Motoi Shoda

A pitfall in the interhemispheric translamina terminalis approach for the removal of a craniopharyngioma significance of preserving draining veins part i. clinical study

The interhemispheric translamina terminalis approach has made total removal of a craniopharyngioma less risky. Nevertheless, one of the pitfalls of this approach is cutting of the draining veins combined with retraction. A case of craniopharyngioma in which a subcortical hematoma developed is reported. The divided draining veins and the 60-minute retraction period were thought to have caused this complication. We therefore determined the clinical effect of cutting the draining veins and retraction on the regional cerebral blood flow and the motor nerve action potential. There were marked changes and a hematoma occurred mostly when the veins were divided and retraction was applied over the area.

Effects of Dorsal Column Spinal Cord Stimulation (DCS) on Reversibility of Neuronal Function—Experience of Treatment for Vegetative States

We have reported that DCS (dorsal column stimulation) improves the clinical symptoms of cases in persistent vegetative states. Since then, we have accumulated 23 cases who have been treated by DCS. We describe the clinical EEG, rCBF, and biochemical changes in cerebrospinal fluid (CSF) caused by DCS in patients in persistent vegetative states; (1) eight of these cases showed good clinical improvement; (2) most patients were young and the CTscan did not show large, diffuse, definite or bilateral low density areas in cortex, brainstem of thalmus; (3) neurostimulation increased rCBF (cerebral blood flow) in many parts of the brain in cases with vegetative states; blood flow increased in the cerebrum, cerebellum and brainstem; (4) neurostimuiation enhanced the metabolism of catecholamines in CSF, NE, DA, DOPAC, HVA, and 5H1AA increased, but 3MT and 5HT decreased in CSF. DCS increased rCBF, enhanced the metabolism of catecholamines in CSF, and improved the EEG in patients in persistent vegetative states.

Functional electrical stimulation (FES) for spinal cord injury.

Restoration of respiratory motion by stimulation of the phrenic nerve was investigated. Respiratory motion was restored successfully by introducing a breathing pacemaker to a patient with respiratory disturbance due to upper cervical spinal cord injury. Breathing pacemakers are considered to be more similar to physiological conditions compared to mechanical ventilators. Although the system is very expensive, its cost effectiveness may be excellent, provided that it can be used for long hours each day over an extended period. The system is effective in improving patient QOL because it dramatically increases patient mobility. From these findings, it is concluded that breathing pacemakers should be used more frequently in Japan, and that various forms of support are necessary to cope with economic and other concerns.

A Case of Atlantoaxial Dislocation surgically Fixated with Laminar Craw Hooks, Spinous Plates, and Occipital Plate System

Although cervical screw fixation is often demonstrated as biomechanical outstanding instrumentation for the case of upper cervical instability, only few reports have presented the complicated technique and high risk in the surgery. In this article, we show a case of atlantoaxial dislocation successfully fixated without any cervical screws.

Intraoperative Subarachnoid Pressure to Predict the Result of Posterior Decompression in Syringomyelia Associated with Chiari Type I Malformation

The surgical treatment for syringomyelia associated with Chiari type I malformation is reported. Surgical treatment is not yet established because the genesis of syringomyelia has not been clarified. We report here the subarachnoid cerebrospinal fluid flow findings during posterior decompression that correlate to the disappearance of syringomyelia.

Effects of Destruction of Nucleus Basalis Meynert on Operant Study and Neurotransmitters in Rats

In senile dementia of the Alzheimer type (SDAT), it has already been reported that the activity of neurotransmitters1–3 and number of cells in the nucleus basalis Meynert (nbM)4 are decreased. The purpose of our study was to evaluate changes in and correlation between the activity of neurotransmitters and response of ibotenic acid-lesioned WKY rats (a model of Alzheimer’s disease) in an operant study.