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Biomedical subjects

M Sonobe

Publications and source records attributed to M Sonobe.

At least 73 records · Page 4Linked to original sources
PubMed1981

Early operations for ruptured intracranial aneurysms. Comparative study with computed tomography.

The authors have analyzed the correlation between the results of early operation for ruptured intracranial aneurysms (45 cases) and CT scan (54 cases) performed within the second week after subarachnoid haemorrhage (SAH). There was a good correlation between the results of early operation within one week after the haemorrhage and CT findings. Surgical results were closely correlated to the incidence of vasospasm in our cases. All cases with symptomatic vasospasm showed bilateral high density in the cistern or ventricles on CT scan performed within three days after initial bleeding. For the cases within 24 hours after haemorrhage, surgical operation is recommended as early as possible, including removal of blood clots in the basal cistern and Sylvian fissure, and ventriculo-cisternal drainage for improvement of cerebrospinal fluid (CSF) circulation. On the other hand, the cases in which operations were performed during the second to seventh days and where CT scan revealed bilateral high density in the cistern or ventricles resulted in poor outcome or death.

Adult↗
PubMed1981

Multiple intracranial aneurysms associated with moyamoya disease. Case report.

A case of multiple intracranial aneurysms associated with unilateral moyamoya vessels is reported. The authors have reviewed the age, sex, initial symptoms, site of aneurysm, and operative indication in similar cases reported in the literature. It was found that aneurysms associated with moyamoya disease were frequently located in the vertebrobasilar system.

Adult↗
PubMed1981

[Early operations for ruptured intracranial aneurysms--comparative study with computed tomography (author's transl)].

The authors have analyzed the correlation between the result of early operation for ruptured intracranial aneurysms (45 cases) and CT scan (54 cases) performed within the second weeks after subarachnoid hemorrhage (SAH). 1) Twelve patients operated on within 24 hours after SAH showed no mortality and a morbidity of 16%. On the contrary, in 12 patients operated on during 2nd-7th days after SAH, the mortality rate was 38% and the morbidity 15%. 2) There was a good correlation between the result of early operation within one week after the hemorrhage and CT findings. Surgical results were closely correlated to the incidence of vasospasm in our cases. All cases with symptomatic vasospasm showed bilateral high density in the cistern or ventricles on CT scan performed within 3 days after initial bleeding. 3) In the cases of ruptured aneurysm with giant intracranial hematoma, but no remarkable blood clot in ventricles or basal cisterns, the results of surgery in acute stage were good. 4) For the cases within 24 hours after the hemorrhage, it is recommended to carry out surgical operation as early as possible, including removal of blood clots in the basal cistern and sylvian fissure, and ventriculo-cisternal drainage for improvement of cerebrospinal fluid (CSF) circulation. On the other hand, the cases in which operations were performed during 2nd-7th days and CT scan revealed bilateral high density in the cisterns or ventricles resulted in poor outcome or death.

Adult↗
PubMed1981

[Computed tomography of ruptured arteriovenous malformations in the acute stage (author's transl)].

Eighteen patients with angiographically proved intracranial arteriovenous malformation (AVM) were studied by computed tomography (CT) and their clinical features were reviewed at the same time. The pathophysiology of ruptured AVM in the acute stage was discussed. Seven of the 18 patients were performed CT scan within 7 days after the onset. Although all but one of the patients showed symptoms and signs suggestive of subarachnoid hemorrhage (SAH), intracerebral hematoma was demonstrated in all cases and two of them were accompanied by ventricular rupture. On the more, no high density lesion was demonstrated in cerebral cisterns by plain CT scan as seen in the acute stage of ruptured cerebral aneurysms. Six patients were performed contrast study within 7 days after the onset and showed no enhancement effect. On the contrary, nine of 10 patients performed contrast study more than 8 days after the onset showed enhancement effect. It has been commonly postulated that subarachnoid hemorrhage is the main pathophysiology of ruptured AVM. However, out study on CT scan of ruptured AVM demonstrated that intracerebral hematoma or ventricular hemorrhage is the chief underlying pathophysiology of ruptured AVM in the acute stage.

