Takaoki Tada

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.

A Trial to Produce Acute and Chronic Focal Epileptic Models with Subpial Injection of Ferrous Chloride Solution

In an attempt to produce experimental epileptic models with chemical materials (Almina gel, Cobalt and Penicillin), many tests have been conducted up to now. But they have made either acute models or chronic models of epileptogenic foci with a chemical material. In maklng a chronic model, the frequency of this epileptogenic discharge was considerably LOW in many experiments. On our model with the subpial injection of a ferrous chloride solution by changing the concentration, either an acute or chronic epileptic model can be produced with ease. The incidence of the epileptic discharge was very high, approximately 100 per cent.

Sequential Changes in Content of Excitatory Amino Acids in the Focus of Epilepsy in Seizure Induction

L-Glutamate (Glu) and L-Aspartate (Asp), two major excitatory amino acids, have been postulated to be involved in seizure susceptibility and seizure ind~ction.l-~ In order to examine the relationship between epilepsy, especially seizure induction, and excitatory amino acids, we examined the sequential changes in the content of excitatory amino acids in the focus of epilepsy by the microdialysis system in a cat amygdaloid kindling model.

Surgical Indication of Arteriovenous Malformation at Ventrolateral. Craniocervical Junction

We presented four cases of arteriovenous malformation in the vicinity of medulla oblongata, located ventrolaterally at the craniocervical junction. All cases developed subarachnoid hemorrhage and the initial symptoms were not specific except for the severe nuchal rigidity and headache. Three cases were surgically treated. Satisfactory results were obtained by clipping of the feeding arteries and coagulation of the abnormal vessels with bipolar coagulator. One case died of fourth attack on the second day after admission and was autopsied. Bilateral vertebral angiography is the best for diagnosis and the open mouth projection is essential because a shortened vascular figures of vertebral arteries can be corrected and because abnormal vessels can be found usually in the open mouth space. In our cases, C2 radiculomedullary artery, anterior spinal artery, posterior spinal artery and the abnormally dilated artery branching from posterior inferior cerebellar artery and vertebral artery to flow into the lateral-inferior portion of medulla oblongata participated as feeding arteries. As the lesion located at the lateral and ventral surface of medulla oblongata, the surgical procedures were difficult totally to remove. If the anterior spinal artery is not the main feeding artery, the operating purpose can be attained by clipping or ligaturing the other feeding arteries and then coagulating the abnormal vessels as much as possible. When the main feeding artery is the anterior spinal artery and the arteriovenous malformation locates in the medulla oblongata, it is impossible to treat this surgically by the dorsal approach. It may be necessary to carry out the other ways such as the transclival approach.

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.

Histological Study of Epileptic Focus Induced by Ferrous Chloride

てんかん焦点の組織学的研究において完成された焦点の観察も重要であるが, 焦点完成までの経時的組織変化および焦点形成に関与した物質の脳内・細胞内作用場所の同定も重要であると考えられ, 本実験を行った。塩化第一鉄, フェリチンを脳内に注入し, 慢性焦点性てんかんモデルを作製し, 光顕, 電顕などを用い焦点を観察した結果, 神経細胞内には, paired cisternaeの出現, 神経膠細胞には微細繊維の増加などの所見を得た。鉄の局在に関しては, 神経細胞, 神経膠細胞細胞質内から, 二次的ライソゾーム内にとり込まれ, 終生細胞内に鉄が留まると考えられた。これらの結果より, 形態学的側面よりみた, てんかん波出現に関する考察を試みた。