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Munehito Yoshida

Publications and source records attributed to Munehito Yoshida.

11 recordsLinked to original sources
PubMed2003

[A case of amnesia caused by a subcortical hematoma in the left retrosplenial region].

A 54-year-old right-handed woman suffered transient aphasia and persistent amnesia caused by a subcortical hematoma in the left occipital lobe. She appeared to have aphasia, although it disappeared within 3 weeks. It is noteworthy that she had a lesion in the left retrosplenial region but exhibited both verbal and non-verbal memory impairment. However, her intelligence, remote memory and digit span were normal. She had no topographic disturbance. Computed tomography and magnetic resonance imaging revealed a subcortical hematoma in the left occipital lobe including the retrosplenial region. Single photon emission CT showed a low perfusion area in the retrosplenial region and in the left thalamus. We concluded that the retrosplenial amnesia might be caused by the interruption of hippocampal input into the anterior thalamus.

Amnesia↗
PubMed2003

Mobility and muscle strength contralateral to hemiplegia from stroke: benefit from self-training with family support.

OBJECTIVE: To determine whether patient exercise with the support of family members maximizes mobility and improves muscle strength in the nonparetic lower limb after stroke. DESIGN: Comparison of improvement at 2 wk between conventional exercise sessions and a program also including the participation of family members. Subjects were 60 patients rendered nonambulatory by severe hemiparesis from their first stroke. Of these, 42 had family members participating in their therapy. Lower limb strength was measured on the nonparetic side using an isokinetic machine. Mobility status was assessed using the Rivermead Mobility Index. Patients were evaluated at the first inpatient gym session and again at 1 and 2 wk. RESULTS: At the first evaluation, lower limb strength and the Rivermead Mobility Index score did not differ between the two groups. Reevaluations were conducted at 1 and 2 wk after the first evaluation. Patients' strength and mobility improved more when family members participated. CONCLUSION: Family participation is an important contributor to stroke rehabilitation.

Aged↗
PubMed2002

Does reconstruction of posterior ligamentous complex with extensor musculature decrease axial symptoms after cervical laminoplasty?

STUDY DESIGN: The authors retrospectively determined the prevalence of neck and shoulder symptoms (axial symptoms) after expansive laminoplasty with reattachment of spinous process and extensor musculature in patients with cervical myelopathy. OBJECTIVES: To determine the prevalence of both preoperative and postoperative axial symptoms of expansive laminoplasty when they occur after expansive laminoplasty. SUMMARY OF BACKGROUND DATA: Several clinical reports have noted that laminoplasty for cervical myelopathy produces positive clinical outcomes. However, recent reports have pointed out that complications from laminoplasty, such as axial symptoms, may be severe enough to interfere with daily activities. METHODS: The authors used a modified spinous process-splitting laminoplasty, which involved reattaching the spinous process with extensor musculature after enlarging the spinal canal by use of the French window method. Postoperative axial symptoms were investigated in 173 of 214 patients (80.1%) who underwent expansive laminoplasty between January 1989 and December 1998. The patients included 121 men and 52 women, and their average age was 61.5 years. The presence or absence and grade of axial symptoms before and after laminoplasty were investigated. The severity and duration of complications were also recorded, along with differences between age, sex, spinal alignment, and cervical diseases. RESULTS: Neck and/or shoulder stiffness worsened in 15% of the patients and declined in 21%. Neck pain worsened in 10% of the patients and improved in 11%. Neck and/or shoulder stiffness worse than moderate was recognized in 14.4% of the patients. Neck pain worse than moderate was recognized in 5% of the patients. In the 137 patients who had no axial pain before surgery, only 13 patients experienced such symptoms after surgery, and in most cases these symptoms were minimal. In only 1 case, significant postoperative neck pain arose de novo as a result of this surgery. In 88 patients who had no neck and/or shoulder stiffness before surgery, only 16 patients experienced such symptoms after surgery, and in most cases these were minimal. A similar pattern held true for each of the other grades of preoperative axial symptoms. The recovery rate score (Japanese Orthopedic Association) was 47.5 +/- 32.3 in the patients whose axial symptoms were worse than moderate and 60 +/- 28.9 in patients whose axial symptoms were less than mild. This difference was significant (P < 0.05). CONCLUSION: Laminoplasty is an appropriate operation for cervical spondylotic myelopathy and did not, in this study, seem to have any significant influence on the development or resolution of axial symptoms.

