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IKEUCHI Yusuke
University Hospital / Neurosurgery
Assistant Professor

Researcher basic information

■ Research Keyword
  • 神経再生
  • 神経保護
  • Bioinformatics
  • No-reflow現象
  • Carbenoxolone
  • 脳虚血再灌流障害
  • 脳梗塞
■ Research Areas
  • Life sciences / Neurosurgery

Research activity information

■ Paper
  • Yamanishi Shunsuke, Nagashima Hiroaki, Tanaka Kazuhiro, Ikeuchi Yusuke, Fujimoto Yosuke, Sasayama Takashi
    Glioblastoma, particularly IDH-wildtype GBM, has a poor prognosis and frequently recurs locally even after standard therapy. This retrospective study analyzed 100 patients with newly diagnosed IDH-wildtype GBM treated at Kobe University Hospital between January 2013 and December 2022, comparing those who underwent intraoperative photodynamic therapy (PDT) with talaporfin sodium (n = 44) and those who did not (n = 56). Recurrence patterns, progression-free survival (PFS), overall survival (OS), adverse events, and prognostic factors were evaluated. The PDT group demonstrated a significantly lower rate of local recurrence (45.5% vs 69.6%, p = 0.012), although distant or disseminated recurrences were relatively more frequent. Median PFS and OS were significantly longer in the PDT group (10.8 and 24.6 months, respectively) compared with the non-PDT group (9.3 and 17.6 months; p = 0.016 and p = 0.034). Two cases of grade 3 adverse events were observed in the PDT group, both of which improved with conservative management. Multivariate analysis identified gross total resection and younger age as independent favorable prognostic factors. In a subgroup analysis of patients who underwent gross total resection and had known MGMT promoter methylation status, PDT significantly prolonged survival in the MGMT-unmethylated group (790 vs 570 days, p = 0.0310), but not in the methylated group. These findings suggest that PDT is safe and may particularly benefit patients with MGMT-unmethylated IDH-wildtype GBM.
    Japan Society for Laser Surgery and Medicine, Apr. 2026, The Journal of Japan Society for Laser Surgery and Medicine, 47(1) (1), 79 - 84, Japanese

  • Hiroaki Nagashima, Kazuhiro Tanaka, Shunsuke Yamanishi, Yusuke Ikeuchi, Takashi Sasayama
    BACKGROUND: The optimal management of primary central nervous system lymphoma (PCNSL) in elderly patients remains challenging, as whole-brain radiotherapy (WBRT) is associated with substantial delayed neurotoxicity. METHODS: We retrospectively analyzed 65 patients aged ≥ 65 years diagnosed with PCNSL between 2008 and 2024 who received either high-dose methotrexate (HD-MTX) followed by WBRT (n = 29) or R-MPV with or without WBRT (n = 36). Clinical characteristics, cerebrospinal fluid (CSF) biomarkers, treatment outcomes, and MRI-based ventricular volume-used as a surrogate for treatment-related neurotoxicity-were evaluated. White matter changes were additionally assessed using the Fazekas scale. RESULTS: The median age was 72 years. Median progression-free survival (PFS) and overall survival (OS) for the entire cohort were 32.8 and 38.2 months, respectively. WBRT was independently associated with inferior PFS and OS. Patients treated with R-MPV without WBRT achieved longer PFS (53.2 vs. 27.2 months) and superior OS (not reached vs. 35.9 months) compared with those receiving HD-MTX plus WBRT. MRI analysis demonstrated significantly greater ventricular enlargement in the WBRT group (14.6% vs. 2.9% per year; p < 0.001). Among WBRT-treated patients, elevated CSF IL-10 (>100 pg/mL) correlated with accelerated ventricular enlargement. Progression of white matter changes assessed by the Fazekas scale was also significantly greater in the WBRT group. CONCLUSIONS: In elderly PCNSL patients, R-MPV without routine WBRT provides effective disease control while being associated with less structural brain change. CSF IL-10 may represent a potential biomarker of susceptibility to treatment-related brain structural alterations.
    Mar. 2026, Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 149, 111997 - 111997, English, International magazine
    Scientific journal

  • Hiroyasu Shose, Takashi Mizobe, Taiji Ishii, Naomi Yagi, Masaaki Kohta, Yusuke Ikeuchi, Masahiro Maeyama, Satoshi Nakamizo, Akitsugu Morishita, Hideo Aihara, Shotaro Tatsumi, Takashi Sasayama
    American Society of Neuroradiology (ASNR), Mar. 2026, American Journal of Neuroradiology, ajnr.A9291 - ajnr.A9291
    Scientific journal

  • Yoji Yamaguchi, Masaaki Kohta, Kenji Ishikawa, Yasuo Naito, Michio Yamaguchi, Yusuke Ikeuchi, Hiroyasu Shose, Kazuhiro Tanaka, Atsushi Fujita, Takashi Sasayama
    BACKGROUND: Migraine-related presenteeism is a global concern, arising when individuals attend work during a headache attack, resulting in reduced performance. To clarify this issue, we investigated the effect of the presence and severity of headache attacks on cognitive function in patients with migraine. METHODS: We conducted a retrospective analysis of prospectively collected cohort data from April to December 2019, enrolling participants aged 18–80 years who met the ICHD-3 criteria for migraine. Participants were categorized into four groups based on headache (HA) intensity at the time of their clinic visit: no HA, mild, moderate, or severe. Cognitive function was assessed using the Digit Cancellation Test (D-CAT) and the Trail Making Test (TMT). Patients with severe HAs were excluded, as pain relief treatment was prioritized. Statistical comparisons were conducted across the remaining groups. RESULTS: A total of 259 patients were analyzed, including 125 without HAs (HA (−)) and 134 with HAs (HA (+)), of whom 79 were mild and 55 were moderate. The HA (+) group showed significantly lower D-CAT scores compared with the HA (−) group (p < 0.05), while TMT scores did not differ significantly between the two groups. Within the HA (+) group, no significant differences in D-CAT or TMT scores were observed between patients with mild and moderate HAs. Similarly, cognitive scores did not differ between migraine patients with and without aura. CONCLUSION: Migraine patients experiencing a headache attack had reduced cognitive function compared with HA-free migraine patients, and this dysfunction was independent of HA severity. These findings suggest that the presence of a headache attack itself – regardless of its severity – may impair cognitive function and have potential implications for work efficiency and presenteeism. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-026-04782-z.
    Mar. 2026, BMC neurology, 26(1) (1), English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Takashi Sasayama, Kazuhiro Tanaka, Hiroaki Nagashima, Michiko Takahashi, Misa Yamanishi, Misaki Kuroda, Satoko Tabuchi, Keisuke Hagihara, Shunsuke Yamanishi, Yusuke Ikeuchi, Yuichi Fujita, Hirohumi Iwahashi, Sayaka Hotta, Michiko Matsunaga, Shoji Sanada, Yoshihiro Muragaki, Masamitsu Nishihara
    BACKGROUND: Altered tumor metabolism has renewed interest in ketogenic strategies, despite limited clinical evidence in glioma. Whereas the ketogenic diet (KD) alone elevates intratumoral amino acids, bevacizumab (BEV) co-administration suppresses these metabolites and curtails tumor growth, pointing to a synergistic therapeutic potential. METHODS: We conducted a clinical pilot study to evaluate the combination of KD and standard therapy, combining BEV, in patients with malignant glioma. A standardized modified ketogenic diet (mKD) regimen was implemented: carbohydrate intake was restricted to 10 g/day in the first week, 20 g/day in the following 2 months, and ≤30 g/day thereafter. MCT oil was administered at ≥50 mL/day, and ketone formula supplements were provided as needed. The primary endpoint was to assess safety and feasibility. RESULTS: 10 patients were enrolled. The duration of mKD ranged from 63 to 1,954 days, with a median of 185 days. All patients showed a rapid increase in serum ketone levels and achieved therapeutically adequate glucose-ketone index values. All participants met the predefined safety criteria, and no severe adverse events were reported. One patient discontinued the diet owing to moderate abdominal pain. The objective response rate was 50%, and notably, one patient remained on mKD for more than 5 years without tumor recurrence. The median progression-free survival from mKD initiation was 9.5 months, and the median overall survival was 31 months. CONCLUSIONS: The combination of mKD and standard therapy with BEV was safe and feasible in patients with malignant glioma. Larger clinical trials are needed to determine its anti-tumor efficacy and clinical benefit.
    2026, Neuro-oncology advances, 8(1) (1), vdaf264, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Noriaki Ashida, Atsushi Fujita, Young Ju Kim, Shunsuke Yamanishi, Yusuke Ikeuchi, Kazuhiro Tanaka, Yoichi Uozumi, Masamitsu Nishihara, Kohkichi Hosoda, Takashi Sasayama
    Dec. 2025, Radiology Case Reports
    Scientific journal

