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KOHTA MasaakiUniversity Hospital / NeurosurgeryAssociate Professor
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■ Award- Aug. 2015 The Mt Fuji Workshop on CVD, 優秀ポスター賞, 急性M2閉塞に対するPenumbra ACEを用いたdirect aspirationの有用性Japan society
- 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 magazineScientific journal
- BACKGROUND: In recent years, the effects of general anesthetics on the brain have been widely studied at the sedation level using resting-state functional magnetic resonance imaging (rs-fMRI). Most anesthesia protocols use a single agent, and changes in spontaneous brain activity are examined to show the characteristics of each anesthetic agent. However, no studies have used rs-fMRI to evaluate the effects of anesthesia during actual surgery. We examined the feasibility of evaluating the effects of general anesthesia with sevoflurane using rs-fMRI during neurosurgery. METHODS: We enrolled 20 adult patients scheduled for transsphenoidal surgery. We compared differences between before and during general anesthesia in terms of brain functional connectivity of the thalamus by seed-to-voxel correlation analysis and local neural activity using fractional amplitude of low-frequency fluctuations (fALFF) analysis. An exclusion mask was applied to exclude brain areas showing intraoperative spatial artifacts and correct for differences in the magnitude of intra- and preoperative head movements. RESULTS: We analyzed 16 patients. Functional connectivity of the thalamus to the contralateral thalamus, bilateral caudate nucleus and globus pallidus were significantly decreased during anesthesia. The precuneus and posterior cingulate cortex showed significantly decreased fALFF values during anesthesia. CONCLUSION: These findings were consistent with previous studies and indicate the feasibility of intraoperative rs-fMRI during general anesthesia.Mar. 2025, Journal of anesthesia, English, Domestic magazineScientific journal
- PURPOSE: Tumor morphology critically influences facial nerve (FN) outcomes following vestibular schwannoma (VS) surgery. This study aimed to develop a nomogram based on preoperative features for preoperative prediction of FN outcomes after VS surgery. METHODS: A retrospective analysis included patients with sporadic VS who underwent surgical resection via the retrosigmoid approach. Tumor size was assessed using the Koos grade, the intrameatal components using the fundal fluid cap (FFC) sign, and the cerebellopontine angle cisternal components using our modified morphological subclassification. Logistic regression analysis was performed to construct a nomogram for predicting immediate postoperative FN function. RESULTS: A total of 265 patients with VS met the inclusion criteria. Of these patients, 62 (23.4%) had poor FN function (House-Brackmann grade ≥ III) immediately after surgery. Univariate logistic regression analysis identified the Koos grade (p = 0.001), FFC sign (p = 0.023), and morphological subtype (p < 0.001) as significant predictors of poor FN function immediately after surgery. In multivariate logistic regression analysis, the FFC sign (OR 2.07, p = 0.042) and morphological subtype (OR 8.21, p < 0.001) remained statistically significant independent predictors of poor FN function. A nomogram constructed based on these indicators demonstrated good discrimination in the training cohort (area under the curve [AUC] 0.80), internal validation cohort (AUC 0.79), and external validation cohort (AUC 0.97). CONCLUSIONS: A simple and reliable nomogram incorporating the Koos grade, FFC sign, and morphological subtype accurately predicts the risk of FN injury during surgery aimed at total resection of VS. This clinically straightforward tool can assist in patient counseling and development of more individualized surgical strategies to improve FN outcomes in patients with VS.Mar. 2025, Journal of neuro-oncology, English, International magazineScientific journal
- PURPOSE: Flow-diverter (FD) stents were developed to treat aneurysms that are difficult to treat with conventional coiling or surgery. This study aimed to compare usefulness of Silent MRA and TOF (time of flight) -MRA in patients with aneurysms after FD placement. MATERIALS AND METHODS: We retrospectively collected images from 22 patients with 23 internal carotid artery aneurysms treated with FD. Two radiologists conducted MRA and DSA experiments. In the first reading experiment, the radiologists evaluated the aneurysm filling by employing Silent MRA and TOF-MRA and utilizing the modified O'Kelly-Marotta (OKM) scale, a four-class classification system for aneurysms after FD placement. We then calculated the agreement between the modified OKM scale on MRA and the original OKM scale on DSA. In the second reading experiment, the radiologists rated blood flow within the FD using a five-point scale. RESULTS: The weighted kappa value of the OKM scale between DSA and TOF-MRA was 0.436 (moderate agreement), and that between DSA and Silent MRA was 0.943 (almost perfect agreement). The accuracies for the four-class classification were 0.435 and 0.870 for TOF-MRA and Silent MRA, respectively. The mean score of blood flow within FD for TOF-MRA was 2.43 ± 0.90 and that for Silent MRA was 3.04 ± 1.02 (P < 0.001). CONCLUSION: Silent MRA showed a higher degree of agreement than TOF-MRA in aneurysm filling with DSA. In addition, Silent MRA was significantly superior to TOF-MRA in depicting blood flow within the FD. Therefore, Silent MRA is clinically useful for the follow-up of patients after FD placement.Aug. 2024, Japanese journal of radiology, English, Domestic magazineScientific journal
- 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 magazineScientific journal
- BACKGROUND: The reported actual risk of rupture for vertebral artery dissection (VAD) in patients presenting with headache is very low, ranging from 0.4% to 1.0%. The authors report a case in which the dissection site dilated rapidly within several hours after the dissection occurred resulting in subarachnoid hemorrhage (SAH). OBSERVATIONS: A 49-year-old healthy man who had participated in a marathon noticed a headache while running. Magnetic resonance imaging (MRI) performed 2 days later revealed no findings suspicious for right VAD, but a string sign was observed in the left side, suggesting left VAD. Three hours following MRI, he developed severe headaches and became unconscious at home, prompting emergency services to rush him to the hospital. A computed tomography scan showed diffuse SAH and a rapidly enlarged aneurysmal dilatation in the right vertebral artery. He underwent endovascular internal trapping to prevent rebleeding. He was discharged without any neurological symptoms. No recurrence or new dissection occurred after 2 years of follow-up. LESSONS: Even in the absence of typical imaging findings, strict management, such as blood pressure control, is required when clinical findings strongly suggest VAD, and differentiation of VAD from primary headache is important. https://thejns.org/doi/10.3171/CASE24202.Jul. 2024, Journal of neurosurgery. Case lessons, 8(3) (3), English, International magazineScientific journal
- A 68-year-old man presented with a headache that had started 1 month earlier. The scalp vein dilatation was observed at presentation. The findings of computed tomography and magnetic resonance imaging raised suspicion of a dural arteriovenous fistula, leading to the definitive diagnosis by digital subtraction angiography. Scalp vein signs can be a useful clue to suspect intracranial abnormalities, including dural arteriovenous fistula.Jul. 2024, Journal of general and family medicine, 25(4) (4), 239 - 240, English, Domestic magazineScientific journal
- 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.Apr. 2024, Neurosurgery, 95(4) (4), 751 - 760, English, International magazineScientific journal
- 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.Journal of Neurosurgery Publishing Group (JNSPG), Mar. 2024, Journal of Neurosurgery: Case Lessons, 7(10) (10), English, International magazineScientific journal
- BACKGROUND: Cavernous sinus dural arteriovenous fistula (CSDAVF) is an abnormal arteriovenous connection involving the dura mater within or adjacent to the wall of the cavernous sinus. While cases with superior ophthalmic vein drainage and ocular symptoms are typical, we report a rare case of CSDAVF draining into the perimedullary vein of the medulla oblongata and spinal cord and causing cerebellar ataxia and myelopathy as the initial presentation. CASE DESCRIPTION: A 73-year-old man presented with vertigo and rapidly progressing gait disturbance. Digital subtraction angiography revealed a left CSDAVF draining only into the spinal perimedullary veins, which was classified as Cognard type V. We performed a transvenous embolization through the occluded left inferior petrosal sinus and achieved a super-selective shunt occlusion using three platinum coils. The postoperative course was uneventful with immediate improvement of symptoms. CONCLUSION: CSDAVF should be considered as a differential diagnosis in a patient with venous congestion in the brainstem.2024, Surgical neurology international, 15, 359 - 359, English, International magazineScientific journal
- Dec. 2023, Acta neurologica Belgica, 124(3) (3), 1073 - 1075, English, International magazine
- Nov. 2023, Neuro-Chirurgie, 69(6) (6), 101485 - 101485, English, International magazine
- 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.Mar. 2023, Journal of neurosurgery, 139(4) (4), 1 - 8, English, International magazineScientific journal
- 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