Adult↗
PubMed2002

Lumbar sagittal balance influences the clinical outcome after decompression and posterolateral spinal fusion for degenerative lumbar spondylolisthesis.

STUDY DESIGN: This study was designed to assess both lumbar sagittal balance and clinical outcomes of decompression and posterolateral fusion for degenerative lumbar spondylolisthesis. As an index for the radiologic evaluation of sagittal alignment, the L1 axis S1 distance was used (i.e., the horizontal distance from the plumbline of the center in the L1 to the back corner of the S1). OBJECTIVE: To determine whether lumbar sagittal balance affected the clinical outcome after posterolateral fusion. SUMMARY OF BACKGROUND DATA: Little is known about whether the sagittal vertical axis influences clinical outcomes in cases of degenerative lumbar spondylolisthesis. METHODS: A retrospective review of 47 patients (15 men and 32 women), ranging in age from 41 to 79 years, was conducted. The mean follow-up period was 3.6 years. Relations among outcomes including the visual analog pain scale, recovery rate, L1 axis S1 distance, slippage, and lumbar lordosis were evaluated. RESULTS: Recovery rates were 44% and 62% in patients whose preoperative L1 axis S1 distance, respectively, was more than 35 mm (Group A, n = 16) and less than 35 mm (Group B, n = 31) (P < 0.05). Follow-up assessment found a positive correlation between only lordosis and recovery rate. Severe low back pain and lower recovery rate were observed in patients with in situ fusion in Group A (n = 9), as compared with patients with reduced slippage in Group A (n = 7) and patients in Group B. CONCLUSIONS: Both preoperative L1 axis S1 distance and lordosis at follow-up assessment affected surgical outcome. Reduction of slippage may improve clinical outcomes of posterolateral fusion for degenerative lumbar spondylolisthesis with an L1 axis S1 distance more than 35 mm.

Adult↗
PubMed2002

Transient aphasia and persistent amnesia after surgery for internal carotid artery--posterior communicating artery aneurysm.

We report a case of transient aphasia and persistent amnesia after clipping of a ruptured cerebral aneurysm to treat a subarachnoid hemorrhage. Postoperatively, aphasia was identified and magnetic resonance imaging (MRI) showed an abnormal intensity area in the left anterior thalamus. Single photon emission computed tomography (SPECT) revealed a wider area of low perfusion surrounding the left thalamus and left frontotemporal lobe than that shown by the MRI. His aphasia resolved over the subsequent 12-week period. He was left with an isolated disturbance of memory; in the absence of any dementia, aphasia or disturbance of consciousness, his condition was classified as one of amnesia. SPECT 14 weeks after admission revealed an area of low perfusion limited to the left thalamus. These findings suggest that the persistence of amnesia in this case was caused by the infarction of the mammillothalamic tract, and the recovery from aphasia may have resulted from the disappearance of surrounding edema.

Amnesia↗
PubMed2002

Unilateral spatial neglect in patients with cerebral hemorrhage: the relationship between hematoma volume and prognosis.

