PubMed Health⌕ Search

Biomedical subjects

K Fujitsu

Publications and source records attributed to K Fujitsu.

36 records · Page 2Linked to original sources
PubMed1987

[Subdural tension pneumocephalus following surgery of chronic subdural hematoma].

Subdural tension pneumocephalus (TP) following surgery for chronic subdural hematoma was analyzed in 5 cases from clinical standpoints of view, especially from CT findings. The cases were compared with 14 cases of subdural asymptomatic pneumocephalus (AP). The TP tends to complicate elderly patients who showed a poor re-expansion of the brain after irrigation of bilateral chronic subdural hematoma. In such patients, it is difficult to make an exact diagnosis of TP because of residual mass effect of the evacuated hematoma. Significance of mass effect caused by subdural air has been discussed in the literature only little. In this study, we found two new CT findings suggesting increased tension of subdural air. First, the subdural tensive air separates and compresses the frontal lobes. The compressed frontal lobes with widened interhemispheric space between the frontal poles mimic the silhouette of Mt. Fuji. We called this CT finding "Mt. Fuji" sign. The presence of air between the frontal poles associated with massive air over the frontal lobes presumably indicates an increased tension of the subdural air. "Mt. Fuji" sign was seen in 4 cases out of 5 TP cases. Another sign is the presence of multiple small air bubbles in the subarachnoid space, especially in the cisterns. We proposed that these air bubbles were trapped in the subarachnoid space through a tear of the arachnoid membrane which is caused by increased tension of air in the subdural space. This finding was present in 4 cases with TP. We emphasize that these two CT signs are helpful to make an accurate diagnosis of TP following surgery for chronic subdural hematoma.

Aged↗
PubMed1986

Orbitocraniobasal approach for anterior communicating artery aneurysms.

We describe an orbitofrontotemporobasal craniotomy technique that allows excellent access to anterior communicating artery aneurysms. This orbitocraniobasal approach is particularly useful for the surgical treatment of ruptured aneurysms in the acute stage of subarachnoid hemorrhage, when retraction of the brain needs to be kept to a minimum. With this approach, retraction of the orbital contents decreases the amount of retraction of the brain to such an extent that a brain spatula is not necessary for access to the anterior communicating artery complex. The procedure is described, as is a modification of the approach for removal of large tumors on the skull base.

Cerebral Arteries↗
PubMed1986

[Traumatic aneurysm occurring after surgical procedure of large cerebral aneurysm].

A case of intracranial traumatic aneurysms occurring after surgical treatment of a large cerebral aneurysm is reported. A 56-year-old man was admitted to our department with complaints of headache, nuchal pain and nausea. Left carotid angiography (Lt-CAG) revealed a large aneurysm, measuring 20 mm in maximum diameter, of the azygos anterior cerebral artery. Successful clipping operation was performed on day 17 of subarachnoid hemorrhage. Unfortunately, small cortical branches were pulled out during the procedure from the right pericallosal artery. The postoperative Lt-CAG showed formation of two other aneurysms. Second operation was done on day 28 after the first operation. These aneurysms were located at the previously injured sites on the right pericallosal artery. From the history sited above, we diagnosed them as traumatic aneurysms. The second operation resulted in successful obliteration of these two traumatic aneurysms. Literature review yielded 25 similar cases, and the authors discuss the etiologic factors of the traumatic aneurysm due to surgical procedure.

Cerebral Angiography↗
PubMed1986

[Surgical approach for jugular foramen neurinoma--combined suboccipital and infralabyrinthine approach using a rotatable head holder].

