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Biomedical subjects

K Hinokuma

Publications and source records attributed to K Hinokuma.

At least 19 recordsLinked to original sources
PubMed1999

Primary intraorbital ectopic meningioma.

We report a case of intraorbital meningioma. Operative findings and histopathological examination revealed the tumoc to be meningothelial meningloma and to be located entirely outside the optic dura. This case demonstrates the occurrence of primary intraorbital ectopic meningioma, and the tumor was removed through a modified Dolenc approach. The primary intraorbital ectopic meningioma is discussed and the surgical approach to the orbital apex region is reviewed.

Case Reports↗
PubMed1999

[Endovascular treatment of ruptured intracranial aneurysms using platinum coils in patients over 80 years of age].

Endovascular treatment of intracranial aneurysms using plantinum coils was performed in 10 patients over 80 years of age. The patients ranged in age from 81 to 96 years. Preoperative Hunt and Kosnik grading revealed one patient in grade I, 4 in grade II, 3 in grade III, and 2 in grade IV. The aneurysms were located in the internal carotid artery in 6 patients, in the anterior communicating artery in 1, and in the middle cerebral artery in 3 respectively. Intra-aneurysmal occlusion was accomplished in 8 patients with total or subtotal occlusion in 6 and partial occlusion in 2. In one patient with a peripheral middle cerebral artery aneurysm, the parent artery was occluded just proximal to the aneurysm. In the remaining one patient in grade III, an aneurysm associated with wide neck could not be occluded because of coil protrusion into the parent artery. In 9 patients who were successfully treated, all five patients in grade I or II and one in grade III resulted in good outcome, but the other three patients in grade III and IV showed poor outcome. No evidence of recurrent hemorrhage was noted during the follow-up period ranging from 2 months to 4 years. Endovascular coil embolization is a useful therapeutic alternative for treating ruptured intracranial aneurysms in patients over 80 years of age, especially those in Grade I or II.

Aged↗
PubMed1997

Visual evoked potential guidance for posteroventral pallidotomy in Parkinson's disease.

Visual evoked potentials (VEPs) to photic stimulation of the eyes were used to identify the optic tract and thus determine the location of the globus pallidus internus (GPi) in eight patients with Parkinson's disease who then underwent posteroventral pallidotomy. Distinct waves appeared at 1 or 2 mm below the target (4 to 5 mm below the intercommissural line) and the amplitude significantly increased at 5 or 6 mm below, strongly suggesting that the electrode was in contact with the optic tract. In the medio-lateral direction, potentials were successively recorded in an area of 4 to 8 mm length, indicating the width of the optic tract. The trajectory at the mid point showed the most significant potentials which suggested the center of the optic tract. The site of the first lesion was placed 0 to 2 mm lateral to this trajectory and 5 mm above the point at which the amplitudes of responses increased. The actual lesion site significantly differed from the tentative target in a medio-lateral direction by 1 to 5 mm (mean 3.0 +/- 1.5 mm, n = 6). The Unified Parkinson's Disease Rating Scale score significantly improved and magnetic resonance imaging taken 2 or 3 weeks after the operation showed a lesion within the GPi in each patient. Recording of VEPs greatly facilitates accurate determination of the GPi.

Aged↗
PubMed1997

Epidermoid tumor in the sphenoid sinus--case report.

A 36-year-old male presented with a very rare epidermoid tumor in the sphenoid sinus manifesting as paresis of the right sixth cranial nerve and diplopia. Computed tomography and magnetic resonance imaging revealed a mass lesion in the sphenoid sinus expanding to the clivus. The cystic tumor, which contained cholesterin crystals, was extensively removed via the transsphenoidal approach. Histological examination showed epidermoid cell layers, consistent with the diagnosis of epidermoid tumor. Epidermoid tumors should be considered in the differential diagnosis of lesions in the sphenoid sinus.

Adult↗
PubMed1997

Unilateral sensori-neural hearing disturbance caused by intramedullary cerebellar tumors--three case reports.

Three patients presented with unilateral sensori-neural hearing disturbance as the initial symptom of cerebellar tumors: a 19-year-old female with a medulloblastoma (Case 1), a 45-year-old male with a cerebellar low-grade glioma (Case 2), and a 49-year-old female with a cerebellaer hemangioblastoma (Case 3). In Cases 1 and 2, the whole length of the eight cranial nerve was intact according to magnetic resonance imaging and intraoperative findings. In Case 3, the intracerebellar tumor had bulged into the cerebellopontine cistern, compressing the eighth cranial nerve near the brainstem. Auditory evoked brainstem responses showed only the first wave in all three patients, and the following waves could not be discriminated. Unilateral sensori-neural hearing disturbance occurs very rarely in patients with intramedullary cerebellar lesions because the auditory neural pathway is bilaterally innervated. Intramedullary tumors may cause unilateral sensori-neural hearing disturbance by infiltrating or causing edematous changes of the eighth cranial nerve or the cochlear nucleus in the brainstem, or by compressing the nerve in the cistern. The symptoms are the same as those of acoustic neurinoma, so intramedullary cerebellar tumors should be considered in the differential diagnosis of unilateral sensorineural hearing disturbance.