  • Shunsuke Yamanishi, Hiroaki Nagashima, Kazuhiro Tanaka, Yusuke Ikeuchi, Masahiro Nakahara, Hirofumi Iwahashi, Satoshi Nakamizo, Hirotomo Tanaka, Masamitsu Nishihara, Tomoo Itoh, Yoshihiro Muragaki, Takashi Sasayama
    PURPOSE: Various immune cells infiltrate glioma tissues and secrete inflammatory mediators. This study aimed to identify inflammatory mediators in the CSF that are indicative of the tumor microenvironment (TME) and have prognostic significance in patients with glioma. METHODS: This retrospective study included patients newly diagnosed with glioma. CSF concentrations of soluble CD163 (sCD163), a marker of M2 macrophages, were measured using a human ELISA kit and compared with the percentage of CD163-positive area in tumor tissue (tCD163 (%)). In addition, concentrations of 37 inflammatory mediators in CSF were quantified using Bio-Plex Pro™ Human Inflammation Assays. Correlations among these mediators and their associations with clinical outcomes were analyzed. RESULTS: A total of 125 patients were evaluated for sCD163. Both sCD163 levels and tCD163%) were significantly higher in WHO grade 4 gliomas and showed a positive correlation. Multivariate correlation analysis revealed a clear segregation of CSF inflammatory mediators into sCD163 positive-corelate and sCD163 negative-correlate clusters. sCD163 positive-correlate cluster includes various TNF superfamilies and sTNF receptors, while sCD163 negative-correlate cluster includes interferon-α/β (IFN-α/β) and verous interleukines (ILs). Among patients with IDH-wild glioblastoma, the ratio of sCD163/IFN-α/β was associated with poor prognosis. CONCLUSION: Elevated sCD163 levels in CSF were positively associated with various TNFSFs and sTNFRs and inversely associated with type 1 IFNs and various ILs, suggesting a dominant influence of tumor associated M2 macrophages on the TME. The sCD163/type I IFN ratio may serve as a potential prognostic indicator in patients with IDH-wildtype glioblastoma.
    Nov. 2025, Journal of neuro-oncology, 176(1) (1), 93 - 93, English, International magazine
    Scientific journal

  • Yusuke Ikeuchi, Atsushi Fujita, Masaaki Kohta, Hiroyasu Shose, Shunsuke Yamanishi, Naoto Nakamura, Kazuhiro Tanaka, Hidehito Kimura, Takashi Sasayama
    BACKGROUND AND OBJECTIVES: Delayed rupture following flow diverter (FD) placement in intradural internal carotid artery aneurysms (ICA-Ans) is a well-documented life-threatening complication. Delayed rupture of extradural ICA aneurysms (EICA-Ans) after FD placement is rare, and no comprehensive analysis has been conducted. This study systematically reviewed cases of delayed rupture of EICA-Ans after FD placement and investigated the anatomical features associated with this complication. METHODS: We performed a systematic review of the literature and identified 18 cases of delayed rupture after FD placement of EICA-Ans. These were analyzed alongside 2 cases from our institution. As a comparison group, we reviewed 24 patients treated with FD for unruptured EICA-Ans without delayed rupture at our institution. Anatomical features, including the cavernous internal carotid artery (C-ICA) angulation and aneurysm neck location relative to the horizontal segment of the C-ICA, were evaluated. RESULTS: Among patients with delayed rupture, 15 of 17 aneurysms exhibited severe C-ICA angulation (<90°), and 16 of 17 aneurysms had proximally located necks in the horizontal segment. These features were significantly more frequent in the delayed rupture group than in the nondelayed rupture group (15/17 vs. 5/24; P < 0.001). CONCLUSIONS: Severe C-ICA angulation and proximal aneurysm neck location may increase mechanical stress after FD placement, potentially contributing to a delayed rupture. The identification of high-risk anatomical features can optimize patient selection and procedural strategies.
    Nov. 2025, Journal of the neurological sciences, 478, 123712 - 123712, English, International magazine
    Scientific journal

  • Hidehito Kimura, Tatsuya Mori, Kosuke Hayashi, Yusuke Ikeuchi, Kazuhiro Tanaka, Masakazu Shinohara, Akio Tomiyama, Eiji Kohmura, Takashi Sasayama
    The mechanisms underlying cerebral aneurysm wall fragility remain unclear. Proteomic analysis has revealed predominant expression of myoglobin in thickened aneurysm wall regions. Given its nitric oxide-scavenging function, myoglobin may enhance wall stability. Hence, we aimed to elucidate its biological relevance in aneurysm wall specimens collected during surgical clipping. Immunostaining confirmed the presence of myoglobin and α-smooth muscle actin (α-SMA) in all 21 specimens. Double-immunofluorescence staining demonstrated that myoglobin was primarily localized on the luminal side of the α-SMA-positive layer. The median colocalization rates were 19.7% (interquartile range [IQR], 7.2%-43.4%) in the α-SMA-positive areas and 24.7% (IQR, 10.9%-56.8%) in the α-SMA-positive cells. Periostin staining demonstrated partial colocalization with α-SMA within the smooth muscle layer, with additional periostin-positive cells located luminally, beyond α-SMA expression. The colocalization rates of periostin were 41.8 ± 25.0% in α-SMA-positive areas and 55.8 ± 25.2% in α-SMA-positive cells. Myoglobin and periostin were highly expressed on the luminal sides, with median colocalization rates of 96.4% (IQR, 72.3%-99.0%) and 97.1% (IQR, 87.0%-100%) in periostin-positive areas/cells. Myoglobin density was positively correlated with collagen content. These findings suggest that periostin-expressing migrated myofibroblasts may produce myoglobin that could enhance collagen retention, wall thickening, and cerebral aneurysm wall stability.
    Nov. 2025, Journal of neuropathology and experimental neurology, English, International magazine
    Scientific journal