A 36-year-old male with jugular foramen neurinoma was operated upon using a rotatable head holder, which enables the surgeon to rotate the patient's head at any time during the procedure and to gain access in multiple directions to the tumor. The tumor was situated primarily in the jugular foramen and showed partial extension into intracranial as well as into extracranial space. The patient was placed in the lateral position with a rotatable head holder, which allows rotation of the patient's head with the range of 10 degrees face up to 80 degrees face down from the horizontal plane. A linear skin incision was made, beginning behind the auricle and extending along the anterior margin of the sternocleidomastoid muscle, and the sternocleidomastoid muscle was divided just below the tip of the mastoid process. During mastoidectomy and suboccipital craniectomy, the patient's head was rotated 15 degrees face down and sigmoid sinus was exposed toward the jugular foramen, meanwhile the posterior fossa dura mater was opened and the intracranial portion of the tumor was removed with the head positioned 45 degrees-60 degrees face down. The patient's head is then turned 30 degrees face down and the facial canal was opened to displace the facial nerve forward. This oblique posterior approach minimized facial nerve displacement and provided excellent exposure of the large tumor rest which was situated mainly in the jugular foramen and partly extended extracranially. The rotatable head holder allows excellent access in multiple directions and is very helpful in approaching to jugular foramen neurinomas which grow primarily in the jugular foramen and extend both into intra- and extracranially.

Adult↗
PubMed1985

Correlation between plasma fibrin-fibrinogen degradation product values and CT findings in head injury.

Plasma fibrin/fibrinogen degradation product (FDP) determinations and CT scans were performed in 26 patients on the first, third, and seventh day after head injury. Plasma FDP concentrations were increased in the patients with cerebral contusion shown on CT scans, while the plasma FDP values were normal in the patients with various sized epidural haematomas. Furthermore, the plasma FDP elevation appeared to be more marked and more prolonged in the patients with severe contusion than in those with mild contusion. These findings suggest that the degree of the increase in plasma FDP is proportional to the amount of brain tissue destruction.

Brain Concussion↗
PubMed1985

Zygomatic approach for lesions in the interpeduncular cistern.

Lesions in the interpeduncular cistern include basilar tip aneurysms, craniopharyngiomas, and chordomas. The surgical approach to these lesions presents a special technical problem, particularly when they are located high in the interpeduncular fossa. For the purpose of minimizing brain retraction and achieving excellent exposure within the interpeduncular cistern, the authors have developed a new surgical technique which involves detachment of the zygomatic arch. The patient is placed in the supine position with the head rotated 45 degrees to the contralateral side and tilted down 30 degrees so that the surgeon can see into the interpeduncular cistern obliquely from below. The zygomatic arch of the temporal bone as well as a portion of the lateral orbital rim (the posterior ridge of the frontal process of the zygomatic bone) is removed to expose the anterior temporal base. With posterior retraction of the temporal lobe, the arachnoid membranes covering the Sylvian stem are opened in a retrograde fashion until the tentorial edge is sufficiently exposed. The posterior communicating artery and the optic tract are elevated to enter the interpeduncular cistern, after which the oculomotor nerve is dissected free of its surrounding arachnoid membranes and displaced posteroinferiorly. Two patients with basilar tip aneurysms were operated on with this zygomatic approach, and a subtemporal modification of the zygomatic approach was used to treat a craniopharyngioma and a chordoma in two other patients. The procedure is described and a short description of its clinical use is given.

Basilar Artery↗
PubMed1981

[A case of alpha-fetoprotein producing primary intracranial embryonal carcinoma treated with combination chemotherapy with cis-platinum, vinblastine and bleomycin (author's transl)].