- Background: Spinal cord infarction is a rare but serious complication of neurointervention that has been rarely documented. An association between spinal cord infarction and the placement of large bore catheters in the vertebral artery (VA) has been mentioned, but the precise etiology remains unclear. Case Description: A 72-year-old female presented with the right hemiparesis and left thermal hypoalgesia directly after endovascular coil embolization for an unruptured basilar tip aneurysm. Magnetic resonance imaging demonstrated right-sided upper cervical (C2-3) spinal cord infarction. Conventional bilateral vertebral angiograms revealed no opacification of the anterior spinal arteries. Cone-beam computed tomography showed a watershed area of radiculomedullary arteries that was correlated with the extent of the ischemic lesion. Thus, the spinal cord ischemia may have had multifactorial causes combined with reduced perfusion pressure to the spinal cord, which was caused by the placement of the guiding catheter in the VA and intensive hypotension during general anesthesia. Conclusion: Spinal cord infarction should be recognized as a serious complication of endovascular treatment involving posterior circulation.Scientific Scholar, Sep. 2022, Surgical Neurology International, 13, 415 - 415, English, International magazineScientific journal
- BACKGROUND AND PURPOSE: ICA-selective MRA using a pencil beam presaturation pulse can accurately visualize anterior communicating artery flow. We evaluated the impact of anterior communicating artery flow on the perioperative hemodynamic status and new ischemic lesions after carotid revascularization. MATERIALS AND METHODS: Eighty-three patients with carotid artery stenosis were included. We assessed anterior communicating artery flow using ICA-selective MRA. The preoperative hemodynamic status was measured using SPECT. We also measured the change in regional cerebral oxygen saturation after temporary ICA occlusion. New ischemic lesions were evaluated by DWI on the day after treatment. RESULTS: Anterior communicating artery flow was detected in 61 patients, but it was not detected in 22 patients. Preoperative cerebrovascular reactivity was significantly higher in patients with (versus without) anterior communicating artery flow with a mean peak systolic velocity of ≥200 cm/s (39.6% [SD, 23.8%] versus 25.2% [SD, 16.4%]; P = .030). The decrease in mean regional cerebral oxygen saturation was significantly greater in patients without (versus with) anterior communicating artery flow (8.5% [SD, 5.6%] versus 3.7% [SD, 3.8%]; P = .002). New ischemic lesions after the procedure were observed in 23 patients. The multivariate logistic regression analysis revealed that anterior communicating artery flow (OR, 0.07; 95% CI, 0.012-0.45; P = .005) was associated with new ischemic lesions. CONCLUSIONS: The absence of anterior communicating artery flow influenced the perioperative hemodynamic status in patients with carotid stenosis and was associated with an increased incidence of new ischemic lesions after carotid revascularization.Aug. 2022, AJNR. American journal of neuroradiology, 43(8) (8), 1124 - 1130, English, International magazineScientific journal
- PURPOSE: The objective of this study was to evaluate our 12-year experience in treating Borden type III transverse-sigmoid sinus (TSS) dural arteriovenous fistulas (DAVFs) and discuss the technical aspects of ipsilateral and contralateral transvenous embolization (TVE) approaches. METHODS: We retrospectively reviewed charts of consecutive patients with TSS DAVF treated with multimodal treatment between April 2008 and March 2020. The baseline patient characteristics, imaging data, details of procedure, data sets of sinus pressure monitoring, and clinical results were systematically collected. RESULTS: Of 44 patients with TSS DAVF who were treated during study periods, 23 patients of Borden type III were extracted. Among the 23 patients, 18 with transfemoral TVE were included for analysis. TVE was performed using an ipsilateral approach in 8 patients and a contralateral approach in 10. Pressure monitoring data revealed that initial mean sinus pressure (43.5 mmHg vs. 29.5 mmHg; P = 0.033), maximum sinus pressure during the procedure (69.0 mmHg vs. 40.5 mmHg; P = 0.011), and sinus pressure gradient (22.5 mmHg vs. 5.5 mmHg; P = 0.021) were significantly higher in the ipsilateral approach group. The complete obliteration rate by primary embolization was 94% in our cohort with the recurrence rate of 5.6% with a median follow-up period of 57 months. CONCLUSION: Our study showed the durability of TVE for patients with Borden type III TSS DAVF. TVE performed via the contralateral approach might prevent a potentially dangerous increase in intraprocedural sinus pressure and cortical venous reflux.Jul. 2022, Clinical neuroradiology, 33(1) (1), 161 - 169, English, International magazineScientific journal
- Endoplasmic reticulum (ER) stress is an important process during the progression of atherosclerosis. The aim of this study was to elucidate the association of ER stress and clinical instability of carotid plaque. One hundred ninety-three patients with carotid stenosis undergoing carotid endarterectomies (CEAs) were enrolled. We classified the patients into 3 groups: the asymptomatic, symptomatic, and cTIA (crescendo transient ischemic attack)/SIE (stroke in evolution) groups. Immunohistological staining was performed to assess ER stress and apoptosis. The correlation between ER stress marker expression and clinical instability was analyzed by Tukey-Kramer test and ordinal logistic regression. From the 193 CEAs, 24 asymptomatic plaques and 24 symptomatic plaques were randomly selected, and all 7 plaques in the cTIA/SIE group were selected. Glycophorin A staining demonstrated significant correlation between intraplaque hemorrhage and clinical instability (odds ratio [OR], 1.27; 95%CI, 1.14-1.41). The expression of ER stress markers (glucose-regulated protein 78 [GRP78] and C/EBP homologous protein [CHOP]) exhibited a significant correlation with clinical instability (GRP78: OR, 1.25; 95%CI, 1.14-1.38, CHOP: OR, 1.39; 95%CI, 1.16-1.66). Double-label immunofluorescence demonstrated ER stress markers were detected in CD68-positive cells and smooth muscle actin (SMA)-positive cells. The coexpression of the ER stress markers exhibited a significant correlation with clinical instability (CD68/GRP78: OR, 1.13; 95%CI, 1.05-1.20, CD68/CHOP: OR, 1.092; 95%CI, 1.04-1.14, SMA/CHOP: OR, 1.082; 95%CI, 1.04-1.13). However, the colocalization of CHOP and cleaved caspase-3 (apoptosis marker) did not correlate with clinical instability. These findings indicated that the ER stress pathway may be a potential therapeutic target in the prevention of stroke.Jun. 2022, Translational stroke research, 13(3) (3), 420 - 431, English, International magazineScientific journal
- OBJECTIVE: Epilepsy in glioblastoma patients significantly reduces their quality of life; however, little is known about the association between predicting epilepsy and metabolites in tumors. In this study, we used 3.0-T magnetic resonance imaging and 1H-magnetic resonance spectroscopy (MRS) to quantify metabolite concentrations in patients with varying epilepsy histories. METHODS: Fifty-one patients with glioblastoma underwent pretreatment 3.0-T MRI/1H-MRS scanning. Single-voxel (1.5 cm3) MRS, in an enhanced lesion, was acquired using a double-echo point-resolved spectroscopic sequence with chemical-shift selective water suppression. MRS data were quantified with linear combination model (LC-Model) software. We compared the MRS data between groups with and without epilepsy during the postoperative course (EP). RESULTS: The ratios of glutamate (Glu) and glutamate + glutamine (Glx) to total creatine (Glu/tCr and Glx/tCr) in the tumor were associated with epilepsy history. The receiver operating characteristic curve analysis showed that a Glu/tCr value of 1.81 was 70% sensitive and 90% specific for the prediction of EP (area under curve: 0.82). In the analysis excluding patients with preoperative epilepsy, a Glu/tCr value of 1.81 was 75% sensitive and 88% specific for the prediction (area under curve: 0.87). CONCLUSIONS: Intratumoral metabolite concentrations measured using pretreatment 3.0-T MRI/1H-MRS changed characteristically in the group with EP. Our study suggests that the Glu/tCr ratio in tumors has adequate reliability in predicting EP. Pretreatment MRS is a minimally invasive and simple procedure that can provide useful information on glioblastoma patients.Jan. 2022, World neurosurgery, 160, e501-e510, English, International magazineScientific journal
- BACKGROUND: Some reports have described intraosseous arteriovenous fistulas showing osteolytic changes, but an osseous arteriovenous fistula (AVF) at the jugular bulb showing extensive bone destruction is a very rare disease. CASE DESCRIPTION: A 60-year-old man presented with pulsatile tinnitus and right facial nerve palsy. Radiological imaging showed a large homogenously enhanced osteolytic lesion at the right jugular foramen. A cerebral angiogram showed a high-flow vascular lesion of the jugular bulb associated with retrograde sinus reflux, resulting in venous congestion of the deep venous system. These findings led us to misdiagnose this lesion as a glomus jugular tumor. However, combined arterial and venous angiography after transarterial embolization revealed the precise angioarchitecture, and we finally diagnosed this lesion as a high-flow osseous AVF at the jugular bulb. We performed transvenous embolization using a triple catheter technique. The lesion was successfully obliterated, and the 6-months angiogram showed no recurrence. CONCLUSION: A rare case of high flow osseous AVF at the jugular bulb associated with osteolytic changes in the surrounding bony structure is reported. Although many hypervascular lesions at the jugular bulb are glomus tumors, bone destructive osseous AVF at the jugular bulb should be considered.Sep. 2021, Neuro-Chirurgie, 68(5) (5), 525 - 529, English, International magazineScientific journal
- Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended for high stroke-risk patients with carotid artery stenosis to reduce ischemic events. However, we often face difficulty in determining the best treatment strategy. We aimed to develop an accurate post-CEA/CAS outcome prediction model using machine learning that will serve as a basis for a new decision support tool for patient-specific treatment planning. Retrospectively collected data from 165 consecutive patients with carotid stenosis underwent CEA or CAS and were divided into training and test samples. The following five machine learning algorithms were tuned, and their predictive performance was evaluated by comparison with surgeon predictions: an artificial neural network, logistic regression, support vector machine, random forest, and extreme gradient boosting (XGBoost). Seventeen clinical factors were introduced into the models. Outcome was defined as any ischemic stroke within 30 days after treatment including asymptomatic diffusion-weighted imaging abnormalities. The XGBoost model performed the best in the evaluation; its sensitivity, specificity, positive predictive value, and accuracy were 31.9%, 94.6%, 47.2%, and 86.2%, respectively. These statistical measures were comparable to those of surgeons. Internal carotid artery peak systolic velocity, low-density lipoprotein cholesterol, and procedure (CEA or CAS) were the most contributing factors according to the XGBoost algorithm. We were able to develop a post-procedural outcome prediction model comparable to surgeons in performance. The accurate outcome prediction model will make it possible to make a more appropriate patient-specific selection of CEA or CAS for the treatment of carotid artery stenosis.Springer Science and Business Media LLC, Jun. 2021, Neurosurgical Review, 45(1) (1), 607 - 616, English, International magazineScientific journal
- Although transvenous embolization (TVE) via the superior ophthalmic vein (SOV) is adopted in treating cavernous sinus dural arteriovenous fistula (CS DAVF), its effect on the coil volume is rarely understood. The purpose of the study was to investigate if there is a difference in the total number of coils used and in patient safety when comparing two access strategies. We retrospectively reviewed charts for patients with CS DAVF treated with TVE between January 2008 and March 2018. The baseline patient characteristics, details of procedure, placed coils, and clinical results were compared. A total of 42 patients with CS DAVF were treated with the inferior petrosal sinus (IPS) (n = 32) or SOV (n = 10) approach. TVE via SOV showed a high success rate of 100% (10/10) by transfemoral access. The total number (23 versus 11; P < 0.001), length (159 versus 81 cm; P = 0.003), and volume of placed coils (111 versus 46 mm3; P = 0.005) were significantly lower in patients treated via SOV. Patients treated via SOV had significantly higher initial intrasinus pressure (49 versus 59 mmHg; P = 0.022) obtained by microcatheters; however, no adverse events occurred related to elevated sinus pressure between both approaches. Procedural complications and cranial nerve palsy outcomes were not significantly different. In cases with a visualized pathway to the SOV, this approach should be preferred, in all other cases standard approach via the IPS should be used, even if it cannot be visualized.Feb. 2021, Neurosurgical review, 44(1) (1), 401 - 409, English, International magazine[Refereed]Scientific journal
- Cancer cells optimize nutrient utilization to supply energetic and biosynthetic pathways. This metabolic process also includes redox maintenance and epigenetic regulation through nucleic acid and protein methylation, which enhance tumorigenicity and clinical resistance. However, less is known about how cancer cells exhibit metabolic flexibility to sustain cell growth and survival from nutrient starvation. Here, we find that serine and glycine levels were higher in low-nutrient regions of tumors in glioblastoma multiforme (GBM) patients than they were in other regions. Metabolic and functional studies in GBM cells demonstrated that serine availability and one-carbon metabolism support glioma cell survival following glutamine deprivation. Serine synthesis was mediated through autophagy rather than glycolysis. Gene expression analysis identified upregulation of methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) to regulate one-carbon metabolism. In clinical samples, MTHFD2 expression was highest in the nutrient-poor areas around "pseudopalisading necrosis." Genetic suppression of MTHFD2 and autophagy inhibition caused tumor cell death and growth inhibition of glioma cells upon glutamine deprivation. These results highlight a critical role for serine-dependent one-carbon metabolism in surviving glutamine starvation and suggest new therapeutic targets for glioma cells adapting to a low-nutrient microenvironment.Jan. 2021, Acta neuropathologica communications, 9(1) (1), 16 - 16, English, International magazineScientific journal
- The ketogenic diet (KD) is a high fat and low carbohydrate diet that produces ketone bodies through imitation of starvation. The combination of KD and Bevacizumab (Bev), a VEGF inhibitor, is considered to further reduce the supply of glucose to the tumor. The metabolite changes in U87 glioblastoma mouse models treated with KD and/or Bev were examined using gas chromatography-mass spectrometry. The combination therapy of KD and Bev showed a decrease in the rate of tumor growth and an increase in the survival time of mice, although KD alone did not have survival benefit. In the metabolome analysis, the pattern of changes for most amino acids are similar between tumor and brain tissues, however, some amino acids such as aspartic acid and glutamic acid were different between tumors and brain tissues. The KD enhanced the anti-tumor efficacy of Bev in a glioblastoma intracranial implantation mouse model, based on lowest levels of microvascular density (CD31) and cellular proliferation markers (Ki-67 and CCND1) in KD + Bev tumors compared to the other groups. These results suggested that KD combined with Bev may be a useful treatment strategy for patients with GBM.Jan. 2021, Scientific reports, 11(1) (1), 79 - 79, English, International magazineScientific journal
- Treating carotid blowout syndrome following rupture of giant pseudoaneurysms is difficult because the destroyed parent artery precludes conventional treatment. We present a patient with a ruptured giant pseudoaneurysm that we occluded using a modified internal trapping technique with low-concentration N-butyl-2-cyanoacrylate (NBCA) and a minimum number of coils. An 80-year-old man with a history of chemoradiation therapy for oropharyngeal cancer presented with several episodes of active bleeding from the subsequent tracheostomy site. Radiological examination revealed a giant right common carotid artery (CCA) pseudoaneurysm. Endovascular internal trapping was performed using both NBCA and coils under proximal flow control. We slowly injected 9 ml of low-concentration NBCA, which subsequently filled the entire pseudoaneurysm. We then injected an additional 2 ml of NBCA into the proximal CCA to achieve complete obliteration. No re-bleeding was observed during the 6-month follow-up. Endovascular internal trapping using low-concentration NBCA was feasible to treat a giant CCA pseudoaneurysm. The injected low-concentration NBCA filled the entire pseudoaneurysm without the risk of catheter entrapment.Jan. 2021, Vascular and endovascular surgery, 55(1) (1), 81 - 85, English, International magazine[Refereed]Scientific journal
- It is essential to establish cardiopulmonary bypass by percutaneous insertion of a large-bore catheter via both the femoral vein and internal jugular vein (IJV) for minimally invasive cardiac surgery (MICS). Complications associated with IJV catheterization during MICS have been reported in the literature; however, vascular injury of the subclavian artery (SCA) is rare. We herein present a rare case in which an iatrogenic arteriovenous fistula (AVF) between the right SCA and IJV after MICS was successfully treated by endovascular coil embolization. A 61-year-old man who had undergone mitral valve repair by MICS 10 months before presentation was referred because of pulsatile cervical bruit and tinnitus. Radiographic examination revealed a right SCA pseudoaneurysm associated with an AVF located between the right common carotid artery and vertebral artery. The AVF was completely occluded with detachable coils using a double-catheter technique to avoid coil migration into the IJV. This technique has been used to treat high-flow or complex AVFs, including pulmonary and renal AVFs. As shown in the present case, it is also useful to treat an iatrogenic AVF between the SCA and IJV.Oct. 2020, Annals of vascular surgery, 68, 571.e15-571.e20, English, International magazine[Refereed]Scientific journal
- Although ultrasonographically-guided carotid interventions without contrast medium have been reported in the literature, we found no report regarding stenting of the vertebral artery origin for treatment of stenosis. Here, we report the case of an iodine-allergic patient in whom a stenosis at the origin of the vertebral artery was successfully treated with ultrasonographically-guided stent placement without contrast medium. B-mode longitudinal images were monitored during the insertion of the embolism-protection device, when positioning the stent, and for the evaluation of the stent opening. This technique can be an alternative option in selected patients, especially those allergic to the contrast medium.Jul. 2020, Journal of clinical ultrasound : JCU, 48(6) (6), 362 - 366, English, International magazine[Refereed]Scientific journal