  • Tatsuya Mori, Hidehito Kimura, Kosuke Hayashi, Yusuke Ikeuchi, Shunsuke Yamanishi, Hiroyasu Shose, Naoto Nakamura, Masahiro Sugihara, Akio Tomiyama, Eiji Kohmura, Takashi Sasayama
    The wall properties of cerebral aneurysms, whether thin or thick, cannot be determined using conventional imaging techniques. We previously reported that two parameters, wall shear stress vector direction variation (WSSDV) and oscillatory shear index (OSI), may predict the wall-thinning areas of cerebral aneurysm walls in computational fluid dynamics (CFD) analysis. In this study, we evaluated the positive predictive value (PPV) of these parameters in detecting thin-walled regions (TIWRs) and thick-walled regions (TKWRs) by performing preoperative CFD analysis and proposed that distinct flow patterns determine aneurysm wall thinning or thickening. A total of 42 microsurgical clipping surgeries for unruptured intracranial aneurysms (UIAs) were performed at our hospital between January 2019 and August 2022 without any deterioration of the modified Rankin scale in all patients. We identified 39 actual TIWRs (aTIWRs) in the intraoperative photographs of the aneurysms among 46 expected TIWRs (eTIWRs) of the color maps (PPV: 85%; 95% CI 0.72-0.92), 23 actual TKWRs (aTKWRs) among 29 expected TKWRs (eTKWRs, PPV: 79%; 95% CI 0.62-0.90) on the WSSDV color maps, whereas the OSI color map revealed 39 aTIWRs among 46 eTIWRs (PPV: 85%; 95% CI 0.72-0.92) and 30 aTKWRs among 45 eTKWRs (PPV: 67%; 95% CI, 0.52-0.79). Spearman's rank correlation analysis revealed a strong correlation between the WSSDV and OSI (Spearman's ρ = 0.849, 95% CI 0.73-0.92, p < 0.001). These two parameters reflected the degree of wall shear stress vector change during the cardiac cycle. Parallel or divergent flows may cause aneurysm wall thinning, whereas rotational or convergent flows may cause wall thickening.
    Oct. 2025, Neurosurgical review, 48(1) (1), 717 - 717, English, International magazine
    Scientific journal

  • 血栓回収術中に採取した血栓遠位血液のメタボロミクス解析による局所代謝環境の評価 Pilot Study
    池内 佑介, 甲田 将章, 庄瀬 裕康, 山西 俊介, 岩橋 洋文, 原田 知明, 長嶋 宏明, 田中 一寛, 藤田 敦史, 細田 弘吉, 篠山 隆司
    (一社)日本脳循環代謝学会, Oct. 2025, 脳循環代謝, 37(1) (1), 73 - 73, Japanese

  • Yusuke Ikeuchi, Masaaki Kohta, Kohkichi Hosoda, Shunsuke Yamashita, Hiroyasu Shose, Shunsuke Yamanishi, Kazuhiro Tanaka, Takashi Sasayama
    In this systematic review, we aim to clarify common findings on carbenoxolone's effects on neurological conditions, including stroke, across studies and identify areas where knowledge remains incomplete. We searched several electronic databases, including PubMed, Web of Science, and the Cochrane Library, from their inception and finally included 60 studies in our review. This review reveals carbenoxolone's neuroprotective properties, such as gap junction inhibition, inhibiting the enzyme 11β-hydroxysteroid dehydrogenase (HSD) type I, inducing heat shock proteins, and inhibiting amyloid β42 aggregation. Conversely, it highlights carbenoxolone's neurotoxic potential, including inhibiting the enzyme 11β-HSD type II, mitochondrial dysfunction, and impaired astrocytic uptake of excitotoxic substances. Gap junctions also act as a pathway for neurotrophic factors and drugs that provide neuroprotection, and their inhibition by carbenoxolone may be detrimental to neuronal survival. In the systematic review, the comparison of carbenoxolone concentrations used in in vitro experiments that reported inhibition of 11β-HSD and gap junctions showed significant differences, with higher concentrations noted for gap junction inhibition. Induction of heat shock proteins and inhibition of amyloid-β were limited to long-term administration. Studies related to stroke demonstrated that all instances of hemorrhagic stroke exhibited neurotoxic effects. Additionally, studies administering carbenoxolone after cerebral ischemia reported poor outcomes in experiments with higher dosages and in chronic phases. In conclusion, carbenoxolone presents both neuroprotective and neurotoxic potential, necessitating cautious application in clinical settings. Future research should prioritize comprehensive, high-throughput studies to elucidate carbenoxolone's diverse mechanisms and long-term impacts, optimizing its therapeutic potential for neurological diseases.
    May 2025, European journal of pharmacology, 994, 177387 - 177387, English, International magazine
    Scientific journal

  • 長期のケトン食療法施行後特異な再発形態を示した膠芽腫の1例
    篠山 隆司, 田中 一寛, 長嶋 宏明, 山西 俊介, 池内 佑介, 小松 正人, 神保 直江, 児玉 良典, 伊藤 智雄
    日本脳腫瘍病理学会, May 2025, Brain Tumor Pathology, 42(Suppl.) (Suppl.), 088 - 088, Japanese

  • 稀なBRAF遺伝子変異(T599_V600insT,T599dup)を認めたGangliogliomaの1例
    田中 一寛, 長嶋 宏明, 山西 俊介, 池内 佑介, 岡藤 悠真, 原田 知明, 神保 直江, 篠山 隆司
    日本脳腫瘍病理学会, May 2025, Brain Tumor Pathology, 42(Suppl.) (Suppl.), 127 - 127, Japanese

