Biomedical subjects

Kuniaki Nakahara

Publications and source records attributed to Kuniaki Nakahara.

9 recordsLinked to original sources

PubMed2006

Age dependence of fusion of primary occipital sutures: a radiographic study.

PURPOSE: When linear lucency is present in the occipital bone on radiographs throughout childhood, differential diagnosis becomes important because some primary sutures are similar to fractures. The authors here chronicled the normal development of ossification centers, sutures, and synchondroses in the chondrocranium by radiographic examination. METHODS: One hundred and twenty-seven children, aged from newborns to 6 years and without any skull base deformities, were referred to for radiographs of Towne's projection. RESULTS: In the occipital bone at birth, three primary sutures could be identified. At the age of 0-3 years, occipital and innominate sutures started to fuse, this being complete by 4 years, whereas mendosal sutures persisted until 6 years of age, after which no primary sutures could be seen. CONCLUSION: The complex process of skull base development features a step-wise process sutural closure for which radiographic standards allow differential diagnosis from fractures with judgment of the timing.

Aging↗

PubMed2006

Usefulness of transcervical approach for surgical treatment of hypoglossal schwannoma with paraspinal extension: case report.

BACKGROUND: Usefulness of transcervical approach to hypoglossal schwannoma with paraspinal extension is described herein. CASE DESCRIPTION: A 54-year-old woman presented with gradually worsening left hypoglossal nerve palsy. The findings were of a tumor lying in the left hypoglossal canal and paraspinal region and were consistent with hypoglossal schwannoma. Subtotal intracapsular removal of the tumor was performed via transcervical approach. The symptoms improved, and no additional symptoms were noted. CONCLUSION: The transcervical approach and intracapsular removal of the tumor under electrophysiological monitoring provided for successful minimally invasive surgery in this case of hypoglossal schwannoma.

Cervical Vertebrae↗

PubMed2006

Subcutaneous pneumocele associated with ventriculoperitoneal shunt migration into the mechanically occluded colon - case report.

A 62-year-old man presented with shunt failure manifesting as consciousness disturbance 4 years after placement of a ventriculoperitoneal shunt for subarachnoid hemorrhage. Physical examination found subcutaneous pneumocele around the peritoneal catheter extending from the abdomen to the neck. He had undergone pelvic radiation therapy for bladder cancer 2 years before. The peritoneal catheter was removed from the cervical region, and external ventricular drainage and a descending colon stoma for ileus release were positioned. The cerebrospinal fluid was clear and yielded no cultures. No inflammatory changes were seen. He developed carcinomatous peritonitis and died 4 months later. Retrograde colon gas reflux due to catheter perforation into the colon occluded by metastatic sigmoid cancer was probably the cause. Fragility of the wall of colon associated with the prior abdominal radiation therapy might have been a contributing factor. Subcutaneous pneumocele around the peritoneal catheter, i.e. pneumocele within the fibrous sheath surrounding the catheter, is a differential diagnosis to cerebrospinal fluid collection in patients with subcutaneous swelling around the catheter.

Carcinoma↗

PubMed2006

Pituitary apoplexy manifesting as diffuse subarachnoid hemorrhage.

A 46-year-old woman presented with hemorrhage from a non-functioning pituitary adenoma manifesting as sudden onset of severe headache. Computed tomography demonstrated diffuse subarachnoid hemorrhage (SAH) and a suprasellar mass with intratumoral hematoma. The patient underwent transnasal transsphenoidal removal of the pituitary adenoma. This type of SAH with intratumoral hematoma simulates rupture of an anterior cerebral artery aneurysm.

Adenoma↗

PubMed2006

Stereotactic radiosurgery as adjuvant treatment for residual solitary fibrous tumor. Case report.

This 50-year-old woman presented with headache and visual disturbance. Neuroimaging results demonstrated a well-demarcated tumor attached to the falx cerebri near the transverse sinus, and the lesion was subtotally removed. Based on histological and immunohistochemical evaluation, a solitary fibrous tumor (SFT) was diagnosed. During the next 32 months, the size of the residual tumor increased slightly at the transverse sinus. Stereotactic radiosurgery (SRS) was performed as an adjuvant treatment. Over the course of the next 4 years the tumor decreased in size. The authors suggest that SRS constitutes good adjuvant treatment for regrowing residual SFTs not amenable to reoperation.

Brain Neoplasms↗

PubMed2006

Shunt infection.

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Age Factors↗

PubMed2005

Dilation of spinal epidural veins caused by spontaneous intracranial hypotension: case report.

A 30-year-old woman presented with headache which occurred when standing up from a recumbent position. Magnetic resonance (MR) imaging of the brain revealed slightly diffuse enhancement of the dura mater and two ventral extradural spinal flow voids in the supine position. Radionuclide cisternography identified cerebrospinal fluid leakage localized below the cervical level. Vertebral angiography demonstrated two dilated ventral extradural veins. The patient was treated by conservative therapy and improved with rest. The unusual clinical presentation with dilation of two epidural veins indicates the diagnostic value of MR imaging in cases of spontaneous intracranial hypotension.

Adult↗

PubMed2003

Unusual accessory cranial sutures in pediatric head trauma--case report.

A one-year, 9-month-old boy presented with pediatric head trauma associated with unusual accessory cranial sutures. Radiography demonstrated unusual bilateral longitudinal linear bone defects extending from the foramen magnum to the mendosal sutures, and bilateral transverse linear bone defects around the foramen magnum. No swelling or soreness were found in the occipital area, and there was no past history of head trauma. Therefore, the bone defects were considered to be accessory cranial sutures. Complex developmental patterns of the occipital bone and the considerable normal variation of sutures may simulate fractures around the foramen magnum. The present case of accessory cranial sutures is another example.

Congenital Abnormalities↗

PubMed2003

Development of multiple cerebral arteriovenous malformations documented in an adult by serial angiography. Case report.

A 50-year-old woman with a parietal intracerebral hematoma was initially treated by hematoma evacuation. Initial preoperative and follow-up angiograms obtained 6 months later demonstrated no pial arteriovenous malformations (AVMs). She suffered a subarachnoid hemorrhage 8 years later. Results of follow-up cerebral angiography revealed the development of previously undetected multiple cerebral AVMs. This appears to be the first reported case of the development of multiple cerebral AVMs in an adult, demonstrated on serial angiography.

Cerebral Angiography↗