脳底動脈瘤を伴うモヤモヤ病の一例

A case of Moyamoya disease associated with basilar aneurysm was reported. This case was rare in that it developed from subarachnoid hemorrhage attributable to rupture of basilar aneurysm. The pathological findings of the intracranial blood vessels were almost identical to the findings presented in previous reports. In the vertebral basilar artery system, a remarkable intimal thickening of the intimal cushion type was observed on the side opposite to the origin of the aneurysm. This finding in light of its position was possibly implicated in the formation of cerebral aneurysm in view of the irregularity in blood flow at that site. In the study of the blood vessels of the entire body, slight localized thickening of the intima was observed in the coronary artery, aorta, common carotid artery, renal artery, and common iliac artery, suggesting a possible relation with systemic disease

モヤモヤ病に合併した脳動脈瘤 : CTによる追跡

We recently experienced a case which had an aneurysm with Moyamoya disease. He developed by a sudden severe headache, vomiting and conscious disturbance. CT was performed, and it revealed hematoma having a diameter of 1.0 cm adjacent to the anterior horn of the lateral ventricle in the head of the left caudate nucleus, and both lateral ventricles, 3rd ventricle, and 4th ventricle were found to be filled with clot. On the 17th day after onset, cerebral angiography was performed and it was found that both internal carotid arteries were strongly stenotic and Moyamoya vessels araised from bifurcation of each internal carotid artery. A spherical aneurysm 3×3 mm in size was seen in the periphery of the Moyamoya vessels, and its location was coincided with intracerebral hematoma on CT. This aneurysm were observed in enhanced CT, and became to smaller and smaller. We performed repeat cerebral angiography on 72nd day after onset, and found the aneurysm to be disappeared

重症頭部外傷，高血圧性脳出血，破裂脳動脈瘤に併発した胃腸出血

As a complication in patients with head injury or cerebral stroke, gastrointestinal bleeding is an important problem in neurosurgery. We reviewed 411 cases of hypertensive intracerebral hemorrhage, ruptured cerebral aneurysm and severe head injury in order to ascertain the pathologic condition of the gastrointestinal bleeding and to introduce an effective method of therapy. In 411 cases, gastrointestinal bleeding was observed in 19 cases (4.6%). Among the cases of hypertensive intracerebral hemorrhage or ruptured cerebral aneurysm, the frequency was high in males. Among the cases of severe head injury, the frequency was high in children. Dogmatyl® had no prophylactic effect for gastrointestinal bleeding. Administration of steroids had no relationship to gastrointestinal bleeding. Of the 19 cases with the gastrointestinal bleeding, laparotomy was performed on 6 cases. Of the 19 cases, 10 cases died. From our review, laparotomy is considered to be the most satisfactory method of therapy

"Insist on recovery" as a Positive Prognostic Factor in Japanese Stroke Patients

Aim: We designed two-step analyses to examine the effect of acceptance of disability or "insist on recovery" in Japanese stroke patients: firstly on their functional improvement and secondly on their psychological symptoms. Methods: We assessed disability using functional independence measurements (FIM), examined the stage of acceptance of disability by observation using Fink's theory (from shock to defensive retreat, acknowledgement, and acceptance/change stage), and quantitatively estimated "insist on recovery" (on a scale from 1 to 4) by observation. We then assessed the differences over time and the effects on the improvement in their FIM. We assessed depression using the Zung Self-rating Depression Scale (SDS); apathy using the Apathy Scale (AS), and assessed the correlation with the acceptance stage or "insist on recovery." Results: The acceptance stage and functional improvement progressed significantly, but "insist on recovery" did not change significantly during hospitalization. Multiple regression analysis revealed that the "insist on recovery" score (but not the acceptance stage) was a good predictor of the degree of improvement in FIM (FIM gain per week) in the elderly group. Post-hoc testing showed that the SDS or AS score decreased from the 1st stage to the 4th stage (but increase at the 3rd stage) of acceptance, the score decreasing from 1 to 3; however the score for "insist on recovery" increased from 3 to 4. Conclusions: The appropriate level of "insist on recovery" reduced depression and apathy, resulting in enhanced improvement of disability after a stroke in elderly stroke patients

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present