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Biomedical subjects

T Kayama

Publications and source records attributed to T Kayama.

At least 109 records · Page 6Linked to original sources
PubMed1991

Early CT features of ruptured cerebral aneurysms of the posterior cranial fossa.

This report describes our retrospective evaluation of CT features of the acute phase in 34 cases of ruptured cerebral aneurysms of the posterior cranial fossa. The results are as follows. 1. Examination of cisternal haematoma distribution revealed that SAH had extended to the supra- and infratentorial cisterns in 28 cases (82%). There were only 6 cases (18%) in which SAH was confined to the posterior cranial fossa only but even when there was subarachnoid haematoma in both the supra- and infratentorial cisterns, thick haematomas were seen at the periphery of the brain stem. In cases of vertebral artery-posterior inferior cerebellar artery aneurysms (VA-PICA AN), haematomas in the ambient cistern were thicker on the aneurysm side. In addition, in cases of basilar artery-bifurcation (BA-Bifurcation AN) and basilar artery-superior cerebelli artery aneurysms (BA-SCA AN), there were many thick, high-density haematomas in the interpeduncular cistern. 2. The rate of intracerebral haemorrhage was extremely low (1 patient). 3. The rate of intraventricular haemorrhage was high, and these haemorrhages demonstrated a reflux pattern. 4. The rate of hydrocephalus was high (76.5%) in comparison with that noted in association with SAH due to the rupture of anterior circulation aneurysms.

Adult↗
PubMed1991

Intratumoral oxygen pressure in malignant brain tumor.

Oxygen pressure (pO2) in brain tumors, pO2 in brain cortex surrounding the tumors, and PaO2 were measured simultaneously during total resection in 16 patients with previously untreated brain tumors in order to detect hypoxic regions within the tumors. When the inhaled O2:N2O ratio was 1:3 under enflurane anesthesia, mean PaO2 was 109.2 +/- 5.8 mm Hg, a rather high value when compared with that obtained when air is inhaled under atmospheric pressure. The simultaneously measured intratumoral pO2 and pO2 in brain cortex surrounding the tumor were 15.3 +/- 2.3 and 59.8 +/- 6.5 mm Hg, respectively. Each intratumoral pO2 value was significantly lower than that of pO2 in brain cortex surrounding the tumor (mean less than 30 mm Hg, Wilcoxon signed rank test, p less than 0.005) and influenced the oxygen effects on radiation. These results appear to confirm that there are hypoxic regions within human brain tumors. A comparison between intratumoral pO2 and either the angiographic or contrast-enhanced computerized tomography scans of the tumor vasculature disclosed no correlation.

Adolescent↗
PubMed1991

[Dissecting aneurysm of distal posterior inferior cerebellar artery--case report and review of the literature].

A rare case of dissecting aneurysm of distal posterior inferior cerebellar artery (PICA) is reported. A 51-year-old woman was admitted to our hospital complaining of severe headache and nausea. CT scan revealed subarachnoid hemorrhage which was thicker in the posterior fossa. The vertebral angiography demonstrated an aneurysm on the telovelotonsillar segment (Lister's classification) of the left PICA. On the third day, the left suboccipital craniotomy was performed and the fusiform aneurysm was resected. The postoperative course was uneventful. Histological examination of the resected aneurysm showed a dissection between the ruptured elastic lamina and the tunica media. Dissecting aneurysm of distal PICA is still belong to a rare entity. In all three cases found in the literature, the dissecting aneurysms are sited in the anterior medullary segment of PICA. Probably, this is the first report described a dissecting aneurysm on the more distal part-telovelotonsillar segment of PICA. The clinical features, pathogenesis and treatment of intracranial dissecting aneurysms are briefly discussed with reviewing the literature.

Aortic Dissection↗
PubMed1991

[Aneurysms of the distal posterior inferior cerebellar artery; the report of 10 cases].

