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Biomedical subjects

Shuji Kamikawa

Publications and source records attributed to Shuji Kamikawa.

8 recordsLinked to original sources
PubMed2006

Neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle: indications, technique, complications, and results.

OBJECTIVE: Evaluation of results of the neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle. METHODS: From 2001 to 2004, 23 patients (mean age, 30.6 yr) with tumors located in the pineal region or posterior third ventricle underwent neurofiberscopic biopsy with simultaneous third ventriculostomy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by radiotherapy and/or chemotherapy without open surgery (eight patients), establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy (11 patients), differentiation of the recurrent neoplasm and radiation necrosis (two patients), and decompression of the large tumor-associated cyst (two patients). In six previously shunted patients, substitution of the ventriculoperitoneal shunt on the third ventricle stoma was performed. RESULTS: There was no postoperative mortality or permanent morbidity. In all cases, the obtained tissue sample was sufficient for pathological diagnosis. Transient postoperative complications included fever (15 patients), nausea and vomiting (three patients), and diplopia (one patient). On the long-term follow-up, delayed third ventricular stoma failure caused by tumor regrowth and scar formation was found in one patient, and dissemination of the malignant glioma through the subarachnoid space was found in another patient. CONCLUSION: Neurofiberscopic biopsy represents a useful method for sampling of tumors of the pineal region and posterior third ventricle, which can be effectively used in both previously shunted and shunt-free patients.

Adolescent↗
PubMed2005

Neurofiberscope-guided management of slit-ventricle syndrome due to shunt placement.

OBJECT: The purpose of this study was to evaluate an original neurofiberscope-guided strategy for the management of slit-ventricle syndrome that occurs after shunt placement. METHODS: Between 1995 and 2003 15 patients with slit-ventricle syndrome (mean age 14.2 years) underwent endoscopic third ventriculostomy (ETV) and shunt removal. During the initial surgical procedure a neurofiberscope with a small outer diameter was inserted along the shunt tube into the collapsed ventricle for endoscopically controlled removal of the ventricular catheter and evaluation of brain compliance. If the latter was sufficiently preserved, primary ETV and shunt removal were performed (four cases). If brain compliance seemed to be significantly reduced, endoscopically controlled replacement of the ventricular catheter and implantation of the Codman-Hakim programmable valve shunt device were performed (11 cases). In these patients, delayed ETV and shunt removal were performed later (mean period of 16.3 months). No medical or surgical complications occurred in any case. Follow up ranged from 6 to 84 months (mean 31.1 months; median 22 months). All patients became shunt independent and 13 became symptom free. Overall, the size of the ventricles returned to normal in five cases, became slightly dilated in nine, and moderately dilated in one. CONCLUSIONS: Neurofiberscope-guided treatment of slit-ventricle syndrome involving shunt removal and ETV appears to be beneficial; all patients in this series were symptom free and shunt independent at the end of follow up.

Adolescent↗
PubMed2004

Double-endoscopic approach for management of convexity arachnoid cyst: case report.

BACKGROUND: Controversy exists about the best treatment modality for arachnoid cysts. Widely accepted neurosurgical options include craniotomy with open resection of the cyst walls, shunting procedures and stereotactic fenestration of the cyst cavity. Recently, neuroendoscopic approach showed its effectiveness for treatment of these lesions. CASE DESCRIPTION: In the presented case the large convexity arachnoid cyst was diagnosed in a 22-year-old woman with head dullness and local bone bulging. No neurologic signs were found. Surgery was performed by double-neuroendoscopic approach with simultaneous use of two flexible ventriculofiberscopes, which permitted wide resection of the inner cyst wall. Complete resolution of symptoms was noted soon after surgery. CONCLUSION: Double-endoscopic approach might be useful for complex neuroendoscopic procedures that need different simultaneous surgical actions, particularly for cases of large arachnoid cysts.

Adult↗
PubMed2003

Histologic diagnosis and management of hypothalamic tumors in children by the use of newly developed flexible neuroendoscopes.

Hypothalamic tumors are difficult to treat surgically, and chemotherapy and/or radiation are given based on the histology and the neuraxis staging of the tumors. We have developed flexible neuroendoscopes (Yamadori-type 8 and 9) which have excellent image quality and maneuverability as well as capabilities for biopsy and electrocoagulative debulking of the cystic tumors. We report the successful application of the neuroendoscopes to 10 children with hypothalamic tumors diagnosed with computed tomography or magnetic resonance imaging. Histologic diagnosis was obtained from all the patients. Cystic tumors were evacuated, hydrocephalus managed with endoscopic operations, and some benign tumors were removed totally. The relatively non-invasive approach reported here would represent a significant technical advance in the diagnosis and management of hypothalamic and other ventricular tumors.

Adolescent↗