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Takao Sagiuchi

Publications and source records attributed to Takao Sagiuchi.

At least 19 recordsLinked to original sources
PubMed2006

Ruptured pediatric posterior cerebral artery aneurysm 9 years after the onset of Kawasaki disease: a case report.

CASE REPORT: A 12-year-old boy who had a history of Kawasaki disease 9 years ago experienced a subarachnoid hemorrhage by ruptured right posterior cerebral artery aneurysm. On day 1 operation, as the aneurysm was very fragile and bled easily, two intraoperative ruptures, including a very premature rupture, were encountered. As a result, a left hemiparesis especially severe in the left hand was caused by the right anterior thalamic infarction due to the occlusion of a thalamo-perforating artery arising near the neck of the aneurysm. DISCUSSION: The histopathological examination of the intraoperative excised aneurysmal dome disclosed the thickening of the endothelial inner due to the endothelial hypertrophy and the invasion of inflammatory cells. This finding of the aneurysm was partially mimicking the finding of the coronary artery of the patients with Kawasaki disease. The combination of cerebral aneurysm and Kawasaki disease has never been reported until now, and the etiology of the aneurysm of this patient is unclear.

Aneurysm, Ruptured↗
PubMed2006

Technetium-99m ethyl cysteinate dimer dynamic and static single photon emission computed tomography in crossed cerebellar diaschisis.

A 69-year-old man with a past history of right middle cerebral artery (MCA) occlusion had cerebral single photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimer (Tc-99m ECD). Dynamic SPECT in the super-early phase revealed normal uptake in the left cerebellum and hypoactivity in the right MCA territory. Conventional static SPECT revealed decreased cerebral blood flow in the right MCA territory and the left cerebellum, indicating crossed cerebellar diaschisis. Our SPECT studies revealed decreased retention of Tc-99m ECD in the cerebellum manifested as crossed cerebellar diaschisis.

Aged↗
PubMed2006

Endovascular surgery for very small ruptured intracranial aneurysms. Technical note.

Application of endovascular surgery for very small aneurysms is controversial because of technical difficulties and high complication rates. The aim in the present study was to assess treatment results in a series of such lesions at one institution. Since 1997, endovascular surgery has been advocated for very small ruptured aneurysms (< 3 mm in maximum diameter) that fulfill the criterion of a fundus/neck ratio greater than 1.5. Twenty-one patients were treated, for whom the World Federation of Neurosurgical Societies classification before treatment was Grade I in 10, Grade II in two, Grade III in two, Grade IV in five, and Grade V in two. The aneurysm location was the internal carotid artery in four, the anterior communicating artery in 11, the middle cerebral artery in one, and the vertebrobasilar system in five. In all patients, endovascular surgery was performed using Guglielmi detachable coils after induction of general anesthesia. Initially, the presumed volume of the lesions was calculated for each aneurysm. Thereafter, the appropriate coil length was decided according to the volume embolization ratio, as 30 to 40%. In all attempts to obliterate aneurysms a single coil was used. All aneurysms were completely obliterated as confirmed by postembolization angiography, without procedure-related complications. During the follow-up period only one patient needed additional coil embolization for a growing aneurysm. Final outcomes were good recovery in 15 patients, moderate disability in five, and severe disability in one. Appropriate selection of patients and coils, and use of sophisticated techniques allow a good outcome for patients with very small aneurysms.

Adult↗
PubMed2006

Regression of an atlantoaxial degenerative articular cyst associated with subluxation during conservative treatment. Case report and review of the literature.

The presence of an atlantoaxial degenerative articular cyst is rare; when present this lesion extends posteriorly to the dens, causing cervicomedullary compressive myelopathy. The authors describe a symptomatic case of this lesion associated with atlantoaxial subluxation in a 76-year-old man. The patient's neurological symptoms resolved and corresponded to a reduction in the size of the cyst. After 8 months of continued conservative treatment, in which the patient wore a Philadelphia collar, the cyst spontaneously regressed. Subsequently, a C1-2 posterior fusion was performed to treat the atlantoaxial subluxation.

Aged↗
PubMed2005

Increased accumulations of N-isopropyl-p-[123I]-iodoamphetamine related to tumefactive multiple sclerosis.

We present a 21-year-old woman with tumefactive multiple sclerosis (MS) that exhibited a rapidly progressive course. There were multiple tumor-mimicking contrast-enhance lesions with surrounding edema and mass effect on magnetic resonance imaging. Both early and delayed brain single photon emission computed tomography (SPECT) with N-isopropyl-p-[123I]-iodoamphetamine demonstrated increased accumulations of the tracer and a high retention on the lesions. The SPECT findings represent a diagnostic pitfall for distinguishing MS from malignant brain tumors in patients with intracranial tumor-like lesions.