- Tumor biopsy is essential for the definitive diagnosis of central nervous system (CNS) lymphoma. However, the biopsy procedure carries the risk of complications such as bleeding, convulsions, and infection. Cerebrospinal fluid (CSF) β2-microglobulin (β2-MG), soluble IL-2 receptor (sIL-2R), and interleukin-10 (IL-10) are known to be useful diagnostic biomarkers for CNS lymphoma. The C-X-C motif chemokine ligand 13 (CXCL13) was recently reported to be another useful biomarker for CNS lymphoma. The purpose of this study is to establish a diagnostic algorithm that can avoid biopsy by combining these diagnostic biomarkers. In the first, we conducted a case-control study (n = 248) demonstrating that the CSF CXCL13 concentration was significantly increased in CNS lymphoma patients compared with various other brain diseases (AUC = 0.981). We established a multi-marker diagnostic model using CSF CXCL13, IL-10, β2-MG, and sIL-2R from the results of the case-control study and then applied the model to a prospective study (n = 104) to evaluate its utility. The multi-marker diagnostic algorithms had excellent diagnostic performance: the sensitivity, specificity, positive predictive value, and negative predictive value were 97%, 97%, 94%, and 99%, respectively. In addition, CSF CXCL13 was a prognostic biomarker for CNS lymphoma patients. Our study suggests that multi-marker algorithms are important diagnostic tools for patients with CNS lymphoma.Jun. 2020, Cancer medicine, 9(12) (12), 4114 - 4125, English, International magazine[Refereed]Scientific journal
- We describe a unique technique to reduce the amount of contrast medium by injecting diluted contrast medium from the microcatheter during neurointervention. A patient with severe renal impairment due to polycystic kidney was referred for endovascular surgery for wide-neck middle cerebral artery aneurysm. In order to reduce the amount of contrast medium, contrast medium was injected from the microcatheter placed in the middle cerebral artery during coil embolization; renal function decline was not observed after the procedure. This technique, therefore, reduces the amount of contrast medium and enables one to perform coil embolization safely.May 2020, Radiology case reports, 15(5) (5), 542 - 544, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Few studies have examined the usefulness of intraoperative magnetic resonance spectroscopy (iMRS) for identifying abnormal signals at the resection margin during glioma surgery. The aim of this study was to assess the value of iMRS for detecting proliferative remnants of glioma at the resection margin. METHODS: Fifteen patients with newly diagnosed glioma underwent single-voxel 3-T iMRS concurrently with intraoperative magnetic resonance imaging-assisted surgery. Volumes of interest (VOIs) were placed at T2-hyperintense or contrast-enhancing lesions at the resection margin. In addition to technical verification, the correlation between the MIB-1 labeling index (a pathologic feature) and metabolites measured using iMRS (N-acetyl-L-aspartate [NAA], choline [Cho], and Cho/NAA ratio) was analyzed. RESULTS: iMRS was performed for 20 VOIs in 15 patients. Fourteen (70%) of these VOIs were confirmed to be MIB-1-positive. There was a significant positive correlation between the Cho/NAA ratio and MIB-1 index (r = 0.46, P = 0.04). Cho level (P = 0.003) and Cho/NAA ratio (P = 0.002) were significantly higher in VOIs that were MIB-1-positive than in those that were MIB-1-negative. Detection of a Cho level >1.074 mM and a Cho/NAA ratio >0.48 using iMRS resulted in high diagnostic accuracy for MIB-1-positive remnants (Cho level: sensitivity 86%, specificity 100%; Cho/NAA ratio: sensitivity 79%, specificity 100%). CONCLUSIONS: This study provides evidence that 3-T iMRS can detect proliferative remnants of glioma at the resection margin using the Cho level and Cho/NAA ratio, suggesting that intraoperative magnetic resonance imaging-assisted surgery with iMRS would be practicable in glioma.May 2020, World neurosurgery, 137, 149 - 157, English, International magazine[Refereed]Scientific journal
- We present a unique sinus protection technique that uses a short-length supercompliant balloon during the transarterial Onyx embolization for the dural arteriovenous fistula (DAVF) of the lateral tentorial sinus. With this technique, we temporarily change the Borden classification from type II to type III, avoiding venous compromise and reducing the risk of Onyx migration into the patent sinus. A 54-year-old man presented with left persistent tinnitus of 4 months' duration. Cerebral angiography revealed a Borden type II left lateral tentorial sinus-DAVF associated with retrograde cortical venous reflux draining into the vein of Labbé. In the venous phase, the ipsilateral transverse-sigmoid sinus was recognized as a functional sinus and the posterior temporal vein drained into the transverse sinus near the drainage channel. We planned to perform transarterial Onyx embolization using a short-length sinus protection balloon to protect against Onyx migration. During transarterial Onyx injection, a 7 × 7-mm HyperForm balloon was navigated into the affected sinus and positioned to cover the drainage channel from the shunt. After confirming the change in Borden classification with angiography, transarterial Onyx embolization was performed via the middle meningeal artery. This procedure resulted in complete obliteration of the fistula with good patency of both the transverse-sigmoid sinus and neighboring normal cortical veins. No procedure-related complications were observed and the patient remained free of recurrence during the 24-month follow-up period. Short-length balloon-protected Onyx embolization can be safe and effective for the treatment of Borden type II DAVF.Apr. 2020, Radiology case reports, 15(4) (4), 405 - 410, English, International magazine[Refereed]
- BACKGROUND AND PURPOSE: Photodynamic therapy is a novel treatment that provides effective local control, but little is known about photodynamic therapy-induced changes on MR imaging. The aim of this study was to assess the utility of DWI and ADC in monitoring the response of malignant gliomas to photodynamic therapy. MATERIALS AND METHODS: Time-dependent changes in DWI and ADC values after photodynamic therapy were analyzed in a group that received photodynamic therapy in comparison with a group that did not. RESULTS: Twenty-four patients were enrolled (photodynamic therapy, n = 14; non-photodynamic therapy, n = 10). In all patients who received photodynamic therapy, linear high signals on DWI in the irradiated area were detected adjacent to the resection cavity and were 5-7 mm in depth from 1 day posttreatment and disappeared in about 30 days without any neurologic deterioration. The non-photodynamic therapy group did not show this change. The photodynamic therapy group had significantly lower ADC values from 1 day posttreatment (P < .001), which increased steadily and disappeared by 30 days. There was no decline or time-dependent change in ADC values in the non-photodynamic therapy group. CONCLUSIONS: The acute response of malignant gliomas to photodynamic therapy was detected as linear high signals on DWI and as a decrease in ADC values. These findings were asymptomatic and transient. Although the photodynamic therapy-induced acute response on MR imaging disappeared after approximately 30 days, it may be helpful for confirming the photodynamic therapy-irradiated area.Dec. 2019, AJNR. American journal of neuroradiology, 40(12) (12), 2045 - 2051, English, International magazine[Refereed]Scientific journal
- BACKGROUND: There has been no effective method to predict ischemic intolerance to temporary internal carotid artery (ICA) occlusion during carotid artery reconstruction. Pencil beam presaturation (BeamSAT) pulse suppresses the flow signal of the target vessel in magnetic resonance angiography (MRA). Applying this method, we constructed ICA-selective MRA images. The aim of this study was to identify patients at risk for ischemic intolerance by ICA-selective MRA. METHODS: By evaluating flow of anterior communicating artery (Acom) and A1 portion of anterior cerebral artery with ICA-selective MRA and posterior communicating artery (Pcom) with conventional MRA, we investigated associations of these collateral flow patterns with ischemic intolerance and decrease of regional cerebral oxygen saturation. RESULTS: The study included 58 patients who underwent carotid endarterectomy or carotid artery stenting. Six of 7 patients without Acom flow and Pcom flow demonstrated ischemic intolerance, whereas all patients (n = 51) with Acom and/or Pcom flow demonstrated tolerance. The accuracy of this prediction model according to Acom and Pcom flow patterns for ischemic intolerance was 0.98 (P = 0.01, binomial test). Regional cerebral oxygen saturation decrease after ICA occlusion was significantly larger in patients without Acom flow and Pcom flow (12.0% ± 6.0%) than in patients with Acom flow and Pcom flow (3.0% ± 3.1%, P < 0.01) and in patients with Acom flow but no Pcom flow (2.4% ± 5.2%, P < 0.01). CONCLUSIONS: These findings support the importance of Acom flow as a collateral route. ICA-selective MRA enables prediction of ischemic intolerance to temporary ICA occlusion during carotid endarterectomy or carotid artery stenting. This method provides valuable information regarding probability of an ischemic complication.Oct. 2019, World neurosurgery, 130, e899-e907, English, International magazine[Refereed]Scientific journal
- BACKGROUND: The aneurysmal bone cyst (ABC) is a rare osteolytic lesion that is often associated with osseous disease such as fibrous dysplasia (FD). CASE DESCRIPTION: A 66-year-old woman previously diagnosed with FD presented with suddenly reduced visual acuity. Computed tomography and magnetic resonance imaging revealed a large osteolytic lesion in the middle cranial fossa that had invaded the left orbit. Although its radiological findings were compatible with an ABC, rotational digital subtraction angiography revealed that this osteolytic lesion was a large middle meningeal artery (MMA) aneurysm. To release the compression force on the optic nerve and confirm the diagnosis, we performed endovascular embolization, followed by surgical removal of the lesion. Histologic examination revealed that the resected lesion met the requirements of a thrombosed aneurysm. No new neurologic deficits appeared after the surgery, and no symptomatic recurrence have been noted during the 6-month follow-up. CONCLUSIONS: This is the first case report to show that ABC-like lesions in patients with FD could be thrombosed MMA aneurysms. It is thus possible that some lesions previously diagnosed as ABCs were thrombosed MMA aneurysms or included a thrombosed MMA aneurysm. It is therefore important to rule out the presence of a MMA aneurysm when we encounter what appears to be an ABC in the presence of FD.Oct. 2019, World neurosurgery, 130, 439 - 443, English, International magazine[Refereed]Scientific journal
