Biomedical subjects

Hirotsugu Ohta

Publications and source records attributed to Hirotsugu Ohta.

7 recordsLinked to original sources

PubMed2005

[Clinical application of ibudilast for elder patients with chronic subdural hematoma].

Ibudilast, an antagonist of platelet-activating factor receptors, was administered to patients with chronic subdural hematoma (CSDH) to assess its effectiveness in preventing recurrence. The remaining volumes of subdural hematomas on brain computed tomography were measured approximately 1-2 months after using ibudilast. The hematomas were significantly smaller and there was no recurrence. Ibudilast administration may be useful in the prevention of recurrence of CSDH.

Aged↗

PubMed2004

Preoperative evaluation of trigeminal neuralgia due to epidermoid tumor using a three dimensional fast advanced spin echo--case report.

We report preoperative virtual images reconstructed from three-dimensional fast advanced spin echo (3D-FASE)and evaluate the cause of a trigeminal neuralgia due to an epidermoid tumor. A 60-year-old man had a 3-year-history of atypical trigeminal neuralgia in the left V2 region accompanied by a hypesthesia in the cheek. Neuroimaging demonstrated an epidermoid tumor in the left cerebello-pontine cistern. As the preoperative virtual images reconstructed from 3D-FASE images indicated that the superior cerebellar artery compressed the trigeminal nerve at the root entry zone, we carried out total removal of the tumor and microvascular decompression of the trigeminal nerve. It was possible to visualize the fine structures around the trigeminal nerve, because an epidermoid tumor shows a high intensity mass on 3D-FASE images. The simulated 3D images were useful in deciding upon the additional microvascular decompression surgery for trigeminal neuralgia after total removal of the epidermoid tumor.

Carcinoma, Squamous Cell↗

PubMed2004

[Spontaneous intracranial hypotension associated with trochlear nerve palsy and bilateral chronic subdural hematoma].

Spontaneous intracranial hypotension (SIH) is a rare disease which is associated with variety of symptoms and signs including cranial neuropathies. Though diplopia occurred reportedly in about one fourth of SIH cases, trochlear nerve palsy has been reported only one case in the literature. A 71-year-old previously healthy male developed postural headache and nausea. After 15 days, he began to have diplopia caused by right trochlear nerve palsy. He consulted our hospital 2 months later because only diplopia was not recovered. Magnetic resonance imaging (MRI) showed bilateral thin chronic subdural hematoma (CSDH), brain sagging and downward brain stem displacement, but not ischemic change in brain stem. We suspected SIH for right trochlear nerve palsy, and he had symptomatic therapy. Two months later, he had burr hole surgery because of disturbance of consciousness and right hemiparesis due to progressive bilateral-CSDH. To say nothing of disturbance of consciousness and right hemiparesis, his trochlear nerve palsy was completely recovered after surgery at once. Follow-up MRI showed brain sagging and downward brain stem displacement were recovered.

Aged↗

PubMed2004

[Multiple cerebral aneurysms and a contralateral occluded internal carotid artery associated with persistent primitive trigeminal artery].

The frequency of angiographic demonstration of persistent primitive trigeminal artery (PTA) is 0.06 to 0.6%. It is well recognized that approximately 13.8 to 27.8% of patients with PTA also have intracranial aneurysms. However their association with the contralateral occluded internal carotid artery (IC) has not been reported. We reported such an extremely rare case of PTA associated with multiple cerebral aneurysms and a contralateral occluded IC. A 61-year-old female suffered from sudden onset of severe headache with nausea and vomiting. When she was admitted to our hospital, she complained only of headache with nausea. Computed tomography demonstrated a diffuse subarachnoid hemorrhage. Angiography showed a ruptured anterior communicating artery (Acom). Aneurysm and a left IC-PC large aneurysm with a broad neck. The angiogram also demonstrated a left PTA originating from the cavernous portion of the left internal carotid artery and ending at the midportion of the basilar artery and the contralateral occluded IC in the cervical portion. An operation was performed at day 3 using the left pterional approach, and the two aneurysms were successfuly clipped using the suction-decompression method. The patient was discharged with no neurological deficits.

Arterial Occlusive Diseases↗

PubMed2004

[Multiple myeloma presenting with multiple subcutaneous masses].

