Biomedical subjects
Publications and source records attributed to Y Numaguchi.
A cavernous hemangioma in the pineal region of a 22-year-old man is reported. Because the patient had diabetes insipidus and a contrast-medium-enhanced mass in his pineal region on computed tomography, a germinoma was suspected. A ventricular shunt was made and the tumor was irradiated, but without a response. After irradiation the tumor was entirely removed, and postoperatively the diabetes insipidus improved.
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Publications in the scientific literature are controversial in regard to the clinical significance of intracerebral venous angiomas. The present study of 11 patients with venous angiomas underscores the clinical importance of these lesions as potential causes of cerebral hemorrhage and obstructive hydrocephalus. The clinical and radiographic manifestations in 9 of these 11 patients correlated well. In cases of venous angiomas, the venous phase of angiography must be carefully scrutinized, particularly in patients with subarachnoid or intracerebral hemorrhage. Some diagnostic problems related to the angiography of venous angiomas are discussed.
A 5-year-old female patient with a left facial strawberry nevus, ipsilateral optic atrophy and cerebellar signs was observed. Computed tomography and cerebral angiography confirmed left cerebellar hypoplasia and cerebrovascular abnormalities such as internal carotid arterial stenosis, basilar artery occlusion, and a saccular aneurysm of left carotid siphon, all of which are presumed to develop congenitally. This case may represent a new variety of neurocutaneous syndrome which is different from other syndromes associated with facial hemangioma, such as the Sturge-Weber syndrome and the Wyburn-Mason syndrome.
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The radiological manifestations of 16 pituitary adenomas, six meningiomas and 14 craniopharyngiomas were reviewed. The differential diagnosis of these tumors is possible with a few exceptions when skull radiography, CT, angiography and metrizamide cisternography are carefully evaluated. Prolonged injection angiography (PIA) is particularly important for demonstrating the contours of pituitary adenomas and meningiomas. Metrizamide cisternography is indicated when the tumor contours are obscure using PIA, or when the differential diagnosis is uncertain.
The radiological manifestations of primary intracranial sarcomas may be non-specific and they vary widely according to their histological variations. Reticulum cell sarcomas, however, can be included in the differential diagnosis with a high degree of reliability when one observes a hypovascular mass with arterial encasement and deep medullary veins. Tumor vessels and tumor stains supplied by dilated feeding arteries suggest the possibility of a sarcoma of the brain or of the meninges in infants. Nine reticulum cell sarcomas, four undifferentiated sarcomas, and one fibrosarcoma are presented here with their radiological manifestations, especially on angiography.
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Anomalous single pulmonary veins (AUSPV) is a rare anomaly of the pulmonary venous system. Six cases have been documented in the literature, and two additional are reported here. Since AUSPV mimics pulmonary varices on pulmonary angiography, careful interpretation of the pulmonary venous anatomy by bidirectional and stereoscopic angiography is mandatory for diagnosing this anomaly.
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Three cases of cystic neurinoma arising from the upper cervical spinal nerve roots and extending to the posterior cranial fossa through the foramen magnum were reported. Case 1 was a 52-year-old female presenting marked bilateral papilledema, hyperactive right knee jerk, left positive Gordon reflex and trunkal ataxia. The mass was mostly cystic and arose from the left 1st cervical nerve root. It extended to the posterior fossa, occupied the cerebello-medullary cistern and displaced the left cerebellar hemisphere posteriorly and superiorly. Case 2 was a 39-year-old male presenting marked bilateral papilledema, neck stiffness, dysfunction of the right 7, 9, 10 and 11th cranial nerves, gaze nystagmus, Horner's syndrome, right limb ataxia, and ataxic gait. The mass was totally cystic containing yellowish fluid and was growing from the right 2nd cervical spinal nerve root. The mass extended to the posterior cranial fossa up to the right cerebello-pontine angle and compressed the medulla oblongata, upper cervical cord and 7th through 11th cranial nerves on the right side. Case 3 was a 66-year-old male presenting marked bilateral papilledema, gaze nystagmus, left hemiparesis, bilateral hyperactive deep tendon reflexes, numbness of the left fingers and ataxic gait. CT scanning revealed in the midline of the posterior cranial fossa a low density mass which was enhanced in a ring-like fashion. Vertebral angiograms showed an avascular mass displacing the PICAs upwards and elongating its cranial loops antero-posteriorly. The mass was totally cystic, arose from the left 2nd cervical spinal nerve root, extended to the posterior cranial fossa and occupied the cisterna magna and vallecula. Foramen magnum syndrome was discussed and the symptoms and signs presented in these three cases were compared with those presented by foramen magnum meningioma in other reports.