Search Results

You are looking at 1 - 10 of 19 items for

  • Author or Editor: Kazuo Tabuchi x
  • Refine by Access: all x
Clear All Modify Search
Restricted access

Blood blisterlike aneurysms of the internal carotid artery

Masamitsu Abe, Kazuo Tabuchi, Hiroaki Yokoyama, and Akira Uchino

Object. An aneurysm arising from the anterior wall of the internal carotid artery (ICA) is a poorly understood entity. A small hemispherical bulge from the anterior wall of the ICA, which is called a “blood blisterlike aneurysm” (BBA), may be confused with a tiny berry aneurysm although the clinical features are distinctly different. This paper summarizes the clinical course of patients with this lesion to clarify the nature of the BBA.

Methods. Six patients with BBAs who presented with subarachnoid hemorrhage (SAH) are described. In all patients, the initial angiogram obtained soon after SAH showed only a small bulge from the anterior wall of the ICA. In three of the six patients this bulge had progressed to a saccular appearance within a few weeks. The wall of the lesion was so thin and fragile that the aneurysm ruptured at the base during clipping or within a few hours after clipping in two patients.

Conclusions. From the authors' experience, as well as a review of the literature, which includes an autopsy study of similar cases, it is inferred that these lesions are focal wall defects covered only with thin fibrous tissue and that they are therefore not true aneurysms. Direct clipping often causes laceration of the lesion, whereas complete wrapping or clipping after wrapping is effective, but may fail to prevent growth of the aneurysm. Endovascular occlusion of the cervical ICA with or without bypass surgery, which is less risky than direct surgery, is another option.

Restricted access

Rosai—Dorfman disease presenting multiple intracranial lesions with unique findings on magnetic resonance imaging

Case report

Hiroki Udono, Kouzou Fukuyama, Hiroaki Okamoto, and Kazuo Tabuchi

✓ Rosai—Dorfman disease (RDD) is a rare idiopathic histoproliferative disease affecting the systemic lymph nodes. Although an extranodal lesion has also been recognized, central nervous system involvement is extremely rare. To the authors' knowledge, only 20 cases of intracranial lesions have been reported previously. Intracranial RDD is clinically and radiologically difficult to distinguish from meningioma, and histological examination is essential for a definitive diagnosis. The authors treated a large frontal lobe tumor associated with multiple meningeal nodules in a 67-year-old patient presenting with diplopia and headache. Radiological examination indicated that the mass was an inflammatory lesion rather than a meningioma. Microscopically the lesion consisted of mixed inflammatory infiltrate with marked emperipolesis, which is characteristic of RDD. A review of the literature and a discussion of the differential diagnosis of this rare lesion are also presented.

Restricted access

Detection of simian virus 40 DNA sequence in human primary glioblastomas multiforme

Tomohiko Kouhata, Kouzou Fukuyama, Naoshi Hagihara, and Kazuo Tabuchi

Object. Deoxyribonucleic acid oncoviruses can induce neoplastic transformation of cells because their viral proteins interfere with antiproliferative cellular proteins. Simian virus 40 (SV40) is a DNA virus that induces the emergence of ependymomas, choroid plexus tumors, mesotheliomas, osteosarcomas, sarcomas, and various tumors when injected into newborn hamsters. Recently, approximately 60% of human ependymomas, choroid plexus tumors, and mesotheliomas were reported to contain and express SV40 DNA sequences. In this study the presence of SV40 DNA sequences was investigated in human brain tumors.

Methods. Three of 32 glioblastomas mutiforme (GBMs), but none of two ependymomas and five medulloblastomas, were found to possess SV40 DNA sequences when examined using polymerase chain reaction (PCR). The DNA sequence analysis of PCR-amplified fragments disclosed that the samples were identical to the regulatory region of SV40. All three GBMs, which arose in elderly patients with wild-type p53, were considered to be primary (de novo) tumors. Although each of the three tumors was immunohistochemically negative for SV40 T antigen, in situ hybridization successfully demonstrated the messenger RNA for SV40 T antigen.

Conclusions. The results of this study indicate that latent infection of SV40 in elderly people may be implicated in the tumorigenesis of certain primary GBMs.

