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Biomedical subjects

S Kuramoto

Publications and source records attributed to S Kuramoto.

At least 109 records · Page 6Linked to original sources
PubMed1988

[A case of acute subdural hematoma associated with convexity meningioma].

A 61-year-old normotensive woman was admitted to our hospital with complaints of severe headache and nausea. She has had a limp due to the poliomyelitis in her childhood. Three days before admission, she had a headache without unconsciousness. On admission, she was almost alert. Her vital signs were normal. A mild monoparesis of the atrophic right lower extremity was evident. This impairment was due to her past poliomyelitis. There were no other motor palsy, sensory loss, nuchal rigidity, and papilledema. A plain CT scan showed a crescent high density zone adjacent to a round high density mass in the left convexity. A cerebral angiogram showed a vascular left temporoparietal mass supplied by a middle meningeal artery. A craniotomy was then immediately performed. The well encapsulated tumor was totally resected, and the adjacent subdural hematoma was also evacuated. Histologically, the tumor was transitional meningioma with areas containing thin-walled vessels and focal necrosis. Postoperative course was uneventful. The origin of hemorrhage in this case would seem to be the thin-walled blood vessel with loss of vessel support. The clinical significance and the mechanism of the hemorrhage from the meningioma were discussed.

Acute Disease↗
PubMed1988

[A case of duplication of the middle cerebral artery associated with arteriovenous malformation of the temporal lobe].

A rare case of duplication of the middle cerebral artery associated with an arteriovenous malformation of the left temporal lobe is reported. A 45-year-old man was admitted to our clinic on January 7, 1985 with a history of sudden onset of headache and nausea, followed by loss of consciousness for 20 minutes. Neurological signs were negative on admission. An arteriovenous malformation of the left temporal lobe fed by a duplicated middle cerebral artery and the original MCA were demonstrated on left carotid angiography. No other vascular lesion was observed on the angiograms. The arteriovenous malformation was successfully removed on January 17, 1985. Postoperative course was uneventful. Embryological relation of duplication of the middle cerebral artery to other cerebrovascular anomalies is briefly discussed.

Cerebral Angiography↗
PubMed1987

A new instrument for noninvasive measurement of intracranial pressure through the anterior fontanel. I. Preliminary report.

A pressure sensor has been developed with which intracranial pressure of infants with open anterior fontanell can be measured. The sensor consists of a light, small strain-gauge transducer (Statham P-50, Gould, USA), supported by a thin phosphorus bronze sheet having a strong spring quality characteristic. The light and small assembly, which weighs only 2.55 g, allows lengthy, continuous measurement with little drift. It eliminates almost any gravitational component in the recorded pressure. The thermal influence is also minimal and the thermal equilibrium is reached within 10 min. The sensor is precise and accurate in a range from 0 to 500 mm H2O, with excellent linear response. This newly developed fontanel pressure sensor has been successfully applied without the need for surgical procedures previously required to measure intracranial pressure.

Body Temperature↗
PubMed1987

A clinicopathological study of post-bulbar duodenal ulcer--analysis of 6 cases and comparison to usual chronic duodenal ulcer.

We investigated the functional and morphological aspects of acid secretion in 6 patients with post-bulbar duodenal ulcer and compared the findings with the events of 40 patients with the usual chronic duodenal ulcer. The post-bulbar ulcer patients showed a much higher acidity, and a biphasic, prolonged acid secretion pattern, presumably representing an enhanced parietal cell function. Histological study of antrectomized specimens revealed that 4 of those with the post-bulbar ulcer had a small antrum in which the fundic gland area expanded distally. The proximal border of the pyloric gland area was within 4 cm of the pylorus. This would suggest the presence of a large parietal cell mass. On the contrary, however, there was no such instance in those patients with the usual duodenal ulcer. Hyperacidity, due to a large parietal cell mass and an enhanced parietal cell function, may play an important role in the pathogenesis of post-bulbar duodenal ulcer.

Adult↗
PubMed1987

Granulomas of the gut in Crohn's disease. A step sectioning study.

To investigate the distribution of granulomas in Crohn's disease, a step sectioning study of the surgically resected intestines was carried out. This study proved that granulomas in Crohn's disease are found in the seemingly uninvolved intestinal mucosa as well as in the affected mucosa. Granulomas in the apparently involved mucosa were close to the mucosal surface (less than 500 microns) and small (80 to 160 microns across), while in the affected mucosa they were farther away from the mucosal surface (more than 500 microns) and larger (more than 160 microns across). We emphasize that these small granulomas, namely microgranulomas, in the apparently uninvolved intestinal mucosa, are of great value in diagnosing Crohn's disease.

