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Biomedical subjects

N Saeki

Publications and source records attributed to N Saeki.

123 records · Page 7Linked to original sources
PubMed1986

[Progressive dysautonomia in hemangioblastoma in the region of the fourth ventricle].

Tumors of the posterior fossa presenting orthostatic hypotension are rare and only nine cases have been reported so far. The locations of almost all these tumors were near the fourth ventricle and three of them were hemangioblastoma. A case of a tumor of the fourth ventricle showing autonomic disturbances mainly composed of orthostatic hypotension is reported. A 42-year-old male was admitted to the Department of Neurology of Chiba University Hospital on June 25th, 1981 because of three years' history of autonomic disturbances including orthostatic syncope, impotence, urinary disturbance and bowel dysfunction such as vomiting, diarrhea and constipation. He also complained of weight loss and staggering of gait to the left side. On admission, the patient was emaciated being 50 kg in weight and 172 cm in height. Neurological examination revealed hippus of bilateral pupils in light reflex, saccadic eye movement, slightly hypoactive deep tendon reflexes, mild terminal oscillations in bilateral finger-to-nose test, oscillation in the left heel-to-knee test, staggering tendency of gait to the left, slightly impaired tactile and thermal sensations in distal parts of the legs. Autonomic disturbances were showed by orthostatic hypotension (BP 104-50 in supine and 70-40 in sitting position), impotence, weight loss, anorexia, decrease of sweating, spontaneous yawning and loss of sensation of bladder fullness. About 5 weeks after admission, he began to complain of temporal headache and showed impairment of memory, drowsiness, paroxysmal apnea and papilledema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Island groin flap.

An island groin flap was used for satisfactory reconstruction of defects in the anterior thigh, lower abdomen, or perineal regions in 9 patients. This flap has several advantages: simple operation, wide range of coverage, large rotation arc, direct closure of the donor site, and no sacrifice of muscle. Comparison with tensor fascia lata and other musculocutaneous flaps is made.

Adult↗
PubMed1985

[Neurinoma with intrasellar extension: a case report].

A 64-year-old female visited Kawatetsu Chiba Hospital complaining of left retro-orbital pain. A month before, she had experienced ptosis and diplopia, that had been releaved two days later by corticosteroid. On admission, she had no neurological deficits except for minimal anisocoria, with the left pupil larger than the right. There was no cutaneous manifestation of von Recklinghausen's disease. Skull X-ray films showed depression of the floor of the sella turcica on the left side. CT scans demonstrated a parasellar enhancing mass with intrasellar extension. Left carotid angiogram showed intracavernous portion of the internal carotid artery displaced laterally, inferiorly, and anteriorly. With a tentative diagnosis of laterally extending pituitary adenoma, a transsphenoidal operation was carried out, which disclosed a solid tumor locating beside the medially-displaced pituitary gland. The histological diagnosis was typical neurinoma. Parasellar neurinoma is not so common. It is usually difficult to determine the origin of the parasellar neurinoma. Trigeminal neurinoma arising from the Gasserian ganglion is generally recognized to be the most frequent. However, the absence of the trigeminal nerve involvement, unusual CT findings, and angiographical changes in the present case were all different from those of the typical trigeminal neurinoma. We believe that the tumor of this case originated from the oculomotor nerve. Fifteen cases of neurinoma of the oculomotor, trochlear, and abducens nerve have been reported to date. Their clinical features were reviewed.

Brain Neoplasms↗
PubMed1981

[Superior Foville syndrome after clipping of basilar bifurcation aneurysm--case report (author's transl)].

