Yasuo Yamanouchi

Spontaneous disappearance of middle fossa arachnoid cyst after head injury.

A case of middle fossa arachnoid cyst is presented, which disappeared after head injury. Five days after the trauma, CT scan revealed subdural fluid collection in addition to an arachnoid cyst in the middle fossa on the same side. As the subdural fluid resorbed, the cyst became smaller and disappeared on the follow-up CT scans without surgical intervention.

When do brain abnormalities in cerebral palsy occur? An MRI study

The authors used MRI to analyse retrospectively the brain images of patients with cerebral palsy (CP) to evaluate its the role in the assessment of brain abnormalities and injury, and the relationship of pre‐, peri‐ and postnatal events to CP. 70 patients with CP aged two to 16 years who underwent MRI were divided into four groups: group 1 (26 patients) comprised subjects whose CP was considered to have been caused by neuronal migration disorders in the embryonal stage; group 2 (30 patients) contained subjects whose cause was vascular disorders; in group 3 patients (five) the cause was intra‐uterine infection; and CP clearly attributable to birth asphyxia (group 4) was noted in only nine patients. The results indicate that CP of term infants is often the result of prenatal factors, and their MRI findings indicated migration and cerebral infarction. Brain MRI is an essential examination in identifying the factors causing brain damage in CP.

Operative approach to the frontal skull base: extensive transbasal approach.

An operative technique called the extensive transbasal approach is reported with the operative results of 11 cases. This is an operative mode in which en bloc osteotomy of the orbital roofs and frontal sinus is performed after ordinary bifrontal craniotomy. Through this approach, a far wider operative space than that afforded by conventional operative techniques is possible, and reconstruction of the frontal base can be made securely. We consider this approach of major clinical value.

Solitary myofibromatosis of the skull: a case report and review of literature.

Case reportWe present a case of solitary myofibromatosis of the skull in a 4-year-old girl. Surgery was performed and the final diagnosis of myofibromatosis was made histopathologically.DiscussionSolitary myofibromatosis of the skull is rare and we found approximately 20 reported cases in the English-language literature. We reviewed eight well-described cases.ConclusionNeuroradiologically, common features such as a lytic lesion with a sclerotic rim on roentgenogram and intra-diploic lesion with periosteal new bone formation both in the outer and inner table of the skull on computed assisted tomography are noticed.

A case of primary Ewing's sarcoma of the occipital bone presenting with obstructive hydrocephalus.

BackgroundEwing’s sarcomas account for approximately 10% of primary malignant bone tumors. While most of the primary Ewing’s sarcomas occur in the long bones, pelvis, or ribs, approximately 1–6% of these sarcomas arise in the skull. We found approximately 50 cases of Ewing’s sarcoma of the calvarium reported in our search of the literature. Of these, 36 cases were reported in detail.Case report and discussionIn this article we describe a rare case of primary Ewing’s sarcoma of the occipital bone presenting with acute obstructive hydrocephalus and review the literature.

Gyriform calcification after purulent meningitis.

SummaryA 2-month-old baby developed bilateral frontoparietal gyriform calcification after purulent meningitis. Biopsy revealed severe cerebral cortical degeneration with many calcified foci. Another feature of interest was reabsorption of calcification over a period of 4.5 months.

Ultrastructural study of a cerebral gangliocytoma.

A pure cerebral gangliocytoma leaving no sign or symptom of recurrence after surgical removal is reported, with special reference to its CT scan and the ultrastructural findings. Unusual, large, dense bodies having the size of 800-1200 m mu and radiating from a central core were identified on the ultrastructural study. Microcystic formations might have been produced by active secretory granules containing dense core vesicles. The literature concerning the dense core vesicle of ganglion cell tumors is reviewed.

Expression of Rb2/p130 protein correlates with the degree of malignancy in gliomas.

It has been reported that there is an inverse correlation between the immunohistochemical expression of Rb2/p130, a member of the retinoblastoma gene family, and the degree of malignancy in at least some histological types. In order to investigate the expression of this protein in gliomas, we evaluated 58 samples from patients with resected gliomas. We focused on the relationship between the degree of malignancy of the glioma and the immunohistochemical detection of Rb2/p130. Expression of Rb2/p130 was observed in 38 glioma specimens (65.5%), including a high expression level in low-grade glioma specimens (>30% positive cells in 84% of tumors) and a low expression level in high-grade glioma specimens (>30% positive cells in 12% of tumors). The most aggressive of the gliomas exhibited very low to undetectable levels of Rb2/p130. Moreover, we observed an inverse correlation between Rb2/p130 expression and the degree of malignancy. These findings suggest that the differentiation of gliomas might be partially mediated by the Rb2/p130 gene, and that Rb2/p130 expression can additionally be an indicator of a better prognosis in patients with gliomas.

An immunohistochemical and electron microscopic study of atypical teratoid/rhabdoid tumor

We report two infant cases with atypical teratoid/rhabdoid tumor (AT/RT) located in the cerebellar vermis and spinal cord. MRI showed the tumors were isointense on T1-weighted images and mixed intensity of isointense and slight high intensity on T2-weighted images. Postcontrast MRI demonstrated clear margin of tumor and heterogeneous strong enhancement. It was difficult to differentiate the tumor from medulloblastoma by hematoxylin and eosin staining. However, immunohistochemical staining showed that these tumor cells react positively for cytokeratin, smooth muscle actin (SMA), and epithelial membrane antigen (EMA) and helped us with the differentiation. Electron microscopic study has confirmed the presence of mesenchymal components, such as filaments and desmosome junctions in the rhabdoid cells, but no neuronal components. The tumors rapidly increased in size, showing high MIB-1 index, and the prognosis was gave.

Traumatic Subarachnoid Hemorrhage Associated With Acupuncture

Subarachnoid hemorrhage as a complication of acupuncture has been reported in only a few cases. We report another case and discuss the implications of subarachnoid hemorrhage following acupuncture. Although acupuncture has traditionally been thought to be relatively safe, physicians should be aware that it may be a cause of intracranial hemorrhage.