Adult↗
PubMed1987

[Follow-up study of inaccessible giant aneurysms of the intracranial internal carotid artery].

Inaccessible giant aneurysms of the internal carotid artery had been treated with various methods. But these results are not always satisfactory. To determine the optimal treatment for these aneurysms, long-term follow-up study was carried out in 8 patients. They included 7 females and one male with ages ranging from 18 to 72 years. The aneurysms arose at the cavernous portion in 6 patients, at bifurcation of the posterior communicating artery and the ophthalmic artery in 2 patients. All but 2 patients had multiple cranial nerve palsies before admission. Those patients younger than 60 years had the ligation of the internal or common carotid arteries with or without EC-IC bypass. The others had conservative treatments including repeated Matas test. Follow-up period was 17 to 112 months after discharge. Follow-up results showed gradual decrease of the size of the aneurysms on CT scan and improvement of signs in all 3 operated cases. But only one aged patient who had repeated Matas maneuver had spontaneous improvement of her signs. There was no improvements in the others with conservative treatment. From the results of the present study, we would like to recommend carotid ligation with EC-IC bypass for the patients younger than 60 years after preoperative balloon occlusion test. When the patients were intolerable in temporary balloon occlusion of the internal carotid artery, detachable balloon embolization or electrothrombosis with copper wire also will be the treatment of choice. In the aged patients with high surgical risk, repeated balloon occlusion test or Matas test seems to be effective to promote intra-aneurysmal thrombosis.

Adult↗
PubMed1987

[Treatment of acute subdural hematoma with low GCS score].

In order to clarify the present problems in the treatment of acute subdural hematoma with low GCS score (5 or less), we studied the difference of the outcomes from two different surgical treatments for these patients. The present series included 30 patients who had GCS scores of 3, 4 or 5, and they were divided into two groups: 16 in DH group who had decompressive hemicraniectomy and 14 in HITT group who had hematoma irrigation with trephination therapy. The mean age of the patients was 47 years. They all had an intensive medical management including barbiturate therapy under intracranial pressure (ICP) monitoring after the operation. Time course of ICP after operation was classified as controlled, high but reduced and uncontrollable, based on the ICP level of 30 mmHg. The outcomes of the patients were determined by use of Glasgow outcome scale and classified into good, poor and dead. In these patients, the outcome was good in 13.3%, poor in 23.3% and dead in 63.4%. There was no survived case in those with GCS score of 3. The mortality rate in older patients over 60 years was high as 81.8%. ICP was well controlled in 2 patients (12.4%) in DH group. But there is no such case in HITT group. Uncontrollable ICP was more frequently seen in HITT group than in DH group. The patients showed different outcomes in the two types of treatment. Good outcome was found in 18.7% and the mortality rate was 56.3% in DH group. On the other hand, only one patient (7.1%) showed good outcome and the mortality rate of 71.4% in HITT group.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1987

[Assessment of functional status in children with brain tumors].

Thirty children treated for brain tumors between 1978-1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 +/- 16, performance IQ: 77 +/- 20, full scale IQ: 80 +/- 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P less than 0.01). Twenty-one (72%) children showed subnormal IQ scores (IQ less than 90) and 7 children showed normal IQ scores (IQ greater than or equal to 90). Concerning social and emotional function, twelve children (45.7%) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 +/- 13, performance IQ: 71 +/- 15, full scale IQ: 71 +/- 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P less than 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus, The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Medullary venous malformation with azygos anterior cerebral artery aneurysm: a case report].

A case of medullary venous malformation with azygos anterior cerebral artery aneurysm is reported, which was associated with the leptomenigeal angiomatosis on the cortex of the right frontal lobe. A 62-year-old female was admitted to the Kurume University Hospital on June 21, 1985, because of a convulsive seizure. On admission, neurological and general examinations, except for slightly liver function disorder, was no abnormality. Plain CT scan showed the cortical atrophy and two small high-density areas in the right frontal lobe. Enhanced CT scan showed a high-density area in the genu of the corpus callosum. MRI (magnetic resonance imaging), on T2 weighted image, showed a high signal intensity area in the right paraventricular deep white matter and the right frontal region. A right internal carotid angiogram in the venous phase showed numerous enlarged medullary veins in the deep frontal region, converging into a single large draining vein that empties into the basal vein of Rosenthal. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. Twenty eight days after admission, a right frontal cranioplastic craniotomy was performed. During operation, the surface of the right frontal lobe was covered by fine, vascular networks, which was reddish brown. A right frontal lobectomy, including venous malformation and vascular networks, was performed. The aneurysm was clipped via an interhemispheric approach. Histologically, the malformation vessels had spread into the subarachnoid space.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiomatosis↗
PubMed1987

[A case of bilateral absence of internal carotid with cerebral aneurysm].

