Search

Your search keyword '"Kawashima, Akitsugu"' showing total 245 results
Start Over Author "Kawashima, Akitsugu"
245 results on '"Kawashima, Akitsugu"'

62. Treatment and Outcome of Vertebrobasilar Dolichoectatic Aneurysms: A Multinational study of 183 patients

Author

Jahromi, Behnam Rezai, Dashti, Reza, Ohadi, Amin, Srinivasan, Visish, Ota, Nakao, Kaukovalta, Hanna, Schwartz, Christoph, Lindgren, Antti, Koivisto, Timo, Tähtinen, Olli, Silva, Joao, Rustemi, Oriela, Jahromi, Babak, Killer-Oberpfalzer, Monika, Potts, Matthew, Kelahaara, Milla, Noda, Kusumo, Hecker, Constantin, Griessenauer, Christoph J., Numminen, Jussi, Göhre, Felix, Andrade-Barazante, Hugo, Hijazy, Ferzat, Wessels, Lars, Kalani, Yashar, Vajkoczy, Peter, Spetzler, Robert, Jääskeläinen, Juha E., Kawashima, Akitsugu, Winkler, Ethan, Tanikawa, Rokuya, Hernesniemi, Juha, Lawton, Michael, and Niemelä, Mika

Published
2024
Full Text
View/download PDF

63. Predictive factors for improvement of symptomatic cerebral vasospasm following subarachnoid hemorrhage by selective intra-arterial administration of fasudil hydrochloride

Author

Kuwano, Atsushi, Ishiguro, Taichi, Nomura, Shunsuke, Omura, Yoshihiro, Hodotsuka, Kenichi, Tanaka, Yukiko, Murakami, Masato, Kawamata, Takakazu, and Kawashima, Akitsugu

Abstract

Background Symptomatic cerebral vasospasm after subarachnoid hemorrhage (SAH) is a significant cause of delayed cerebral ischemia that leads to poor outcomes. Selective intra-arterial administration of fasudil hydrochloride (IAF) has been adopted for its vasodilatory effect on spasm arteries to prevent delayed cerebral ischemia. However, its effect on clinical outcomes and predictive factors for good recovery are not fully understood. This study aimed to investigate the outcomes of selective IAF and identify predictive factors for good outcomes in patients with cerebral vasospasm after SAH.Methods A retrospective study of 36 patients with cerebral vasospasm following SAH who underwent selective IAF at our institution between January 2014 and May 2022 was conducted. We evaluated the improvements in neurological findings before and after selective IAF. Statistical analyses were performed to determine factors associated with good outcomes.Results Selective IAF improved the neurological findings in 26 patients (72.2%). Pre-therapeutic absence of cerebral infarction in more than 1/3 of the spasm artery perfusion area was significantly associated with an improvement in neurological findings (p< 0.0001). Furthermore, there was a tendency for a good outcome when the age was younger (p= 0.093), and the spasm was limited to peripheral vessels (p= 0.065).Conclusion Our study indicates that selective IAF has a promising effect in improving symptomatic vasospasm, except when a large cerebral infarction exists in the spasm artery perfusion area. Early consideration of selective IAF could be recommended once patients experience symptomatic cerebral vasospasm after SAH.

Published
2024
Full Text
View/download PDF

66. Extracranial internal carotid artery vasospasm during thrombectomy.

Author

Miura, Isamu, Kawashima, Akitsugu, Hayashi, Masataka, Tanda, Akane, Ishikawa, Tomomi, and Kawamata, Takakazu

Abstract

The use of a stent retriever increases the risk of intracranial vasospasm. Here, we report the case of a man who developed severe vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever inserted for the treatment of acute cerebral ischemia. A 47-year-old right-handed man presented with sudden-onset right-sided weakness and difficulty speaking. The patient’s National Institutes of Health Stroke Scale score was 6 and he had an Alberta Stroke Program Early Computed Tomography Score of 9. The patient was started on intravenous alteplase therapy, and an acute thrombectomy was performed. Left internal carotid digital subtraction angiography showed narrowing of the left common and internal carotid arteries and occlusion of the proximal left M1 segment of the middle cerebral artery. A stent retriever was retracted into a guiding catheter placed at the left carotid bulb under continuous suction. Recanalization of the middle cerebral artery was not achieved and there was significant narrowing in a long segment of the extracranial internal carotid artery associated with exacerbation of the patient’s aphasia. The cervical vasospasm improved after nicardipine infusion via the catheter. We encountered vasospasm in a long segment of the extracranial internal carotid artery after mechanical irritation by a stent retriever. If a stent retriever is used in a patient with a narrow extracranial internal carotid artery, consideration should be given to using a Penumbra or smaller guiding catheter located in the distal internal carotid artery to prevent irritation to the cervical vessel wall. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

