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Biomedical subjects

M Tsuru

Publications and source records attributed to M Tsuru.

At least 73 records · Page 4Linked to original sources
PubMed1983

Atlantoaxial dislocation associated with neurofibromatosis. Report of three cases.

Atlantoaxial dislocation was found in three patients with neurofibromatosis. Roentgenographic findings included marked reduction of sagittal diameter at the C-1 vertebral level, and cervical spine abnormalities associated with mesodermal dysplasia, such as posterior scalloping of the cervical spinal bodies with dural ectasia and vertebral body deformity (vertebral body dysplasia). Although the relationship of the atlas and axis did not change with neck position, all three patients had progressive neurological deficits and were treated by decompressive surgery combined with fusion. The pathogenesis of atlantoaxial dislocation associated with neurofibromatosis is discussed.

Adult↗
PubMed1983

Calcification of the ligamentum flavum of the cervical spine. Report of four cases.

Four cases of calcification of the cervical ligamentum flavum are reported, all in women over 60 years of age. Neurological findings were not significantly different from those of other cervical compressive diseases. Among radiological examinations, computerized tomography was the most valuable diagnostic tool. Calcification might have been induced by the degeneration or abnormal nutritional state of the ligamentum flavum. Endocrine abnormalities and inflammatory processes might also have been contributory factors.

Aged↗
PubMed1983

[Primary intracranial germ cell tumor with abnormal high value of alpha-fetoprotein after the radiation therapy].

A 7-year-old boy was admitted to Hokkaido University Hospital complaining of headache and vomiting. On admission he was slightly confused and presented Parinaud's sign. CT scan revealed abnormal high density mass with contrast enhancement effect at the pineal region and obstructive hydrocephalus. Laboratory studies showed the normal value of human chorionic gonadotropin and no trace of alpha-fetoprotein. Germinoma was most suspected based on the findings of CT scan and laboratory studies. The radiation therapy was carried out for a month and CT scan taken after the radiation therapy revealed marked reduction of the size of the tumor at the pineal region, and he was discharged. But he was re-admitted 3 months after the discharge complaining of headache and vomitting again. CT scan showed the recurrence of the tumor and laboratory studies showed abnormal high value of A.F.P. After the ventriculo-peritoneal shunt, the sub-occipital craniectomy was performed by the Stein's approach, and the tumor was removed. Pathologically the tumor was a typical yolk sac tumor. This case is a very interesting case because it suggests an alternation of the element of the germ cell tumor by the radiation therapy. At first admission, germinoma was the main element of the tumor judging from the effectiveness of the radiation therapy and laboratory studies. But the main element of the tumor seemed to have changed to yolk sac tumor after the radiation therapy. The relation between the tumor markers and the types of the germ cell tumor and histopathological characters of the intracranial germ cell tumor were discussed.

Brain Neoplasms↗
PubMed1983

[Evaluation of radiation immunochemotherapy in the treatment of malignant glioma. Combined use of ACNU, VCR and PS-K].

In a follow up study of 38 patients with supratentrial malignant glioma verified histologically during the 3 years from 1979 to 1982, the same therapeutic method which was the postoperative synchronized radiation-immunochemotherapy was applied. And we investigated the relationships between the survival rate and the histological malignancy, the operative area, and age of admission. Total dose of 5000 to 6000 rad radiation was given after surgery. 0.02 mg/kg of VCR was administered intravenously on the first and the 29th day of radiation, and 2 mg/kg of ACNU was administered intravenously 24 hours after VCR administration. After synchronized radiotherapy, 2 mg/kg of ACNU was given every 6 weeks and 3 g of PS-K was given orally every day. Dose of PS-K was increased especially during the radiation and for 2 weeks after ACNU administration. This radioimmunochemotherapy was applied to 38 patients with malignant glioma, 25 cases of glioblastoma multiforme, 12 cases of malignant astrocytoma, one cases of malignant ependymoma, one case of malignant oligodendroglioma. A complete clinical course of all patients was observed. 18 of 38 cases are surviving. The survival rate of malignant gliomas was 71.2% for one year, 47.6% for 2 years, 34.8% for 3 years. The survival rate of glioblastoma was 56.3% for one year, 36.9% for 2 years, 12.3% for 3 years. The survival rate of the patients receiving macroscopically total removal was higher than that of the patients receiving subtotal removal. The survival rate of the younger patients (under 49 years old) was higher than that of the older patients (over 50 years old). Side effect of this therapy was myelosupression in 75.8%.

