[Acute epidural hematoma].
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Biomedical subjects
Publications and source records attributed to Tsuneyoshi Eguchi.
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A 74-year-old man was diagnosed with cerebellar glioblastoma multiforme (GBM). He initially presented with headache, nausea, vomiting, and truncal ataxia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a round mass with ring enhancement in the vermis of the cerebellum. Subtotal removal of tumour was performed, and the pathological diagnosis was cerebellar glioblastoma multiforme. Subsequently, radiochemotherapy was performed. GBM of the cerebellum is rare and only accounts for a small fraction of all GBM. To our knowledge, there have only been 7 cases of senile cerebellar GBM reported. Our patient is one of the oldest cases recorded in the Asian literature.
Rapid and accurate diagnosis of the hemodynamics of the brain is essential for the treatment of acute ischemic stroke. This study investigated whether time-to-peak and diffusion-weighted magnetic resonance (MR) imaging are useful for predicting the course of stroke. Fourteen patients with non-lacunar acute ischemic stroke underwent emergent MR imaging within 24 hours from the onset followed by cerebral angiography and xenon-enhanced computed tomography (CT). Serial CT was obtained to monitor changes in the size and nature of the infarct. Volumes of the abnormal lesions demonstrated on time-to-peak (VT) or diffusion-weighted (VD) images were measured, and the ratio of VT to VD was calculated. Based on this ratio, patients were classified into three groups: Group 1 (VT/VD 0.5-1.5, n = 9), Group 2 (VT/VD > 1.5, n = 3), and Group 3 (VT/VD < 0.5, n = 2). The size of the infarct detected as a low-density area on serial CT scans did not change significantly throughout the course in Group 1 patients, but showed enlargement in all three patients in Group 2. Two patients in Group 3 had major trunk occlusion followed by spontaneous reperfusion, and both developed hemorrhagic transformation. Our study showed that classification of ischemic stroke based on the VT/VD ratio was predictive of the time course of the infarct, and may be useful in selecting the initial therapeutic procedure immediately after the onset of stroke.