Ikuo Ihara

Epilepsy and variation in the frontal lobe artery.

A patient with a rare variation of fronto-orbital artery (FOA) that developed generalized tonic and clonic seizures is reported. The epilepsy focus was in her left frontal region, where blood was supplied by the contralateral fronto-orbital artery. The region was vulnerable to ischemic changes due to a decrease in blood CO2 gas caused by an increase in endogenous progesterone in the luteal period. The anomaly illustrates an important mechanism of ischemia in epilepsy.

Traumatic stenosis of the internal carotid artery in children

Two cases of stenosis of the internal carotid artery after blunt craniocervical trauma in children are described. Their neurological symptoms developed a few hours after the injury. A superficial temporal artery-middle cerebral artery anastomosis was performed in one, and the other was conservatively treated because of the spontaneous resolution of the stenosis. The pathophysiology and treatment of this clinical entity, especially in children, are discussed.

Cerebral Blood Flow Monitoring in Early Stage of Subarachnoid Hemorrhage

Because of the high risk in the development of cerebral ischemia, it is of great importance to know the change of cerebral blood flow (CBF) in the acute stage of subarachnoid hemorrhage (SAH). Especially in cases with diffuse and thick clot in the subarachnoid space, symptomatic cerebral vasospasm is strongly expected and intensive care of these patients is required to prevent the decrease of CBF. However, because of the difficulty of repeated measurement of CBF in these patients, it seems impossible to know the sequential changes of CBF.