Adjuvants, Immunologic↗
PubMed1983

[Facial nerve reconstruction--after the operation of C-P angle tumor].

Nineteen patients who undergo facial nerve reconstruction after the operation of cerebellopontine angle tumor from 1964 to 1981 were investigated. Eighteen cases were of acoustic neurinoma, and one was of low grade astrocytoma. Spinal accessory-facial nerve anastomosis was performed in thirteen cases. Cross facial nerve graft was done in three cases. Hypoglossal-facial nerve anastomosis, phrenico-facial nerve anastomosis, and intracranial direct anastomosis were done in one case each. In spinal accessory-facial nerve anastomosis cases, good result was obtained only in 30%, but using microsurgical technique since 1972, its rate went up to 50%. In cross facial nerve anastomosis cases in which two sural nerve grafts were used and the zygomatic and the buccal branches of the right and left connected each other, only one of three revealed good result. The cases of hypoglossal and intracranial direct facial anstomosis resulted in good recovery. As our conclusion, it is difficult to obtain the powerful reinnervation by means of the spinal accessory facial nerve anatomosis and the cross facial nerve graft. Therefore, the best method to be chosen in facial nerve reconstruction seems intracranial direct anastomosis. If the method is impossible, hypoglossal-facial nerve anastomosis should be chosen as the second best. The cross facial nerve graft seems to be leaving much room for technical improvement.

Accessory Nerve↗
PubMed1983

[Surgical management of arteriovenous malformations in the posterior fossa].

The authors reported 3 cases of dural arterio-venous malformation (AVM) in the posterior fossa and discussed mainly on surgical treatment. Case 1: 53-year-old man was admitted to our clinic with complaints of amnesia, visual impairment, dysarthria and gait disturbance. Neurological examination on admission disclosed slight disturbance of consciousness, bilateral papilledema, horizontal nystagmus, dysarthria and ataxic gait. Contrast CT showed a presence of vermiform irregular high density with enlarged ventricle, indicating phlebectasia in the brainstem and the cerebellum. Angiograms revealed a presence of dural AVM at the straight sinus fed by branches of external carotid artery and vertebrobasilar circulation with appearance of phlebectasia due to increase in straight sinus pressure on later phase. Dural sinus isolation for the affected sinus was performed under large occipital craniotomy which was initially reported by Hugosson and Bergström. Case 2: 55-year-old man was admitted to our hospital with complaint of gait disturbance. Neurological examination at the time of admission disclosed signs of raised intracranial pressure and caudal cranial nerves disturbance. Bruit synchronized with radial pulse was audible over the left occipital region. Angiograms showed a presence of dural AVM at the left transverse and sigmoid sinus with many feeding arteries and abnormal venous returns. Isolation of the involved sinuses was performed as same as in case 1. Case 3: 39-year-old woman was admitted to our clinic with complaints of protrusion of eyes and uncomfortable machinery noise over the right retromastoid region.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Functional recovery following surgical removal of traumatic epidural hematoma--factor analysis].