We examined patients with cerebral hemorrhage to determine the correlations between unilateral spatial neglect (USN) and neurological deficits, the site of lesions, and performance on activities of daily living (ADL) tests at discharge. Thirty-two right-handed patients with right hypertensive intracerebral hemorrhage (putamen 16, thalamus 16) were examined for neurological and neuropsychological deficits in addition to USN, and they received CT scans. USN was revealed in 26 of the patients (81.3%), of which 13 cases were putaminal hemorrhage and the other 13 were thalamic hemorrhage. The 32 patients were subdivided into three groups: those without USN, those with transient USN, and those with persistent USN. Among the patients with putaminal hemorrhage, the presence and persistence of USN seemed to be largely dependent on the size of the hematoma. Of the 7 cases with hematoma volume greater than 40ml, 4 revealed persistent USN; the other 3 cases, each of whom was under 50 years of age, showed transient USN. No cases with hematoma smaller than 20ml revealed USN. Among the thalamic hemorrhages, the size of the hematoma had no relation to the presence of USN. All 13 cases of USN caused by thalamic hemorrhage were transient. Among all the patients, those with USN showed lower ADL scores on admission than patients without USN. At discharge, ADL among patients with transient USN had improved more than the ADL of patients without USN. Therefore, we suspected that improvement in ADL might be affected by USN.

Activities of Daily Living↗
PubMed2002

Vascularized fibular osteocutaneous grafts in the treatment of severely infected wrist arthritis.

The authors successfully treated two cases of wrist arthritis severely infected by Staphylococcus aureus and Mycobacterium tuberculosis with vascularized fibular osteocutaneous grafts. The surgical procedure was divided into two stages, with extensive debridement of the infected wrist joint, and reconstruction with a vascularized fibular osteocutaneous flap. This two-staged surgery yielded complete amelioration of the severely infected wrist arthritis, and permanent stabilization of the wrist joint.

Arthritis, Infectious↗
PubMed2002

Quantitative assessment of impairment in constructional ability by cube copying in patients with aphasia.

Constructional apraxia was evaluated in patients with aphasia using a cube-copying task. It was assessed whether quantitative assessment of cube copying could be used to estimate the performance intelligence quotient (IQ) according to neuropsychological tests. Abnormality in the cube-copying test was observed in 42 of 46 patients (91.3%). Performance according to Raven's coloured progressive matrices and the revised Wechshler adult intelligence scale (WAIS-R) in patients with poor cube copying was significantly lower than in the other four patients. Numbers of the connections completed and plane-orientation errors made in the cube-copying test were significantly correlated with performance IQ on the WAIS-R, correlating particularly with block design, digit symbol, and object assembly in performance IQ subtests. The quantitatively scored cube-copying test, then, can roughly predict non-verbal IQ in patients with aphasia.

Adult↗
PubMed2002

Preoperative instability does not influence the clinical outcome in patients with cervical spondylotic myelopathy treated with expansive laminoplasty.

Sixty-seven patients with cervical spondylotic myelopathy treated with expansive laminoplasty were retrospectively reviewed at a minimum 2-year follow-up. This study was designed to evaluate whether preoperative instability influences the clinical outcome in patients with cervical spondylotic myelopathy treated with laminoplasty without spinal fusion. Patients with preoperative instability were older and had shorter durations of symptoms prior to surgery than those without the instability. There were no significant differences in prevalence of axial symptoms, neurologic recovery, or radiologic findings between patients with and without preoperative cervical instability. At follow-up, the cervical range of motion was limited to 43.5% of the preoperative range, and no cervical instability was observed in any patients. Preoperative instability does not influence the clinical outcome and can be ignored if expansive laminoplasty is indicated for patients with cervical spondylotic myelopathy.

Adult↗
PubMed2002

Relationships between sagittal alignment of the cervical spine and morphology of the spinal cord and clinical outcomes in patients with cervical spondylotic myelopathy treated with expansive laminoplasty.

A total of 103 patients with cervical spondylotic myelopathy undergoing laminoplasty were retrospectively reviewed to evaluate whether sagittal alignment of the cervical spine and morphology of the spinal cord influence surgical outcomes. Sagittal alignment of the cervical spine did not influence surgical outcomes. Neurologic recovery in patients with anterior convexity of the spinal cord was better than in those without this type of spinal cord. In patients with supplementation of decompression at C2, sagittal morphology of the spinal cord did not influence neurologic recovery. It is important to acquire anterior convexity of the spinal cord after surgery if laminoplasty is performed below C3. In patients with kyphosis, where anterior convexity of the spinal cord is not thought to be obtained postoperatively, it is possible that additional decompression of C2 improves outcome.

Adult↗