  • Shunsuke Yamanishi, Hiroaki Nagashima, Kazuhiro Tanaka, Takiko Uno, Yusuke Ikeuchi, Hirofumi Iwahashi, Mitsuru Hashiguchi, Shintaro Horii, Tomoo Itoh, Yoshihiro Muragaki, Takashi Sasayama
    PURPOSE: To investigate the relationship between the tumor microenvironment (TME), tumor-related seizures (TRS), and cerebrospinal fluid (CSF) markers that predict preoperative seizures in patients with glioblastoma. METHODS: In total, 47 patients with isocitrate dehydrogenase (IDH) wild-type glioblastoma who underwent preoperative CSF examination, 3-T magnetic resonance spectroscopy (MRS), and neurological surgery between January 2017 and December 2023 were included. We measured the concentrations of soluble CD163 (sCD163), a soluble form of the M2 macrophage marker, in the CSF, the metabolite concentration on MRS, and the number of CD163-positive M2 macrophages in the tumor tissue. Factors associated with preoperative seizures were examined. RESULTS: Twelve patients (25.5%) had preoperative seizures. sCD163 levels in the CSF were positively correlated with the number of CD163-positive M2 macrophages in the tumor tissue, and both were significantly lower in the preoperative seizure group than in the non-preoperative seizure group (p = 0.0124 and p < 0.0001, respectively). MRS indicated that only glutathione (GSH) concentrations were higher in the preoperative seizure group than in the non-preoperative seizure group (2.55 mM and 1.87 mM, respectively; p = 0.0171). CD163-positive M2 macrophages were inversely correlated with GSH levels. sCD163 in the CSF had a high predictive accuracy (sensitivity, 91.7%; specificity, 54.3%; and area under the receiver operator curve, 0.745) for preoperative seizures. CONCLUSIONS: The CSF level of sCD163 is useful for predicting the TME and preoperative seizures in IDH wild-type glioblastoma.
    Jan. 2025, Journal of neuro-oncology, 171(1) (1), 95 - 103, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Yusuke Ikeuchi, Masamitsu Nishihara, Kohkichi Hosoda, Noriaki Ashida, Shunsuke Yamanishi, Hiroaki Nagashima, Kazuhiro Tanaka, Yoshihiro Muragaki, Takashi Sasayama
    OBJECTIVE: We investigated whether air in the cisterns or ventricles on postoperative computed tomography (CT) (reflecting the opening of the cerebrospinal fluid spaces during surgery) is a predictor of classical or nodular leptomeningeal disease (LMD) after resection of brain metastases. METHODS: We retrospectively analyzed 73 patients who underwent gross total resection of brain metastases between 2012 and 2020. Patients with air in the cisterns or ventricles on postoperative day 1 CT were categorized into the air-positive group, whereas those without air in the cisterns or ventricles on postoperative day 1 CT were categorized into the air-negative group. The primary outcome was the occurrence of classical or nodular LMD (nLMD), which was assessed using survival analysis. RESULTS: There were 15 (21%) patients in the air-positive group and 58 (79%) in the air-negative group. The air-positive group exhibited significantly more cerebellar and ventricular contact lesions than the air-negative group. The 4-year rate of classical or nLMD was significantly higher in the air-positive group than in the air-negative group (67% vs. 33%, P < 0.001). Multivariate analysis identified air in the cisterns or ventricles on postoperative CT as the only significant predictor of classical or nLMD (P < 0.001). CONCLUSIONS: Postoperative air in the cisterns or ventricles can predict early classical or nodular leptomeningeal disease.
    Jan. 2025, World neurosurgery, 193, 903 - 910, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Yosuke Fujimoto, Yuichi Fujita, Kazuhiro Tanaka, Hiroaki Nagashima, Shunsuke Yamanishi, Yusuke Ikeuchi, Hirofumi Iwahashi, Shoji Sanada, Yoshihiro Muragaki, Takashi Sasayama
    BACKGROUND AND OBJECTIVES: Photodynamic therapy (PDT) with talaporfin sodium is an intraoperative local therapy administered after the surgical removal of malignant gliomas. However, its clinical efficacy in a large patient population has not been determined. To analyze the clinical outcomes and prognosis in isocitrate dehydrogenase (IDH)-wildtype glioblastoma patients treated with PDT. METHODS: This retrospective study included patients with newly diagnosed IDH-wildtype glioblastoma treated at Kobe University Hospital between January 2013 and December 2022. PDT involves irradiation of the resection cavity with a 664-nm semiconductor laser after an intravenous infusion of talaporfin sodium. The main outcome measures were the recurrence patterns and survival times, which were compared between the PDT and non-PDT groups. Univariate and multivariate analyses were used to determine the prognostic factors. In addition, adverse events and prognostic factors in the PDT group were analyzed. RESULTS: A total of 44 and 56 patients were included in the PDT and non-PDT groups, respectively. The local recurrence rate was significantly lower in the PDT group than in the non-PDT group (51.3% vs 83.9%), whereas the distant recurrence and dissemination rates were significantly higher in the PDT group than in the non-PDT group (48.7% vs 16.1%). Two grade 3 adverse events were observed in the PDT group. The median progression-free survival and overall survival times were significantly longer in the PDT group than in the non-PDT group (progression-free survival: 10.8 vs 9.3 months, respectively, and overall survival: 24.6 vs 17.6 months, respectively). Multivariate analysis of the PDT groups revealed that younger age was an independent prognostic factor. CONCLUSION: PDT with talaporfin sodium provided effective local control with minimal adverse effects. The survival time of the patients treated with PDT was significantly longer than that of the patients who did not receive PDT. Therefore, a randomized controlled clinical trial on PDT is warranted.
    Nov. 2024, Neurosurgery, English, International magazine
    Scientific journal

  • 播種にて発症した転移性脳腫瘍の特徴
    篠山 隆司, 田中 一寛, 長嶋 宏明, 山西 俊介, 池内 佑介
    (一社)日本癌治療学会, Oct. 2024, 日本癌治療学会学術集会抄録集, 62回, O88 - 5, English

  • Yusuke Ikeuchi, Atsushi Fujita, Masaaki Kohta, Shunsuke Yamanishi, Kazuhiro Tanaka, Takashi Sasayama
    BACKGROUND AND OBJECTIVES: Spinal dural arteriovenous fistulas (SDAVFs) lead to progressive neurological decline with symptoms such as paraparesis, bowel and bladder dysfunction, and sensory disturbances because of impaired spinal cord venous drainage. This study aimed to systematically review the literature on multiple synchronous SDAVFs and present 2 cases from our institution. METHODS: A comprehensive search was performed to identify all published cases of multiple synchronous SDAVFs. Overall, 23 patients with multiple synchronous SDAVFs were identified, including 21 from 19 articles and 2 from this study. The clinical presentation, lesion location, radiographic features, surgical treatment, and outcomes were analyzed in each patient. RESULTS: All patients in this study were male, and the duration from symptom onset to diagnosis in many of these patients was longer than that previously reported. Previous studies suggested that multiple SDAVFs typically occurred within 3 or fewer vertebral levels. However, >50% of the examined patients had remote lesions separated by more than 3 vertebral levels. Patients with remote lesions had a significantly worse outcome (1/7 vs 8/11, 95% CI 0.001-0.998; P = .049). CONCLUSION: Accurately locating fistulas before spinal angiography is critical for managing multiple remote SDAVFs. Considering the possibility of multiple remote SDAVFs, careful interpretation of imaging findings is essential for an accurate diagnosis and appropriate treatment planning.
    Oct. 2024, Neurosurgery, 95(4) (4), 751 - 760, English, International magazine
    Scientific journal