95. Abstract W P114.

Author

Yamazaki, Masako, Ohnishi, Tomoko, Hosokawa, Kazuya, Okada, Yoshikazu, Kawashima, Akitsugu, Yoneyama, Taku, Yamaguchi, Kouji, and Uchiyama, Shinichiro

Published
2014

96. Abstract TP136.

Author

Yamazaki, Masako, Okada, Yoshikazu, Kawashima, Akitsugu, Yamaguchi, Koji, Yoneyama, Taku, and Uchiyama, Shinichiro

Published
2013

97. A case of bilateral vertebral artery dissection treated by bilateral surgical occlusion and low-flow bypass.

Author

Yokoyama T, Nomura S, Ishiguro T, Hodotsuka K, Kuwano A, Tanaka Y, Murakami M, Kawamata T, and Kawashima A

Abstract

Background: Bilateral vertebral artery dissection aneurysm (VADA) is a rare condition that leads to severe stroke. However, the surgical strategy for its treatment is controversial because the pathology is very complicated and varies in each case. Here, we report a case of bilateral VADA that was successfully treated with staged bilateral VADA occlusion and low-flow bypass., Case Description: A Japanese man in his 40s presented with bilateral VADA with subarachnoid hemorrhage. He had only mild headaches without any other neurological deficits. Subsequently, the ruptured left VADA was surgically trapped. However, on postoperative day 11, the contralateral VADA enlarged. The right VADA was then proximally clipped via a lateral suboccipital approach. Furthermore, a superficial temporal artery-superior cerebellar artery bypass was performed through a subtemporal approach in advance to preserve cerebral flow in the posterior circulation. The bilateral VADA was obliterated, and the patient had an uneventful postoperative course during the 1-year and 6-month follow-up period., Conclusion: Bilateral VADA can be successfully treated with staged bilateral VADA obstruction and low-flow bypass. In this case, as the posterior communicating arteries were the fetal type and the precommunicating segments of the posterior cerebral arteries (P1) were hypoplastic, a low-flow bypass was used to supply the basilar and cerebellar arteries, except the posterior cerebral and posterior inferior cerebellar arteries. Furthermore, low-flow bypass is a less invasive option than high-flow bypass., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Published
2024
Full Text
View/download PDF

98. Transient neurological events in childhood moyamoya disease.

Author

Chiba K, Aihara Y, Fukui A, Yamaguchi K, Kawashima A, Okada Y, and Kawamata T

Subjects
Adult, Humans, Child, Retrospective Studies, Postoperative Complications epidemiology, Postoperative Complications etiology, Cerebrovascular Circulation physiology, Moyamoya Disease diagnostic imaging, Moyamoya Disease epidemiology, Moyamoya Disease surgery, Facial Paralysis etiology, Cerebral Revascularization adverse effects
Abstract

