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T Tei

Publications and source records attributed to T Tei.

52 records · Page 3Linked to original sources
PubMed1982

[A case of hemangioma calcificans (author's transl)].

A 32-year-old male, who had had temporal lobe seizure for the past 10 years, was admitted to the neurosurgical institute of Tenri Hospital on March 10, 1981. Physical examination on admission revealed some memory disturbance, neuroasthenic tendency and a purplish nevus in the left foot. Plain x-ray series of the skull showed several nodular calcified lesions in the medial aspect of the left temporal lobe. Electroencephalography showed sporadic negative spikes and irregular slow waves dominant in the left anterior quadrant of the head. CT scan showed a high-density area in the left hippocampal gyrus with slight enhancement by contrast medium. Under stereotactic consideration, a left temporal osteoplastic craniotomy and total removal of the mass were performed on March 20, 1981. The histological examination proved it to be calcified cavernous hemangioma or hemangioma calcificans after Penfield and Ward (1948). Postoperative course was uneventful; even 4 weeks after surgery, electroencephalogram became normalized, and memory and anxiety scores became better. At present, in spite of decreased anticonvulsant, the patient has had no more seizure since surgery, and has returned to his business without any complaint. The authors have emphasized the necessity of active operation for hemangioma calcificans even for the one located in the depth of the dominant cerebral hemisphere. Stereotactic consideration can make the surgical risk minimize. CT scan especially with its contour plot of the images is helpful precisely to locate the lesion. For the nevus in the left foot, the biopsy was refused by the patient, which might have connection with the intracerebral cavernous angioma.

Adult↗
PubMed1982

[Three cases of arachnoid cysts associated with chronic subdural hematoma (author's transl)].

The association of arachnoid cyst of the middle cranial fossa and subdural hematoma has been emphasized previously but is not common knowledge. We present three cases of arachnoid cyst of the middle cranial fossa and associated chronic subdural hematoma. The importance of computed tomography for the diagnosis of arachnoid cyst associated with the hematoma is emphasized. Pathogenesis of arachnoid cyst and the hematoma remain uncertain. However histological findings suggested that subdural CSF collection might be important to develop hemorrhagic outer membrane of the chronic subdural hematoma.

Adolescent↗
PubMed1982

[Secondary empty sella syndrome: report of three cases and review of the literature].

Three cases of the secondary empty sella syndrome were reported. Case 1. A 57-year-old female was admitted to our clinic because of recurrent visual disturbance. Fourteen years previously a pituitary adenoma was diagnosed and two courses of radiation therapy was given elsewhere, the total dosage being unknown. Pneumoencephalography revealed air collection in the sellar cavity. Exploratory craniotomy demonstrated an empty sella with downward migration of the optic nerve and chiasm. Case 2. A 40-year-old female was readmitted to our clinic for possible recurrent pituitary adenoma. Three years previously she underwent transsphenoidal surgery and postoperative radiation therapy with a tumor dose of 6,400 rad. She had headache and visual disturbance. Pneumoencephalography showed air extension into the sellar cavity. Case 3. A 50-year-old female was readmitted to our clinic because of general prostration and headache. Ten years previously she received transsphenoidal surgery and postoperative radiation therapy with a tumor dose of 6,650 rad for a pituitary adenoma. Endocrine evaluation revealed a hypopituitarism. Pneumoencephalography showed air extension into the sellar cavity. The etiology of secondary empty sella has not been clarified yet, although the primary empty sella has been considered to result from incomplete development of the diaphragma sellae. We consider that the most important factor should be present in the diaphragma itself. It is conceivable that the diaphragma sellae becomes weak due to 1) compression by the tumor, 2) mechanical injury during operation, 3) radiation effect. Then, these preceding factors might bring about herniation of the optic nerve and chiasm with the diaphragma sellae into the sellar cavity. Therefore, we propose that early diagnosis of pituitary tumor should be important, and that careful packing of the sellar floor at transsphenoidal surgery should be essential to prevent occurrence of the secondary empty sella syndrome.

Adenoma↗
PubMed1981

[Case report of acute central cervical cord injury with C7 laminar fracture and extradural hematoma (author's transl)].

A 57-year-old epileptic male with an acute central cervical cord injury was reported, who fell down from 2.5 meter height to a dry river bed presumably during a convulsive seizure. Upon physical examination at the time of admission, 4 hours post trauma, there were severe neck pain with limited neck motion, sensory level at C4 bilaterally, no motion at all in the upper extremities, and minimal motion in the lower extremities as well as apparent urinary retention. Plain cervical spine series showed moderate posterior osteophytes at C4--C5 and C5--C6, although the film of lateral view did not visualize a part of C7 well. After 4 days' clinical observation, a myelography was done at lateral cervical approach between C1 and C2, which showed a complete block at C3. Urgent laminectomy C3 through C7 showed a fracture of the C7 spinous process extending to the bilateral lamina and an extradural hematoma from C3 to C7 with thickness of 3 to 5 mm. Neither pial incision nor dorsal myelotomy was performed because of no remarkable swelling of the cord. Post-operative course was uneventful, the patient recovering first the motion in the lower extremities, urinary retention, and motion in the upper extremities. At 10 months' follow-up after the operation, he could take care of himself in dressing, eating and toileting, although he had had residual motor disturbance in his hands and fingers especially in fine finger movements. It was keenly felt important to visualize C7-T1 in roentgenograms of lateral cervical view in cases of acute cervical injury, for which swimmer view and/or tomogram might be necessary. Queckenstedt's test was criticized as a dangerous maneuver in such case but C1--C2 myelography is considered safer and more informative. Literature on the acute central cervical cord injury were reviewed.

Acute Disease↗
PubMed1981

[Two cases of the diencephalic syndrome were reported with hormonal studies (author's transl)].

Two cases of the diencephalic syndrome were reported with hormonal studies. The first case was initially admitted at her age of 4 years and 10 months old. Progressive visual disturbance and horizontal nystagmus had developed one year prior to the admission. Her weight gain had stopped since 10 months old. Partial removal of the hypothalamic pilocytic astrocytoma and 5,000 rad of lineac radiotherapy brought satisfactory effects on her previous symptoms. She was readmitted, however, at her age of 8 years and 10 monts old because of precocious puberty. Her breast development was in Tanner's grade 2, and her bone maturation was equivalent to one of 11 years old. Hormonal studies showed decreased urine 17-OHCS and 17-KS, elevated serum LH, E1 and E2. The CT scan disclosed some enhanced area in the vicinity of the optic chiasm, which had not changed for the last one year. The second case was admitted at his age of 10 years and 9 months old because of progressive marked emaciation of 6 months' duration. Parinaud's sign was only positive neurological finding. The CT verified enhanced areas in the pineal and chiasm. Cytological study of CSF gave the diagnosis of germinoma. Hormonal studies showed decreased urine 17-OHCS and 17-KS, decreased T3, T4, ACTH, and increased PRL as well as increased HGH. Local lineac irradiation by 5,500 rads was given, during which the enhanced area in CT disappeared and his weight gain started. Increased HGH became normalized but paradoxical response of HGH to GTT remained same.

Astrocytoma↗