- Japan Stroke Society, 2019, Japanese Journal of Stroke, 41(3) (3), 177 - 181Scientific journal
- Molecular mechanism underlying ischemic stroke remains poorly understood. We previously reported glucose 6-phosphate dehydrogenase (G6PD) activity in pentose phosphate pathway (PPP) is activated via heat shock protein 27 (HSP27) phosphorylation at serine 85 (S85) by ataxia telangiectasia mutated (ATM) kinase during cerebral ischemia. This mechanism seems to be endogenous antioxidative system. To determine whether this system also works during reperfusion, we performed comparative metabolic analysis of reperfusion effect on metabolism in rat cortex using middle cerebral artery occlusion (MCAO). Metabolic profiling using gas-chromatography/mass-spectrometry analysis showed changes in metabolic state that depended on reperfusion time. Enrichment analysis showed PPP was significantly upregulated during ischemia-reperfusion. Significant increases in fructose 6-phosphate and ribulose 5-phosphate after reperfusion also suggested enhancement of PPP. In relation to PPP, ischemia-reperfusion induced an increase of up to 69-fold in HSP27 transcripts after 24-h reperfusion. Immunoblotting showed gradual increase in HSP27 protein and marked increase in HSP27 phosphorylation (S85) that were time-dependent (4.5-fold after 24-h reperfusion). G6PD activity was significantly elevated after 1-h MCAO (20%), reduced after 1-h reperfusion, increased gradually thereafter and significantly elevated after 24-h reperfusion. The NADPH/NAD+ ratio displayed similar increasing pattern. Intracerebroventricular injection of ATM kinase inhibitor (KU-55933) significantly reduced HSP27 phosphorylation and G6PD activity, significantly increased protein carbonyl, and resulted in increase in infarct size (100%) 24-h after reperfusion following 90-min MCAO. Consequently, G6PD activation via HSP27 phosphorylation by ATM kinase may be part of endogenous antioxidant defense neuroprotection mechanism that is activated during ischemia-reperfusion. These findings have important implications for treatment of stroke.May 2018, Brain research, 1687, 82 - 94, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: Abducens nerve palsy (ANP) after transvenous embolization (TVE) for cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) sometimes persists. The aim of this study was to assess the correlation between the coil mass and the long-term outcome of ANP after TVE. METHODS: Between January 2008 and July 2016, 33 patients with a CS DAVF underwent TVE at our institute. On the basis of the relationship to the internal carotid artery (ICA), we divided the lateral part of the CS into the following 3 portions: anterolateral, anterolateral to the anterior bend of the ICA; middle-lateral (ML), lateral to the horizontal segment of the ICA; and posterolateral, posterolateral to the posterior bend of the ICA. RESULTS: ANP persisted in 4 patients. The number of coils (35.3 vs. 21.9 coils; P = 0.04), coil volume (198.4 vs. 103.6 mm3; P = 0.03), and coil volume in the ML (54.9 vs. 20.3 mm3; P = 0.01) were significantly greater in the ANP group than in the non-ANP group. In the logistic regression analysis, only the ML coil volume was significantly associated with the persistence of ANP (P = 0.04). Based on the receiver operating characteristic curve, the optimal cutoff value of the ML coil volume was 27.9 mm3 (sensitivity, 100%; specificity, 72.4%). CONCLUSIONS: Overpacking in the ML of the CS should be avoided to prevent persistent ANP. The cutoff value of the ML coil volume may provide a good guide for the practical use of TVE for CS DAVFs.May 2018, World neurosurgery, 113, e38-e44, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Extension of a pituitary adenoma to the oculomotor cistern harbors the risk of oculomotor nerve impairment and further extension into the interpeduncular cistern. The role of endoscopic endonasal surgery for those lesions was investigated. METHODS: The medical records were retrospectively analyzed. Attention was paid to the oculomotor nerve function and removal rate of the tumor within the oculomotor and interpeduncular cisterns. RESULTS: Six patients were eligible for the study, including 2 with oculomotor nerve palsy. The tumor from the oculomotor and interpeduncular cistern was removed in all except on one side of the case with bilateral tumor extension. The oculomotor nerve palsy demonstrated partial recovery in both cases during the 3-month follow-up. CONCLUSION: The pituitary adenoma extending to the oculomotor cistern can be removed under the endoscope. Improvement of oculomotor nerve palsy can be achieved, and further tumor extension into the interpeduncular cistern can be prevented.Mar. 2018, Head & neck, 40(3) (3), 536 - 543, English, International magazine[Refereed]Scientific journal
- It is sometimes difficult to distinguish gliomas from other tumors on routine imaging. In this study, we assessed whether 3-T magnetic resonance spectroscopy (MRS) with LCModel software might be useful for discriminating glioma from other brain tumors, such as primary central nervous system lymphomas (PCNSLs) and metastatic tumors. A total of 104 cases of brain tumor (66 gliomas, 20 PCNSLs, 6 metastatic tumors, 12 other tumors) were preoperatively investigated with short echo time (35 ms) single-voxel 3-T MRS. LCModel software was used to evaluate differences in the absolute concentrations of choline, N-acetylaspartate, N-acetylaspartylglutamate, glutamate + glutamine, myo-inositol (mIns), and lipid. mIns levels were significantly increased in high-grade glioma (HGG) compared with PCNSL (p < 0.001). In multivariate logistic regression analysis, mIns was the best marker for differentiating HGG from PCNSL (p < 0.0001, odds ratio 1.9927, 95% confidence interval 1.3628-3.2637). Conventional MRS detection of mIns resulted in a high diagnostic accuracy (sensitivity, 64%; specificity, 90%; area under the receiver operator curve, 0.80) for HGG. The expression of inositol 3-phosphate synthase (ISYNA1) was significantly higher in gliomas than in PCNSLs (p < 0.05), suggesting that the increased level of mIns in glioma is due to high expression of ISYNA1, the rate-limiting enzyme in the mIns-producing pathway. In conclusion, noninvasive analysis of mIns using single-voxel MRS may be useful in distinguishing gliomas from other brain tumors, particularly PCNSLs.Jan. 2018, Journal of neuro-oncology, 136(2) (2), 317 - 326, English, International magazine[Refereed]Scientific journal
- Urban and Partner, Nov. 2017, Neurologia i Neurochirurgia Polska, 51(6) (6), 525 - 530, English, International magazine[Refereed]Scientific journal
- Aug. 2017, Neuroscience, 357, 414 - 414, English, International magazine[Refereed]Scientific journal
- BACKGROUND: Magnetic resonance spectroscopy (MRS) is a potentially useful modality for evaluating brain metabolites in patients with dural arteriovenous fistula (dAVF). Here we describe a different pattern of MRS-based cerebral metabolism findings in patients with dAVF. CASE DESCRIPTIONS: We performed MRS in 3 patients with transverse sigmoid sinus dAVF associated with cortical venous reflux. In case 1, which was associated with vasogenic edema on T2-weighted magnetic resonance imaging (MRI), decreased preoperative N-acetylaspartate (NAA)/creatine (Cr) and myo-inositol (mIns)/Cr and increased lactate (Lac)/Cr ratios improved after treatment. In case 2, a decreased preoperative NAA/Cr ratio improved after treatment. These 2 patients presented with seizures. In case 3, the patient presented with headache and showed no metabolic changes on preoperative or postoperative MRS. CONCLUSIONS: Our results suggest that patients with dAVF can be classified based on a combination of metabolic and signal changes seen on T2-weighted MRI. MRS may allow significantly expanded evaluation of the metabolic changes associated with dAVF for appropriate classification and management.Aug. 2017, World neurosurgery, 104, 1050.e7-1050.e11, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: The magnetic resonance imaging technique known as territorial arterial spin labeling (TASL) allows for noninvasive visualization of perfusion territories. The objective of this study was to use TASL to assess the relationship between perioperative changes in the perfusion territories of the internal carotid artery (ICA) and cerebral blood flow (CBF) after carotid revascularization. METHODS: In 32 patients, ICA perfusion volume (PV) and CBF were measured before and after carotid endarterectomy/carotid artery stenting using TASL and single-photon emission computed tomography, respectively. ICA flow was measured during carotid endarterectomy before and after reconstruction, using an electromagnetic flowmeter. Eleven healthy volunteers, as the normal control group, underwent TASL evaluation. RESULTS: We classified patients into 2 groups: the normal PV group (ICA PV ≥ mean-2 standard deviation of healthy volunteers; n = 13) and the reduced PV group (ICA PV < mean-2 standard deviation; n = 19). The postoperative increase in the ICA PV and CBF were significantly greater in the reduced PV group than in the normal group (90.4% ± 131.8% vs. 10.5 ± 9.8%, P = 0.017, 32.0 ± 25.7% vs. 10.5% ± 10.7%, P = 0.0032, respectively). ICA flow increased significantly after reconstruction in both the normal PV group (115.1 ± 48.1 mL/minute to 159.1 ± 53 mL/minute; P = 0.016) and reduced PV group (57.8 ± 38.3 mL/minute to 182.3 ± 52.6 mL/minute; P < 0.0001). However, in some patients in the reduced PV group, the PV increased only slightly, whereas the ICA flow markedly increased, which resulted in a large CBF increase, such as hyperperfusion. CONCLUSIONS: The TASL study suggested that an imbalance between increases in the PV and ICA flow could play an important role in the pathophysiology underlying postoperative abnormal increases in CBF.Jun. 2017, World neurosurgery, 102, 477 - 486, English, International magazine[Refereed]Scientific journal