Adult↗
PubMed2005

Compensation of intraoperative transcranial motor-evoked potential monitoring by compound muscle action potential after peripheral nerve stimulation.

It is often difficult to evaluate the results of transcranial motor-evoked potential (TCMEP) monitoring in patients under general anesthesia because these results are strongly affected by anesthetics and muscle relaxants. To exclude effects of muscle relaxants on TCMEP, compound muscle action potential (CMAP) by supramaximum stimulation of the median nerve immediately after transcranial stimulation (300 to 600 V) was recorded in 70 neurosurgical operations. A relative amplitude index (RAI) was defined as the amplitude of TCMEP after the operative procedure divided by the amplitude of TCMEP before the operative procedure. The RAI was calculated and was compensated by the amplitude of CMAP in 141 limbs. In 12 limbs of 7 patients with postoperatively progressed motor paresis, the compensated RAI was less than 0.2. The compensated RAI in all other 129 limbs of 63 patients without postoperative motor palsy was more than 0.2. These results suggest that compensation of TCMEP monitoring by CMAP is an easy and accurate method for removing the effects of muscle relaxants in TCMEP.

Action Potentials↗
PubMed2005

Intractable seizures associated with proximal migration of a ventriculoperitoneal shunt. Case report.

A 6-year-old girl, who had received a ventriculoperitoneal (VP) shunt using the Codman-Hakim programmable valve system at age 3 months, presented with intractable seizures. Neuroimaging studies showed migration of the proximal part of the system, including the prechamber, into the cranium through the right frontal burr hole. Electroencephalography showed spike-and-wave complexes in the right hemisphere including the site of the migration. The ictus was resolved following revision surgery. The clinical findings suggested the seizures were due to irritation of the brain parenchyma by the migrated system. Proximal migration of a VP shunt may cause both shunt failure and additional focal symptoms.

Female↗
PubMed2005

Glioblastoma multiforme metastasis to the axis. Case report.

Extracranial bone metastasis from glioblastoma multiforme (GBM) has rarely been reported in the literature, and most metastatic GBMs are multiple bone metastases. The authors describe the first case of a GBM with metastasis only to the axis. This 42-year-old man presented with a 2-month history of headache, nausea, vomiting, and disorientation. Magnetic resonance imaging demonstrated a right temporal tumor, which was diagnosed as a GBM based on tumor resection. The patient was treated using radiation (6000 cGy) and the intravenous administration of nimustine hydrochloride. Eighteen months thereafter, he experienced the sudden onset of neck pain. Magnetic resonance studies revealed a tumor in the axis that was diagnosed as GBM based on biopsy procedure.

Adult↗
PubMed2005

[Aplasia of the right internal carotid artery presenting with callosal hemorrhage: case report and review of the literature].

A 73-year-old woman without a history of cerebral ischemia suffered from sudden onset headache. Brain computed tomography (CT) showed intracerebral hemorrhage in the corpus callosum with intraventricular hemorrhage and thin subarachnoid hemorrhage in the basal cistern. Cerebral angiography showed narrowing of the right internal carotid artery just distal to its origin in the neck and abrupt occlusion just after branching of the ophthalmic artery with moyamoya-like vessels. The right A2 segment showed irregular dilatation and stenosis. The right middle cerebral artery was supplied from the basilar artery via the right posterior communicating artery. There was neither aneurysm nor arteriovenous malformation. Thin-slice bone-window CT of the skull base revealed hypoplasia of the right carotid canal. Aplasia of the right internal carotid artery was diagnosed. The origin of the hemorrhage was thought to be the irregularly opacified right A2 segment, which had been subjected to long-standing hemodynamic stress as collateral vessel.

Aged↗
PubMed2004

Cerebral infarction and fluid collection due to an enlarged dissecting aneurysm of the middle cerebral artery--case report.

A 53-year-old man presented with cerebral infarction associated with a dissecting aneurysm of the left middle cerebral artery (MCA), with enlargement and fluid collection. Anticoagulant therapy was performed as the first stage treatment for cerebral infarction. Serial magnetic resonance imaging showed that the dissecting aneurysm had enlarged and fluid collection adjacent to the aneurysm had developed since the first admission. Surgery was performed to ligate the MCA proximal to the aneurysm. Intraoperative findings showed the branch of the MCA was obstructed by intramural hemorrhage of the aneurysm dome. Histological examination showed direct obstruction of the MCA branch artery by intramural hemorrhage of aneurysm dome had caused the cerebral infarction and the fluid collection surrounding the aneurysm resulted from minor leakage or exudation of intramural hemorrhage to the outer surface of the dissecting aneurysm.