Non mycotic and non traumatic distal posterior inferior cerebellar artery (PICA) aneurysms are rare, but eleven aneurysms in ten cases were reported. They all originated from subarachnoid hemorrhage due to rupture of these aneurysms. The patients in these cases were all admitted within 5 days after the onset. The neurological state of four cases on admission was grade 4 or 5 in Hunt and Kosnik's grading system. Two patients of grade 5 died within 24 hours after the onset. The CT scan on admission revealed heavy subarachnoid hemorrhage mainly in the posterior fossa. In severe cases, ventricle hematoma, cerebellar hematoma and/or subdural hematoma were evident in the posterior fossa. The locations of these eleven aneurysms were as follows: On the bifurcation of the Telovelotonsillar segment in six cases. In the cortical segment in three cases. In the anterior medullary and tonsillomedullary segment in one case. Six saccular aneurysms were situated on bifurcations of parent arteries but three saccular aneurysms did not arise from bifurcations. Two of them were not from turning points of the arteries. One fusiform aneurysm situated on the bifurcation of telovelotonsillar segment was excised, and histologically shown to be a dissecting aneurysm with hypoplasia of elastic lamina and tunica media in the parent artery. Three cases were associated with small AVM located on the superior surface of the cerebellar vermis and fed mainly by the superior cerebellar artery (SCA) in two cases, and by SCA and PICA in one case. In these cases the hemodynamic stress on PICA did not seem to increase so remarkably.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Superior petrosal sinus dural arteriovenous malformation with varix indenting brain stem--report of a case and review of the literature].

A rare case of the dural AVM mainly around the left petrosal sinus was reported. A 64 years old man was admitted just after the sudden onset of severe headache and nausea. The CT scan revealed subarachnoid hemorrhage in the left ambient cisterns. A small hematoma was also found in the left cerebellar peduncle. External carotid angiogram showed a dural AVM which nidus was located adjacent to the left superior petrosal sinus. Its feeding arteries were as follows; the middle meningeal artery, the artery of foramen rotundum, the accessory meningeal artery, the dural branch of occipital artery and the ascending pharyngeal artery. The voluminous petrosal vein and the dilated cortical veins were identified as drainers and, the portion of the latter appeared as "varix" embedded in the pons, which was clearly delineated by MRI. In the venous phase, stenotic straight sinus and residual Falcine sinus were illustrated. Superselective embolization of the feeding arteries was employed followed by the direct clippings of draining vein. Postoperative course was uneventful. The present case should be classified into the tentorial dural AVM. Only 26 cases of this rarely encountered entity was reported in the literature. Based on both the present and the previously reported cases, the clinical features, treatment and pathogenesis of this disease were briefly discussed.

Brain Stem↗
PubMed1990

[A case of recurrence of a metastatic brain tumor which disappeared due to chemotherapy only].

A rare case of recurrence of a metastatic brain tumor which disappeared due to chemotherapy only is reported. A 52-year-old male was noticed to have an abnormal shadow in his chest X-P at a routine medical examination, so a close examination was made. He was diagnosed as having right renal cell carcinoma which had metastasized to the lung. He was treated by intra-arterial infusion of anti-cancer drugs and embolization of the right renal artery. No renal symptom was seen, growth of the primary tumor stopped, and the abnormal shadow in his chest diminished. However, weakness in the left hand appeared 19 months after the first examination and he was admitted to our clinic. He was alert, but slight left hand weakness was observed. CT scan revealed a diffusely enhanced mass in the right parietal lobe. Total removal of the brain tumor was performed and the histology was metastasis of renal cell carcinoma. He was discharged and was able to walk but he had slight left hemiparesis. UFT 6 capsules a day were administrated in our out-patient clinic. However, CT scan revealed recurrence of the tumor 2 weeks after discharge, we followed up with conservative treatment, and no growth of the tumor was seen. It disappeared 5 months after discharge after being treated with UFT only. We regard UFT as having been effective in this case.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Influence of superior cervical ganglion on cerebral hemodynamics--measurements of cerebral blood flow and metabolism during superior cervical ganglionectomy in patients with moyamoya disease].