- Rac signaling impacts a relatively large number of downstream targets; however, few studies have established an association between Rac pathways and pathological conditions. In the present study, we generated mice with double knockout of Rac1 and Rac3 (Atoh1-Cre;Rac1flox/flox;Rac3-/- ) in cerebellar granule neurons (CGNs). We observed impaired tangential migration at E16.5, as well as numerous apoptotic CGNs at the deepest layer of the external granule layer (EGL) in the medial cerebellum of Atoh1-Cre;Rac1flox/flox;Rac3-/- mice at P8. Atoh1-Cre;Rac1flox/flox;Rac3-/- CGNs differentiated normally until expression of p27kip1 and NeuN in the deep EGL at P5. Primary CGNs and cerebellar microexplants from Atoh1-Cre;Rac1flox/flox;Rac3-/- mice exhibited impaired neuritogenesis, which was more apparent in Map2-positive dendrites. Such findings suggest that impaired tangential migration and final differentiation of CGNs have resulted in decreased cerebellum size and agenesis of the medial internal granule layer, respectively. Furthermore, Rac depleted/deleted cells exhibited decreased levels of Mid1 and impaired mTORC1 signaling. Mid1 depletion in CGNs produced mild impairments in neuritogenesis and reductions in mTORC1 signaling. Thus, a novel Rac-signaling pathway (Rac1-Mid1-mTORC1) may be involved in medial cerebellar development.May 2017, Development (Cambridge, England), 144(10) (10), 1863 - 1875, English, International magazine[Refereed]Scientific journal
- The metabolic pathophysiology underlying ischemic stroke remains poorly understood. To gain insight into these mechanisms, we performed a comparative metabolic and transcriptional analysis of the effects of cerebral ischemia on the metabolism of the cerebral cortex using middle cerebral artery occlusion (MCAO) rat model. Metabolic profiling by gas-chromatography/mass-spectrometry analysis showed clear separation between the ischemia and control group. The decreases of fructose 6-phosphate and ribulose 5-phosphate suggested enhancement of the pentose phosphate pathway (PPP) during cerebral ischemia (120-min MCAO) without reperfusion. Transcriptional profiling by microarray hybridization indicated that the Toll-like receptor and mitogen-activated protein kinase (MAPK) signaling pathways were upregulated during cerebral ischemia without reperfusion. In relation to the PPP, upregulation of heat shock protein 27 (HSP27) was observed in the MAPK signaling pathway and was confirmed through real-time polymerase chain reaction. Immunoblotting showed a slight increase in HSP27 protein expression and a marked increase in HSP27 phosphorylation at serine 85 after 60-min and 120-min MCAO without reperfusion. Corresponding upregulation of glucose 6-phosphate dehydrogenase (G6PD) activity and an increase in the NADPH/NAD+ ratio were also observed after 120-min MCAO. Furthermore, intracerebroventricular injection of ataxia telangiectasia mutated (ATM) kinase inhibitor (KU-55933) significantly reduced HSP27 phosphorylation and G6PD upregulation after MCAO, but that of protein kinase D inhibitor (CID755673) did not affect HSP27 phosphorylation. Consequently, G6PD activation via ischemia-induced HSP27 phosphorylation by ATM kinase may be part of an endogenous antioxidant defense neuroprotection mechanism during the earliest stages of ischemia. These findings have important therapeutic implications for the treatment of stroke.May 2017, Neuroscience, 349, 1 - 16, English, International magazine[Refereed]Scientific journal
- May 2017, NEUROLOGIA I NEUROCHIRURGIA POLSKA, 51(3) (3), 247 - 251, English, International magazine[Refereed]Scientific journal
- The Cognard type V dural arteriovenous fistula (dAVF), which has a drainage route into the spinal vein, is a rare subtype of cranial dAVF. Because of typical features such as progressive myelopathy and brainstem dysfunctions, aggressive treatments should be considered. To eliminate venous congestion of the spinal cord, various approaches including surgical interruption of the spinal draining vein or transarterial embolization with cyanoacrylate have been reported. The introduction of nonadhesive Onyx has changed the treatment of dAVF, although little is known about the clinical usefulness of this type of fistula. We describe a case of the Cognard type V dAVF, draining into the spinal vein through the occipital sinus (OS) successfully treated by transarterial double catheter injection of Onyx. We used the alternating injections from 2 microcatheters until the Onyx reached the OS and reflowed into feeders adequately. This technique contributed to the elimination of the remaining afferent flow in an early stage of Onyx injection and achieved enough penetration into the draining vein.Apr. 2017, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 26(4) (4), e62-e63, English, International magazine[Refereed]Scientific journal
- Astrogliosis (i.e. glial scar), which is comprised primarily of proliferated astrocytes at the lesion site and migrated astrocytes from neighboring regions, is one of the key reactions in determining outcomes after CNS injury. In an effort to identify potential molecules/pathways that regulate astrogliosis, we sought to determine whether Rac/Rac-mediated signaling in astrocytes represents a novel candidate for therapeutic intervention following CNS injury. For these studies, we generated mice with Rac1 deletion under the control of the GFAP (glial fibrillary acidic protein) promoter (GFAP-Cre;Rac1flox/flox). GFAP-Cre;Rac1flox/flox (Rac1-KO) mice exhibited better recovery after spinal cord injury and exhibited reduced astrogliosis at the lesion site relative to control. Reduced astrogliosis was also observed in Rac1-KO mice following microbeam irradiation-induced injury. Moreover, knockdown (KD) or KO of Rac1 in astrocytes (LN229 cells, primary astrocytes, or primary astrocytes from Rac1-KO mice) led to delayed cell cycle progression and reduced cell migration. Rac1-KD or Rac1-KO astrocytes additionally had decreased levels of GSPT1 (G1 to S phase transition 1) expression and reduced responses of IL-1β and GSPT1 to LPS treatment, indicating that IL-1β and GSPT1 are downstream molecules of Rac1 associated with inflammatory condition. Furthermore, GSPT1-KD astrocytes had cell cycle delay, with no effect on cell migration. The cell cycle delay induced by Rac1-KD was rescued by overexpression of GSPT1. Based on these results, we propose that Rac1-GSPT1 represents a novel signaling axis in astrocytes that accelerates proliferation in response to inflammation, which is one important factor in the development of astrogliosis/glial scar following CNS injury.Jan. 2017, The Journal of biological chemistry, 292(4) (4), 1240 - 1250, English, International magazine[Refereed]Scientific journal
- The Japanese Society for Neuroendovascular Therapy, 2017, Journal of Neuroendovascular Therapy, 11(8) (8), 409 - 415Scientific journal
- BACKGROUND: Thromboembolic events are infrequent but serious complications of transcatheter aortic valve implantation (TAVI), occurring in 2.3-10% of the patients. However, the cause of post-TAVI stroke is unclear. CASE DESCRIPTION: A 90-year-old female underwent transfemoral-TAVI for severe aortic stenosis. Ten days later, she presented with an ischemic stroke of the left middle cerebral artery territory due to new-onset atrial fibrillation (NOAF). She underwent emergent endovascular thrombectomy with good reperfusion approximately 6 hours after onset of symptoms. At hospital discharge, her National Institutes of Health Stroke Scale score was 11. CONCLUSIONS: Although NOAF is rare during the subacute phase of TAVI, in this patient it might be the cause of her stroke. This finding suggests that dual antiplatelet therapy alone may be insufficient in the prevention of stroke after TAVI. Nonetheless, this case demonstrates the efficacy and safety of endovascular thrombectomy in patients with acute ischemic stroke caused by NOAF after TAVI.2017, Surgical neurology international, 8, 193 - 193, English, International magazine[Refereed]Scientific journal
- BACKGROUND: The etiology of hydrocephalus associated with the small- to medium-sized vestibular schwannomas is still controversial. We investigated tumor-specific factors related to the association of hydrocephalus with small- to medium-sized vestibular schwannomas. METHODS: Among the 77 patients with vestibular schwannoma smaller than 30 mm, 9 patients demonstrated associated communicating hydrocephalus. Patient medical records, radiologic data, and histopathologic specimens were reviewed retrospectively. The age of the patients, and size, mean apparent diffusion coefficient (ADC) value, and histologic features of the tumors were compared with those of patients without hydrocephalus. RESULTS: The symptoms related to hydrocephalus improved in all patients after tumor removal. Both the mean size and ADC values exhibited a statistically significant difference between the tumors with and without hydrocephalus (P < 0.01). CONCLUSIONS: The size and ADC value of the tumor were significantly related to the association with hydrocephalus. The increased tumor ADC value was considered to be the result of degenerative change and suggested the involvement of protein sloughing in the etiology of the associated hydrocephalus.Oct. 2016, World neurosurgery, 94, 261 - 267, English, International magazine[Refereed]Scientific journal
- Aug. 2016, Neuroradiology, 58(8) (8), 839 - 40, English, International magazine[Refereed]Scientific journal
