PubMed Health⌕ Search

Biomedical subjects

Yoichiro Hashimoto

Publications and source records attributed to Yoichiro Hashimoto.

35 records · Page 2Linked to original sources
PubMed2005

[Urinary retention associated with unilateral medullary infarction].

A 59-year-old man without any history of urinary disturbance, admitted to our hospital because of dysarthria and left hemiparesis. Diffusion weighted MR image of the brain of the 2nd hospital day showed left lateral medullary infarction. He also suffered from urinary disturbance which revealed to be the atonic bladder after the urodynamic study. Although the autonomic disturbance, such as Horner syndrome, is a well-known symptom in patients with lateral medullary infarction, few reports mentioned about the prevalence and the extent of urinary disturbance. The obstructive urinary disturbance observed in the present patient was thought to be caused by the unilateral lateral medullary infarction.

Diffusion Magnetic Resonance Imaging↗
PubMed2005

[A case of interhemispheric subdural empyema with sinusitis diagnosed by diffusion-weighted MRI].

The patient was a 29-year-old man with sinusitis. He was admitted with high grade fever, headache, vomiting and disturbance of consciousness. Neurological examination revealed nuchal rigidity, aphasia, right hemiparesis, right sensory disturbance and bilateral Babinski signs. A nonenhanced CT on admission showed a low density area in the interhemispheric fissure. Gadolinium-enhanced MRI and DWI showed an interhemispheric subdural empyema and sinusitis. Neurological deficits gradually improved, after he underwent urgent surgical drainage of sinusitis followed by antibiotics therapy. About three weeks later, he developed right hemiparesis and disturbance of consciousness, and MRI demonstrated the expansion of interhemispheric subdural empyema. Therefore, he underwent surgical drainage of interhemispheric subdural empyema. He was discharged from our hospital without neurologic deficit. We suggest that MRI, in particular DWI, is a useful additional imaging modality for the diagnosis of interhemispheric subdural empyema.

Adult↗
PubMed2005

[Cardioembolic stroke manifested by isolated tonic seizure of the left upper limb].

We reported a 61-year old man with cardioembolic stroke manifested by isolated tonic seizure of the left upper limb. He had a history of chronic atrial fibrillation and transient ischemic attack. He was brought to our hospital by ambulance, when he suddenly had isolated tonic seizure of left upper limb. On admission, he had no neurological symptoms and signs. Brain diffusion weighted MR image disclosed high intensity area in the right parietal lobe, although T2-weighted image did not show any abnormalities. On 8th day, a high intensity area was observed both on the diffusion-weighted and T2-weighted MR images. In case of isolated tonic seizure of left upper limb, careful examination of stroke is required especially if the patient had a high risk of stroke.

Arm↗
PubMed2005

[Diagnostic validity of sensorimotor stroke].

BACKGROUND: In the clinical practice, "sensorimotor stroke" (SMS) do not always correspond to the diagnosis of small-vessel occlusion (SVO, lacune). We aimed to evaluate diagnostic validity of acute SMS with the use of diffusion-weighted MR imaging (DWI). METHODS: We analyzed 57 consecutive patients with first-ever acute ischemic stroke presenting with SMS. Acute infarcts were identified on DWI within 7 days of stroke onset in all patients. Vascular risk factors, emboligenic heart diseases, occlusive cerebral artery disease, infarct size and location, and stroke subtype were evaluated. Stroke subtype was classified according to the TOAST classification. RESULTS: SMS occurred in 57 cases; 40 men and 17 women (mean +/- age, 68.5 +/- 12.1 years). Frequency of hypertension was the highest (n = 30, 53%) in the vascular risk factors. Emboligenic heart diseases and cerebral artery disease were identified in 14 (25%) and 11 patients (19%), respectively. DWI revealed subcortical infarcts in 47 patients (84%) and infarct diameter <15 mm in 25 (44%). Only 18 patients (32%) met the diagnostic criteria for SVO. CONCLUSION: Diagnostic validity of acute SMS was rather low. The clinical picture of SMS is far from being used as synonymous of a SVO.

Adult↗
PubMed2005

[Two cases of top of the basilar syndrome with onset seizure].