The effect of superior cervical ganglionectomy (SCG) on cerebral blood flow and metabolism was investigated in moyamoya disease. Measurement of cerebral blood flow and metabolism was performed in 12 cases (15 operations) of moyamoya disease during SCG. Mean age was 65.2 years (from 3 to 38). 4 were male and eight were female. Ischemic cases were 8 and hemorrhagic cases were 4. At encephalo-duro-anterio-synangiosis, a Laser Doppler flow meter and probes for measuring cortical tissue oxygen and carbon dioxide were set out to allow measurement from identical sites on the surface of the brain over the cortex. Moreover, an electromagnetic flow meter was placed on the common carotid artery. And the mean arterial blood pressure was also measured from femoral artery. After the electrode had been stabilized, continuous recordings were made of cerebral blood flow and metabolism during SCG. The mean arterial blood pressure fell slightly post operatively, but the changes in blood pressure were considered not to be significant enough to affect blood flow. Cortical CBF did not change immediately after SCG. However it increased gradually to 118.8% of preoperation level 30 minutes later respectively, and the difference was observed significant. The carotid blood flow and the tissue oxygen developed a tendency to increase after 30 minutes, but the tissue carbon dioxide did not changed. The present study indicates that superior cervical ganglionectomy is the useful procedure to increase in cerebral blood flow immediately after the operation on patients with moyamoya disease.

Adolescent↗
PubMed1990

[Encapsulated chronic intracerebral hematoma caused by venous angioma of the basal ganglia: a case report].

A case is reported of venous angioma at the right basal ganglia simulating the encapsulated chronic intracerebral hematoma. A 29-year-old man was admitted to our hospital on July 14, 1988 with a two-month history of headache. Neurological examination revealed left homonymous lower quadrantic anopsia. CT scans showed a mosaic high density lesion at the right basal ganglia with extensive adjacent edema. MRI revealed that the high density lesion on CT scans was the combination of a reticulated core of mixed signal intensity with a surrounding rim of decreased signal intensity. The lesion was accompanied with extensive edema. Followed up CT scans showed the transformation of the lesion and ring-shaped enhancement. A right frontotemporal craniotomy was performed on August 9, 1988. After thorough dissection of the sylvian fissure and small corticotomy to the insula, a tough capsule was seen. There was blood in various stages of organization in the capsule. A histological examination gave a diagnosis of venous angioma in the membrane similar to the outer membrane of chronic subdural hematomas. Postoperatively, the patient showed slight left motor weakness, but it gradually improved and he was discharged on foot, on October 19, 1988. There have been a lot of reports about angiographically occult intracranial vascular malformation (AOIVM). But AOIVM at the basal ganglia is rare, and to our knowledge, only 8 cases have been reported. In our case, the presence of adjacent extensive edema, and ring-shaped enhancement on CT scans confused the preoperative diagnosis. Those findings might have been caused by encapsulation. By using CT scans and MRI, a complete and accurate diagnosis was impossible.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Homocystinuria accompanied with cerebral deep venous thrombosis--a case report].

Homocystinuria is an inborn error of methionine metabolism, of which cause is mainly deficiency of cystathionine synthetase. The major clinical manifestations of homocystinuria are mental retardation, seizures, ectopia lentis, skeletal deformities and occlusive vascular disease. A case of homocystinuria accompanied with deep cerebral venous thrombosis was reported. A 29-year-old woman was admitted to our hospital with unconsciousness and tetraparesis on December 7, 1984. She was diagnosed as homocystinuria due to cystathionine synthetase deficiency at 13-year-old. Amino acid analysis of serum revealed homocystinaemia (1.37 mg/dl, normal 0), hypermethioninaemia (1.27 mg/dl, normal 0.2-0.48) and low cystathionine content. CT scan revealed intraventricular hemorrhage and diffuse low density in basal ganglia and white matter. Cerebral angiograms showed that deep cerebral veins and superior sagittal sinus can not be recognized clearly in any phase, and Sylvian veins are opacified markedly. It is suggested that intraventricular hemorrhage, and low density area in basal ganglia and white matter is due to hemorrhagic infarction by venous thrombosis of internal cerebral vein. The major clinical manifestations of homocystinuria result from the elevated plasma homocysteine level. The excitotoxic effect of homocysteic acid accounts for mental retardation and seizures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Clinical analysis of etiology of spontaneous subarachnoid hemorrhage diagnosed by computed tomography].

