Kikuo Kyoi

Radial artery graft for an extracranial-intracranial bypass in cases of internal carotid aneurysms: Report of two cases

Two cases of internal carotid aneurysms, trapped and bypassed, by means of radial artery grafts are discussed. Neither case has permanent neurological deficit possibly because of an adequate blood supply via the radial artery graft bypass. Although the radial artery graft has been in common use among cardiac surgeons, it is still rare in the neurosurgical field. The advantage of the radial artery is discussed with comparison to other graft materials such as the saphenous vein and the superficial temporal artery. In properly selected cases, the radial artery graft is useful in preventing the ischemic damage caused by an aneurysm being trapped at the main arterial trunk.

Intracerebral hemorrhage in carotid-cavernous fistula

SummaryThis report describes a case of traumatic carotid-carvernous fistula which presented as an intracerebral hemorrhage. The usual ocular signs were absent due to an atypical drainage pattern from the cavernous sinus. Engorgement of the deep venous system of the brain due to the carotid-cavernous fistula was thought to have caused the intracerebral hemorrhage.

Microsurgical treatment of patients with vestibular and cochlear symptoms

Eighteen patients with vertigo, tinnitus, and various hearing disturbances were treated by posterior fossa exploration and microvascular decompression of the eighth cranial nerve; they were followed for more than 3 years. After successful decompression of the eighth nerve from offending vessels, the attacks of vertigo disappeared in 11 patients, improved markedly in 3 patients, and improved mildly in 4 patients. The tinnitus vanished in three patients and decreased in nine. The hearing disturbance improved in only five patients and worsened in three. Because of the satisfactory improvement of the attacks of vertigo, which are the most distressing symptoms for patients, we recommend surgical exploration for patients with severe symptoms of vestibular disturbances.

Neuroradiological study of human brain in the fetal period.

Craniocerebral CT scans were performed on 50 subjects including embryos, fetuses and newborns. Fetuses were divided into three stages based upon CT findings. The first stage ranged from the 8th gestational week to the 12th week, and the second stage from the 13th to 23rd week. Beyond 24 gestational weeks, fetuses were classified as the third stage. In the first stage, it is difficult to recognize the intracranial structure on CT scans. In the second stage, the intracranial structures on CT scans become clearer. Around the lateral ventricle a symmetrical high-density area appears, which corresponds to the germinal matrix. However, at the third stage, the high-density area disappears. The morphological changes of the ventricular system with growth are ascribed to a remarkable development of the cerebral parenchyma.

Malignant Meningioma with Multiple Extracranial Metastases

A rare case of intracranial malignant meningioma with repeated local recurrences and widespread extracranial metastases is reported. A 53-year-old man developed convulsive seizure of the right upper limb and the right side of the face in December 1969 and was diagnosed as having convexity meningioma in the left parietal region. The tumor was totaly removed in May 1970. In February 1974 he noticed right hemiparesis. The recurrent tumor was totally removed. It was a cystic meningioma with histological features of angioblastic type. Subsequently he underwent seven more operations in his clinical course, all of which were subtotal or total extirpations. At the fifth surgery tumors were recognized in the left frontal, anterior-temporal and parieto-occipital regions (multiple meningioma). In March 1980, a large recurrent intracranial tumor was detected by computerized tomography. Chest X-ray revealed a massive tumor shadow in the left lung and multiple nodules of varying sizes throughout both lungs. The patient died in July 1980, 11 years after the first diagnosis. Autopsy showed an extensive residual intracranial tumor in the left temporo-occipital region and multiple metastatic tumors in both lungs, pleura, pericardium and diaphragma. The metastatic tumors were similar to the intracranial meningioma in histological features.

Relationship between CT‐Findings and Electrical Focus in Epileptic Patients

Electroencephalography (EEG), as a functional measurement method, has been the standard for the diagnosis and classification of epilepsy. Computed tomography (CT) has become a routine examination as well, in the clinical treatment of seizure disorders, since the comprehensive presentation of its efficacy by Gastaut and Gastaut (1976).& In patients with various electroclinical types of epilepsy-primary, secondary and partial -a CT scan gave accurate information about the frequency, topography and severity of morphological abnormalities. Several other papers confirm the diagnostic significance of CT scan in demonstrating a structural cerebral 1esion.l” The results demonstrate that CT and EEG identify different aspects of cerebral pathological conditions and can be used in combination to complement one another. In this study, we compared the CT findings in patients with epilepsy with the EEG findings.