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Biomedical subjects

A Hakuba

Publications and source records attributed to A Hakuba.

At least 109 records · Page 6Linked to original sources
PubMed1984

Transuncodiscal approach to dumbbell tumors of the cervical spinal canal.

A combined anterior and lateral approach to the anterior cervical spinal canal with fusion was performed on five patients with cervical dumbbell-shaped tumors. The procedure consists of anterior discectomy and ipsilateral uncectomy, and removal of the posterolateral corners and posterior transverse ridges of the upper and lower vertebral bodies at the level of the tumor. In the case of a large tumor in the spinal canal, additional removal of a limited segment from the lateral part of the vertebral body was performed. The bone defect was filled with a T-shaped iliac bone graft. Two vertebral bodies were fused in each case. The highest level of the operation was C-2 and the lowest was T-1. The authors believe that any cervical dumbbell-shaped tumor below the C-2 level can be removed via an anterolateral approach as long as no more than three levels of the spine are involved.

Adult↗
PubMed1984

[A case of spontaneous spinal epidural hematoma presenting Brown-Séquard syndrome].

Although there have been a few reports of spontaneous spinal epidural hematoma, it may be difficult to make a correct diagnosis of the lesion because of atypical clinical symptoms. The authors reported a case of spontaneous spinal epidural hematoma presenting Brown-Séquard syndrome, with a review of literature. This 75-year-old male experienced a sudden onset of severe dorsal neck pain during sleep associated with right hemiparesis which deteriorated quickly to hemiplegia, without loss of consciousness, nausea, vomiting and vertigo. The patient has a history of hypertension and has been treated for chronic hepatitis for one year. On admission, neurological examination revealed right hemiplegia with normotensive deep tendon reflexes, and loss of pain and temperature sensations below the level of C5 on his left side. Position sense of fingers and toes was diminished on his right side, and hyperesthesia was recognized at the area of C4 level. Consciousness disturbance, cranial nerve signs, and urinary incontinence were not seen. Right retrograde vertebral angiograms showed no abnormal vascular shadow, even though anterior spinal artery was visible at the level of C8 through C5. Cervical CT scan revealed a left-side dominant extradural high density mass which situated dorsally at around the upper part of C2 body changing it's position to dorsolaterally as it descended to the lower part of C5. On contrast enhancement study, only the margin of the lesion was partially enhanced, which might be the hematoma membrane. On the third day after the onset, laminectomy from C2 to C5 was performed and the epidural hematoma was evacuated.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

Occult cranium bifidum. Radiological and surgical findings.

Six cases of congenital subscalp nodule associated with underlying cranium bifidum are reported. A plain skull roentgenogram showed a midline bone defect in the parieto-occipital region near the lambda. CT scan demonstrated neither brain malformation nor ventricular deformity except for the high position of the straight sinus. Cerebral angiography revealed an elongation of the vein of Galen and anomalous upward course of the straight sinus. At surgery, the tumor was solid and connected to a cord which extended intracranially via the cranium bifidum and blended with thickened arachnoid membrane either on the dorsal aspect of the midbrain or at the surface of the anterior vermis. Histologically, the tumor consisted in all cases of arachnoid cells and fibrous tissue with immature glial cells in one case. Possible pathogenesis of these tumors could be a result of the fetal nuchal bleb.

Cerebral Angiography↗
PubMed1982

[An anatomical and technical note for neurosurgery of the jugular foramen tumor [author's transl)].

The basic anatomy of the jugular foramen, some diagnostic principles of the jugular foramen tumors with presentation of our experiences of the 13 cases (6 neurinomas, 6 chemodectomas and 1 meningioma), and the detailed surgical technique used in their removal and its result are described. According to the extension of the tumor, one of the following operative approaches can be selected. A) Transjugular approach consists of a retromastoideal craniectomy following a radical mastoidectomy. The posterior wall of the jugular foramen is scraped out and the sigmoid sinus and the internal jugular vein are resected with the tumor either confined in the jugular foramen or extending out of the skull. B) Transjugular-transpetrosal approach is suitable for the tumor in the jugular foramen extending out of the skull as well as into the CP angle. The petrosal bone is more scraped out for removal of the tumor extending into the CP angle than in the above transjugular approach. In the case of the tumor extending into the CP angle and the upper clivus, the upper petrosal bone medial to the C-5-C-6 segments of the internal carotid artery are also removed and an extensive exposure of the intracranial tumor is obtained. C) A suboccipital craniectomy with retrolabyrinthine removal of the petrosal bone is suitable for large glosso-pharyngeal neurinomas extending into the CP angle but not out of the floor of the skull. In such cases, after removal of the CP angle tumor in the usual way, resection of the remaining jugular foramen tumor is easily performed through opening the petrosal bone forming the medial portion of the dome of the jugular fossa.

