Kensaku Takase

Peripheral hypoglossal nerve palsy caused by lateral position of the external carotid artery and an abnormally high position of bifurcation of the external and internal carotid arteries--a case report.

An unusual case of peripheral hypoglossal nerve palsy, caused by lateral position of the external carotid artery and an abnormally high carotid bifurcation is reported. Improvement followed ligation and cutting of the external carotid artery at its origin. Stroke Vol 15, No 4, 1984

Transcranial Doppler ultrasonography in patients with Moyamoya disease

This study included 17 patients (five men and 12 women) with clinical diagnosis of Moyamoya disease from conventional angiograms. Bilateral basal arteries were measured by the transtemporal approach with a 2 MHz pulsed Doppler instrument (TC-2 64B EME). In 28 out of the 34 basal arteries (82.4%), reliable recordings were obtained. These transcranial Doppler ultrasonography (TCD) findings were classified into three patterns: (1) High-high pattern; the mean cerebral blood flow velocity (CBFV) was increased throughout the basal arteries by over 70 cm/s (seven arteries, 25.0%); (2) high-low pattern; the mean CBFV was fastest (over 70 cm/s) at the ICA or proximal MCA and the mean CBFV decreased remarkably distally (15 arteries, 53.6%); and (3) low-low pattern; the mean CBFV was less than 40 cm/s throughout the basal arteries (arteries, 15.4%). These CBFV patterns as assessed by TCD are compared with the patients age, clinical symptoms and angiographical stagings (Suzukis criteria). The high-high pattern on TCD was predominantly seen in the younger patients and in the earlier stages of the disease. The high-low pattern was the most common pattern of CBFV as assessed by TCD in Moyamoya patients. The low-low pattern on TCD was more common in the later stages following angiographic evaluation by Suzukis criteria. The above patterns based on TCD findings show a good correlation with the age of the patient and the clinical diagnosis at the onset. TCD appears to be very useful in the evaluation of patients with Moyamoya disease.

Availability of Thickness Estimation of the Subcutaneous Fat by Using the Near-infrared Ray Measuring Device

Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area for accurate, safe, and efficacious delivery of medication for long-acting anti-psychiatric drugs. With ultrasonography, accurate evaluation of the

A Case of Holoprosencephaly with a Large Parietal Meningocele-like Cyst

A male neonate was admitted to our hospital because of a parietal cranium bifidum with a large cyst on June 1976. He was born at 40 weeks of gestation weighting 3, 550 gr. At birth, his parietal soft tumor was as large as a goose egg and gradually enlarged to 10 × 13 × 20 cm after a month. After admission, resection of the parietal cyst, plasty of the dura mater and drainage from the cyst cavity were performed. The cyst contained xanthochromic colored fluid amounting to over 1, 750 ml. Pneumoventriculogram (PVG) was performed by air infusion through the drainage. PVG revealed the typical pattern of agenesis of the corpus callosum and hydrocephalus. The cyst with a parietal meningocele-like appearance was in continuity with the ventricular system. Right retrograde brachial arteriography demonstrated the azygos anterior cerebral artery. Then we diagnosed this case as a “diencephalic cyst” with agenesis of the corpus callosum and hydrocephalus. A ventriculo-peritoneal shunt was performed and his subsequent course have been uneventful and satisfactory during the last ten years or more.