We reported 2 patients with top of the basilar syndrome manifested by onset seizure. Patient 1 was a 76-year-old man. When he was sleeping, suddenly he gave a loud cry and went into convulsions. So he was brought to our hospital by ambulance. On admission, he had unconsciousness and left hemiplegia. Patient 2 was a 70-year-old man. When he was bathing, he lost his consciousness and brought to our hospital by ambulance. On admission, he had convulsion and tetraplegia. Both patients had convulsions and palsy when they had brain infarctions. Brain diffusion weighted MR image showed high intensity area in bilateral internal thalamus, brainstem and cerebellum and no high intensity area in cerebral cortex. We know well that Todd's palsy is palsy after convulsion, but vertebro-basilar occlusion also shows convulsion and palsy. Therefore attention should be paid in the case of the patients who had convulsion and palsy.

Aged↗
PubMed2005

[Mobile thrombi in the cervical carotid artery].

Clinical characteristics of mobile thrombus in the cervical carotid artery were investigated. In the 1,528 patients with acute ischemic stroke, mobile thrombi were detected by carotid echography in 14 patients (0.9%; mean 77 years-old; 8 women). Mean National Institutes of Health Stroke Scale was 19 on admission, and 24 on day 10. Mean modified Rankin Scale was 4.6 (dead in 2 patients) at discharge. MR angiography disclosed occlusion of the internal carotid artery in 11 of 14 patients. Mobile thrombi were divided into 3 subtypes: floating thrombus in 5 patients; mobile mural thrombus in 5; oscillating thrombus in 4. Followed echography showed occlusion of the internal carotid artery in 4 of 7 patients. Floating thrombus disappeared in one of 5 patients without clinical recurrence. Although surgical treatment including carotid endarterectomy was not performed in all of the present cases, clinical recurrence during admission was seen in only one patient with embolic stroke in the contralateral internal carotid artery of the mobile thrombus.

Aged↗
PubMed2005

[Bilateral multiple border zone infarctions after massive bleeding: report of two cases].

We present two patients who developed bilateral border zone brain infarctions after massive bleeding. Patient 1 was a 46-year old woman who developed bilateral visual disturbance and left hand monoparesis after excessive menstruation with severe anemia. Diffusion-weighted MRI of brain showed multiple border zone infarcts bilaterally in cerebral and cerebellar hemispheres while brain MRA was normal. Patient 2 was a 67-year old man who developed disturbance of consciousness and right hemiplegia after upper gastrointestinal tract bleeding. Diffusion-weighted MRI of brain showed bilateral multiple border zone infarcts in cerebral hemispheres, although he had asymptomatic occlusion of the left internal carotid artery. The bilateral multiple border zone infarcts are one of the key findings suggesting the presence of anemic hypoxia as a result of global brain hypoperfusion caused by massive blood loss.

Aged↗
PubMed2004

MR imaging findings of spinal posterior column involvement in a case of Miller Fisher syndrome.

SUMMARY: The site of lesions causing ataxia in Miller Fisher syndrome (MFS) remains in dispute. A 43-year-old man manifested rapidly progressive left-sided ptosis, bilateral abducens palsy, areflexia, and severe ataxia. Initial MR imaging showed confined lesions of the cauda equina with gadolinium enhancement. A diagnosis of MFS was made, and the patient underwent immunotherapy. His ophthalmoplegia disappeared, but other symptoms remained. Five months after onset, MR imaging disclosed lesions confined to the spinal posterior column, which were considered to result from involvement of posterior nerve roots of the cauda equina and to be responsible for his remaining severe ataxia.

Adult↗
PubMed2004

[Posterior encephalopathy syndrome in two patients after cancer surgery with transfusion].

We here report two patients (58-year-old, 77-year-old women) who presented themselves with generalized convulsion, impaired consciousness and hypertension several days after cancer surgery and transfusion. MRI T2 weighted images show an extensive area of increased signal intensity along the occipital cortex, but the underlying white matter revealed slight high signal intensity on diffusion weighted images. Despite similarities of those two cases to posterior leukoencephalopathy syndrome, they differ since the neuroimaging abnormalities are mostly in the occipital cortex. It is likely that the posterior cerebral cortex and white matter are vulnerable to circulatory, vascular and metabolic/toxic impairments. Depending on the abnormalities of many physiological variables, either the subcortical white matter, cortical gray or both might become a major target of this syndrome.

Aged↗
PubMed2004

[Decerebrate rigidity after bilateral carotid arteries occlusion].