UNLABELLED: Factors contributing to functional recovery following evacuation of epidural hematoma were analyzed in 53 subjects. Subjects were limited to the cases with "pure" epidural hematoma. Fifty-three cases were classified into 3 groups based on presence or absence, and duration of preaggravation period (PAP) following occurrence of head trauma (Fig. 1). Level of consciousness at operation and at PAP is summarised in Fig. 2. Major neurological signs at operation are summarized in Table 1. Gradings of functional status were divided to 6 (Table 2). Gradings of 53 subjects which were judged 1 month after removal of epidural hematoma are summarized in Fig. 3. RESULTS: 1) As to outcome in relation to duration of preaggravation period (PAP) and consciousness level at operation (Fig. 4): The patients whose PAP was shorter and whose consciousness level at operation was more severe, took outcome of lower (worse) gradings. 2) As to outcome in relation to interval from the end of PAP to operation and PAP (Fig. 5): The patients whose PAP are within 3 hours, took outcome of relatively good recovery only when epidural hematoma was removed within 5.5 hours after the end of PAP. 3) As to outcome in relation to interval from the end of PAP to operation and consciousness level at operation (Fig. 6): The patients whose consciousness level at operation was better than semicoma took good recovery when epidural hematoma was evacuated within 5.5 hours after the end of PAP. This was right even in the patients who presented with decerebrate posture.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Surgical management of trigeminal neuralgia, hemifacial spasm, paroxysmal tinnitus and nystagmus by neurovascular decompression].

Trigeminal neuralgia, facial spasm, tinnitus, vertigo, and glossopharyngeal neuralgia are believed to be the symptoms complex of hyperactive dysfunction of the cranial nerve caused by vascular cross compression at the root entry (exit) zone of the appropriate nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al (1975). From their experiences of surgery, they emphasized that these symptoms were relieved by surgery. In this report, we will discuss the etiology of the disease, the neurotological examination, the angiographic findings, the operative findings and results in a series of 10 patients who have undergone neurovascular decompression. The series consisted of 4 cases with trigeminal neuralgia, 5 cases with facial spasm, and 1 case with paroxysmal tinnitus accompanied by facial spasm. The postoperative progress in these all patients was excellent and relieved of the symptoms. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia and facial spasm, because the surgery can be performed easily and safely by the neurosurgeons. The indication of the neurovascular decompression for the acoustic nerve and glossopharyngeal nerve is still controversial. In our own case, tinnitus was paroxysmal and complicated with facial spasm, not synchronous with facial spasm, but with nystagmus. This selective synchronism between tinnitus and nystagmus is a particular feature of our clinical instance. This particular clinical experience may provide some highly significant suggestions in considering the applicability of neurovascular decompression to the acoustic nerve.

Aged↗
PubMed1983

[Application of topographic mapping of electroencephalogram to cerebrovascular diseases].

Not a little difficulties lie in extraction of useful information by visual inspection alone from massive amount of data contained in multichannel polygraphic recordings of electroencephalography (EEG). Therefore, an effort to summarize conventional EEG and to demonstrate it semi-quantitatively has been made by many investigators and recently topographic mapping of EEG (TME), which is able to display equipotential maps of square roots of power spectra over each frequency band on computer-driven color video screen, has been designed. This system was clinically applied to the 16 patients who developed cerebrovascular disease with supratentorial lesions. (1) Slow wave focus was more obviously visualized on delta and/or theta bands of TME compared to visual inspection of conventional EEG in 8 cases out of 16. Also, suppression of alpha wave was beautifully demonstrated in 12 cases out of 16. The fact indicates that TME is useful as a sensitive detector of suppressed neuronal function. (2) Improvement of both TME and clinical signs after oxygenation at high pressure (case 3), carotid endarterectomy (case 1) and bypass surgery (case 6) were well correlated. The fact indicates that TME is one of the acceptable objective parameters for assessment of efficacy of various therapies. (3) TME was employed as a test evaluating effectiveness of bypass operation. This test was performed by compressing anastomosed superficial temporal artery (STA) for 10 minutes and change of TME after compression of STA was observed. In case 2 and 15, suppression of alpha activity was obviously noted in the occipital area ipsilateral to the STA compression following compression of STA, which suggested that these 2 cases depend hemodynamically on the anastomosed STA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