Aged↗
PubMed1982

[Thin-section CT scan of the pituitary gland (author's transl)].

Topographic anatomy of the pituitary fossa was studied by 2 mm thin-section CT scan (Somatom II). Nineteen with normal pituitary (control group) and 20 with suspected pituitary abnormality were selected. Plain and contrast CT were performed in all cases. Contrast CT was carried out immediately after the rapid infusion of 220 ml of 30% iodinated contrast medium. In all of control group but two, pituitary gland was detected as homogenous density and its density was as same as density of normal brain tissues, and was enhanced in degree of about 25 CT number. In 2 cases, small low density was visualized in the pituitary gland. Pituitary gland was differentiated from cavernous sinus was usually higher than the pituitary gland. In abnormal group, the microadenoma of the pituitary gland was diagnosed in 5 cases and 3 out of 5 cases was proved by surgery. All 3 microadenomas proved slightly dense by plain CT and enhanced higher than normal pituitary gland by contrast CT. Polytomograms showed no abnormality of the sella turcica in one of these 3 cases. Although 3 microadenomas were detected by the abnormal enhancement, we are not sure whether all of microadenoma can be detected by CT alone. Arachnoid herniation into the pituitary fossa was diagnosed in 7 of control group and 2 of abnormal group. Four out of these 9 cases were verified by using Metrizamide CT. By plain thin-section CT, the diagnosis of arachnoid herniation seems to be possible without Metrizamide CT.

Adenoma↗
PubMed1982

[Computed tomography in brain metastases (author's transl)].

CT scan of the one hundred and sixteen metastatic brain tumors in 50 patients was reviewed and compared to the previous reports. The most common primary organ was lung (43%) followed by breast (18%), colon (10%) and kidney (6%). Solitary nodule was found in 20 patients (40%). On plain CT scan, tumor nodules were demonstrated as slightly high density in 38 (33%), isodensity in 50 (43%) and slightly low density in 28 (24%). Majority of tumor nodules were present in the corticomedullary junction (82%). Brain edema seen as a peritumoral low density was extensive in comparison with the edema in the glioma of the similar size. On contrast CT scan, ring like enhancement was seen in 41 (35%). Intra-tumoral bleeding was shown in 2 metastatic nodules from choriocarcinoma and in one metastatic nodule from renal cell carcinoma. All 3 cases were proved by surgery or autopsy.

Adult↗
PubMed1981

[Cranial computed tomography of the neurofibromatosis (author's transl)].

The computed tomography (CT) was performed in 10 cases of neurofibromatosis. The CT scan showed the abnormal findings in 8 cases out of 10. Skull lesions were noted in 3 cases and intracranial tumors were found in 5 among which multiple neoplasms were seen in 3. Although reported cases were not large enough in number, the incidence and variety of the tumors were similar to others reported before CT era.

Adolescent↗
PubMed1979

Sequential CT observations of irradiated intracranial germinomas.

Computed tomography (CT) has improved the accuracy of preoperative diagnosis of intracranial tumors. CT findings of germinoma are a mass of isodensity or of slightly increased density with significant, homogeneous enhancement after intravenous contrast injection. These findings are characteristic but not pathognomonic, and differential diagnosis from other solid tumors is not easy. Cerebrospinal fluid cytology and response to irradiation aid in this differential diagnosis. The nine cases of germinoma reported showed rapid response to irradiation even at small doses (600 rad), and complete disappearance of the mass on CT at 1,600--3,300 rad. Other radiosensitive masses to be differentiated in the pineal region are pinealocytoma or pinealoblastoma.

Adolescent↗