We reported a 77-year-old woman with atrial fibrillation. She was admitted to our hospital because of bradycardia and disturbance of consciousness. She regained consciousness soon after the admission, however on the 3rd day of admission, she abruptly fell into a coma. Neurological examination revealed decerebrate rigidity, conjugate eye deviation to the right, and bilateral Babinski signs, but remaining oculocephalic reflex in both vertical and horizontal directions. Diffusion-weighed MR image of the brain on the same day demonstrated extensive hyperintense lesions in the bilateral hemispheres, sparing the brainstem. On the duplex carotid ultrasonography just after the MR study, oscillating intraluminal thrombi occluded the right common carotid and the left internal carotid artery. We diagnosed the patient as having bilateral carotid occlusions by cardioembolic mechanism.

Aged↗
PubMed2003

[A case of brain infarction with nephrotic syndrome].

A 47-year-old man lost his consciousness and brought to our hospital by ambulance. On admission, he had aphasia and upper right limb paresis. Diffusion weighted MR image of the brain on admission showed multiple high intensity areas in the left middle cerebral artery (MCA) territory. Brain angiography performed on the 2nd hospital day revealed the left MCA severe stenosis. We started intravenous antithrombotic therapy on the 1st day. The left carotid angiography on 12th day demonstrated that the left MCA stenosis was improved. He had medical history of hypertension, diabetes mellitus and gout. But he had only slight atherosclerosis, and had no arrhythmia and patent foramen ovale. Blood chemistry test showed marked hypoproteinemia and hyperlipidemia, and urine examination showed proteinuria. He was diagnosed as nephrotic syndrome for the first time. Nephrotic syndrome brought hypercoagulability, so we suspected that nephrotic syndrome concerned with brain infarction.

Cerebral Infarction↗
PubMed2002

[A case of Turner syndrome complicated with brain infarction].

A 21 year-old female college student with a history of Turner syndrome at age 9, and 6-year growth hormone replacement therapy noticed weakness of right extremities when she got up on March 26, 2001. On admission, she showed right hemiparesis (4+/5) and hypesthesia on the right of body. The hemiparesis progressed (3-/5) in spite of antithrombotic therapy. Brain MRI revealed a high intensity lesion with a diameter of 1.5 cm in the posterior limb of the left internal capsule and putamen on DWI and T2WI. MR angiography and TC-CFI revealed no stenosis in her left middle cerebral artery, but > 50% stenosis in the horizontal portion (M1) of her right middle cerebral artery. Branch lesions were presumed to exist in the left M1. Non-atherosclerotic angiopathy, coagulopathy, and other conventional risk factors of brain infarction were not found. Pathogenesis of Turner syndrome might have played a role in the development of brain infarction in this patient.

Adult↗
PubMed2002

[Respiratory infectious complications after acute ischemic stroke].

BACKGROUND AND PURPOSE: Respiratory infection is a frequent complication in acute ischemic stroke, but it seems to have been made light of in stroke care. The purpose of this study is to examine the clinical characteristics of respiratory infectious complications in patients with acute ischemic stroke. METHOD: Two-hundred and fifty-eight consecutive patients (158 men, 100 women, 70.6 +/- 12.9 years old) with acute ischemic stroke were admitted to our hospitals between May and October in 1999. Age, gender, history of stroke, the severity of stroke on admission, stroke subtype (lacunar brain infarction, atherothrombotic brain infarction, cardioembolic brain infarction, and others), aspiration, naso-gastric tube feeding, vascular risk factors, the length of hospital stay and outcome of patients were noted. We compared them between patients with and without respiratory infections. RESULTS: Forty-five (17.4%) patients were developed respiratory infections. Cardioembolic stroke patients were more frequently developed respiratory infections (67%) compared with other stroke subtypes. The independent risk factors for respiratory infectious complications by multiple logistic regression model were the aspiration (OR, 5.513; 95% CI, 1.793-16.946) and the severity of stroke on admission (OR, 1.090; 95% CI, 1.034-1.150). Mortality of patients with respiratory infectious complications was as high as 24%, and all survivors discharged to another hospital. After adjustment for age and the severity of stroke, respiratory infection was one of the independent risk factors of poor stroke outcome (OR, 5.838; 95% CI, 1.792-19.018). CONCLUSION: Aspiration and the severity of stroke independently predict development of respiratory infectious complication in acute ischemic stroke. Respiratory infections may make worse their stroke outcome. A measure to infectious complications and aspiration needs to be taken for the patients suffering from severe ischemic stroke.

Acute Disease↗