- INTRODUCTION: We aimed to investigate the safety and feasibility of duplex-assisted carotid artery stenting (CAS) without administration of contrast medium for the prevention of adverse reactions. METHODS: Fifteen patients (9 % of all CASs) with severe carotid stenosis (≥70 %) associated with chronic kidney disease (CKD) (stage ≥3) or allergy to contrast medium underwent duplex-assisted CAS without administration of contrast medium over 4 years. The procedural success rate and perioperative complication rates were compared between the duplex-assisted CAS (n = 15) and conventional CAS (n = 153) groups. RESULTS: The technical success rate was 100 % in both groups. Combined stroke or death rates during the post-procedural period did not differ significantly between the duplex-assisted CAS group (0/15, 0 %) and conventional CAS group (4/153, 2.6 %). None of the 14 patients with CKD in the duplex-assisted CAS group experienced further deterioration of renal function. The mean surface radiation dose of participants in the duplex-assisted CAS group (n = 13, 312 ± 131 mGy) was significantly lower than that of the conventional CAS group (n = 31, 1036 ± 571 mGy) (p < 0.001). The mean duration of CAS procedure was not significantly different between the duplex-assisted CAS group (156 ± 39.7 min) and the conventional CAS group (156 ± 37.4 min). CONCLUSION: Duplex-assisted CAS without administration of contrast medium could be an alternative option in selected patients deemed to be at high risk for renal failure from nephrotoxic contrast medium or who have an allergy to contrast medium.Jul. 2016, Neuroradiology, 58(7) (7), 679 - 86, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: The surgical approach to lesions involving the inferior petrous apex (IPA) is still challenging. The purpose of this study is to demonstrate the anatomical features of the IPA and to assess the applicability of an endoscopic endonasal approach through the foramen lacerum (translacerum approach) to the IPA. METHODS: The surgical simulation of the endoscopic endonasal translacerum approach was conducted in 3 cadaver heads. The same technique was applied in 4 patients harboring tumors involving the IPA (3 chordomas and 1 chondro-sarcoma). RESULTS: By removing the fibrocartilaginous component of the foramen lacerum, a triangular space was created between the anterior genu of the petrous portion of the carotid artery and the eustachian tube, through which the IPA could be approached. The range of the surgical maneuver reached laterally up to the internal auditory canal, jugular foramen, and posterior vertical segment of the petrous portion of the carotid artery. In clinical application, the translacerum approach provided sufficient space to handle tumors at the IPA. Gross-total and partial removal was achieved in 3 and 1 cases, respectively, without permanent surgery-related morbidity and mortality. CONCLUSIONS: The endoscopic endonasal translacerum approach provides reliable access to the IPA. It is indicated alone for lesions confined to the IPA and in combination with other approaches for more extensive lesions.Apr. 2016, Journal of neurosurgery, 124(4) (4), 1032 - 8, English, International magazine[Refereed]Scientific journal
- BACKGROUND AND PURPOSE: We investigated long-term outcomes of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in our institute to evaluate the outcomes of real-world practice in Japan. METHODS: Between August 2006 and July 2013, 203 consecutive carotid revascularizations with either CEA or CAS were performed in our institute. The initial treatment was regarded as the starting point in the cases of the patients who received treatment by bilateral carotid artery stenosis or retreatment. We assessed the long-term outcomes with survival analyses. RESULTS: A total of 182 patients (CEA 111, CAS 71), including 86 symptomatic patients, were included in the current study with a mean follow-up period of 42.9 months. The periprocedural stroke/death/myocardial infarction (MI) rate was 3.6% for CEA and 5.6% for CAS groups (P = .71). Estimates of the 4-year event-free rate from the primary end point (the composite of any stroke, death, or MI within 30 days, and any ipsilateral stroke thereafter) using competing risk analysis were 3.6% for CEA and 7.1% for CAS (P = .156). Kaplan-Meier estimates of the 4-year event-free rate from the secondary end point (the composite of any stroke, death, or MI within 30 days, and any stroke or death thereafter) were 13.8% for CEA and 19.1% for CAS (P = .072). Age was the only significant predictor for the primary end point. Both age and CAS were significant predictors for the secondary end point. CONCLUSIONS: The current study on real-world practices demonstrated perioperative and long-term outcomes that were comparable to previous major studies of large numbers of patients.Feb. 2016, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 25(2) (2), 360 - 7, English, International magazine[Refereed]Scientific journal
- OBJECTIVE: The management of low-grade glioma (LGG) still remains controversial because the effectiveness of early and extensive resection is unclear, and the use of radiation therapy or chemotherapy is not well-defined. In particular, the importance of prognostic factors for survival remains a matter of discussion. The purpose of this study was to validate prognostic factors for survival in patients with LGG. MATERIALS AND METHODS: A consecutive series of 55 patients with WHO grade II LGG treated in our institute between 1983 and 2013 were retrospectively reviewed to determine the prognostic factors for survival. All data were retrospectively analyzed from the aspect of baseline characteristics, pathological findings, genetic change, surgical treatments, adjuvant therapies, and survival time. Cox multivariate analysis was performed to determine the prognostic factors for survival. RESULTS: There were 28 patients with diffuse astrocytoma (DA), 21 patients with oligodendroglioma (OG), and 6 patients with oligoastrocytoma (OA) diagnosed on initial surgery. The median overall survival was 193 months and fifteen patients (27.3%) died. A mutation in isocitrate dehydrogenase-1 (IDH1) was found in 72.9% of LGG, and this mutation was positively correlated with methylation of O6-methylguanine-DNA methyltransferase (MGMT) (p=0.02). A better prognosis was significantly associated with combined IDH1 mutation and MGMT methylation status (both positive vs both negative, HR 0.079 [95% CI 0.008-0.579], p=0.012), as well as histology (OG vs DA and OA, HR 0.158 [95% CI 0.022-0.674], p=0.011) and tumor size (<6 cm vs ≥6 cm, HR 0.120 [95% CI 0.017-0.595], p=0.008). CONCLUSIONS: Tumor histology, size and IDH-mutation status are important predictors for prolonged overall survival in patients with LGG and may provide a reliable tool for standardizing future treatment strategies.Nov. 2015, Clinical neurology and neurosurgery, 138, 37 - 44, English, International magazine[Refereed]Scientific journal
- MicroRNAs (miRs) are small, non-coding RNAs that regulate gene expression and contribute to cell proliferation, differentiation and metabolism. Our previous study revealed the extensive modulation of a set of miRs in malignant glioma. In that study, miR microarray analysis demonstrated the upregulation of microRNA-183 (miR-183) in glioblastomas. Therefore, we examined the expression levels of miR-183 in various types of gliomas and the association of miR-183 with isocitrate dehydrogenase 2 (IDH2), which has complementary sequences to miR-183 in its 3'-untranslated region (3'UTR). In present study, we used real-time PCR analysis to demonstrate that miR-183 is upregulated in the majority of high-grade gliomas and glioma cell lines compared with peripheral, non-tumorous brain tissue. The mRNA and protein expression levels of IDH2 are downregulated via the overexpression of miR-183 mimic RNA in glioma cells. Additionally, IDH2 mRNA expression is upregulated in glioma cells expressing anti-miR-183. We verified that miR-183 directly affects IDH2 mRNA levels in glioma cells using luciferase assays. In malignant glioma specimens, the expression levels of IDH2 were lower in tumors than in the peripheral, non-tumorous brain tissues. HIF-1α levels were upregulated in glioma cells following transfection with miR-183 mimic RNA or IDH2 siRNA. Moreover, vascular endothelial growth factor and glucose transporter 1, which are downstream molecules of HIF-1α, were upregulated in cells transfected with miR-183 mimic RNA. These results suggest that miR-183 upregulation in malignant gliomas induces HIF-1α expression by targeting IDH2 and may play a role in glioma biology.Feb. 2013, Journal of neuro-oncology, 111(3) (3), 273 - 83, English, International magazine[Refereed]Scientific journal
- Trauma to the spinal cord initiates a series of cellular and biochemical processes that damage both neurons and glia. TGF-beta and its receptors are expressed around the injury site following a spinal cord injury. Here, we report that the intrathecal administration of a neutralizing antibody to TGF-beta1 in rats with thoracic spinal cord contusion results in a significant enhancement of the locomotor recovery. The inhibition of TGF-beta1 suppresses glial scar formation and upregulates microglia/macrophage activation after the injury, presumably providing a favorable environment for restoration of the neural network. Rats treated with the anti-TGF-beta1 antibody exhibited a mild enhancement of growth and/or preservation of axons in the injured spinal cord caudal to the site of contusion. These results support the possibility of using TGF-beta1 inhibitors in the treatment of human spinal cord injuries.Dec. 2009, Neuroscience research, 65(4) (4), 393 - 401, English, International magazine[Refereed]
