Interrupted aortic arch type C associated with DiGeorge syndrome in 22q11.2 deletion: first case detected in Japan.
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Biomedical subjects
Publications and source records attributed to Yasushi Ueno.
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A 70-year-old man who had undergone radical surgery for renal pelvic transitional cell carcinoma 9 months previously developed solitary cerebellar metastasis. Despite neurosurgical removal, the patient died and post-mortem pathological examination revealed microscopic metastatic lesions within microvessels of the lung. No other lesion, including local residual cancer, was detected.
We report here a 1-year-old boy with human herpesvirus 6 (HHV 6) -associated encephalopathy. On the 3rd day of fever, he had a generalized tonic seizure followed by mild disturbance of consciousness, which recovered completely the next day. Two days later, he had skin rash of exanthema subitum, and his consciousness declined frequently. EEG demonstrated rhythmic wave bursts originating from central areas bilaterally, followed by a generalized spike-and-wave complex which was associated with disturbed consciousness. We made the diagnosis of a status of complex partial seizures. Because the focal discharge on ictal EEG, MRI was performed. In the subcortical white matter of the frontal-parietal lobes, there were high signals on diffusion-weighted MRI, the apparent diffusion coefficient of which was much lower than that of normal controls. The affected areas soon disappeared with improvement of clinical symptoms. The transient MRI findings may indicate reversible cytotoxic brain edema. He showed no neurological sequelae as yet.
BACKGROUND: A combination of pseudoaneurysm and arteriovenous fistula of the middle meningeal artery is rare. We describe a case of traumatic pseudoaneurysm of the middle meningeal artery, which subsequently formed a fistula with the cavernous sinus. CASE DESCRIPTION: A 23-year-old man suffered from blunt head trauma and skull fractures. Sixteen days later, he suddenly experienced headache and a bruit was auscultated over the left ear. Three-dimensional computed tomographic angiography revealed dilatation of the left middle meningeal artery. The dilation proved to be a pseudoaneurysm on cerebral angiograms and it was also found to have formed a fistula with the cavernous sinus. Both lesions were successfully obliterated by endovascular embolization using microcoils. CONCLUSION: Head injury may lead to asymptomatic pseudoaneurysm or dural arteriovenous fistula. Neurosurgeons should always bear in mind the possibility of such vascular injuries after blunt head trauma to prevent any hemorrhagic complications.
A 62-year-old man with neurofibromatosis type 1 presented with rapid growth of a scalp mass. Head computed tomography demonstrated a large extracranial tumor of soft tissue density with massive intratumoral hematoma. Cerebral angiography demonstrated remarkable hypervascularity of the tumor. Preoperative embolization and total removal of the tumor was performed. The tumor contained a large amount of intratumoral hematoma (500 ml). The histological diagnosis was neurofibroma without malignant transformation. Benign scalp neurofibroma showing massive intratumoral hemorrhage is rare. Rapid growth or intratumoral hemorrhage in neurofibroma may be an indicator of malignant transformation.
Conventional angiography detected three cases of aberrant right subclavian artery. A 51-year-old female presented with a small infarction in the left medulla oblongata and severe stenosis of the left subclavian artery. A 59-year-old female presented with multiple cerebral infarctions and severe atherosclerotic changes in the intracranial arteries. A 58-year-old female presented with aneurysmal subarachnoid hemorrhage. The aberrant right subclavian artery was asymptomatic in all patients. Knowledge of this anatomical variation is important in diagnostic neuroangiography and interventional neuroradiology.
A 75-year-old man who had suffered from right visual disturbance for 10 years suddenly experienced right cavernous sinus syndrome. Magnetic resonance imaging revealed a giant thrombosed aneurysm in the right cavernous sinus extending to the right middle cranial fossa. Digital subtraction angiography disclosed occlusion of the right internal carotid artery at the petrous portion and good cross filling in the right-sided circulation through the anterior communicating artery. There was no filling of the aneurysm. In this case, the mechanism of parent artery occlusion is unclear, but direct compression and stretching of the parent artery by the aneurysm may be involved.
We report a case of duplication or fenestration of the distal part of the basilar artery with Shy-Drager syndrome. Duplication and fenestration of the basilar artery are discussed, and a review of embryologic development is presented.