N. Nakayama, Yasuhiro Ito, T. Sugiyama, Masayuki Gekka, Katsuhiko Maruichi
{"title":"Responsibilities during Open Surgery for Cerebral Aneurysms","authors":"N. Nakayama, Yasuhiro Ito, T. Sugiyama, Masayuki Gekka, Katsuhiko Maruichi","doi":"10.7887/jcns.31.87","DOIUrl":"https://doi.org/10.7887/jcns.31.87","url":null,"abstract":"","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71348570","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}
Minami Sasaki, Y. Higuchi, M. Takada, Jun-ichiro Ikeda, Tatsuya Yamamoto, S. Hirano, Y. Iwadate
{"title":"Breast Cancer Incidentally diagnosed during Implantable Pulse Generator Replacement in a Patient treated with Deep Brain Stimulation : Importance of Breast Cancer Screening in Patients with Implantable Pulse Generator","authors":"Minami Sasaki, Y. Higuchi, M. Takada, Jun-ichiro Ikeda, Tatsuya Yamamoto, S. Hirano, Y. Iwadate","doi":"10.7887/jcns.31.725","DOIUrl":"https://doi.org/10.7887/jcns.31.725","url":null,"abstract":"","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71348917","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":"Pathophysiology and Natural History of Intracranial Aneurysms","authors":"H. Kataoka, Takeshi Miyata, K. Shimizu, T. Aoki","doi":"10.7887/jcns.31.74","DOIUrl":"https://doi.org/10.7887/jcns.31.74","url":null,"abstract":"","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71348925","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}
Recently, the treatment of metastatic brain tumors has evolved dramatically owing to rapid advances in radiation and medical therapy. In the case of radiation therapy, stereotactic radiotherapy is expanding and the maximum number of treatable metastases has increased. In addition, standard radiotherapy after surgical tumor resection is shifting from whole (cid:514) brain irradiation to stereotactic / local irradiation. In the case of medical therapy, molecular (cid:514) targeted therapy has been reported to be effective against brain metastases from non (cid:514) small cell lung cancer, melanoma, and breast cancer with specific genetic abnormalities. The usefulness of immune checkpoint inhibitors has also been demonstrated in large (cid:514) scale clinical trials. As drug therapy based on genetic abnormalities evolves, the importance of genetic testing is increasing and the treatment for metastatic brain tumors is advancing in line with the development of cancer genomic medicine. A combination of multiple modalities is required for the effective treatment of metastatic brain tumors, which means that the need for multidisciplinary teams will increase in the future.
{"title":"Recent Advancements in the Treatment of Brain Metastasis","authors":"A. Mukasa","doi":"10.7887/JCNS.30.365","DOIUrl":"https://doi.org/10.7887/JCNS.30.365","url":null,"abstract":"Recently, the treatment of metastatic brain tumors has evolved dramatically owing to rapid advances in radiation and medical therapy. In the case of radiation therapy, stereotactic radiotherapy is expanding and the maximum number of treatable metastases has increased. In addition, standard radiotherapy after surgical tumor resection is shifting from whole (cid:514) brain irradiation to stereotactic / local irradiation. In the case of medical therapy, molecular (cid:514) targeted therapy has been reported to be effective against brain metastases from non (cid:514) small cell lung cancer, melanoma, and breast cancer with specific genetic abnormalities. The usefulness of immune checkpoint inhibitors has also been demonstrated in large (cid:514) scale clinical trials. As drug therapy based on genetic abnormalities evolves, the importance of genetic testing is increasing and the treatment for metastatic brain tumors is advancing in line with the development of cancer genomic medicine. A combination of multiple modalities is required for the effective treatment of metastatic brain tumors, which means that the need for multidisciplinary teams will increase in the future.","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":"71347005","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}
T. Morioka, N. Murakami, N. Mukae, T. Shimogawa, Ai Kurogi, Akiko Kanata, T. Shono, Satoshi O. Suzuki, M. Mizoguchi
Limited dorsal myeloschisis （ LDM ） , first proposed by Pang et al., is thought to originate from a small segmental failure of the dorsal closure of the neural folds during primary neurulation. The disjunction between the cutaneous and neural ectoderm is impaired at the focal limited nonclosure site. This results in a retained fibroneural stalk linking the skin lesion and the dorsal spinal cord, which results in tethering of the cord. Based on skin manifestations, LDMs were originally categorized as saccular and nonsaccular （ flat ） . Saccular LDM consists of a skin ‒ based cerebrospinal fluid sac topped by a squamous epithelial dome, whereas the flat LDM has a squamous epithelial flat surface or a sunken crater or pit typically called a “ cigarette ‒ burn ” skin lesion. Recently, we reported a human tail ‒ like cutaneous appendage as an additional morphological type of skin lesion. The recommended treatment consisted of prophylactic untethering of the stalk from the cord. Because of the shared origin of LDM and congenital dermal sinus （ CDS ） , CDS elements may be found within the fibroneural LDM stalk with a 10 ‒ 20 ％ possibility. When part of the CDS invested in the intradural stalk is left during untethering surgery, inclusion tumors such as dermoid cysts may develop in the patient. Although the central histopathological finding of LDM stalk is the presence of glial fibrillary acidic protein （ GFAP ）‒ immunopositive neuroglial tissues in the fibrocollagenous tract, immunopositivity for GFAP was observed in 50 ‒ 60 ％ of pathologically examined cases. The presence of neural crest cells, such as peripheral nerve fibers and melanocytes, also assists in the histopathological diagnosis of LDM. In this case report, the diagnostic and surgical strategies of LDM are discussed accord-ingly.