  • Yusuke Ikeuchi, Masaaki Kohta, Shunsuke Yamashita, Shunsuke Yamanishi, Yoji Yamaguchi, Jun Tanaka, Kazuhiro Tanaka, Hidehito Kimura, Atsushi Fujita, Kohkichi Hosoda, Eiji Kohmura, Takashi Sasayama
    Pencil-beam presaturation (BeamSAT) magnetic resonance imaging (MRI) produces selective magnetic resonance angiography (MRA) images of specific arteries, including the unilateral internal carotid artery (ICA-selective MRA) or vertebral artery (VA-selective MRA). We evaluate the influence of flow pattern, visualized using BeamSAT MRI, on preoperative cerebral hemodynamic status and postoperative hyperperfusion syndrome (HPS). Patients undergoing carotid artery stenting or carotid endarterectomy were categorized into two groups to evaluate flow pattern. Patients with neither crossflow on BeamSAT MRI nor mismatch in middle cerebral artery (MCA) signal intensity between ICA-selective and conventional MRA were classified into Group I, comprising 29 patients. Group II included all other patients comprising 19 patients, who were suspected of experiencing changes in intracranial flow patterns. Cerebral blood flow and cerebrovascular reactivity (CVR) were assessed using single-photon emission computed tomography, and potential HPS symptoms were retrospectively assessed by chart review. Preoperative ipsilateral CVR was significantly lower in Group II than in Group I (18.0% ± 20.0% vs. 48.3% ± 19.5%; P < 0.0001). Group II showed significantly impaired CVR (odds ratio 17.7, 95% confidence interval 1.82-171; P = 0.013) in multivariate analysis. The partial areas under the curve of the BeamSAT logistic model (0.843) were significantly larger than those of the conventional logistic model (0.626) over the range of high sensitivity (0.6-1) (P = 0.04). The incidence of postoperative HPS symptoms was significantly higher in Group II than in Group I (8/19 vs. 1/29; P = 0.001). BeamSAT MRI may be a valuable and non-invasive tool for assessing cerebral hemodynamics and predicting postoperative HPS.
    Aug. 2024, Journal of the neurological sciences, 463, 123114 - 123114, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Masaaki Kohta, Yusuke Ikeuchi, Shunsuke Yamashita, Atsushi Fujita, Takashi Sasayama
    Jun. 2024, Acta neurologica Belgica, 124(3) (3), 1073 - 1075, English, International magazine

  • マイクロバブルテストが原因検索に有用であった心房中隔欠損症による脳膿瘍の1例
    金 永珠, 池内 佑介, 長嶋 宏明, 前山 昌博, 堀 達雄, 田中 一寛, 田中 秀和, 本岡 康彦, 篠山 隆司
    77歳女性。脳膿瘍の加療中に奇異性脳塞栓症、肺動脈塞栓症を生じた。原因検索のためマイクロバブルテストを行ったところ、心房中隔欠損症による脳膿瘍と診断された。抗菌薬の投与を継続し、回復期病院へ転院となったが、今後は心房中隔欠損に対し経皮的心房中隔欠損閉鎖術を施行する予定である。
    (株)メディカ出版, May 2024, 脳神経外科速報, 34(3) (3), e80 - e87, Japanese

  • Tatsuya Mori, Hidehito Kimura, Atsushi Fujita, Kosuke Hayashi, Tatsuo Hori, Masahiro Sugihara, Yusuke Ikeuchi, Masaaki Kohta, Akio Tomiyama, Takashi Sasayama
    BACKGROUND: The treatment of vertebrobasilar junction (VBJ) aneurysms is challenging. Although flow diverters (FDs) are a possible treatment option, geometrical conditions hinder intervention. VBJ aneurysms possess dual inflow vessels from the bilateral vertebral arteries (VAs), one of which is ideally occluded prior to FD treatment. However, it remains unclear which VA should be occluded. OBSERVATIONS: A 75-year-old male with a growing VBJ complex aneurysm exhibiting invagination toward the brainstem and causing perifocal edema required intervention. Preoperative computational fluid dynamics (CFD) analysis demonstrated that left VA occlusion would result in more stagnant flow and less impingement of flow than right VA occlusion. According to the simulated strategy, surgical clipping of the left VA just proximal to the aneurysm was performed, followed by FD placement from the basilar artery trunk to the right VA. The patient demonstrated tolerance of the VA occlusion, and follow-up computed tomography angiography at 18 months after FD treatment confirmed the disappearance of the aneurysm. LESSONS: Preoperative flow dynamics simulations using CFD analysis can reveal an optimal treatment strategy involving a hybrid surgery that combines FD placement and direct surgical occlusion for a VBJ complex aneurysm.
    Mar. 2024, Journal of neurosurgery. Case lessons, 7(10) (10), English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Noriaki Ashida, Atsushi Fujita, Hideya Hayashi, Masashi Higashino, Yusuke Ikeuchi, Hirofumi Iwahashi, Masamitsu Nishihara, Kohkichi Hosoda, Takashi Sasayama
    BACKGROUND: Standalone coil embolization is often less effective for partially thrombosed intracerebral aneurysms (PTIA) because of the risk of frequent recurrence if the coil migrates into the thrombus. This report describes a case of PTIA at the basilar tip in which simple coil embolization using a Target 3D Coil resulted in sustained remission without recurrence during long-term follow-up. CASE DESCRIPTION: The patient was a 63-year-old male who presented with right oculomotor nerve palsy after having undergone direct surgery for a basilar artery aneurysm 15 years earlier. Recurrence with partial thrombosis of the basilar artery aneurysm was diagnosed. Target 3D Coil embolization with frame construction in the aneurysmal sac was performed, resulting in the complete disappearance of the aneurysm and improvement of the oculomotor nerve palsy. Magnetic resonance imaging at five years postoperatively confirmed that the thrombus had completely disappeared, and there was no recurrence of the aneurysm. The closed loops in the Target 3D Coil may have contributed to the cohesive mass of coils remaining in the sac of the PTIA, potentially leading to healing. CONCLUSION: The characteristics of the Target 3D Coil may have prevented migration of the coil into the thrombus, potentially contributing to the successful resolution of the aneurysm.
    2024, Surgical neurology international, 15, 103 - 103, English, International magazine
    Scientific journal

  • Masaaki Kohta, Yoshitetsu Oshiro, Yoji Yamaguchi, Yusuke Ikeuchi, Atsushi Fujita, Kohkichi Hosoda, Kazuhiro Tanaka, Satoshi Mizobuchi, Eiji Kohmura, Takashi Sasayama
    OBJECTIVE: Carotid stenosis can lead to both cognitive impairment (CI) and ischemic stroke. Although carotid revascularization surgery, which includes carotid endarterectomy (CEA) and carotid artery stenting (CAS), can prevent future strokes, its effect on cognitive function is controversial. In this study, the authors examined resting-state functional connectivity (FC) in carotid stenosis patients with CI undergoing revascularization surgery, with a particular focus on the default mode network (DMN). METHODS: Twenty-seven patients with carotid stenosis who were scheduled to undergo CEA or CAS between April 2016 and December 2020 were prospectively enrolled. A cognitive assessment, including the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Japanese version of the Montreal Cognitive Assessment (MoCA), as well as resting-state functional MRI, was performed 1 week preoperatively and 3 months postoperatively. For FC analysis, a seed was placed in the region associated with the DMN. The patients were divided into two groups according to the preoperative MoCA score: a normal cognition (NC) group (MoCA score ≥ 26) and a CI group (MoCA score < 26). The difference in cognitive function and FC between the NC and CI groups was investigated first, and then the change in cognitive function and FC after carotid revascularization was investigated in the CI group. RESULTS: There were 11 and 16 patients in the NC and CI groups, respectively. The FC of the medial prefrontal cortex with the precuneus and that of the left lateral parietal cortex (LLP) with the right cerebellum were significantly lower in the CI group than in the NC group. In the CI group, significant improvements were found in MMSE (25.3 vs 26.8, p = 0.02), FAB (14.4 vs 15.6, p = 0.01), and MoCA scores (20.1 vs 23.9, p = 0.0001) after revascularization surgery. Significantly increased FC of the LLP with the right intracalcarine cortex, right lingual gyrus, and precuneus was observed after carotid revascularization. In addition, there was a significant positive correlation between the increased FC of the LLP with the precuneus and improvement in the MoCA score after carotid revascularization. CONCLUSIONS: These findings suggest that carotid revascularization, including CEA and CAS, might improve cognitive function based on brain FC in the DMN in carotid stenosis patients with CI.
    Oct. 2023, Journal of neurosurgery, 139(4) (4), 1010 - 1017, English, International magazine
    Scientific journal

