Minoru Nakamura

Sasebo City General Hospital, Nagasaki, Nagasaki, Japan

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Publications (4)0.39 Total impact

  • Kentaro Hayashi · Hideaki Takahata · Minoru Nakamura
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    ABSTRACT: Two cases of spinal arteriovenous malformation (AVM) with subarachnoid hemorrhage (SAH) are reported. The first case is that of a 14-year-old boy who was transferred to our hospital with a sudden onset of headache. Neurological examination revealed no motosensory deficit, but a brain CT showed a slight diffuse SAH. A left vertebral angiogram demonstrated intramedullary AVM in the cervical region of the spinal cord. This AVM was therefore occluded using a solid embolization material. The patient was then discharged without neurological deficit. The second case is that of a 67-year-old man who visited our hospital with a sudden onset of headache. Neurological examination revealed no motor or sensory deficit, but a brain CT showed SAH, which was dominant in the posterior fossa. Initial cerebral angiography demonstrated no abnormality such as cerebral aneurysm or AVM except for laterality of the C1 radiculo-meningeal artery. A second angiogram on day 11 demonstrated spinal arteriovenous fistula (AVF), which was fed by the left radiculo-meningeal artery and drained to the posterior spinal vein. Embolization for the AVF was performed using liquid material. He was then discharged without neurological deficit. These two cases revealed non-specific SAH symptoms and were indistinguishable from other ruptured aneurysms. Although the brain CT can show a slight SAH or posterior fossa dominant SAH, repeated angiography may be necessary to verify and conclude the diagnosis of spinal AVM.
    No preview · Article · Jul 2004 · No shinkei geka. Neurological surgery
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    ABSTRACT: Brain tumors not uncommonly display a chronic course, with symptoms occurring insidiously. This case report describes a meningioma patient who presented sudden onset and rapidly progressing symptoms. She was 49 years old, a referred case from a nearby hospital, with severe headache and fever. This was also accompanied by unconsciousness and left hermiparesis which necessitated emergency brain CT and MRI scanning. A right temporal 5 cm ring enhancing lesion with massive surrounding edema was revealed. Despite osmotic diuretics to relieve brain edema, symptoms worsened, so decompressive right temporal craniotomy and total excision of the tumor was performed. This mass lesion was found to be extra axial, with histology revealing on atypical meningioma with massive necrosis. This rare case which is thought to be due to massive peritumoral edema, possibly from an ischemic occluded major feeder, conforms to glioma radiologically; while the clinical picture has a similarity to brain abscess. This case is presented as a reminder to neurosurgery practice that meningioma can also be a possibility when a ring enhancing cerebral mass in encountered and is accompanied by such a bizarre sudden and rapidly progressing neurologic condition.
    No preview · Article · Jan 2004 · No shinkei geka. Neurological surgery
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    ABSTRACT: We presented a case in which anti-hypertensive therapy inducing cerebral ischemia led to a diagnosis of moyamoya disease. In cases presenting cerebral ischemia due to the lowering of high systemic blood pressure, it is necessary to make a differential diagnosis of a disease causing hemodynamic cerebral insufficiency.
    No preview · Article · Apr 2003 · No shinkei geka. Neurological surgery
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    ABSTRACT: We report a case of Lhermitte-Duclos disease (LDD) with huge AVMs of left extremities. The patient is a 46-year-old woman, who was identified heart failure due to AVMs at 13 years old and underwent amputation of left arm and several embolizations for AVM of left leg. Following a loss of consciousness, she was admitted to our hospital at 46 years old. CT scan showed a low-density area in the vermis of cerebellum. MR imaging showed a tumor with characteristic parallel linear striation. She was treated with partial resection of tumor. Pathological findings were dysplastic gangliocytoma. She was diagnosed LDD by MR imaging and pathological findings. Some reports describe an association between LDD and Cowden disease. On the other hand, there are reports of an association between Cowden disease and AVM. However, to our knowledge, there is no report of an association between LDD and AVM. Although this case didn't be revealed an association with Cowden disease, we believe that this case is a very interesting one henceforth suggesting the association between LDD, Cowden disease, and AVM.
    No preview · Article · Apr 2003 · Nō to shinkei = Brain and nerve