Tomomi Kimiwada, M. Kitami, Toshiaki Hayashi, Y. Shimanuki, R. Shirane, T. Tominaga
The potential adverse effects of ionizing radiation exposure during imaging studies are particularly relevant to the pediatric population. To reduce radiation exposure, quick‒brain(or rapid sequence)MR imaging has been used to evaluate cerebral ventricle size in pediatric patients with hydrocephalus in Western countries. The objective of this study was to evaluate the quality of images obtained using non‒ sedative quick‒brain MR imaging and consider its merits and limitations. We retrospectively analyzed a series of quick‒brain MRI studies performed without sedation for pediatric patients with hydrocephalus. A total of 41 quick‒brain MRI examinations were performed without sedation for pediatric patients with hydrocephalus with a median age of 9 months at the time of examination. The duration of each study was less than 30 s. The catheter visualization was good, and the image quality was excellent enough for evaluating the cerebral ventricle size. Non‒sedative quick‒brain MR imaging is reliable for evaluating the ventricle size and ventricular catheter in pediatric patients with hydrocephalus. (Received February 10, 2021;accepted April 27, 2021)
{"title":"Non-Sedative Quick-Brain MR Imaging for the Evaluation of Pediatric Patients with Hydrocephalus","authors":"Tomomi Kimiwada, M. Kitami, Toshiaki Hayashi, Y. Shimanuki, R. Shirane, T. Tominaga","doi":"10.7887/jcns.30.675","DOIUrl":"https://doi.org/10.7887/jcns.30.675","url":null,"abstract":"The potential adverse effects of ionizing radiation exposure during imaging studies are particularly relevant to the pediatric population. To reduce radiation exposure, quick‒brain(or rapid sequence)MR imaging has been used to evaluate cerebral ventricle size in pediatric patients with hydrocephalus in Western countries. The objective of this study was to evaluate the quality of images obtained using non‒ sedative quick‒brain MR imaging and consider its merits and limitations. We retrospectively analyzed a series of quick‒brain MRI studies performed without sedation for pediatric patients with hydrocephalus. A total of 41 quick‒brain MRI examinations were performed without sedation for pediatric patients with hydrocephalus with a median age of 9 months at the time of examination. The duration of each study was less than 30 s. The catheter visualization was good, and the image quality was excellent enough for evaluating the cerebral ventricle size. Non‒sedative quick‒brain MR imaging is reliable for evaluating the ventricle size and ventricular catheter in pediatric patients with hydrocephalus. (Received February 10, 2021;accepted April 27, 2021)","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In each patient with traumatic brain injury, the pathology is different, and cerebral blood flow and metabolism changes over time. In such a situation, attention is being paid to neurocritical care, which pro-vides appropriate treatment under monitoring. The emphasis of neurocritical care is （ 1 ） cerebral perfusion pressure / intracranial pressure management ；（ 2 ） infusion / electrolyte management ；（ 3 ） respiratory management ；（ 4 ） sedation / analgesic management ；（ 5 ） body temperature management ； and （ 6 ） diagnostic treatment for convulsions. In recent years, the development of neurocritical care has been remarkable, and many results have been reported. Neurocritical care algorithms using intracranial pressure monitoring or brain tissue oxygen partial pressure monitoring as indicators have been investigated and improved outcomes so that they can be easily practiced in daily medical care. In Japan as well, the spread of neurocritical care that makes full use of monitoring is expected to improve the outcome of severe traumatic brain injury. pressure, brain tissue oxygen partial pressure
{"title":"Theory and Practice of Neurocritical Care for Traumatic Brain Injury","authors":"E. Suehiro, M. Kawashima, Michiyasu Suzuki","doi":"10.7887/jcns.30.720","DOIUrl":"https://doi.org/10.7887/jcns.30.720","url":null,"abstract":"In each patient with traumatic brain injury, the pathology is different, and cerebral blood flow and metabolism changes over time. In such a situation, attention is being paid to neurocritical care, which pro-vides appropriate treatment under monitoring. The emphasis of neurocritical care is （ 1 ） cerebral perfusion pressure / intracranial pressure management ；（ 2 ） infusion / electrolyte management ；（ 3 ） respiratory management ；（ 4 ） sedation / analgesic management ；（ 5 ） body temperature management ； and （ 6 ） diagnostic treatment for convulsions. In recent years, the development of neurocritical care has been remarkable, and many results have been reported. Neurocritical care algorithms using intracranial pressure monitoring or brain tissue oxygen partial pressure monitoring as indicators have been investigated and improved outcomes so that they can be easily practiced in daily medical care. In Japan as well, the spread of neurocritical care that makes full use of monitoring is expected to improve the outcome of severe traumatic brain injury. pressure, brain tissue oxygen partial pressure","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Sakakibara, Homare Nakamura, Hidetaka Onodera, Kimiyuki Kawaguchi, Y. Aida