In 575 cases with subarachnoid hemorrhage (SAH) diagnosed by computed tomography (CT) scan, four vessel cerebral angiography was performed several times at more than two-week intervals to investigate a source of the hemorrhage. The first four-vessel study on admission revealed 530 cases (92.2%) of ruptured cerebral aneurysms, four (0.7%) of ruptured arteriovenous malformation, 25 (4.3%) of unknown etiology. Repeated four vessel study showed eight (32.0%) aneurysms among 25 cases whose first studies were negative. Six of the eight cases had aneurysms in the vertebro-basilar system. In 11 cases, repeated four-vessel study failed to detect the hemorrhagic source; and no generalized diseases were noted. One of them had recurrence of SAH 19 months after the onset of the initial one. The patient was underwent operation, which showed thrombosed ruptured aneurysm. Our present investigation demonstrated that ruptured aneurysm was responsible for 94.8% of all 575 cases of SAH detected by CT scans and 10 cases (1.7%) were diagnosed as cases of SAH of unknown etiology.

Cerebral Angiography↗
PubMed1989

Regional cerebral blood flow with age: changes in rCBF in childhood.

Changes in cerebral blood flow (CBF) and regional cerebral blood flow (rCBF) throughout the entire age range including childhood were reported. The CBF in grey matter of children was markedly higher than that found in adults and showed a negative correlation with age. In contrast, the blood flow in white matter did not show a notable decrease with age. The regional distribution of CBF in children did not exhibit the frontal lobe dominance typical of adults. The rCBF pattern began to approach that of adults with growth and by 10 yr the rCBF pattern of children was similar to that of adults.

Adolescent↗
PubMed1989

[Analysis of PO2 in brain tumor and effectiveness of PFC (perfluorochemicals) to increase intratumoral PO2, blood flow and its clinical use].

The presence of hypoxic Zone in clinical brain tumor is verified. The value of intratumoral PO2 is about 16 mmHg under the condition with physiological PaO2. Perfluorocarbon, which can transport rich O2, was used to increase intratumoral PO2. Intratumoral PO2 increased to about 36 mmHg by using Perfluorocarbon with inhalation of O2. I conducted new Protocol, namely, irradiation method should be selected altered dose fractionation when hypoxic cell of the tumor change to normoxic cell. Perfluorocarbon was administered on the day when irradiation dose is high. Clinical result showed much better than previous our result, especially in the group of glioblastoma, the mean survival duration prolonged 8 months to 2 years.

Brain Neoplasms↗
PubMed1989

[A case of neonatal medulloblastoma].

A nine-day-old female with cerebellar medulloblastoma treated by surgical and radiation therapy is reported. She suffered from vomiting within a few days after birth. Subsequently, her head became enlarged and she was admitted to our hospital. CT scan on admission showed a large mass lesion at the cerebellum expanding to the pineal portion, and marked hydrocephalus. At the age of 14 days, a ventriculo-peritoneal shunt was carried out, and at the age of 67 days, radical resection of the tumor was performed. The histopathological diagnosis was medulloblastoma. Postoperatively, radiation therapy of the brain was carried out. Irradiated dose was 30 Gy on the whole brain and 20 Gy at the location of the lesion. She was discharged at the age of seven months. She remained in good condition with no neurological deficit except for nystagmus. One week later, it was found that she was unable to move her legs and she was readmitted to our hospital. CT scan showed no remarkable change in the intracranial region, but spinal cord swelling was revealed at the Th12-L5 level. Myelography showed a filling defect at the L3-5 level. Radiation therapy of the spinal cord was performed, and the paraparesis gradually improved. However, her general condition was getting worse, and the following CT scan showed intracranial recurrence of the tumor. She deteriorated day by day and at the age of 9.3 months she expired. Brain tumors during the neonatal period are very rare, especially neonatal medulloblastoma. Only 24 cases can be found in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebellar Neoplasms↗
PubMed1989

[Anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms].