Adolescent↗
PubMed1981

[Chronic subdural hematoma associated with intracranial aneurysm (author's transl)].

Four cases of chronic subdural hematoma associated with intracranial aneurysm were reported. In two cases aneurysms were found at the peripheral portion of middle cerebral artery under the hematoma, and in other two cases aneurysms were found incidentally. The causality was discussed about subdural hematoma and intracranial aneurysm especially false aneurysm found in the peripheral artery under the hematoma. Radical operation of intracerebral aneurysm associated with chronic subdural hematoma should be performed after angiography and CT scan regardless the rupture of the aneurysm.

Adult↗
PubMed1981

[Preventive effect on intracranial arterial vasospasm using combined ventriculo-cisternal and cisternal drainage (author's transl)].

Cerebral vasospasm following subarachnoid hemorrhage (SAH) is one of the most important problems in the treatment of ruptured intracranial aneurysms. Several reports have recently emphasized that oxyHb from erythrocytes might be responsible for vasospasm. In this study, the hem-oxygenase which converts oxyHb to bilirubin was analyzed and the increase of hem-oxygenase in the CSF after SAH was reconfirmed. In 23 cases of ruptured intracranial aneurysms, combined ventriculo-cisternal drainage and cisternal drainage designed by us was performed after clipping of aneurysms in early stage after rupture. Through a Y-shaped tube the CSF accumulated in the cistern and was drained extracranially through cisternal drainage. As a result, 2 (9%) of the 23 patients treated with the drainage showed symptomatic vasospasm. On the other hand, 13 (33%) of 39 patients without the drainage showed symptomatic vasospasm. It may be concluded that the drainage may contribute to prevention of cerebral vasospasm after SAH.

Adult↗
PubMed1981

[Primary cerebral neuroblastoma--case report (author's transl)].

Primary cerebral neuroblastoma is rare. The case reported here was a 2-year-old girl who was comatose on admission to the Mito National Hospital. She had experienced headache and vomiting during the last two months. Neurological examination showed bilateral papilledema, left oculomotor palsy and bilateral Babinski's sign. A-P view of the left carotid angiogram showed square shift of the anterior cerebral artery to the right, and the lateral view showed upward and anterior displacement of the middle cerebral artery. CT revealed large mass lesion in the left parieto-temporal lobe, which was slightly enhanced on the contrast study. Subtotal removal of the tumor was performed on the day of admission. On the 15th postoperative day, she was started on radiation therapy to the brain and received 1900 rads. Vincristin and ACNU were administrated with radiation therapy. She improved progressively five weeks after the operation and CT demonstrated marked shrinkage of the tumor. However, signs of increased intracranial pressure were reappeared and she died six months after the operation. Autopsy showed well defined soft and grayish white tumor in the occipito-temporal lobe, which extended to the left thalamus and basal ganglia. No other tumor was present extracranially. Microscopic examination demonstrated Homer-Wright rosette and zonal filament. Pathological diagnosis was neuroblastoma.

Brain Neoplasms↗
PubMed1980

[The association of polycystic kidneys with intracranial aneurysms (author's transl)].

A 48 year-old man is presented who died of rupture of intracranial aneurysm. Autopsy findings revealed a ruptured anterior communicating artery aneurysm associated with polycystic kidneys and polycystic liver. Epidermiological review is performed using "Annual of the Pathological Autopsy Case in Japan" (Vol. 17-20). In 92854 autopsy cases, there are 243 cases of polycystic kidney, 1542 cases of intracranial aneurysm and 10 cases of association with both of them. Several points come clear from comparing our data with foreign ones, as follows; 1) The frequency of polycystic kidney (0.25%) is almost the same between Japan and foreign country. 2) The frequency of intracranial aneurysm (1.6%) is higher in Japan. 3) The frequency of association with both (0.01%) is lower in Japan. 4) The frequency of intracranial aneurysm appears to be higher in cases suffered from polycystic kidney than in others. We suspected that cerebral aneurysm formation is caused by hypertension due to polycystic kidney, although in many reports, the association of polycystic kidney and cerebral aneurysm is explained to be maldevelopment. The operation of cerebral aneurysm with polycystic kidney is the same as that without polycystic kidney. But the control of hypertension and renal function is necessary during and after operation.

