Ikuro Murase

Successful removal of solitary intramedullary spinal cord metastasis from colon cancer

A 69-year-old patient with an intramedullary metastasis from colon carcinoma is presented. Total removal of the tumor brought him 3 months of useful life. Although radiation therapy is generally favored, one should consider microsurgical resection of discrete, solitary intramedullary metastases in patients with radioresistant primary tumors.

Axilloaxillary bypass for the treatment of subclavian artery stenosis complicated by bilateral common carotid artery occlusion: technical case report.

OBJECTIVE AND IMPORTANCEWe successfully treated a patient with stenosis of the left subclavian artery, complicated by bilateral common carotid artery occlusion, via axilloaxillary bypass surgery. CLINICAL PRESENTATIONA 67-year-old patient with a history of hypertension and cerebral infarction underwent neck irradiation for treatment of a vocal cord tumor. Three months later, he began to experience transient tetraparesis several times per day. The blood pressure measurements for his right and left arms were different. Supratentorial blood flow was markedly low. The common carotid arteries were bilaterally occluded, and the right vertebral artery was hypoplastic. Therefore, only the left vertebral artery contributed to the patient’s cerebral circulation; his left subclavian artery was severely stenotic. INTERVENTIONThe patient underwent axilloaxillary bypass surgery because the procedure avoids thoracotomy or sternotomy, manipulation of the carotid artery, and interruption of the vertebral artery blood flow. The patient has been free of symptoms for more than 5 years. CONCLUSIONNeurosurgeons should be aware that extra-anatomic bypass surgery is an effective treatment option for selected patients with cerebral ischemia.