Nobuhiko Takahara

Detection of cerebrovascular disease in diabetic patients by means of the Kana test

Abstract The Kana test, which measures the ability to select written characters while performing memory and processing tasks, was completed by 158 patients with non-insulin-dependent diabetes and 352 healthy control subjects. Test scores in both groups declined with age. Abnormally low scores were obtained by significantly more diabetic patients than controls in each age group. According to computed tomography (CT) results obtained for 94 of the diabetic patients, cerebral infarction was diagnosed in 26 patients and cerebral atrophy in 22; among the 40 patients with very low Kana test scores, 15 had cerebral infarcts and 6 cerebral atrophy. According to magnetic resonance imaging results, cerebral infarction was diagnosed in 25 of the 40 patients with normal CT results; among the 13 patients with very low Kana test scores, 12 had cerebral infarcts. Cerebral blood flow (particularly in the occipital region, the thalamus, and the watershed region of the middle and posterior cerebral arteries) was significantly lower in patients with low Kana test scores than in patients with normal scores. It is concluded that the Kana test is a potentially useful method for detecting cerebral infarction in diabetic patients.

Hemorrhage from a Newly-developed Internal Carotid Posterior Communicating Artery Bifurcation Aneurysm Occurring 11 Years After Contralateral Common Carotid Artery Ligation for the Ruptured Aneurysm

In this paper, a case of ruptured newly-developed right internal carotid posterior communicating artery bifurcation aneurysm, which occurred 11 years after contralateral common carotid artery ligation for a ruptured left side aneurysm, is reported. Common carotid artery ligation for the left internal carotid posterior communicating artery bifurcation aneurysm seemed to be effective to some extent from the following view points : rebleeding from the ipsilateral aneurysm was prevented and a decrease in size of that aneurysm was obtained. The new aneurysm might have developed due to the long-term hemodynamic stress exerted on the pre-existing fragility of the arterial wall. Such stress may have resulted from increased blood volume in the ipsilateral internal carotid artery after the contralateral common carotid artery ligation.