  • Masahiro Sugihara, Atsushi Fujita, Yusuke Ikeuchi, Tatsuo Hori, Masaaki Kohta, Kazuhiro Tanaka, Hidehito Kimura, Takashi Sasayama
    BACKGROUND: Excessive glue injection into the drainage vein in patients with dural arteriovenous fistula (dAVF) can result in venous obstruction. We performed transarterial embolization (TAE) combined with transvenous embolization (TVE) with coils to prevent the glue from migrating into the normal cortical veins. CASE DESCRIPTION: A 57-year-old man was pointed out to have a Borden Type III anterior cranial fossa dAVF during a check-up for putaminal hemorrhage. Because a left frontal normal cortical vein drained into the pathological drainage vein, excessive glue injection into the drainage vein may have caused venous obstruction. We performed TVE with coils at the foot of the draining vein to prevent excessive migration of glue into the drainer, followed by TAE with glue. With this technique, complete obliteration of the shunt without venous ischemia was obtained. CONCLUSION: The combined treatment of TAE and TVE is effective in preventing venous ischemia caused by unintended migration of glue cast into the drainage vein.
    2023, Surgical neurology international, 14, 277 - 277, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Yusuke Ikeuchi, Masamitsu Nishihara, Noriaki Ashida, Kohkichi Hosoda
    BACKGROUND: Some spinal hemangioblastomas (HBLs) resemble spinal vascular malformations. Intracranial subarachnoid hemorrhage (SAH) secondary to spinal HBL has rarely been reported. OBSERVATIONS: A 67-year-old man with a prolonged von Hippel-Lindau disease (VHL) history presented with sudden headache and vomiting. Cranial and cervical computed tomography (CT) revealed severe infratentorial, supratentorial, and cervical SAH. Cranial CT angiography and magnetic resonance imaging revealed a mismatch in hemorrhage and intracranial tumor localization, with no vascular lesions that could lead to intracranial SAH. Cervical CT angiography revealed abnormal blood vessels originating from 5 spinal tumors suspected to be HBLs. We considered that the SAH was caused by venous reflex from vascular malformation-like spinal HBLs. Transarterial embolization (TAE) of the feeding artery of HBLs was performed to improve symptoms and reduce rebleeding risk. Nine months after TAE, angiography showed no venous reflux into the intracranial space. Ten months later, the authors excised the T1-2 tumor because the patient complained of progressive paralysis of the right upper extremity. LESSONS: In HBL with prolonged VHL, intracranial hemorrhage due to venous regurgitation via a mimicked vascular malformation may occur. Reducing venous reflux with TAE may improve symptoms and prevent rebleeding.
    Dec. 2022, Journal of neurosurgery. Case lessons, 4(26) (26), English, International magazine
    Scientific journal

  • Yamanishi Shunsuke, Takaishi Yoshiyuki, Ikeuchi Yusuke, Mizowaki Takashi, Nakamizo Satoshi, Kondoh Takeshi
    Spinal arachnoid web is a rare condition that causes various neurological symptoms due to direct spinal cord compression by a thickened arachnoid membrane and subsequent cerebrospinal fluid (CSF) flow blockage, occasionally leading to presyrinx, which may precede syringomyelia. Magnetic resonance imaging (MRI) is helpful for establishing diagnosis. Although the “scalpel sign” is considered a characteristic finding, the arachnoid web is a fine lesion that is often difficult to visualize.   We have described a case of a 63-year-old woman with complaints of progressive numbness in both her upper and left lower limbs for 10 years and progressive right axillary and upper back pain.   MRI at the previous hospital revealed an intramedullary hypersignal lesion at the T2 level. Heavy T2-weighted sagittal imaging and cine-mode MRI performed at our hospital revealed the “scalpel sign” and a membrane-like structure that was impeding CSF flow on the dorsal side of the spinal cord. She was diagnosed with a spinal arachnoid web ; hence, T1-3 laminectomy was performed to remove arachnoid.   Postoperatively, her neurological symptoms improved remarkably. Her numbness decreased, and the right axillary and back pain disappeared. Furthermore, the “scalpel sign” and intramedullary hypersignal lesion had disappeared. Postoperative cine-mode MRI revealed an improvement in CSF flow. Pathological examination of the resected arachnoid membrane showed normal tissue without any evidence of inflammatory or malignant lesion.   Here, we have reported a case of arachnoid web with presyrinx, a reversible intramedullary lesion. The arachnoid web must be identified as a cause of presyrinx. Even in cases with a long course, surgical treatment should be considered to improve the presyrinx state and ameliorate the neurological condition.
    The Japanese Society of Spinal Surgery, 2022, Spinal Surgery, 36(1) (1), 56 - 61, Japanese

  • Yusuke Ikeuchi, Noriaki Ashida, Masamitsu Nishihara, Kohkichi Hosoda
    OBJECTIVE: Unlike in older adults, ischemic stroke in young patients occurs secondary to preexisting conditions. Infective endocarditis (IE) is among the most important causes of stroke in young adults and has a severe prognosis. There are few reports of mechanical thrombectomy (MT) for IE-induced large-vessel occlusion (LVO). This paper reports a case of acute IE-induced LVO in a young patient who was successfully treated with MT. CASE PRESENTATION: An 18-year-old woman presented to our hospital with severe headache, high fever, and left fingertip pain. She was admitted to the Department of Neurology for conservative treatment of suspected meningitis. On day 2 of admission, she developed acute left hemiparesis, left hemispatial neglect, and dysarthria. MRA showed occlusion of the right M1 segment of the middle cerebral artery, and the patient immediately underwent MT. After a single pass, we achieved thrombolysis in cerebral infarction 2b. A white clot was diagnosed as a vegetation on pathological examination. As transesophageal echocardiography showed a vegetation on the mitral valve, the patient was diagnosed with IE and underwent cardiovascular surgery. The patient recovered well and underwent additional treatment and rehabilitation. CONCLUSION: Although rare, IE-induced septic emboli may occur in young patients with LVO, necessitating MT and pathological diagnosis of the clot.
    2022, Journal of neuroendovascular therapy, 16(8) (8), 402 - 408, English, Domestic magazine
    Scientific journal