Restricted access

Primary intracranial epidermoid carcinoma

Case report

Yoshiki Nosaka, Seigo Nagao, Kazuo Tabuchi, and Akira Nishimoto

✓ A case is presented of primary intracranial epidermoid carcinoma in the right cerebellopontine angle which was visualized as a homogeneously enhanced mass on computerized tomography. At autopsy the malignant tissue was found to have invaded the brain stem.

Restricted access

Aneurysm of a persistent primitive olfactory artery

Case report

Takehisa Tsuji, Masamitsu Abe, and Kazuo Tabuchi

✓ A ruptured anterior cerebral artery (ACA) aneurysm is reported in a patient in whom an anomalous ACA arose from the internal carotid artery at the bifurcation. The aberrant artery coursed anteriorly along the ipsilateral olfactory tract and made a hairpin turn posterior to the olfactory bulb, supplying the circulation of the ACA. Persistence of the primitive olfactory artery is suggested as an embryological origin of this vascular anomaly.

Restricted access

Primary central nervous system lymphoma

Yasuto Kawakami, Kazuo Tabuchi, Rinkichi Ohnishi, Shoji Asari, and Akira Nishimoto

✓ A retrospective analysis of 21 cases of primary central nervous system (CNS) lymphoma is reported. All patients presented with a solitary mass in the supratentorial region. None had previously received immunosuppressive therapy. Neuroradiological studies included technetium-99m-pertechnetate brain scanning in eight cases, cerebral arteriography in all 21 cases, and computerized tomography (CT) in 14 cases. The characteristic features were increased uptake in brain scans, mass effect in arteriograms, and marked contrast enhancement on CT scans. Abnormal tumor vessels were occasionally seen on arteriography, and subtraction films were usually required to appreciate tumor stain. All patients underwent craniotomy, and histological studies of the tumors showed a diffuse type of lymphoma in all cases. Immunoglobulin testing was performed in 19 cases and a monoclonal spike was verified in 10, suggesting a B cell origin. All patients were followed until their death except one who was still alive 12 months from onset of symptoms. Therapy included subtotal resection in all 21 cases, whole-brain irradiation in six cases, chemotherapy in two cases, and a combination of whole-brain irradiation and chemotherapy in nine cases. Three different forms of chemotherapy were used. The results suggest that chemotherapy is an important addition to subtotal resection and whole-brain irradiation in the treatment of primary CNS lymphoma.

Restricted access

Blister or Berry Aneurysm

Restricted access

Blood-Blister-Like Aneurysms

Restricted access

Bilateral intracerebellar calcification associated with cerebellar hematoma

Case report

Yasuto Kawakami, Yoshikuni Nakao, Kazuo Tabuchi, Yoshiki Nosaka, and Takashi Ohmoto

✓ A case of bilateral intracerebellar calcification associated with cerebellar hematoma on the left side is reported. Clinical and microscopic examination failed to clarify the causes of calcification and hematoma. It is postulated that hemorrhage occurred from time to time through the fragile calcified vessel walls, since some portions of the organized hematoma were composed of massive erythrocytes.

Restricted access

Primary intracranial choriocarcinoma

Yasuto Kawakami, Osamu Yamada, Kazuo Tabuchi, Takashi Ohmoto, and Akira Nishimoto

✓ The authors report four cases of primary intracranial choriocarcinoma, all in young males. Three tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in three cases and precocious puberty in two cases. Angiography revealed tumor stain with irregular vessels in all cases. Enhanced computerized tomography scans in the last two cases demonstrated a round, lobulated lesion of high density, with relatively low density in the central portion. Hormonal study was carried out in three cases. In addition to high levels of human chorionic gonadotropin (HCG) in the urine and cerebrospinal fluid and/or of plasma luteinizing hormone (LH), LH in the tumor tissue or medium obtained via cell cultures was also high in all three cases, suggesting inherent activity of HCG secretion by the tumor cells. The tumors were relatively demarcated from the surrounding brain. They were very hemorrhagic, and fresh hematoma was identified in the tumor in one case. Good results were obtained in two cases treated with surgical removal followed by simultaneous chemotherapy and 60Co irradiation.