A case of the anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms was reported. A 20-year-old female suffered from sudden onset of dysphagia and throat pain. Three days later, she was admitted to our hospital, suffering from sudden onset of headache, nausea, vomiting and consciousness disturbance. On admission, consciousness disturbance, bilateral abducent nerve palsy, and left caudal cranial nerve palsy was observed. CT scan revealed a subarachnoid hemorrhage in the basal cisterns with the densest area in the left ambient cistern. Left vertebral angiogram revealed an aneurysm at the left anterior inferior cerebellar artery (AICA). On the third day after admission, operation was performed. The aneurysm was found near the jugular foramen, surrounded by thick clots. The dome was attached to the caudal cranial nerves, and the neck was located at the bending portion of AICA without branches. Neck ligation and clipping was performed. On the fortieth day after the operation, the patient was discharged from our hospital without neurological deficits. To our knowledge, aneurysm at the AICA is rare and only 33 cases have been reported. However, a case with a sudden onset of caudal cranial nerve symptoms, before evident symptoms due to subarachnoid hemorrhage, has never been reported previously.

Adult↗
PubMed1988

A case report of a "necrotizing" entero-colo-proctitis in the adult.

We experienced a patient who died of diarrhea after an operation for glioblastoma. The mucosa of the small and large intestines were entirely denudated. Although the etiology is not clear, this case is supposed to be a very rare one of "necrotizing" enterocolitis in the adult occurring after an operation on a brain tumor.

Adult↗
PubMed1988

[The study of intratumoral PO2 in brain tumors].

The aim of this study was to evaluate the hypoxic cells in the human brain tumor in vivo. Untreated 16 cases of brain tumor were analysed. During the surgery for the purpose of removal of the tumor, needle type-O2 sensors were inserted into femoral artery and in brain tumor to measure PaO2 and intratumoral O2 pressure. A plate type O2 sensor was put on the surface of surrounding brain cortex to measure cortical O2 pressure. These O2 sensors for this study is able to measure O2 pressure continuously and to observe these three O2 pressure simultaneously. Operations were performed endotracheal anesthesia under inhalation of ethrane with maintaining systolic blood pressure 120 mmHg. Setting the rate of O2 and N2O gas inhalation 1/3, PaO2 revealed about 110 mmHg which is similar value as physiological state--1 ATM, air inhalation--. The value of TuO2 and BrO2 were revealed 15.3 +/- 2.3 (mean +/- SE) mmHg and 59.8 +/- 6.5 (mean +/- SE) mmHg. According to these results, it might be said that hypoxic fraction surely exist intratumoral tissue. It is also well known that O2 removes from higher pressure zone to lower pressure zone after O2 was diffused from red blood cell in brain tissue. It might be also mentioned that much lower hypoxic fraction than the value of this study is existing intratumoral tissue. It has long been recognized that hypoxia influences the response of cells and tissues to radiation. However, they have been suspected on the basis of experimental data in vitro. This study showed hypoxic fraction in human brain tumor tissue in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1988

[Computed tomographic evaluation due to ruptured intracranial aneurysms in the posterior fossa].

From April, 1978 through December, 1984, computed tomographic (CT) findings were carefully examined in 34 cases of initial subarachnoid bleeding due to a single ruptured aneurysm in the posterior fossa. All of the patients were hospitalized within 3 days of the onset of symptoms. High-density areas, which indicate the presence of subarachnoid clots, were evaluated in the interhemispheric and Sylvian fissures and the interpeduncular, prepontine, ambient, and quadrigeminal cisterns. The CT data suggest that hematomas in the four cisterns are thicker than those in the supratentorial subarachnoid spaces. Only one patient had an intracerebral hematoma. Hydrocephalus accompanied aneurysms of the posterior fossa more frequently than those of the anterior circulation.

Adult↗