Toyotaka Aiba

Intracranial cavernous malformations and skin angiomas associated with middle fossa arachnoid cyst: A report of three cases

Three cases of multiple intracranial cavernous malformations and skin angioma associated with middle fossa arachnoid cyst are reported. Though no relation was confirmed in the pathogenesis of these lesions, this combination could be a new entity of neurocutaneous phacomatosis.

Bilateral medial medullary infarction due to bilateral vertebral artery dissection.

We describe a 52-year-old woman who experienced transient motor weakness and numbness of the left extremities and presented 2 days later with severe hemiparesis and sensory impairment of the right extremities and right lingual palsy. Magnetic resonance imaging (MRI) revealed bilateral upper medial medullary infarction, primarily in the left ventral portion. The findings of both three-dimensional (3D) computed tomographic and conventional angiography suggested dissection of both intracranial vertebral arteries (VAs). Medial medullary infarction is generally caused by atherosclerosis within a VA or anterior spinal artery. This is the first report of bilateral medial medullary infarction due to dissection of both intracranial VAs.

The prevalence of calcification around odontoid process and the incidence of crowned dens syndrome in the neurosurgical ward: A single institution’s analysis

Abstract Objective: The objective of this study is to assess the prevalence and natural history of odontoid calcification and to identify factors related to its progression to crowned dens syndrome (CDS). Methods: We reviewed a consecutive series of patients who underwent head CT upon admission to the neurosurgical ward of Niigata Prefectural Shibata Hospital. We evaluated the relationship between the presence of odontoid calcification and the patient’s age, sex, and primary disorder for admission. The incidence of CDS was also determined, and factors related to the progression of odontoid calcification to CDS were analyzed. Results: Odontoid calcifications were found in 88 out of 554 patients (15.9%) undergoing CT scans. Age, female, and stroke were predictive of odontoid calcification. The odds ratios (95% CIs) for age, female, and stroke estimated from the logistic analysis were 1.084 (1.054–1.114; p < .0001), 1.746 (1.06–2.875; p = .029), and 1.909 (1.123–3.247; p = .017), respectively. Eleven (12.5%) of the 88 patients with odontoid calcification developed CDS. The age, sex, and primary disorder for admission were not associated with the onset of CDS. Conclusions: Odontoid calcification is observed incidentally on head CT. Clinicians should keep in mind that patients with odontoid calcification might develop CDS, even if they are asymptomatic at the time of CT examination.