Humans↗
PubMed1980

[Lipoma of corpus callosum with callosal agenesis (author's transl)].

Intracranial lipoma is rare. The case reported here was a woman aged 60. She came to our hospital with complaint of headache. Neurological examination was negative. Plain craniogram showed abnormal calcification in the callosal region. A-P view of right carotid angiogram revealed winding sinous course of bilateral anterior cerebral arteries around the calcific deposit. Lateral view showed vertical stretching of ascending portion of the anterior cerebral artery. In the frontal projection of the pneumogram, the lateral ventricles were separated and concave medially with hornlike superior angles. The third ventricle extended upward between the lateral ventricles. The plain CT scan revealed an abnormal low density area (Hounsfield's number-90- -50) in the callosal region. The calcific deposit was seen within a low density area. At operation, the callosal tumor was partially removed. Histologically, lipomatous tissue was demonstrated. In reference to literature, we discussed the roentgenographic findings, especially computed tomography of callosal lipoma.

Agenesis of Corpus Callosum↗
PubMed1979

[Vasoconstriction of external carotid arteries after the rupture of intracranial aneurysm (author's transl)].

A patient in whom vasospasm of not only intracranial but also extracranial arteries was demonstrated after the rupture of an intracranial aneurysm was reported. A 55-year-old male was admitted with a ruptured left IC-PC aneurysm. Intracranial direct operation and continuous ventricular drainage were performed 33 hours after the rupture. Six days after the surgery, right hemiparesis and consciousness disturbances developed. Angiography revealed severe vasospasm of intra-and extracranial arteries, especially branches of the external carotid artery. The symptoms improved markedly following the superior cervical ganglionectomy and perivascular sympathectomy of cervical internal carotid artery on the left side. Vasospasm of the external carotid system, which has not been reported, was further investigated angiographically in 23 patients who had vasospasm of the intracranial arteries after aneurysm rupture. In about 50% of these patients was found vasospasm of the external carotid system too. These changes were not found in control cases without vasospasm of the intracranial arteries. Pathogenesis of the vasospasm of the external carotid system was discussed with particular emphasis on the relationship with the sympathetic nerves.

Carotid Artery Diseases↗
PubMed1978

Vasospasmogenic substance produced following subarachnoid haemorrhage, and its fate.

Fresh blood and supernatants of blood-CSF mixtures incubated for 1 to 15 days were applied to the basilar artery of adult cats, and the degree of constriction was measured with a surgical microscope. The constriction due to fresh blood was weak and transient. It seems possible to assume that serotonin isolated from platelets participates greatly in the transient vasoconstriction induced by fresh blood. Supernatants of blood-CSF mixtures incubated for three days had weak activity in comparison with the powerful and long-lasting activity of those incubated for seven days. Furthermore, mixtures incubated for 15 days had little or no activity. This change in the vasoconstrictive activity was similar to, and coincides chronologically with clinical late spasm following subarachnoid haemorrhage 34. We investigated the vasospasmogenic substance in the seventh day mixture. Heat coagulation, ultrafiltration, sephadex G-100 gel-chromatography, disc-electrophoresis, and Spectrophotography show that extracellular oxyHb has a strong spasmogenic activity. In the 15th day mixture, oxyHb is spontaneously converted to metHb. Experimentally, oxyHb has a strong vasoconstrictive activity, and metHb has no vasoconstrictive activity. We have had success in oxidizing oxyHb into metHb with sodium nitrite, thus preventing experimental vasospasm.

Animals↗