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T Isu

Publications and source records attributed to T Isu.

At least 109 records · Page 6Linked to original sources
PubMed1986

[CT-myelography of cervical cord injury].

UNLABELLED: We reported seven cases of acute cervical cord injuries who were examined by CT-Myelography (CTM) within 7 days after trauma. The presence or absence of spinal cord enlargement, the initial neurological status and the neurological prognosis of these patients were studied. The neurological status of each patient was graded by the method of Frankel who defined five grades from A to E according to the severity of neurological deficits. Seven patients were all males. The youngest was 18 and the oldest was 73 years old, with a mean age of 40.7 years. Follows up periods ranged from 7 to 23 months. RESULT: CTM revealed the enlargement of spinal cord in two cases, who had severe neurological deficits and were graded to A. No neurological improvements were obtained in these cases. Five cases without cord enlargement were graded to A in one patient, B in one patient and C in three patients. Four of these five patients improved neurologically. One grade C patient remained grade C. Complete block of subarachnoid space was observed in two out of seven cases. Cord enlargement was present in one of them. Another case of complete block improved from C to D. CONCLUSION: We consider the presence of cord enlargement which can be demonstrated by CTM well correlates the severity of the cord damage and presume poor neurological prognosis. Internal decompression, such as posterior longitudinal myelotomy may be recommended to the case of cord enlargement. When the cord enlargement is absent, improvement of neurological grade is expected although the initial neurological status shows severe deficits.

Adolescent↗
PubMed1986

[Spinal dural AVM--report of three cases].

A new type of spinal AVM is reported. The characteristics are as follows: All the patients are male over 50-years-old. Their symptoms are insiduous and progressive ischemic pattern. All the lesions locate at the thoracic and lumbar levels. Selective intercostal angiography shows a fistulous AVM adjacent to the intervertebral foramen fed by spinal dural branch and drain into tortuous veins on the spinal cord via radiculomedullary vein. No typical hair-pin configuration by radiculomedullary and spinal cord arteries contributes to the AVM. This type of spinal AVM must be distinguished from so-called singled coiled type spinal cord AVM since pathophysiological features presumably are different from each other; the former is "dural" on anatomical basis, whereas the latter is "pial". Embolization should be recommended as a first choice of treatment to spinal dural AVM.

Aged↗
PubMed1985

Spinal cord and root injuries due to glass fragments and acupuncture needles.

The authors report four cases of extremely rare spinal cord injuries due to foreign bodies. These include one case of injury to the spinal cord caused by glass splinters from a shattered automobile windshield, two cases of spinal cord injury resulting from acupuncture needles, and one case of spinal nerve root injury by acupuncture treatment. The mechanism of occurrence of delayed myelopathy or progressive symptoms, which appeared after acupuncture treatments in two cases, are discussed.

Accidents, Traffic↗
PubMed1985

Paroxysmal tinnitus and nystagmus accompanied by facial spasm.

A case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, in which neurovascular decompression was performed, is reported. The paroxysmal tinnitus and nystagmus were synchronous with each other. Horizontal nystagmus with a rotary component was found to be counterclockwise during the brief attack of tinnitus, whereas its direction became clockwise while free of tinnitus. The patient has been postoperatively relieved not only of the facial spasm, but also of the tinnitus and nystagmus. The mechanism of the occurrence of the syndrome and the significance of the neurootologic examination are discussed.

Arteries↗
PubMed1985

CT myelography with intramedullary enhancement in cervical spondylosis.

The authors describe seven cases of cervical spondylosis in which small high-density areas were detected in the spinal cord on delayed computerized tomographic (CT) myelography. These high-density areas are believed to represent cavities or areas of cystic necrosis. In all seven cases the cervical spinal canal was narrow, and the spondylosis was located at multiple levels, causing a so-called "pincer effect." On the CT scans the high-density areas resembled fried eggs in the gray matter. These areas were localized near the abnormal cervical discs. In two cases in which the Brown-Séquard syndrome was noted, the symptoms could be attributed to the morphology of the high-density area on the affected side of the cord. Following decompressive surgery, most of the symptoms improved except for numbness of the upper extremities and motor weakness of hands.

Aged↗
PubMed1985

[External immobilization of cervical spine with a halo vest--experience with 31 cases].