A 92-year-old female was admitted to our hospital with 2-months history of rapidly enlarging subcutaneous masses in the multiple skull's regions. Neurological examination in the admission showed slightly right hemiparesis. Skull X-P showed multiple osteolytic lesions, and CT showed high density masses. MRI revealed iso-intensity masses on both T1 and T2-weighted images. Gd-DTPA enhanced T1-weighted image showed masses with marked homogeneous enhancement like the dural tail sign in the dura adjacent to the tumors. The tumor in the right frontal subcutaneous region was partialy removed; this mass was diagnosed as multiple myeloma. Because the prognosis of such a case was very poor and she was older, we thought her quality of life (QOL) and she was conservatively treated. A case of multiple myeloma having plasmacytoma in multiple skull's regions was reported. Although 30 cases in the literature of multiple myeloma forming cranial or intracranial plasmacytoma were briefly reviewed, multiple lesion was not reported and we thought it as a very rare case. And if such a case was performed to remove all masses, we believed that three dimensional computed tomography images to distinguish the tumors from skull and skin (Perspective 3D-CT; SIEMES's Somatom Emotion 6 and Syngo) was very valuable for the preoperative evaluation of a surgical approach.

Aged↗

PubMed2003

[Treatment of subarachnoid hemorrhages in an isolated mountainous area].

From January 1997 to December 2001, patients with subarachnoid hemorrhage (SAH) among 14,008 residents in an isolated mountainous area; Oguni and Minamioguni towns in Kumamoto Prefecture, were evaluated. The subjects were patients being treated at Oguni Municipal Hospital. Over a period of 5 years, 19 patients were found to be suffering from SAH in this area, 3 of whom were visitors (residing outside this area). The annual incidence rate of SAH in this area was calculated as 22.9 per 100,000. The sex ratio (men:women) was 4:12. The average age was 67.9 years; 65.0 years for men and 68.8 years for women. Eleven patients were older than 65, and constituted 68.8% of the subjects. The risk factors of SAH were recognized, and both hypertension and smoking constituted 31.6%. Alcohol was 21.1% and hyperlipemia was 15.8%. In 13 clipping operated cases excluding 1 test craniotomy, Hunt & Kosnik's Grades at admission were G.I: 2, G.II: 5, G.III: 3, G.IV: 2 and G.V: 1, and Fisher's Groups were G.I: 0, G.II: 8, G.III: 3 and G.IV: 2. The sites of 16 operated aneurysms were internal carotid-posterior communicating artery (IC-PC): 2, anterior communicating artery (A Co.A): 4, middle cerebral artery (MCA): 10 and vertebral artery-basilan artery (VA-BA): 0. The aneurysmal size were < 5 mm: 5, 6-10 mm: 9 and 11 mm < :2 (average 7.6 mm, 2-15 mm). The results were evaluated at discharge, excluding 1 SAH of unknown etiology. 9 were good, 2 were dependent and 7 including 5 non-operative cases had died. We were satisfied with these results, because we were treating older patients. Although we attempted the clipping operation using only a three dimensional computed tomographic angiograply (3D-CTA; X-Vision GX (TOSHIBA) & X-Tension), we had no problem, except for 1 test craniotomy. 3D-CTA was useful during the clipping operation in the small hospital, especially, in regard to cost.

Aged↗

PubMed2002

[Hypoplasia of internal carotid artery at cervical portion associated with neurofibromatosis type I].

Congenital absence of the internal carotid artery (ICA) is a rare anomaly and aplasia/hypoplasia of the ICA associated with other congenital malformations is uncommon, too. We report a very rare case of hypoplastic carotid canal due to hypoplastic ICA at cervical portion associated with neurofibromatosis type I (NF I). A 22-year-old male with NF I was admitted to our hospital for transient weakness of the left upper and lower limbs. Computed tomography (CT) of the brain demonstrated no abnormal findings. But bone target CT and three dimensional computed tomography (3 D-CT) showed a hypoplasia of right carotid canal. Cerebral angiography revealed that the right ICA was hypoplastic at its cervical portion and occluded at the carotid canal. Rest single photon emission computed tomography (SPECT) demonstrated normal cerebral perfusion, and SPECT with acetazolamide demonstrated showed cerebral perfusion reserve of both hemispheres, too. So he was treated conservatively at the present time. Careful follow up should be performed for such patients, because they are very rare cases and the natural history of them is unknown, too.

Adult↗