachnoid cyst associated with chronic subdural hematoma].

An 11-year-old boy was admitted to our clinic with complaint of headache. On admission he was in drowsy state and neurological examination revealed minimal motor weakness of the right hand. Plain skull roentgenogram demonstrated a thinning of the left temporal bone and elevation of the left sphenoidal wing. CT showed marked displacement of the midline structures from left to right. The left lateral ventricle was collapsed. A well circumscribed, homogenous, high density area was delineated in the left middle fossa. Contrast enhancement was negative. A-P view of left CAG showed a crescent shaped subdural avascular area in the parietal region. The anterior cerebral artery was roundly shifted from left to right. Chronic subdural hematoma due to bleeding of arachnoid cyst was most likely. Subdural collection was evacuated by trephination. The postoperative course was uneventful. Postoperative CT 3 week after operation delineated the arachnoid cyst more clearly as round low density area. Follow-up CT 6 months later showed the arachnoid cyst markedly reduced in size.

Arachnoid↗
PubMed1982

[A case of intracranial tuberculoma].

The patient was a 20-year-old male who was admitted with epileptic seizure in March 5, 1981. For 3 months prior to admission, he had been affected by 3 seizure attacks. At admission, he was completely free neurologically. Laboratory examination showed no abnormality except for markedly positive result of tuberculin reaction test. Chest X-P was normal. Episode of pulmonary tuberculosis was denied. CT revealed irregular shaped low density area in the left postero-parietal region, in which two small high density spots were visualized by contrast enhancement. Craniotomy was made over the left postero-parietal region. The surface of the parietal lobe was slightly hyperemic and edematous. In some parts, the arachnoid membrane was thickened and turbid and cortical vessels involved in it were occluded. Subcortical tissue was softened and appeared necrotic. Two finger's tip sized nodules were touched in it and removed. Histology verified tuberculoma. Post-operative course was uneventful. The anti-tuberculous therapy was started immediately after the operation. CT, 2 months later, showed the low density area reduced markedly in size.

Adult↗
PubMed1981

[Head injury in children--with special reference to CT findings (author's transl)].

Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I & II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented.

Adolescent↗
PubMed1980

[Pituitary adrenocortical response to high dose administration of betamethasone in neurosurgical patients (author's transl)].

Using RIA technique, response patterns of ACTH-adrenocortical system to short term large dose corticosteroid therapy for neurosurgical patients were investigated. The subjects were consisted of 20 males and 13 females, ageing ranging from 10 to 60 years old. The subjects were divided into three groups according to mode of steroid administration. In the first group, 12 mg/day of betamethasone were administered for 5 days and cancelled without gradual reduction. In the second group, 12 mg/day of betamethasone were administered for 4 days and 6 mg/day of betamethasone were given for following 2 days. In the third group, 12 mg/day of betamethasone were administered for 3 days and gradual reduction of betamethasone was given for following 4-5 days. Response of plasma cortisol level to synthetic 18-ACTH were measured in all patients for 3 days after betamethasone administration cancelled. The results led to the following conclusion. 1) The second and third groups had not any clinical symptom after steroid cancelled, but one half cases of the first group had mild headache, nausea for 2 days after cancelled. 2) Recovery process of adrenocortical function in the second group is most rapidly, compared with that in other two groups. 3) In the postoperative steroid therapy in neurosurgery, it could be concluded that 4 days massive administration of steroid followed by stepwise reduction in 2 days would be functionally well tolerated by adrenocortical system.

Adolescent↗
PubMed1980

[Computed tomography in the diagnosis of hemorrhage secondary to intracranial aneurysm. (author's transl)].

In 168 patients with ruptured intracranial aneurysms, the pathology of intracranial hemorrhage visualized on CT was analyzed. Blood in the subarachnoid space could be visualized in 95% of cases within three days after SAH and 75% of 106 cases within two weeks after SAH. In one case blood clot in the subarachnoid space visible up to 13 days after SAH. Concerning the cases within two weeks after the bleeding, intracerebral hematomas were observed in 36% of anterior cerebral aneurysms and middle cerebral aneurysms, 16% of internal carotid aneurysms and none of vetebro-basilar aneurysms. The incidence of the intraventricular hemorrhage was as follows; vertebro-basilar, 44%; anterior cerebral, 38%; internal carotid, 28%; middle cerebral, 12%. On the basis of the pattern of distribution of extravasated blood the location of the ruptured aneurysm was properly predicted in 58% of anterior cerebral, 81% of middle cerebral, 58% of internal carotid and 30% of vertebro-basilar. Especially CT could contribute to predict which aneurysm has ruptured in patients with multiple aneurysms. It was possible to localize the site of bleeding in 11 out of 12 CT positive cases. The development of intracranial hemorrhage demonstrated by CT well correlated with the clinical grading of the patients and the clinical outcome. Patients merely showing subarachnoid hemorrhage were more likely to have good neurological grades, but ones showing complicated intracerebral hematomas and intraventricular hemorrhage had poor neurological grades at the time of the scan. The findings of extensive subarachnoid clot, which were followed by severe vasospasm, and marked intraventricular hemorrhage, usually correlated with poor prognosis. These pathology recognizable on CT was very helpful in determination of the timing of surgery and management of such patients. In conclusion CT is of great value in the examination of SAH when performed in the acute stage and should be the initial examination followed by angiography.

Cerebral Ventriculography↗