Post-traumatic or post-operative immobilization of cervical spine often requires long term bed-rest. But, bed-rest indeed gave discomfort to patients, nonetheless, sometimes complete external fixation cannot be gained. Since 1982, we have applied Halo vest to the patients who required external immobilization of cervical spine. In this paper, we reported our experiences with 31 cases who were treated by Halo vest. Thirty-one cases comprised 19 cases of cervical spinal trauma, 5 cases of atlanto-axial dislocation, 1 case of foramen magnum meningioma, and 6 cases of ossification of posterior longitudinal ligament (OPLL). In traumatic cases, Halo vest was used as external fixation of injured spine in 8 cases, and as an adjunct to surgical fusion in other cases. In case of atlanto-axial dislocation, 3 cases underwent posterior fusion, and 2 cases underwent anterior fusion. Anterior fusion of C1-2 was also done in case of foramen magnum meningioma after total excision of tumor. Six cases of OPLL underwent anterior decompression and anterior fusion. Mean immobilization time by Halo vest was as follows: 58 days (28-113) in case of cervical spinal trauma, 85 days (56-144) in case of atlanto-axial dislocation who underwent posterior fusion, 92 days (89-93) in case of atlanto-axial dislocation and foramen magnum meningioma who underwent anterior fusion, 59 days (54-70) in case of OPLL. Early ambulation was achieved in many cases. Good external fixation and result was obtained 27 cases out of 31 cases. Re-dislocation of cervical spine occurred in 1 case of cervical spinal trauma while he was in Halo vest.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Surgical treatment of trigeminal neuralgia--neurovascular decompression established by Jannetta].

The etiology of trigeminal neuralgia has been unknown. However, recently, trigeminal neuralgia is believed to be caused by vascular cross compression at the root entry zone of the trigeminal nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al. They emphasized that the pain was relieved by surgery. In this report, we will discuss the operative findings and results in a series of 8 patients who have undergone neurovascular decompression. The postoperative progress in all of these patients was excellent and relieved of the pain. 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.

Adult↗
PubMed1984

[Computed tomography in lumbar degenerative disease].

We reported the 18 patients which underwent surgical exploration and reviewed these CT findings. Method. All CT scans were obtained on Somatom II, high resolution CT scanner, with the patient in the supine position. A lateral localizer image (Topogram) was used to select the appropriate intervertebral disk space. The slice thickness was 4 mm. Results. CT findings in lumbar degenerative diseases include bony canal stenosis (central canal stenosis, narrowed lateral recess), soft tissue abnormalities (herniated nucleus pulposus, bulging annulus, hypertrophy and/or ossification of ligamentum flavum, no delineation of nerve root in lateral recess), and spinal instability (spondylolisthesis, vacuum phenomenon). The above three factors contribute to narrowing of spinal canal. No delineation of nerve root or soft tissue replacement of epidural fat in lateral recess suggests that the nerve root may be compressed by some factors. Herniated nucleus pulposus may cause nerve root compression with or without canal stenosis. Conclusion. This study revealed that the CT findings correlated closely with the surgical findings and the site of nerve root compression could be determined.

Adult↗
PubMed1984

[The diagnosis and pathogenetic study of syringomyelia].

Thirteen cases of syringomyelia which was confirmed by metrizamide CT myelography (MCTM) were reported. Nine cases were associated with Chiari malformation, and four were idiopathic type. Delayed CTM which were performed in several hours after the metrizamide myelography disclosed not only the existence of the syrinx but its shape and location. From the investigation of their clinical findings together with the appearance of their syrinx on CT scan, the following results were obtained. The syrinx was not always situated centrally within the cord, but had laterality at some spinal level in nine out of thirteen cases. The main laterality of the syrinx seemed to be located in the posterior horn. In the cases which had unilateral dissociated sensory disturbance, the laterality of sensory disturbance corresponded with the side of syrinx. These results suggested the possibility that the intrathecal injected contrast materials entered into the syrinx via the dorsolateral sulcus of the cord rather than via IV ventricle in some cases.

Adolescent↗
PubMed1984

[A case of paroxysmal tinnitus and nystagmus accompanied by facial spasm].

Trigeminal neuralgia and facial spasm are usually caused by cross vascular compression of the trigeminal root entry zone and facial nerve exit zone. A similar mechanism is believed to affect the acoustic nerve as well, giving rise to tinnitus and nystagmus. We present one case of paroxysmal tinnitus and nystagmus, accompanied by facial spasm, and discuss the mechanism and the significance of the neurotological examination.

Arteries↗
PubMed1983

High resolution computed tomography in the diagnosis of cervical disc disease.

In this study, the authors evaluate the importance of computed tomography (CT) in 15 patients who underwent surgical treatment for cervical disc disease. In nine operated on by an anterior approach, all CT examinations were interpreted as positive for disc herniation and correlated precisely with surgical observations. CT demonstrated protrusion of the disc, centrally in four and posterolaterally in five in all of whom disc material was found posterior to the vertebral body. Of six who underwent laminectomy, either thickening or calcification of the ligamentum flavum was demonstrated by CT and confirmed at surgery in five. Vacuum phenomenon in the intervertebral space and hypertrophy of the intervertebral joint were not infrequently associated. CT can exactly delineate cervical disc lesions and associated pathological changes.

Cervical Vertebrae↗
PubMed1983

Computed tomographic findings of vacuum phenomenon in cervical intervertebral disks.

A gaseous collection in the intervertebral space, or the vacuum phenomenon, was observed on computed tomograms in as many as 30% of the patients with cervical disk disease. The condition most frequently occurred at the level of C5-6. The gas tended to accumulate more often at the marginal region of the intervertebral disks, the level at which marked degeneration was seen; thus, it may be related to cracks within not only the nucleus pulposus, but also in the annulus fibrosus.

Aged↗
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

[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↗