{"title":"Surgical Pathoembryology and Treatment of Limited Dorsal Myeloschisis","authors":"T. Morioka, N. Murakami, N. Mukae, T. Shimogawa, Ai Kurogi, Akiko Kanata, T. Shono, Satoshi O. Suzuki, M. Mizoguchi","doi":"10.7887/jcns.30.424","DOIUrl":"https://doi.org/10.7887/jcns.30.424","url":null,"abstract":"Limited dorsal myeloschisis （ LDM ） , first proposed by Pang et al., is thought to originate from a small segmental failure of the dorsal closure of the neural folds during primary neurulation. The disjunction between the cutaneous and neural ectoderm is impaired at the focal limited nonclosure site. This results in a retained fibroneural stalk linking the skin lesion and the dorsal spinal cord, which results in tethering of the cord. Based on skin manifestations, LDMs were originally categorized as saccular and nonsaccular （ flat ） . Saccular LDM consists of a skin ‒ based cerebrospinal fluid sac topped by a squamous epithelial dome, whereas the flat LDM has a squamous epithelial flat surface or a sunken crater or pit typically called a “ cigarette ‒ burn ” skin lesion. Recently, we reported a human tail ‒ like cutaneous appendage as an additional morphological type of skin lesion. The recommended treatment consisted of prophylactic untethering of the stalk from the cord. Because of the shared origin of LDM and congenital dermal sinus （ CDS ） , CDS elements may be found within the fibroneural LDM stalk with a 10 ‒ 20 ％ possibility. When part of the CDS invested in the intradural stalk is left during untethering surgery, inclusion tumors such as dermoid cysts may develop in the patient. Although the central histopathological finding of LDM stalk is the presence of glial fibrillary acidic protein （ GFAP ）‒ immunopositive neuroglial tissues in the fibrocollagenous tract, immunopositivity for GFAP was observed in 50 ‒ 60 ％ of pathologically examined cases. The presence of neural crest cells, such as peripheral nerve fibers and melanocytes, also assists in the histopathological diagnosis of LDM. In this case report, the diagnostic and surgical strategies of LDM are discussed accord-ingly.","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347174","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 this paper, we propose a brain decoding method for the generation of natural language descriptions based on human brain activity by a deep learning model. In addition, to elucidate brain functions, we focused on predictive coding, which is hypothesized to be one of the functions of the cerebral cortex. We investigated the agreement between the predictions of deep learning model and the actual brain activity data to test the predictive coding hypothesis. Furthermore, we propose a method for generating images from human brain activity data by using the same validation model. (Received November 9, 2020;accepted December 7, 2020)
{"title":"Intelligence of Artificial Intelligence : A Study on Brain Decoding using Machine Learning and the Analysis of Brain Functions","authors":"I. Kobayashi","doi":"10.7887/JCNS.30.120","DOIUrl":"https://doi.org/10.7887/JCNS.30.120","url":null,"abstract":"In this paper, we propose a brain decoding method for the generation of natural language descriptions based on human brain activity by a deep learning model. In addition, to elucidate brain functions, we focused on predictive coding, which is hypothesized to be one of the functions of the cerebral cortex. We investigated the agreement between the predictions of deep learning model and the actual brain activity data to test the predictive coding hypothesis. Furthermore, we propose a method for generating images from human brain activity data by using the same validation model. (Received November 9, 2020;accepted December 7, 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":"71347178","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. Nagao, A. Kambe, M. Sakamoto, M. Kurosaki, Yosuke Nakamura, Shoichiro Izawa, K. Makishima, S. Kuwamoto, Y. Umekita
The frequency of concomitant pituitary tumors during pregnancy is rare. We report the case of patient with prolactin (cid:514) producing pituitary adenoma with pituitary apoplexy during third trimester pregnancy who underwent an emergency surgery. A 21 (cid:514) year (cid:514) old woman was diagnosed with prolactin (cid:514) producing pituitary adenoma 3 years ago. After cabergoline （ CAB ） treatment was started, she became pregnant 2 years later and discontinued the CAB. Afterward, she developed bitemporal hemianopsia. Her serum PRL level was 647.0 ng / m(cid:9520). Her MRI revealed a sellar / presellar tumor that showed fluid (cid:514) fluid level, and the optic chiasma was compressed upward. She underwent transsphenoidal surgery after cesarean section. Histopathological examination of the tumor revealed a sparsely granulated lactotroph adenoma （ SGLA ） with aggressive findings. Her visual field defect was alleviated after surgery. SGLA accounts for the majority of prolactin (cid:514) producing pituitary adenomas. Patients with SGLA usually follow a benign course. Physiological changes due to pregnancy and discontinuation of CAB can affect the development of pituitary apoplexy and aggressive findings. In such cases, integrative treatment involving the cooperation between clinical departments is necessary.