A 52-year-old woman was referred to the Department of Neurosurgery, Saiseikai Fukuoka General Hospital because of the abnormal findings on CT from a private hospital. She had previously had two attacks of severe headache. In May 1985, she noted severe headache with vomiting and was transported to a nearby hospital. She was hospitalized there until CT was performed. On admission, she was clear in consciousness and complained of headache of moderate degree. Neurological examination was normal except for mild nuchal rigidity. A standard series of roentgenograms of the skull revealed a round calcified area in the supraclinoidal region. CT revealed a calcified lesion which must be a vessel in the chiasma cistern just adjacent to the basilar artery which was relatively larger than normal. Furthermore, no carotid canal was visible in the bilateral petrous bone by means of bony algorythum. Selective internal carotid angiographies were attempted. There was no evidence of an internal carotid artery on either sides. Furthermore,the ophthalmic arteries were fed via external carotid systems. A vertebral angiography demonstrated bilateral hypertrophy of the vertebral artery with an aneurysmal shadow in the left P1 of the posterior cerebral artery. The supratentorial circulation was maintained via the right posterior communicating artery in the right middle cerebral artery and the bilateral anterior cerebral arteries. On the other hand, the circulation of the left middle cerebral artery was maintained by the retrograde filling from the right anterior and posterior cerebral arteries. Operation was performed by left sylvian approach followed by subtemporal approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Carotid Artery, Internal↗
PubMed1986

Massive traumatic haematoma of the corpus callosum.

Five unusual cases with massive haematoma of the corpus callosum caused by blunt head trauma are presented. Aside from the callosal haematomas, intraventricular and subarachnoid haemorrhages or small haemorrhagic foci in the basal ganglia or thalamus were common concomitant lesions on the computerized tomographic (CT) scan. The sites of the impacts were the frontal and occipital areas which were close to the midline and above the level of the corpus callosum. Severe and diffuse brain dysfunction was suggested by the severity of the Glasgow coma score (GCS) and the abnormality on multimodality evoked potentials. An intensive medical treatment such as barbiturate could be promising since a direct surgical approach was dubious because of additional damage to the severely injured brain.

Adult↗
PubMed1986

Non-invasive measurement in intracranial pressure and analysis of the pulse waveform.

Non-invasive measurement of the intracranial pressure (ICP) via the anterior fontanelle by using an applanation transducer has been performed. Recently, a new fontanometer using an applanation transducer has been developed in our department by improving the conventional Statham transducer, P-50 which is currently accepted for its high reliability. In this study, by analysing patterns of the ICP pulse waves obtained from this new fontanometer, its clinical evaluation has been made in 27 neonates and infants in intracranial pathologies. Analysing the ICP waveforms, the first peak (P1) was divided by the following second peak (P2) and the changes in P1/P2 were examined. A differential amplifier, a dP/dt detector, was also used to make it easier to identify the turning point on the pulse waves. The results obtained demonstrated that the waveforms of ICP in neonates as well as infants are influenced by not only the intracranial constituents but compliance of the container such as the scalp, cranium and the meninges.

Acute Disease↗
PubMed1986

Analysis of epidural pressure pulse wave (EDP-PW) and common carotid blood velocity (CBFV) in acute intracranial hypertension.

The changes in the two consistent components of epidural pressure pulse wave (EDP-PW), P1 and P2 waves, and mean velocity of common carotid blood flow (CBFV) were studied in 21 patients with acute intracranial hypertension to investigate the origin of th the amplitude change in these components. The amplitudes of P2 wave increased progressively with the rise of EDP, but those of P1 wave remained nearly invariable at EDP of more than 20-30 mmHg which is incompatible with the changes in CBFV. Jugular vein compression caused in rapid rise of EDP and a proportionate increase in the magnitudes of both waves. Hyperventilation and mannitol administration caused a disproportionate reduction in the amplitudes of P2 wave with a fall of EDP. But mannitol at high EDP (more than 40 mmHg) caused a mild fall of EDP and some increase in the amplitudes of P2 wave. These results indicate that the variations in the amplitudes of P1 wave reflect the changes in vascular resistance of the large intracranial conductive arteries, while those of P2 wave result from the changes in the volume of the cerebral bulk. The increase in the amplitudes of P2 wave induced by mannitol at high EDP may suggest a defective autoregulation of the cerebral vessels.

Acute Disease↗