A case of alpha-fetoprotein (AFP) producing primary intracranial embryonal carcinoma was reported with special reference to the chemotherapy. The patient was a 14-year-old male who had suffered from vomiting and disturbance of consciousness. CT scan revealed a tumor originating in the anterior part of the third ventricle and expanding into both lateral ventricles. Right frontotemporal craniotomy was performed and the tumor was totally removed under the microscope. The histological diagnosis was embryonal carcinoma. Inspite of the elevated amount of AFP in the serum, we could not verify the yolk sac element in the surgical specimen. Three months later, he became drowsy and another CT scan revealed recurrence of the tumor. Ommaya's reservoir was placed and CSF was drained to control the intracranial hypertension. But the disturbance of consciousness did not improve. We then started a combination chemotherapy with cis-platinum, vinblastine and bleomycin. Cis-platinum was given in a dosage of 20 mg/m2 body surface area as a 15 min. intravenous infusion for 5 consecutive days every 3 weeks for three courses. Vinblastine was given in a dosage of 0.4 mg/kg body weight intravenously for 2 consecutive days every 3 weeks for three courses. Bleomycin was given in a dosage of 30 mg intravenously 6 hours after vinblastine weekly for a total of 12 weeks. The AFP level of the serum and CSF was monitored every several days. After the chemotherapy, the AFP level of the serum and CSF decreased. Repeated CT scan revealed no evidence of tumor. His clinical condition improved remarkably. Toxicity was vomiting, proteinuria and leukopenia, but not so severe. Proteinuria continued after the chemotherapy, but BUN and creatinine did not elevate. It was emphasized that the combination chemotherapy with cis-platinum, vinblastine and bleomycin is effective remission-induction treatment for AFP producing primary intracranial embryonal carcinoma.

Adolescent↗
PubMed1979

[On the phenomena of multiple extravasations of contrast medium in cerebral angiogram of the cases of hypertensive intracerebral hematoma (author's transl)].

It is interesting to note the pathological findings that the rupture of multiple microaneurysms in the basal ganglia appears to be the cause of the hypertensive intracerebral hematoma. But there is few report that the carotid angiogram demonstrated multiple leakages of contrast medium of intracerebral hematoma in vivo than in Westberg's postmortem angiogram. The authors experienced 15 cases of hypertensive intracerebral hematoma whose cerebral angiogram showed extravasation of contrast material. It was fifty-seven per cent of which angiogram within 6 hours after the stroke showed leakage of contrast medium. However, there was remarkably decreased appearance of the extravasation after 9 hours after the stroke. Moreover, emphasis showed be placed upon the facts that eleven cases of 15 cases showed more than two adjacent spotty extravasations of contrast medium and that six cases demonstrated the simultaneous multiple leakages of contrast material from more than two lentriculostriate arteries. These angiographic findings has led us to the conclusion that there is intimate correlation between the large hematoma and multiple ruptures of the microaneurysms of lentriculostriate arteries.

Adult↗
PubMed1978

[Unilateral exophthalmos caused by organized hematoma of the orbit--report of a case (author's transl)].

The authors reported a case with unilateral proptosis of over ten years' duration due to organized hematoma of the orbit. It has generally been accepted that any given hemorrhage within the orbit can be resolved in a relatively short period of time. Persistent intraorbital hematoma, therefore, in the form of organized hematoma is very unusual in incidence and has been reported very few in the literature. Our patient presented himself with a ten-and-several-year history of unilateral exophthalmos, limited ocular movement and decreased visual acuity on the involved side. There was no specific symptom when compared with the other intraorbital tumors. Total resection of the tumor was performed through transcranial frontozygomatic approach. Histopathologic examination revealed evidence of organized hematoma without definite sources of bleeding such as microangioma, microaneurysm or arteriovenous malformation. Retrospective review of history failed to uncover episodes of hemorrhagic tendency or direct trauma to the head or the orbit. Subsequently a diagnosis of spontaneous organized hematoma was made. Great emphasis was laid on the fact that CT-scan was one of the most useful diagnostic tools. Our surgical approach was introduced and discussed.

Adult↗
PubMedDate not supplied

Computed tomography of intracranial chondroma with emphasis on delayed contrast enhancement.

Intracranial chondroma is an unusual cartilaginous tumor originating from the base of the skull. We report on two cases of intracranial chondroma that showed delayed contrast enhancement on CT after high-dose administration of contrast medium. This CT feature may be useful to differentiate chondromas from other tumors of the skull base such as meningiomas and neurinomas.

Adult↗