妊娠期并发垂体瘤的发生率较低。我们报告一例患者的催乳素(cid:514)产生垂体腺瘤与垂体中风在妊娠晚期谁接受了紧急手术。一名21岁(cid:514)岁(cid:514)的老年妇女3年前被诊断为泌乳素(cid:514)产生垂体腺瘤。卡麦角林(caberoline, CAB)治疗开始后，她在2年后怀孕并停止使用caberoline。后来，她患上了双颞偏盲。血清PRL水平为647.0 ng / m(cid:9520)。她的MRI显示一个鞍/鞍前肿瘤，显示液体(cid:514)液位，视交叉向上压缩。她在剖宫产后接受了蝶窦手术。肿瘤的组织病理学检查显示为稀疏颗粒状乳营养腺瘤(SGLA)，具有侵袭性表现。术后视野缺损减轻。SGLA占大多数催乳素(cid:514)产生垂体腺瘤。SGLA患者通常呈良性病程。妊娠和停用CAB引起的生理变化可影响垂体卒中的发展和侵袭性表现。在这种情况下，需要临床科室合作的综合治疗。
{"title":"A Case of Prolactin-Producing Pituitary Adenoma with Pituitary Apoplexy during Third Trimester Pregnancy in which underwent an Emergency Surgery","authors":"Y. Nagao, A. Kambe, M. Sakamoto, M. Kurosaki, Yosuke Nakamura, Shoichiro Izawa, K. Makishima, S. Kuwamoto, Y. Umekita","doi":"10.7887/JCNS.30.146","DOIUrl":"https://doi.org/10.7887/JCNS.30.146","url":null,"abstract":"The frequency of concomitant pituitary tumors during pregnancy is rare. We report the case of patient with prolactin (cid:514) producing pituitary adenoma with pituitary apoplexy during third trimester pregnancy who underwent an emergency surgery. A 21 (cid:514) year (cid:514) old woman was diagnosed with prolactin (cid:514) producing pituitary adenoma 3 years ago. After cabergoline （ CAB ） treatment was started, she became pregnant 2 years later and discontinued the CAB. Afterward, she developed bitemporal hemianopsia. Her serum PRL level was 647.0 ng / m(cid:9520). Her MRI revealed a sellar / presellar tumor that showed fluid (cid:514) fluid level, and the optic chiasma was compressed upward. She underwent transsphenoidal surgery after cesarean section. Histopathological examination of the tumor revealed a sparsely granulated lactotroph adenoma （ SGLA ） with aggressive findings. Her visual field defect was alleviated after surgery. SGLA accounts for the majority of prolactin (cid:514) producing pituitary adenomas. Patients with SGLA usually follow a benign course. Physiological changes due to pregnancy and discontinuation of CAB can affect the development of pituitary apoplexy and aggressive findings. In such cases, integrative treatment involving the cooperation between clinical departments is necessary.","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":"71347256","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}
K. Matsushima, M. Kohno, N. Nakajima, Hitoshi Izawa, Norio Ichimasu
Facial nerve palsy is a rare symptom of vestibular schwannoma, even when there is substantial tumoral compression of the facial nerve. Here, we describe two cases of large vestibular schwannomas who presented with facial nerve palsy. Both patients experienced post ‒ operative improvement of facial motility, from grade Ⅲ before surgery to grade Ⅰ afterward, according to the House ‒ Brackmann grading system. Although surgical resection of these tumors tends to be difficult, owing to insufficient intraoperative electromyographic responses of the facial nerve, surgical neural decompression may improve long ‒ term facial motility.
{"title":"Post-operative Improvement of Facial Palsy caused by Large Vestibular Schwannomas","authors":"K. Matsushima, M. Kohno, N. Nakajima, Hitoshi Izawa, Norio Ichimasu","doi":"10.7887/JCNS.30.230","DOIUrl":"https://doi.org/10.7887/JCNS.30.230","url":null,"abstract":"Facial nerve palsy is a rare symptom of vestibular schwannoma, even when there is substantial tumoral compression of the facial nerve. Here, we describe two cases of large vestibular schwannomas who presented with facial nerve palsy. Both patients experienced post ‒ operative improvement of facial motility, from grade Ⅲ before surgery to grade Ⅰ afterward, according to the House ‒ Brackmann grading system. Although surgical resection of these tumors tends to be difficult, owing to insufficient intraoperative electromyographic responses of the facial nerve, surgical neural decompression may improve long ‒ term facial motility.","PeriodicalId":39918,"journal":{"name":"Japanese Journal of Neurosurgery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71347350","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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