Objective: Patients sometimes experience transient neurological events (TNEs) during the early postoperative period after revascularization surgery for childhood moyamoya disease. The clinical background and pathophysiology of TNEs remain unclear. This study aimed to evaluate the incidence rate of TNEs and discuss the factors associated with pediatric moyamoya disease., Methods: The authors retrospectively reviewed 110 cerebral hemispheres of 61 pediatric patients younger than 15 years who were treated from 2011 to 2020. All children underwent either simple double-direct or combined revascularization surgery. Of these 61 patients, 52 underwent bilateral surgery and 9 underwent unilateral surgery. The authors calculated the incidence of TNEs in accordance with a previously reported TNE definition. Cerebral blood flow (CBF) was evaluated in all eligible cases with xenon CT immediately after revascularization surgery., Results: The incidence rate of TNEs in patients with childhood moyamoya disease was 26.4%. TNEs occurred after an average (range) of 6.26 (2-12) days postoperatively without triggers, and all identified TNEs spontaneously resolved within 2 weeks. The most common symptoms were dysarthria, facial palsy, and numbness around the mouth, followed by sensory disturbance of the upper extremities. The presence of focal hyperperfusion on xenon CT performed immediately after revascularization surgery was strongly correlated with the incidence of TNEs (p = 0.0001). Focal hyperperfusion was observed in 43 of 110 operative sides (39.1%). Notably, only 25.6% of patients with focal hyperperfusion showed numerical global hyperperfusion. In addition, a decrease in CBF compared with the thalamic region in the contralateral side was observed in TNE-affected cases (p = 0.0443)., Conclusions: TNEs occurred more frequently in childhood moyamoya disease patients than expected. The clinical background, including symptoms, timing, and duration, was almost identical to TNEs in adults. Focal hyperperfusion, rather than numerical global hyperperfusion, was strongly correlated with the incidence of TNEs. Furthermore, the authors advocate the notion that a clinical course where symptoms occur without triggers may be a unique characteristic of TNEs, especially in childhood moyamoya disease.

Published
2022
Full Text
View/download PDF

99. [Advantages and Pitfalls of the Lateral Supraorbital Approach as Less Invasive Surgery for Unruptured Anterior Circulation Aneurysms].

Author

Ishiguro T, Kawashima A, Nomura S, Hashimoto K, Hodotsuka K, Kim K, Momosaki N, and Kawamata T

Subjects
Craniotomy, Humans, Neurosurgical Procedures, Retrospective Studies, Treatment Outcome, Aneurysm, Ruptured surgery, Intracranial Aneurysm surgery
Abstract

The lateral supraorbital approach(LSOA)is widely accepted as a less invasive surgical technique compared with the conventional pterional approach(PA). However, only a few studies have reported less invasiveness associated with LSOA. To evaluate this issue, we retrospectively investigated the surgical outcomes in 133 patients who underwent LSOA and 28 patients who underwent PA for unruptured anterior circulation aneurysms. We analyzed operation time, postoperative symptoms and complications, and the length of postoperative hospitalization(in days)for each method. All aneurysms were successfully clipped regardless of the approach. The operation time was significantly shorter, the postoperative headache rate was lower, resumption of oral intake was more rapid, and length of hospitalization was shorter in the LSOA group. Statistical significance was not observed in the postoperative complication rates. Compared with conventional PA, LSOA was associated with less invasiveness and better patient satisfaction. LSOA is a safe and effective alternative to conventional PA, following optimal patient selection.

Published
2020
Full Text
View/download PDF

100. Chronic subdural hematoma of the posterior fossa treated by suboccipital craniotomy.

Author

Mochizuki Y, Kobayashi T, Kawashima A, Funatsu T, and Kawamata T

Abstract

Background: Chronic subdural hematoma (CSDH) of the posterior fossa is uncommon in adults. Only a few cases have been reported, and most of these were secondary to head injury or anticoagulant therapy. We herein describe a case of successful surgical treatment of CSDH in the posterior fossa after surgical removal of a large supratentorial and infratentorial dermoid cyst., Case Description: A 71-year-old woman underwent removal of a left supratentorial and infratentorial dermoid cyst via a left transzygomatic approach. Three years, 6 months after surgery, screening computed tomography revealed CSDH in the supratentorial and infratentorial regions. Four months later, the patient was transferred to the emergency department with cerebellar ataxia, vomiting, and deterioration of consciousness. Two hematomas, one in the supratentorial region and one in the infratentorial region, were greatly compressing the brain, and seemed to be separate lesions. It was difficult to judge on computed tomography whether there was communication between these two hematoma cavities. The patient underwent hematoma removal via suboccipital craniotomy for the posterior fossa CSDH to resolve brain stem compression. Burr-hole irrigation was used for the supratentorial CSDH to avoid upper herniation. The patient recovered uneventfully and was discharged with no neurological deficits., Conclusion: Although the optimal treatment for CSDH of the posterior fossa remains unclear because of the limited number of previous reports, direct decompression of the posterior fossa via suboccipital craniotomy should be considered, especially when CSDH exists primarily at the cerebellopontine angle and strongly compresses the brain stem., Competing Interests: There are no conflicts of interest.

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results