Adult↗
PubMed1996

Surgical approach to the internal auditory meatus in acoustic neuroma surgery: significance of preoperative high-resolution computed tomography.

OBJECTIVE AND METHOD: To establish a surgical approach that provides better access to the internal auditory meatus (IAM) in acoustic tumor removal via a suboccipital transmeatal route, the anatomic location of the labyrinth with regard to the sigmoid-fundus line and the extent of bone removal from the IAM were evaluated by pre- and postoperative high-resolution computed tomography for 47 patients. RESULTS: The labyrinth was located lateral to the sigmoid-fundus line in 22 cases (lateral type, 46.8%), on the line in 9 (on-the-line type, 19.1%), and medial to the line in 16 (medial type, 34.0%). Postoperative high-resolution computed tomography showed that the mean length of the posterior wall from the fundus was shortened to 5.1 +/- 1.1 mm (n = 27) in the partially resected group and to 2.0 +/- 0.6 mm (n = 20) in the widely opened IAM group. The labyrinth was damaged in four cases from the widely opened IAM group; the preoperative status of the labyrinth was medial to the sigmoid-fundus line in three and on the line in one. The cochlear nerve was preserved in seven (31%) partially resected and in eight (50%) widely opened IAM cases. The overall success rate of hearing preservation was 4 of 22 (18.2%) partially resected and 5 of 16 (31.2%) widely opened cases. CONCLUSION: Preoperative evaluation of the anatomic relation between the IAM and the labyrinth by high-resolution computed tomography provides an efficient surgical approach to the IAM and contributes to anatomic and functional preservation of the cochlear nerve.

Female↗
PubMed1996

Glioblastoma multiforme in the left frontal lobe subsequent to malignant lymphoma in the right orbit.

A 62-year-old male presented with glioblastoma multiforme in the left frontal lobe manifesting as motor aphasia, subsequent to a malignant lymphoma in the right orbit. He underwent subtotal removal of the right orbital mass presenting as right exophthalmos which was shown by histological examination to be non-Hodgkin's lymphoma. He received 30 Gy Lineac irradiation to the right orbit. His post-operative course was satisfactory. Magnetic resonance (MR) imaging with gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) 7 months later demonstrated a small spotty enhanced lesion in the left frontal lobe. He developed motor aphasia 1 year after irradiation. MR imaging disclosed an enhanced mass in the left frontal lobe, which was totally removed. Histological examination revealed glioblastoma multiforme. Patients with malignant lymphoma may develop a subsequent second malignant tumor. MR imaging with Gd-DTPA is quite useful for early detection of a second brain tumor.

Brain Neoplasms↗
PubMed1995

Intrasellar neuronal choristoma associated with growth hormone-producing pituitary adenoma containing amyloid deposits.

The histological, immunocytochemical, and ultrastructural features of an intrasellar neuronal choristoma associated with pituitary growth hormone (GH)-producing adenoma are reported. Immunohistochemistry studies and electron microscopy examination showed the adenoma cells to be positive for GH but negative for prolactin, and the neurons of the choristoma to have GH-releasing factor (GRF) neurosecretory activity. The adenoma also had many amyloid deposits in its extracellular space immunoreactive to GRF. This is the first report of the tumor containing amyloid deposits.

Adenoma↗
PubMed1995

[Neuropathology of syringomyelia].

Eighteen autopsy cases of syringomyelia were studied neuropathologically. In 5 cases associated with Chiari type I malformation, the syrinx was irregular in shape and communicated with the subarachnoid space at the entry zone of the posterior nerve roots. The central canal above the level of the syrinx was patent in 2 but closed in 3 out of 5 cases. In cases associated with Chiari type I malformation, communication between the syrinx and the subarachnoid space was considered to play an important role in the pathogenesis of syringomyelia. In 6 cases associated with Chiari type II malformation, the syrinx central canal, and the central canal was patent from the 4th ventricle to the syrinx in all cases. In these cases, direct continuity between the 4th ventricle and the syrinx was essential for the development of the syrinx. In cases associated with posterior fossa or spinal canal tumors, the local circulatory disturbance and/or edema due to the tumors were thought to cause the syrinx.

Adolescent↗
PubMed1992

Meningioma in a neonate: case report.

A 10-day-old female with a parasagittal meningioma presenting as a subcutaneous tumor is reported. Meningiomas within the 1st month of life are rare. The clinical and pathological characteristics of congenital meningioma are reviewed.

Female↗
PubMed1992

Syringomyelia. A neuropathological study of 18 autopsy cases.