{"title":"Acromegaly of the Carney Complex Patient : Case Report","authors":"Y. Sakakibara, Homare Nakamura, Hidetaka Onodera, Kimiyuki Kawaguchi, Y. Aida","doi":"10.7887/jcns.30.741","DOIUrl":"https://doi.org/10.7887/jcns.30.741","url":null,"abstract":"","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Paradigm Shift in the Stroke Medical Care System","authors":"S. Miyamoto, Kiyofumi Yamada","doi":"10.7887/JCNS.30.194","DOIUrl":"https://doi.org/10.7887/JCNS.30.194","url":null,"abstract":"","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"30 1","pages":"194-198"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Yokobori, Kazuma Sasaki, Ami Shibata, Takahiro Kanaya, Yu Fujiki, M. Yamaguchi, Shin Sato, A. Watanabe, Yutaka Igarashi, Go Suzuki, Junya Kaneko, R. Nakae, Hidetaka Onda, A. Kitahashi, Saori Kudo, Yasuhiro Takayama, Y. Naoe, H. Sato, K. Unemoto, A. Fuse, A. Morita, H. Yokota
Takumi Kajitani, H. Karibe, A. Narisawa, Hideo Saito, M. Goto, M. Kameyama, T. Tominaga
The sudden onset of oculomotor nerve(OCN)paralysis is a symptom that suggests the impending rupture of a cerebral aneurysm. The mechanism of such OCN paralysis has been proposed as direct compression by an enlarged aneurysm and/or blood leakage from an aneurysm. In this article, we report a rare case of aneurysm enlargement in the posterior communicating(Pcom)artery direction to compress the OCN. A 60‒year‒old woman presented with left OCN paralysis with both ptosis and mydriasis. Although CT did not show any intracranial hemorrhage, CT angiography revealed a left internal carotid‒ Pcom(IC‒PC)aneurysm. We diagnosed it as an impending rupture of the aneurysm that required emergency surgery. Intraoperative findings revealed that the fetal Pcom artery, but not the aneurysm, compressed the OCN. We performed neck clipping and partial wrapping of the aneurysm to change the Pcom artery direction to decompress the OCN. Her symptoms improved after surgery. There was a case report in which the Pcom artery compressed the OCN directly instead of the aneurysm, suggesting that it was caused by an abnormal running of the fetal Pcom artery. In this case, aneurysm clipping reduces the volume of the aneurysm to normalize the Pcom artery direction, resulting in neurovascular decompression of the oculomotor nerve. (Received March 5, 2020;accepted June 24, 2020)
{"title":"Oculomotor Nerve Palsy caused by the Posterior Communicating Artery with Impending Ruptured Internal Carotid-Posterior Communicating Aneurysm : A Case Report","authors":"Takumi Kajitani, H. Karibe, A. Narisawa, Hideo Saito, M. Goto, M. Kameyama, T. Tominaga","doi":"10.7887/JCNS.30.59","DOIUrl":"https://doi.org/10.7887/JCNS.30.59","url":null,"abstract":"The sudden onset of oculomotor nerve(OCN)paralysis is a symptom that suggests the impending rupture of a cerebral aneurysm. The mechanism of such OCN paralysis has been proposed as direct compression by an enlarged aneurysm and/or blood leakage from an aneurysm. In this article, we report a rare case of aneurysm enlargement in the posterior communicating(Pcom)artery direction to compress the OCN. A 60‒year‒old woman presented with left OCN paralysis with both ptosis and mydriasis. Although CT did not show any intracranial hemorrhage, CT angiography revealed a left internal carotid‒ Pcom(IC‒PC)aneurysm. We diagnosed it as an impending rupture of the aneurysm that required emergency surgery. Intraoperative findings revealed that the fetal Pcom artery, but not the aneurysm, compressed the OCN. We performed neck clipping and partial wrapping of the aneurysm to change the Pcom artery direction to decompress the OCN. Her symptoms improved after surgery. There was a case report in which the Pcom artery compressed the OCN directly instead of the aneurysm, suggesting that it was caused by an abnormal running of the fetal Pcom artery. In this case, aneurysm clipping reduces the volume of the aneurysm to normalize the Pcom artery direction, resulting in neurovascular decompression of the oculomotor nerve. (Received March 5, 2020;accepted June 24, 2020)","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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