  • Yusuke Ikeuchi, Tomoya Shimasaki, Naoki Nitta, Yusuke Yamamoto, Taiji Ishii
    BACKGROUND: Traumatic intracranial aneurysm (TICA) accounts for approximately 1% of cerebral aneurysms. There are few reports of TICA limited to the posterior inferior cerebellar artery (PICA-TICA). CASE DESCRIPTION: A 69-year-old woman fell into a shallow river, bruising her head and chest, and was admitted to our emergency department with disorientation. Computed tomography (CT) showed subarachnoid hemorrhage (SAH), intraventricular hemorrhage (IVH), left temporal lobe contusion, and fractures of the right temporal bone. A cerebral CT angiogram revealed no vascular abnormalities or aneurysms. The patient was in a semi-comatose state 2 h later, and CT showed worsening SAH. A cerebral angiogram revealed an 11 mm aneurysm of the anterior medullary segment of the right PICA. We attempted intra-aneurysmal embolization intending to preserve the PICA, but the aneurysmal neck was thin, and the microcatheter could not be placed in a stable position. Therefore, n-butyl-2-cyanoacrylate (NBCA) was injected to embolize the aneurysm. When the microcatheter was removed, NBCA was scattered distally in the PICA, and the distal PICA was occluded. The aneurysm could be embolized, but there was an increase in hemorrhagic contusion in the left temporal lobe. Decompression craniectomy was performed, but she died due to hemorrhagic contusion and uncal herniation 6 days after surgery. CONCLUSION: PICA-TICA is often accompanied by IVH and SAH, and there are some reports of cases with a vascular anomaly of the posterior circulation. Since TICA is at risk of rapid growth and rupture, an early and appropriate diagnosis is important.
    2022, Surgical neurology international, 13, 257 - 257, English, International magazine
    Scientific journal

  • Yusuke Ikeuchi, Noriaki Ashida, Masamitsu Nishihara, Kohkichi Hosoda
    BACKGROUND: Limb-shaking transient ischemic attacks (LS-TIAs) are a rare form of TIAs that present as involuntary movements of the limbs and indicate severe cerebral hypoperfusion. LS-TIAs are often reported in patients with carotid artery stenosis but can also affect patients with intracranial artery stenosis and moyamoya disease (MMD). OBSERVATIONS: A 72-year-old woman presented with repeated episodes of involuntary shaking movements of the right upper limb. Cerebral angiography revealed complete occlusion of the M1 segment of the left middle cerebral artery (MCA), and the left hemisphere was supplied by moyamoya vessels. She was treated with left direct revascularization without complications, and her involuntary movements subsided. However, she demonstrated involuntary shaking movements of the right lower limb 2 months postoperatively. Cerebral angiography revealed complete occlusion of the A1 segment of the left anterior cerebral artery (ACA). The multiple burr hole opening (MBHO) procedure was performed to improve perfusion in the left ACA territory and after 3 months, the patient's symptoms resolved. LESSONS: This case demonstrated that LS-TIAs can also develop as ischemic symptoms due to MMD. Moreover, instances of LS-TIA of the upper and lower limbs developed separately in the same patient. The patient's symptoms improved with direct revascularization and MBHO.
    Sep. 2021, Journal of neurosurgery. Case lessons, 2(10) (10), CASE21401, English, International magazine
    Scientific journal

  • Posterior Decompression and Fixation for Cervical Spinal Cord Injury with Atlantoaxial Subluxation and Calcification of Cervical Ligamentum Flavum in a Patient with Coffin-Lowry Syndrome-A Case Report-
    池内佑介, 高石吉將, 小山淳二, 山西俊介, 阿久津宣行, 河村淳史, 近藤威
    症例は12歳男児で、脱力発作による転倒後出現した両上肢巧緻性低下を主訴とした。特徴的な顔貌と手指、発達障害の症状と遺伝子検査から幼少期にCoffin-Lowry syndromeと診断され経過観察中であり、約1ヵ月に1回の頻度で意識消失を伴わない脱力発作をきたしていた。頸椎CTではC2-4に黄色靱帯の石灰化と肥厚を認め、頸椎MRIにてC3-4にT2WIで髄内高信号を認めた。頸椎動態撮影にて環軸椎亜脱臼を認め、さらに前屈位で第3頸椎の後方すべりによる不安定性を認めた。黄色靱帯の石灰化・肥厚と環軸椎亜脱臼を有していた患者が転倒により非骨傷性頸髄損傷をきたしたと判断した。C2-4の黄色靱帯石灰化症に対する後方減圧術とC1-4の後方固定術を行った。術後は新規神経学的異常は出現せず、四肢の不全麻痺も改善して歩行可能となり、術後10日目に自宅退院した。
    (一社)日本脊髄外科学会, Aug. 2021, 脊髄外科, 35(2) (2), 181 - 187, Japanese

  • 高石 吉將, 中溝 聡, 溝脇 卓, 勝部 毅, 池内 佑介, 山西 俊介, 近藤 威
    症例は56歳男性で、転倒後に右3～5指のしびれが出現し、その後頸部を伸展した際に左上下肢に電撃痛が出現し、徐々に歩行障害・巧緻運動障害が悪化した。頸椎X線側面像においてC6/7間にすべり症を認め、3D-CTではC6に両側分離症を認めC6棘突起は正中において二分していた。MRIではC5/6の黄色靱帯の肥厚による脊髄への圧迫所見を認め、第6頸椎分離すべり症とC5/6黄色靱帯肥厚による脊髄症と診断した。まず後方から手術を行い、C5 lateral mass screw、C7 pedicle screwを挿入して固定後C6椎弓切除術を行い、C5/6間の黄色靱帯も可能な限り摘出し減圧した。さらに10日後にC5/6、C6/7に腸骨、プレートを用いた前方固定術を施行した。術後上肢のしびれは残存したが歩行障害は改善し、術後1ヵ月時点でneurosurgical cervical spine scaleは11点(改善率57.1%)、JOAスコアは13点(改善率55.6%)となった。
    (一社)日本脊髄外科学会, Aug. 2021, 脊髄外科, 35(2) (2), 193 - 197, Japanese

  • 甲状腺腫瘍を合併した頸椎症性神経根症に対して甲状腺摘出と顕微鏡下頸椎椎間孔拡大術の一期的手術が有用であった1例
    池内 佑介, 高石 吉將, 李 佳奈, 山西 俊介, 溝脇 卓, 中溝 聡, 牧野 邦彦, 近藤 威
    35歳女性。1年前からの頸部痛と右肩甲骨から右上腕部、右3、4指にかけての疼痛を主訴とした。10年前に前医にて無症候性甲状腺結節の穿刺細胞診(FNA)で良性を指摘され、経過観察中であった。MRIで左側優位の椎間板膨隆、右側C6/7椎間孔狭窄と同部の椎間板ヘルニアを認めた。CTで19mm大の甲状腺結節を認め、FNAを施行した。その結果、濾胞上皮細胞を認め、悪性所見はなかったが、確定診断ができなかった。甲状腺腫瘍を合併した頸椎症性神経根症と暫定診断し、甲状腺右葉の摘出が甲状腺腫瘍の確定診断に有用と判断した。頸椎前方アプローチによる顕微鏡下頸椎椎間孔拡大術および甲状腺腫瘍摘出術を一期的に施行した。病理診断は良性の濾胞性腺腫であった。術後経過は良好で、術後10日に自宅退院となった。術後10ヵ月の現在、神経症状の出現はなく、甲状腺結節の再発も認めていない。
    (株)メディカ出版, Jul. 2021, 脳神経外科速報, 31(4) (4), e1 - e7, Japanese