Eighteen autopsy cases of syringomyelia were studied neuropathologically. In six cases associated with Chiari II malformation, the central canal was patent from the fourth ventricle to the syrinx, and the syrinx was simply a dilated central canal. In four cases associated with Chiari I malformation, the syrinx was irregularly shaped and communicated with the subarachnoid space at the entry zone of the posterior nerve roots. In six cases associated with spinal cord or posterior fossa tumors, the syrinx was located adjacent to the tumor tissues, and occupied the medullary gray matter or the spinal intermediate zone and the ventral part of the posterior horn. With regard to the pathogenesis of syringomyelia, we concluded that in cases associated with Chiari II malformation, vermian protrusion and direct continuity between the fourth ventricle and the syrinx were essential. In cases associated with Chiari I malformation, in addition to tonsillar protrusion, communication between the syrinx and the subarachnoid space was thought to play an important role, and in cases associated with tumors, the circulatory disturbance due to the presence of the tumors caused the syrinx.

Aged↗
PubMed1991

Creutzfeldt-Jakob disease in a patient with a cadaveric dural graft.

We report a 26-year-old woman with Creutzfeldt-Jakob disease (CJD) who had received cadaveric dural material 33 months before the onset of neurologic symptoms. This is the fourth case in which a dural graft was the putative source of the CJD agent. All four cases had the grafting before changes in the sterilization procedure adopted in 1987 to inactivate the CJD agent.

Adult↗
PubMed1990

Dural arteriovenous malformation with abnormal parenchymal vessels: an autopsy study.

A 48-year-old man with dural arteriovenous malformation (AVM) is reported. Radiologically, the dural AVM was demonstrated mainly in the region of the left transverse sinus. Postmortem examination revealed dural AVM involving the bilateral transverse, superior sagittal and straight sinuses. In addition, numerous malformed venous vessels and extensive necrosis were observed mainly in the parenchyma of the brain stem and cerebellum. The present case suggests that dural AVMs may be associated with malformed venous vessels in the brain parenchyma.

Adult↗
PubMed1989

Occurrence of 15-nm-wide straight tubules in neocortical neurons in progressive supranuclear palsy.

Ultrastructural investigations were carried out on the cerebral neocortex in two cases of progressive supranuclear palsy. In both cases, characteristic 15-nm-wide straight tubules were observed in the neurons. The numbers of cells containing the straight tubules and of tubules in individual cells were small. However, the occurrence of the tubules strongly suggests that the cerebral neocortex is also exposed to the disease process in progressive supranuclear palsy.

Aged↗
PubMed1989

Glomeruloid blood vessels in ethylnitrosourea-induced rat gliomas. Histological and immunohistochemical studies.

Glomeruloid blood vessels (GBVs), a characteristic histological feature of most human malignant gliomas, were recognized with high incidence in autochthonous rat gliomas induced by transplacental administration of ethylnitrosourea. To evaluate some of the biological properties of these GBVs, we carried out a study using histological methods and immunohistochemical staining for glial fibrillary acidic protein, factor VIII-related antigen (VIII Ag) and bromodeoxyuridine (BrdUrd). Of 22 animals with large, massively growing gliomas in the CNS, GBVs including conglomerate aggregations of small blood vessels with endothelial hyperplasia and strong VIII Ag expression were observed in 13 large gliomas histologically consisting of primitive neuroepithelial neoplasms (PNN; so called ependymoma) and mixed-type gliomas in combination with astrocytoma and PNN or anaplastic astrocytoma. The anaplastic gliomas in our series were devoid of GBVs. These findings indicate that GBV formation takes place in a histological variety of experimental gliomas. Furthermore, the GBVs were frequently associated with the vasculo-mesenchymal stroma in the parent gliomas, suggesting an intimate relationship with the morphogenesis of GBVs. In addition, it was shown that the GBVs had a higher BrdUrd-labelling index than that of other blood vessels in gliomas and also that of neoplastic cells in most parent gliomas, except for anaplastic gliomas. Based on these results, the possible mechanism of GBV morphogenesis is discussed with regard to the roles of macromolecules in the induction and regulation of GBVs.

Animals↗
PubMed1988

[Cerebral lateralization in two cases of crossed dextral aphasia with right-hemisphere arteriovenous malformation].

This paper reports two cases of crossed dextral aphasia. The first patient was a 60-year-old right-handed male with no family history of sinistrality. He experienced sudden onset of left hemiplegia and loss of consciousness. A CT scan showed high-density area in the right fronto-parietal region. An angiography revealed an arteriovenous malformation (AVM) in the right parietal lobe. It was fed by a branch of the middle cerebral artery and drained through a cortical vein. Neuropsychological examination one week after the surgery showed severe defects of all language moderalities. He was alert and cooperative, but completely mute. He recognized common words by auditory and visual stimuli, but could not perform simple command. He wrote some meaningless letters when asked to write his own name. Auditory and reading comprehension gradually improved thereafter, but Broca's type of aphasia with non-fluent hesitant and effortful output was still present four months after the surgery. The second patient was a 38-year-old right-handed male. All members of this family are right-handed except for one sister who is left-handed. He suddenly suffered left hemiparesis and loss of consciousness. A CT scan disclosed a right parietal intracerebral hematoma. And an AVM which was fed by the angular artery and drained through a cortical vein was angiographically demonstrated in the same area. Postoperatively the left hemiparesis rapidly disappeared, but left homonymous hemianopsia and anomic type of aphasia still persisted. His speech was fluent and daily communication was possible in spite of circumlocutory paraphasic output.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