The patient was a 48-year-old housewife, who had a sudden onset of severe headache followed by loss of consciousness for a few hours on the day of admission. Initially she showed slight restlessness due to headache, neck stiffness and subhyaloid hemorrhage. Four-vessel study revealed a basilar aneurysm on right retrograde brachial angiography and anterior communicating aneurysm on left carotid angiography. Two weeks after the onset, when she had no neurological deficit except for intermittent appearance of disorientation, both aneurysms were successfully clipped through right pterional approach of Yasargil. The subarachnoid hemorrhage was apparently due to basilar bifurcation aneurysm. Postoperatively, she showed right hemiparesis including her face, aniscocoria (left, 4 mm, oval: right, 1.5 mm, round) and conjugate deviation toward the left. The disturbance of conjugate eye movement and the hemiparesis completely disappeared in 2 and 7 days respectively. The patient was discharged 4 weeks postoperatively with mild left 3rd nerve palsy. At present, one year postoperatively, she is fully engaged in her housewife life without any neurological deficits. A case of superior Foville syndrome combined with Weber syndrome after clipping of basilar bifurcation aneurysm was reported and its anatomicoclinical mechanism was reviewed. The pathogenesis was supposed to be left midbrain ischemic lesion due to circulatory disturbance of P-1 perforators (P-1: proximal posterior cerebral artery); e.g., occlusion on clipping of vasospasm. This P-1 perforator syndrome after aneurysmal clipping has been reported only little. The importance of preservation of these perforators with careful dissection and manipulation under microscopy was emphasized.

Basilar Artery↗
PubMed1981

[A case of hematoma localized to midbrain tegmentum following closed head injury (author's transl)].

UNLABELLED: CASEs of primary brain stem lesion following closed head injury, verified on CT scan, have been increasingly reported recently. However, most of them have supratentorial lesions in addition to brain stem, resulting in a poor outcome. In this paper, a case of localized brain stem hematoma following closed head injury, is reported based on CT findings. CASE: A 26-year-old man slipped down on his back and hit the right occipital area with following loss of consciousness for several minutes. Since then, he continued to have gait disturbance and visited our hospital on the next day. On admission, he presented truncal ataxia, left trochlear nerve palsy, right Horner's syndrome and left hemihypesthesia. CT scan revealed a small hematoma localized to the right midbrain tegmentum at the level of inferior colliculus, well correlating with his clinical presentation. He gradually improved on conservative treatment and returned to his former work one month after the accident. This case suggests that there may be cases of primary brain stem injury with no other intracranial lesion based on CT findings and with a good prognosis. Shear strain is said to be a probable mechanism for explaining brain stem injury, which is usually combined with other parenchymal lesions. In our case, however, more focal factor--nervous and/or vascular compression against the tentorial edge--is suspected for producing this localized midbrain lesion.

Adult↗
PubMed1979

Subacute bilateral epidural hematomas in an infant.

Subacute bilateral epidural hematomas in a two-year-old girl are presented. No similar case in this age group has been reported. CT scans may increase the detection of bilateral epidural hematomas in children in the future. The diagnostic and therapeutic characteristics of epidural hematoma in children are discussed.

Age Factors↗
PubMed1977

Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis.

The microvascular anatomy of the posterior part of the circle of Willis, important in surgery of pituitary tumors and basilar aneurysms, was defined in 50 cadaver brains. Significant findings were as follows: 1) Anomalies of the posterior half of the circle of Willis were found in 46% of cases. 2) Hypoplastic P-1 (posterior cerebral segment) and posterior communicating segments gave origin to the same number and size of perforating arteries, having the same termination as normal-sized segments. Thus hypoplastic segments should be handled with care and divided to aid in exposure of the basilar bifurcation only after careful consideration. 3) An average of four perforating branches arose from P-1; most from the superior and posterior sufaces. No branches arose from the anterior surface of the basilar bifurcation. The most proximal P-1 branch originated 2 to 3 mm distal to the basilar bifurcation. It was most commonly a thalamoperforating artery. The largest P-1 branch was usually a thalamoperforating or a posterior choroidal artery. 4) An average of seven branches emerged from the superior and lateral surfaces of the posterior communicating artery. The anterior half was a richer source of perforators than the posterior half. The largest communicating branch in 80% of specimens supplied the premamillary area. 5) The anterior choroidal artery originated from the carotid artery on both sides in all cases. A double anterior choroidal artery was present in 4% of cases.

Adult↗