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Biomedical subjects

R Tsugane

Publications and source records attributed to R Tsugane.

At least 55 records · Page 3Linked to original sources
PubMed1989

Craniopharyngioma with extension into the cerebellopontine angle. Case report.

A rare case of craniopharyngioma which extended from the suprasellar region into the cerebellopontine angle (CP angle) is reported. This patient, a 18-year-old man who underwent two surgeries for suprasellar craniopharyngioma did not show recurrence during interval studies. However, nine years after the second surgery CT scan and MRI indicated a left CP angle mass when he was submitted to suboccipital craniectomy and tumor resection. He had been on human growth hormone (hGH) regimen for his pituitary dwarfism before tumor recurrence. The authors speculate retrospectively that the tumor growth in the left CP-angle was correlated with hGH therapy in this particular case.

Adolescent↗
PubMed1988

[Renal protection in acute neurosurgical diseases--effect of a low dose dopamine with reference to acute renal failure and hypernatremia in patients with dehydration].

The authors reviewed the effect of low dose dopamine administration (1-5 micrograms/kg/min) in neurosurgical patients with acute renal failure (5 cases) or hypernatremia (7 cases) in whom cerebral dehydration therapy for intracranial hypertension was thought to be causative of these disorders. Cases with hypernatremia (serum sodium over 155 mEq/l) were considered in the stage of impending acute renal failure as in the majority of cases serum creatinine levels were mildly elevated while urinary sodium was markedly diminished. Associated with systemic hypovolemia, in cases with acute renal failure (with serum creatinine over 3.5 mg/dl and urinary output of less than 20 ml/hr for more than 4 hour duration) the urinary sodium levels were less than 20 mEq/l. In all the cases treated by low dose dopamine, urinary output and sodium increased within 6 hours and in the following 24 hours stabilized urinary output with its elevated sodium (some 100 mEq/l) was obtained. As the result, elevated urea-nitrogen or serum sodium was rather easily washed out and the patients were kept adequately hydrated afterwards. Any complications such as aggravation of cerebral edema or convulsive disorder were not associated with this regime. The authors, therefore, would emphasize that low dose dopamine administration resulting in sodium diuresis and increase in renal blood flow is a practical way of method in treating patients with hypernatremia or acute renal failure caused by hyperosmolar agent infusion in their acute stage.

Acute Kidney Injury↗
PubMed1987

Infantile acute subdural hematoma.

A retrospective analysis of the infantile acute subdural hematoma was made with special reference to its pathogenesis. In 11 of 15 cases, the hematomas were bilateral or a contralateral subdural fluid collection was present. In 7 of 11 patients who underwent operation the collection was bloody fluid and/or clotted blood. In 3 patients, a subdural membrane, as seen in adult chronic subdural hematoma, was found. In only 1 patient with unilateral hematoma was clotted blood present without subdural membrane. The thickest collection of clotted blood was in the parasagittal region. It is postulated that in most cases hemorrhage occurs after minor head injury, from the bridging veins near the superior sagittal sinus, into a pre-existing subdural fluid collection such as chronic subdural hematoma or subdural effusion with cranio-cerebral disproportion, and that infants without intracranial disproportion are unlikely to have acute subdural hematoma caused by minor head injury.

Acute Disease↗
PubMed1986

[A case of central pontine myelinolysis].

