Isao Yamamoto

Infantile acute subdural hematoma

A retrospective analysis of the infantile acute subdural hematoma was made with special reference to its pathogenesis. In 11 of 15 cases, the hematomas were bilateral or a contralateral subdural fluid collection was present. In 7 of 11 patients who underwent operation the collection was bloody fluid and/or clotted blood. In 3 patients, a subdural membrane, as seen in adult chronic subdural hematoma, was found. In only 1 patient with unilateral hematoma was clotted blood present without subdural membrane. The thickest collection of clotted blood was in the parasagittal region. It is postulated that in most cases hemorrhage occurs after minor head injury, from the bridging veins near the superior sagittal sinus, into a pre-existing subdural fluid collection such as chronic subdural hematoma or subdural effusion with craniocerebral disproportion, and that infants without intracranial disproportion are unlikely to have acute subdural hematoma caused by minor head injury.

Spontaneous cervical epidural hematoma.

The authors report a case of spontaneous cervical epidural hematoma in a 13-year-old boy who exhibited hematoma recurrence 3 years after the first incidence. A review of the literature indicates very few reports of the recurrence of spinal epidural hematoma.

Unusual craniocerebral penetrating injury by a chopstick

The case of a 53-year-old man who attempted suicide by introducing a wooden chopstick through his nostril into his brain is reported. The importance of computed tomography is stressed in the diagnosis of intracranial wooden foreign bodies.

Bilateral Spontaneous Carotid-Cavernous Fistulas Treated by the Detachable Balloon Technique: Case Report

This report describes the case of a 39-year-old woman with bilateral spontaneous carotid-cavernous fistulas that were treated successfully by the detachable balloon technique. The clinical features and management are reviewed.

Intracranial Paramedian Hourglass-Shaped Dermoid Associated with Hereditary Steatocystoma multiplex

This is the first report to describe the coexistence of two rare diseases, intracranial paramedian hourglass-shaped dermoid and steatocystoma multiplex. A 46-year-old female with a history of steatocystoma multiplex, bradydactylies and kyphosis showed oscillopsia, ataxia and hemifacial spasm. MRI findings suggested a giant dermoid cyst extending from the left middle temporal fossa to the cerebellopontine angle, and this was confirmed surgically. We propose the involvement of some genetic factor or pathological process common to both disorders, steatocystoma multiplex and dermoid. From the clinical point of view, patients with cystic skin lesion should also be checked for intracranial lesion.

Intrauterine Development of the Skull

Depressed skull fracture may occur in utero1,2 as well as during the process of delivery. The mechanism of these depressions is not entirely clear. Even in the newborn and infant, roentgenographic diagnosis of linear skull fracture is sometimes ambiguous because numerous accessory sutures may be present.3 To understand depressed skull fracture, more details about the normal developmental anatomy of the skull in utero are needed. There have been a great number of extensive studies regarding the embryology of the human skull,4–11 but much of the information is not practical for neurosurgeons to utilize.