  • 高石 吉將, 中溝 聡, 鵜山 淳, 勝部 毅, 池内 佑介, 近藤 威
    24歳女性。咽頭痛と発熱を主訴に当院の耳鼻咽喉科を受診したが、頭痛もみられたことから、髄膜炎の精査目的で脳神経外科へ紹介となった。髄液検査目的で腰椎穿刺が行われたが、検査翌日に激しい腰背部痛、起立性頭痛が出現した。胸椎MRIを行ったところ、穿刺部位であるL3/4の周辺よりも胸椎レベルに大量の髄液貯留が認められた。対処として安静と補液にて経過観察した結果、頭痛や背部痛の軽減、髄液貯留の縮小が認められた。以上、これらの臨床的経過より、本症例は腰椎穿刺後頭痛と確定診断された。
    (一社)日本脊髄外科学会, Apr. 2021, 脊髄外科, 35(1) (1), 75 - 78, Japanese

  • 鵜山 淳, 池内 佑介, 勝部 毅, 高石 吉將, 近藤 威
    (NPO)日本脳神経外科救急学会, Dec. 2020, Neurosurgical Emergency, 25(2) (2), 365 - 371, Japanese

  • An Arteriovenous Malformation of the Corpus Callosum Presenting Intraventricular Hemorrhages and Treated with Transarterial Embolization and Gamma Knife Therapy
    池内佑介, 鵜山淳, 勝部毅, 中溝聡, 高石吉將, 近藤威
    (NPO)日本脳神経外科救急学会, Dec. 2020, Neurosurgical Emergency, 25(2) (2), 378 - 383, Japanese

  • 症候性頭蓋内動脈硬化性病変に対するsubmaximal angioplastyの有用性についての検討
    蘆田 典明, 池内 佑介, 西原 賢在, 細田 弘吉
    (一社)日本脳神経血管内治療学会, Nov. 2020, 脳血管内治療, 5(Suppl.) (Suppl.), 102 - 102, Japanese

  • 池内 佑介, 溝脇 卓, 阪上 義雄, 細田 弘吉
    淡路島は高齢化が急速に進行しており、2017年時点で65歳以上の高齢者人口比率(高齢者比率)が約35%、75歳以上の超高齢者人口比率(後期高齢者比率)が約20%である。当施設は島内唯一の三次救急医療センターであり、島内の重症頭部外傷はほぼ全例が当施設に搬送され治療されている。今回、2014年4月～2018年3月に入院した重症頭部外傷72例を対象とし、「高齢者比率」「後期高齢者比率」「転倒転落比率」「初診時GCS」「初診時D-dimer」「予後(GOS)」などについて調査し、JNTDBプロジェクト2015(P2015)のデータと比較した。結果、高齢者比率は65.3%でP2015(53.6%)に比べて有意に高値、後期高齢者比率は50.0%でP2015(33.3%)に比べて有意に高値、転倒転落比率は55.5%でP2015(40.7%)に比べて有意に高値であった。退院6ヵ月後のGOSがGRまたはMDを予後良好とし、SDまたはVS、Dを予後不良と定義すると、予後良好は23例(32%)、予後不良は49例(68%)であった。予後不良予測因子について検討するため、「年齢(65歳以上)」「初診時D-dimer(50μg/ml以上)」「初診時GCS(3～8)」を説明変数として多変量ロジスティック回帰分析を行った結果、「年齢」と「初診時D-dimer」は有意な予測因子であったが、「初診時GCS」は有意な予測因子とはならなかった。
    (一社)日本脳神経外傷学会, Dec. 2019, 神経外傷, 42(2) (2), 201 - 206, Japanese

  • 池内 佑介, 鵜山 淳, 濱口 浩敏, 三宅 茂, 近藤 威
    (NPO)日本脳神経外科救急学会, Mar. 2019, Neurosurgical Emergency, 24(1) (1), 78 - 86, Japanese

  • Atsushi Uyama, Atsushi Fujita, Takeshi Kondo, Yoshiyuki Takaishi, Atsushi Arai, Naoto Nakamura, Yusuke Ikeuchi, Masahiro Nakahara, Shigeru Miyake, Hirotoshi Hamaguchi, Eiji Kohmura
    The benefits of mechanical thrombectomy(MT)for acute M2 occlusion have remained unclear because of unavoidable device-related complications due to vascular morphological characteristics. We developed a Penumbra-assisted half-stent thrombectomy for achieving secure retrieval of thrombus with minimal damage to the small-caliber vessel. In total, 6 patients were treated with MT for acute M2 occlusion using this technique between November 2016 and May 2017, including 3 men and 3 women, mean age 74.8(51-98)years. The mean baseline National Institutes of Health Stroke Scale score was 17.5(6-32), and Alberta Stroke Program Early Computed Tomography Score-Diffusion-Weighted Imaging was 7.5(6-9). After navigation of the microcatheter through the thrombus in M2 supported by a Penumbra 4MAX as a distal access catheter, the stent retriever(SR)was partially deployed to cover the entire thrombus. The 4MAX was then advanced towards the caudal end of the thrombus, and the SR was pulled back into the 4MAX with simultaneous aspiration of the 4MAX. We used the Trevo XP3 in 5 patients and Revive SE in 1 patient. The mean procedure time from groin puncture to recanalization was 60(54-66)min. Successful recanalization(Thrombolysis in Cerebral Infarction score 2b or 3)was achieved in 5(83%)patients. There were no cases of symptomatic intracranial hemorrhage. Good outcome(modified Rankin Scale score 0 to 2)at 3 months was achieved in 3(50%)patients. Penumbra-assisted half-stent thrombectomy appears to be an effective alternative strategy in MT for acute M2 occlusion.
    (株)医学書院, Jan. 2019, No shinkei geka. Neurological surgery, 47(1) (1), 71 - 78, Japanese, Domestic magazine

■ MISC
■ Lectures, oral presentations, etc.
  • 低濃度NBCAを用いた感染性脳動脈瘤に対する治療
    甲田 将章, 池内 佑介, 庄瀬 裕康, 原田 知明, 藤田 敦史, 篠山 隆司
    日本脳神経血管内治療学会学術集会抄録集, Nov. 2024, Japanese, (一社)日本脳神経血管内治療学会

  • 硬膜外内頸動脈瘤のFlow diverter留置後の遅発性破裂に関する自験例を含む系統的レビュー
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