A case of central pontine myelinolysis (CPM) following rapid correction of hyponatremia is reported and a review of the literature is made. The patient was a 63-year-old non-alcoholic female who had no liver or kidney diseases in her past history. She was found unconscious after a series of convulsions and was admitted to the hospital. Eighteen months prior to admission, she had a surgery for a ruptured anterior communicating artery aneurysm. Her postoperative course was uneventful except for an urinary incontinence and mild disorientation. She was initially lethargic with conjugate deviation toward right. Nine days after admission, she still remained lethargic, and laboratory studies showed a serum sodium value of 93 mEq/l, serum osmolarity 206 mOsm/l and urine osmolarity 270 mOsm/l when she was clinically diagnosed as having SIADH. She was treated by a strict elimination of water, and administration of sodium, dexamethasone and demeclocycline. In three days, serum sodium was corrected and returned to 137 mEq/l. However, she deteriorated in consciousness and became comatose and developed quadriplegia. CT scans and cerebral angiograms were normal. One month later, another CT scans demonstrated a well-defined hypodensity area in the pons. Brain stem auditory response (BSAR) showed a prolongation of III-V interpeak latency, especially IV-V interval. Her neurological state was essentially unchanged thereafter and she died of septic shock after 12 months' hospitalization. No permission for autopsy was obtained. The clinical course, CT scans and BSAR reported here are indicative of the diagnosis of CPM.

Brain Stem↗
PubMed1985

Superior sagittal sinus thrombosis associated with Evans' syndrome of haemolytic anaemia.

A case of superior sagittal sinus thrombosis associated with Evans' syndrome of immune haemolytic anaemia is reported. The neurological symptoms and signs were headaches, right quadrant hemianopia, dyslexia without agraphia, motor aphasia, numbness in and weakness of the right upper extremity, papilloedema and coma. The cerebral venous sinus thrombosis, involving cerebral veins, superior sagittal sinus and straight sinus, was diagnosed by cerebral angiography. It is noteworthy that the superior sagittal sinus thrombosis occurred during a haematological recovery period, with rapid responses to treatment with 6-mercaptopurine and high doses of adrenocorticosteroids. Following a reduction in the doses of these drugs, the symptoms and signs related to the superior sagittal sinus thrombosis gradually subsided, and the haematological pictures remained in remission.

Adult↗
PubMed1984

Peripheral aneurysms of the posterior inferior cerebellar artery.

Nonmycotic peripheral posterior inferior cerebellar artery (PICA) aneurysms are rare. The authors report six cases of peripheral PICA aneurysm. Two of these are unusual; one was fusiform and another was a double aneurysm arising from the peripheral PICA. The previously reported 40 cases of peripheral PICA aneurysm are reviewed.

Adult↗
PubMed1981

[Abdominal complications of V-P or L-P shunt operation --a bowel perforation and historical review (author's transl)].

We have experienced a case of shunt tube perforation into the transverse colon in which a Pudenz infantile V-A shunt tube was installed for a hydrocephalic baby. The shunt operation was performed at a year and one month of his age in this patient and bowel perforation was disclosed and corrected twenty months following the operation. From a retrospective point of view, however, slight sign of meningitis could be suspected two months earlier and judging from his symptoms of transient intracranial hypertension, the bowel perforation might be traced back even earlier. In the past twenty year history of V-P shunt maneuver, quite a number of papers on various kinds of specific complications have been reported. On reviewing these reported cases out of English and Japanese literature, numerous abdominal complications such as twenty-eight perforations, fifty CSF ascites or pseudocysts, three umbilical perforations, two vaginal perforations, five migrations into scrotum, and some volvulus and bladder perforations can be collected. These are summarized and discussed briefly in this paper.

Ascites↗
PubMed1979

Non-communicating hydrocephalus caused by dural arteriovenous malformation.

The case of a female infant with a non-communicating hydrocephalus caused by an enormously dilated straight sinus and the dilated posterior one third of the sagittal sinus is presented. These sinuses drained a torcular dural arteriovenous malformation. Conray ventriculography revealed a complete obstruction of the junction of the aqueduct and fourth ventricle with cephaloventral displacement of the ventricular system by the dilated sinuses. Placement of a ventriculoperitoneal shunt was followed by artificial embolization, by selective catheterization, into the dural feeding arteries.

Arteries↗
PubMed1978

A newly designed multipurpose microneurosurgical head frame. Technical note.

A new multipurpose head frame has been designed for microneurosurgery. It consists of a head holder with a frame to hold self-retaining brain retractors, hand rests, instrument holders, a plate for cotton patties, and skin-flap retractors. It has been satisfactorily used in 100 operations for 1 year.

Humans↗