Aortic Dissection↗
PubMed2003

Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion--case report.

A 48-year-old man presented with idiopathic spinal cord herniation associated with calcified thoracic disc extrusion at the T7-8 intervertebral level, manifesting as Brown-Sequard syndrome at the thoracic level persisting for 20 years. Preoperative magnetic resonance imaging and computed tomography myelography revealed ventral displacement of the spinal cord and extrusion of a calcified disc at the T7-8 intervertebral level. At surgery, the spinal cord herniation at this level was released from the dura mater and carefully returned to the dural sac. An extruded calcified thoracic disc was found just below the dural defect at the same level. The development of idiopathic spinal cord herniation is associated closely with a defect in the ventral dura mater of unknown etiology. In our case, the etiology of the ventral dural defect was probably associated with the calcified thoracic disc extrusion.

Brown-Sequard Syndrome↗
PubMed2002

Huge chronic subdural hematoma mimicking cerebral infarction on computed tomography--case report.

A 70-year-old male presented with progressive consciousness disturbance. He had a history of cerebrovascular accident in the left cerebral hemisphere. The initial diagnosis was newly developed extensive left cerebral hemispheric infarction based on computed tomography. However, magnetic resonance imaging and surgical findings were consistent with chronic subdural hematoma (CSDH). The preexisting neurological disease may have allowed such unexpected CSDH expansion.

Aged↗
PubMed2002

[No 123I-BMIPP accumulation in the myocardium and type I CD36 deficiency in a patient with acute subendocardial infarction: a case report].

This patient was a 70-year-old man had acute subendocardial infarction in the inferior wall. 123I-BMIPP myocardial scintigraphy showed no accumulation in the myocardium. 123I-MIBG myocardial scintigraphy on the early and delay images and 99mTc-tetrofosmin myocardial scintigraphy at rest showed slightly decreased accumulation of the tracer in the apical region and in middle inferior wall of the left ventricle, indicating subendocardial infracted area. In the examinations of CD36 in platelets and monocytes, the patient had negative CD36 in platelets and monocytes, and type I CD36 deficiency was diagnosed. We supposed that no 123I-BMIPP accumulation may be related closely to type I CD36 deficiency.

3-Iodobenzylguanidine↗
PubMed2002

Increased uptake of technetium-99m-hexamethylpropyleneamine oxime related to primary leptomeningeal melanoma.

We present an autopsy case of primary leptomeningeal melanoma visualized with technetium-99m-hexamethylpropyleneamine oxime (Tc-99m-HMPAO) single photon emission CT (SPECT) of the brain. Increased uptake of Tc-99m-HMPAO coincided with leptomeningeal enhancement on MR images and with the tumor location of the autopsy findings. It was thought that Tc-99m-HMPAO could correlate closely with melanoma. Tc-99m-HMPAO SPECT clearly showed primary leptomeningeal melanoma and severe hypoperfusion induced by intracranial hypertension and tumor proliferation.

Adult↗
PubMedDate not supplied

Diffusion-weighted MRI of the cervical cord in acute spinal cord injury with type II odontoid fracture.

The authors present a case of acute spinal cord injury demonstrated by diffusion-weighted MRI (DWI) of the cervical cord. DWI taken 2 hours after injury showed intramedullary hyperintensity with a decrease of the apparent diffusion coefficient (ADC) value at C1-C2 vertebral levels. On T -weighted images obtained 1 month after injury, the lesion was hyperintense, indicating the existence of myelomalacia. DWI of the cervical cord provided satisfactory images and was a useful method for detecting and visualizing of the affected cord in the super-early stage.(2)

Cervical Vertebrae↗
PubMedDate not supplied

Case report: diffusion-weighted MRI in anterior spinal artery stroke of the cervical spinal cord.

The authors present a case of anterior spinal artery stroke demonstrated by diffusion-weighted MRI (DWI) using single-shot echo-planar imaging. DWI clearly demonstrated hyperintensity with a decreased apparent diffusion coefficient (ADC) at 26 hours after onset. At 28 days, there was persistent hyperintensity with an increased ADC, corresponding to T2-weighted hyperintensity in the whole spinal gray matter at the C2-C7 vertebral level. DWI provided satisfactory images and was helpful for diagnosing and evaluating anterior spinal artery stroke.

Anterior Spinal Artery Syndrome↗