- Delayed onset massive oedema and deterioration in traumatic brain injury.A 52-year-old man fell from standing and a computed tomography (CT) scan revealed traumatic intracerebral haematoma and subarachnoid haemorrhage in the temporal cortex. He was treated without surgery and discharged. On day 30 after the accident, he had no neurological deficit. On day 37 he complained of headache and urinary incontinence, and on day 39 he was hospitalized due to progressive neurological deterioration (reduced conciousness, dilated pupils, and left hemiplegia). A CT scan revealed a diffuse low-density in the right cerebral hemisphere with marked midline shift. Emergency decompressive craniectomy and right temporal lobectomy were performed. Angiography after surgery revealed moderate vasospasm in the right middle and anterior cerebral arteries. The patient remained severely disabled. Delayed onset neurological deterioration can be caused by brain oedema and vasospasm after traumatic brain injury, despite an intervening period of improvement.Feb. 2007, Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 14(2) (2), 167 - 70, English, International magazine[Refereed]
- Feb. 2005, NEUROSURGERY, 56(2) (2), 214 - 222, English[Refereed]Scientific journal
- Japanese Congress of Neurological Surgeons, 2005, Japanese Journal of Neurosurgery, 14(11) (11), 718 - 722, Japanese[Refereed]Scientific journal
- (一社)日本脳神経血管内治療学会, Nov. 2024, 日本脳神経血管内治療学会学術集会抄録集, 40回, 695 - 695, Japanese低濃度NBCAを用いた感染性脳動脈瘤に対する治療
- (一社)日本脳神経血管内治療学会, Nov. 2024, 日本脳神経血管内治療学会学術集会抄録集, 40回, 763 - 763, Japanese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
- 2024, 日本分子脳神経外科学会プログラム・抄録集, 24thカルベノキソロンの脳虚血再灌流障害に対する保護効果の検証
- 2024, 日本分子脳神経外科学会プログラム・抄録集, 24th公開データを用いた頚動脈プラークのシングルセルRNA-seq解析
- (NPO)日本脳神経血管内治療学会, Nov. 2023, 脳血管内治療, 8(Suppl.) (Suppl.), S230 - S230, Japanese脊髄動静脈シャント疾患に対する集学的治療 当施設の経験から
- (NPO)日本脳神経血管内治療学会, Nov. 2023, 脳血管内治療, 8(Suppl.) (Suppl.), S572 - S572, Japanese全弓部人工血管置換術後の高齢者の未破裂脳動脈瘤に対して、上腕動脈穿刺、総頸動脈穿刺によって治療したコイル塞栓術2例
- (NPO)日本脳神経血管内治療学会, Nov. 2023, 脳血管内治療, 8(Suppl.) (Suppl.), S584 - S584, Japanese当施設での穿刺部合併症の頻度と考察
- (NPO)日本脳神経血管内治療学会, Nov. 2023, 脳血管内治療, 8(Suppl.) (Suppl.), S706 - S706, Japanese治療困難な大型動脈瘤に対する開頭による分枝血管クリッピング術を併用したフローダイバーター留置術
- (NPO)日本脳神経血管内治療学会, Nov. 2023, 脳血管内治療, 8(Suppl.) (Suppl.), S718 - S718, Japanese大型脳動脈瘤に対するフローダイバーター留置術 当科での経験から
- (株)インナービジョン, Nov. 2022, INNERVISION, 37(12) (12), 11 - 15, Japanese
- (NPO)日本脳神経血管内治療学会, Nov. 2022, 脳血管内治療, 7(Suppl.) (Suppl.), S75 - S75, JapaneseP2Y12阻害薬の抗血小板作用に対するVerify nowと光透過法凝集能測定装置の比較検討
- (NPO)日本脳神経血管内治療学会, Nov. 2022, 脳血管内治療, 7(Suppl.) (Suppl.), S135 - S135, JapaneseCatalys6+Trevoを第一選択とした急性脳主幹動脈閉塞に対する血栓回収療法
- (NPO)日本脳神経血管内治療学会, Nov. 2022, 脳血管内治療, 7(Suppl.) (Suppl.), S142 - S142, Japanese頭蓋内硬膜動静脈瘻に対する経動脈的塞栓術
- (NPO)日本脳神経血管内治療学会, Nov. 2022, 脳血管内治療, 7(Suppl.) (Suppl.), S205 - S205, Japanese全弓部人工血管置換術後の高齢者の未破裂脳動脈瘤に対して、上腕動脈穿刺、総頸動脈穿刺によって治療したコイル塞栓術2例
- (株)インナービジョン, Nov. 2022, INNERVISION, 37(12) (12), 11 - 15, Japanese【動画対応DRシステムを極める 高精度の診断・治療を支える技術の動向と臨床の最前線】動画対応DRシステムの活用と期待! エキスパートの目線 脳外科手術での動画対応DRシステムの活用
- (公社)日本診療放射線技師会, Sep. 2022, JART: 日本診療放射線技師会誌, 69(9) (9), 961 - 961, Japaneseいま港町神戸から発信 多職種で考える日本の現状 高齢化社会での脳卒中 多職種で取り組む脳卒中診療
- (一社)日本脳循環代謝学会, Nov. 2021, 脳循環代謝, 33(1) (1), 104 - 104, Japanese内頸動脈狭窄症におけるBeam SAT MRAによる周術期脳血流循環動態評価
- (NPO)日本脳神経血管内治療学会, Nov. 2021, 脳血管内治療, 6(Suppl.) (Suppl.), S153 - S153, JapaneseBorden type III横-S状静脈洞部硬膜動静脈瘻に対するアプローチ側の検討
- (NPO)日本脳神経血管内治療学会, Nov. 2021, 脳血管内治療, 6(Suppl.) (Suppl.), S252 - S252, Japanese低濃度NBCAとDeFrictorを用いた感染性脳動脈瘤に対する治療
- (一社)日本頭痛学会, Nov. 2021, 日本頭痛学会誌, 48(2) (2), 444 - 444, Japanese片頭痛患者における発作間欠期の安静時functional MRIの脳機能ネットワーク解析
- (NPO)日本脳神経血管内治療学会, Nov. 2020, 脳血管内治療, 5(Suppl.) (Suppl.), 70 - 70, Japanese低濃度NBCAを用いた感染性脳動脈瘤に対する治療
- (NPO)日本脳神経血管内治療学会, Nov. 2020, 脳血管内治療, 5(Suppl.) (Suppl.), 49 - 49, JapaneseIsolated sinusを呈する横-S状静脈洞部硬膜動静脈瘻に対する治療戦略
- (NPO)日本脳神経血管内治療学会, Nov. 2020, 脳血管内治療, 5(Suppl.) (Suppl.), 82 - 82, Japanese放射線治療後の頸動脈可動性プラークに対する頸動脈ステント留置術の治療経験
- (一社)日本脳循環代謝学会, Nov. 2020, 脳循環代謝, 32(1) (1), 105 - 105, Japanese内頸動脈狭窄症におけるBeam SAT MRAによる術前脳血流循環動態評価の有効性
- (NPO)日本脳神経血管内治療学会, Nov. 2020, 脳血管内治療, 5(Suppl.) (Suppl.), 70 - 70, Japanese低濃度NBCAを用いた感染性脳動脈瘤に対する治療
- (一社)日本癌治療学会, Oct. 2020, 日本癌治療学会学術集会抄録集, 58回, O70 - 6, English悪性脳腫瘍に対する光線力学療法の現状と課題
- (一社)日本脳卒中の外科学会, Jul. 2020, 脳卒中の外科, 48(4) (4), 275 - 280, Japanese
- (株)全日本病院出版会, Feb. 2020, OCULISTA, (83) (83), 59 - 64, Japanese【知らずにすまない神経眼科疾患!】脳静脈洞血栓症
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S212 - S212, JapaneseAIの機械学習で頸動脈狭窄症治療後早期の転帰を予測する 実臨床での応用[Refereed]
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S237 - S237, Japanese急性脳主幹動脈閉塞に対する血栓回収療法 ADAPT firstかSTENT firstか[Refereed]
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S288 - S288, Japanese海綿静脈洞部硬膜動静脈瘻に対する経大腿-上眼静脈アプローチを成功させるために[Refereed]
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S212 - S212, JapaneseAIの機械学習で頸動脈狭窄症治療後早期の転帰を予測する 実臨床での応用
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S237 - S237, Japanese急性脳主幹動脈閉塞に対する血栓回収療法 ADAPT firstかSTENT firstか
- (NPO)日本脳神経血管内治療学会, Nov. 2019, 脳血管内治療, 4(Suppl.) (Suppl.), S288 - S288, Japanese海綿静脈洞部硬膜動静脈瘻に対する経大腿-上眼静脈アプローチを成功させるために
- (一社)日本脳卒中学会, May 2019, 脳卒中, 41(3) (3), 177 - 181, Japanese
- (NPO)日本脳神経血管内治療学会, Nov. 2018, 脳血管内治療, 3(Suppl.) (Suppl.), S133 - S133, Japanese動脈硬化性頸部内頸動脈急性閉塞に対する血管内再開通療法
- (NPO)日本脳神経血管内治療学会, Nov. 2018, 脳血管内治療, 3(Suppl.) (Suppl.), S219 - S219, Japanese神経ネットワークを用いた頸動脈ステント留置術前後における認知機能の評価
- (NPO)日本脳神経血管内治療学会, Nov. 2018, 脳血管内治療, 3(Suppl.) (Suppl.), S259 - S259, Japanese海綿静脈洞部硬膜動静脈瘻に対する上眼静脈アプローチの有用性
- 克誠堂出版(株), Jul. 2018, 麻酔, 67(7) (7), 743 - 744, Japanese術中fMRIによる麻酔・意識の研究 Pharmacological fMRI[Refereed]
- (一社)日本脳神経外傷学会, Feb. 2018, 日本脳神経外傷学会プログラム・抄録集, 41回, 69 - 69, Japanese環軸椎骨折に伴う両側椎骨動脈損傷に対して一期的に両側椎骨動脈コイル塞栓術を施行した1例
- <p><b>Objective:</b> We report a case of a spinal dural arteriovenous fistula (s-dAVF) involving feeders from multiple intervertebral levels. Transarterial glue embolization was performed with controlling the blood flow from a feeder other than the one through which n-butyl-2-cyanoacrylate (NBCA) was injected using a balloon placed at a different level of a segmental artery. WiThe Japanese Society for Neuroendovascular Therapy, 2018, NOUSHINKEI KEKKANNAI TIRYOU, 12(4) (4), 199 - 205, English[Refereed]Report scientific journal
- Nov. 2017, NEURO-ONCOLOGY, 19, 238 - 238, EnglishINTRAOPERATIVE MAGNETIC RESONANCE SPECTROSCOPY (iMRS) FOR GLIOMA SURGERYSummary international conference
- (NPO)日本脳神経血管内治療学会, Nov. 2017, 脳血管内治療, 2(Suppl.) (Suppl.), S100 - S100, Japanese頭蓋内硬膜動静脈瘻における経動脈的塞栓術 NBCAとOnyxの比較検討
- (NPO)日本脳神経血管内治療学会, Nov. 2017, 脳血管内治療, 2(Suppl.) (Suppl.), S115 - S115, Japanese3D-DSA fusion画像が有用であった脊髄硬膜動静脈瘻2例
- (NPO)日本脳神経血管内治療学会, Nov. 2017, 脳血管内治療, 2(Suppl.) (Suppl.), S195 - S195, JapaneseLateral tentorial sinus部硬膜動静脈瘻に対するsinus protectionを併用した経動脈的Onyx塞栓術
- (NPO)日本脳神経血管内治療学会, Nov. 2017, 脳血管内治療, 2(Suppl.) (Suppl.), S265 - S265, JapaneseSHOURYUを用いた中大脳動脈瘤に対するコイル塞栓術と治療成績
- 日本脳循環代謝学会, Nov. 2016, 脳循環代謝, 28(1) (1), 133 - 133, Japanese神経画像最前線 神経機能の可視化はどこまで進んだか BeamSAT MRIを用いた、内頸動脈狭窄症手術時の一時遮断に対する不耐性予測因子の検討
- 日本脳循環代謝学会, Nov. 2016, 脳循環代謝, 28(1) (1), 172 - 172, JapaneseTerritorial Arterial Spin Labelingによる頸動脈狭窄症患者における術前後の灌流域評価
- (NPO)日本脳神経血管内治療学会, Nov. 2016, 脳血管内治療, 1(Suppl.) (Suppl.), S168 - S168, Japanese頭蓋内硬膜動静脈瘻における液体塞栓物質の役割 Onyx時代を目前にして
- (NPO)日本脳神経血管内治療学会, Nov. 2016, 脳血管内治療, 1(Suppl.) (Suppl.), S274 - S274, Japanese当院におけるPenumbra 5MAX ACE導入前後での急性期再開通療法の治療成績の比較
- (一社)日本癌治療学会, Oct. 2016, 日本癌治療学会学術集会抄録集, 54回, WS15 - 5, Japanese脳腫瘍 グリオーマに対する治療戦略 グリオーマ摘出術における3.0-Tesla術中MRスペクトロスコピーの有用性の検討
- (株)にゅーろん社, Aug. 2016, The Mt. Fuji Workshop on CVD, 34, 177 - 181, Japanese急性M2閉塞に対するPenumbra ACEを用いたdirect aspirationの有用性[Refereed]
- Feb. 2016, STROKE, 47, EnglishLong-term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting: Real-World Status of Single Institute in JapanSummary international conference
- (NPO)日本脳神経血管内治療学会, Nov. 2015, JNET: Journal of Neuroendovascular Therapy, 9(6) (6), S253 - S253, Japanese海綿静脈洞部硬膜動静脈瘻(CS dAVF)に対する経静脈的塞栓術(TVE) 留置コイル部位、体積と中長期フォローにおける外転障害との関連に関する検討
- (NPO)日本脳神経血管内治療学会, Nov. 2015, JNET: Journal of Neuroendovascular Therapy, 9(6) (6), S416 - S416, JapaneseIsolated sinusを呈する横-S状静脈洞部硬膜動静脈瘻に対する治療戦略
- 日本脳循環代謝学会, Oct. 2015, 脳循環代謝, 27(1) (1), 134 - 134, Japanese頸動脈狭窄病変におけるMRI・BeamSAT撮像による選択的脳血管灌流領域の評価
- (一社)日本脳卒中の外科学会, May 2015, 脳卒中の外科, 43(3) (3), 175 - 180, Japanese【頸動脈狭窄症に関する諸問題】 無症候性頸動脈狭窄症に対する手術治療の現状と課題
- (NPO)日本脳神経血管内治療学会, Dec. 2014, JNET: Journal of Neuroendovascular Therapy, 8(6) (6), 234 - 234, Japanese頸動脈狭窄症に対する血行再建術(CEA/CAS)の中長期成績[Refereed]
- (NPO)日本脳神経血管内治療学会, Dec. 2014, JNET: Journal of Neuroendovascular Therapy, 8(6) (6), 303 - 303, Japanese血管内治療における8Fr NeuroEBUカテーテルの有用性[Refereed]
- (NPO)日本脳神経血管内治療学会, Dec. 2014, JNET: Journal of Neuroendovascular Therapy, 8(6) (6), 346 - 346, Japanese院内発症の急性期脳主幹動脈閉塞に対する再開通療法の治療成績の検討 院外発症例との比較[Refereed]
- (NPO)日本脳神経血管内治療学会, Dec. 2014, JNET: Journal of Neuroendovascular Therapy, 8(6) (6), 360 - 360, JapaneseTAEにより治療し得たnon-sinus type dural AVFの2例[Refereed]
- (一社)日本頭痛学会, Nov. 2014, 日本頭痛学会誌, 41(2) (2), 276 - 276, Japanese脳神経外科診療における疼痛管理を目的としたアセトアミノフェン静注の有用性
- (一社)日本脳卒中の外科学会, Mar. 2014, 脳卒中の外科, 42(2) (2), 103 - 108, Japanese80歳以上くも膜下出血患者への脳動脈瘤直達術の治療成績
- (一社)日本定位・機能神経外科学会, Dec. 2013, 機能的脳神経外科, 52, 161 - 165, Japaneseバクロフェン髄注療法による治療に難渋した脳性麻痺の1例[Refereed]
- (NPO)日本脳神経血管内治療学会, Nov. 2013, JNET: Journal of Neuroendovascular Therapy, 7(6) (6), 291 - 291, Japanese特発性頸部内頸動脈解離に対するステント留置術に関する検討[Refereed]
- (NPO)日本脳神経血管内治療学会, Nov. 2013, JNET: Journal of Neuroendovascular Therapy, 7(6) (6), 310 - 310, Japanese脊髄動静脈瘻に対する塞栓術[Refereed]
- Nov. 2013, NEURO-ONCOLOGY, 15, 23 - 24, EnglishJAK2-STAT3 ACTIVATION IS ASSOCIATED WITH CEREBROSPINAL FLUID INTERLEUKIN-10 (IL-10) IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMASummary international conference
- (NPO)日本脳神経血管内治療学会, Nov. 2013, JNET: Journal of Neuroendovascular Therapy, 7(5) (5), 330 - 337, JapaneseShaggy aortaと高度腎機能障害を有する無症候性両側頸部内頸動脈高度狭窄症に対してCABG前に両側CASを施行した1例[Refereed]
- (公社)日本医学放射線学会, Feb. 2013, Japanese Journal of Radiology, 31(Suppl.I) (Suppl.I), 59 - 59, Japanese眼窩内から海綿静脈洞にみられたSolitary fibrous tumorの1例
- 2013, 日本薬理学会近畿部会プログラム・要旨集, 124th, 31, Japaneseアストロサイト特異的Rac1ノックアウト(KO)による神経損傷後の機能回復促進
- (NPO)日本脳神経血管内治療学会, Nov. 2011, JNET: Journal of Neuroendovascular Therapy, 5(4) (4), 267 - 267, Japaneseコンプライアントバルンの様々な場面での有用性
- (一社)日本脳神経外科学会, Oct. 2008, 日本脳神経外科学会総会CD-ROM抄録集, 67回, 3J - 05, Japanese内頸動脈近位部動脈瘤の手術手技に対する考察
- 公立豊岡病院, Dec. 2005, 公立豊岡病院紀要, (17) (17), 27 - 30, Japanese脊髄髄内に原発した悪性リンパ腫の1例
- 日本脳神経外科コングレス, Nov. 2005, 脳神経外科ジャーナル, 14(11) (11), 718 - 722, JapaneseNBCAを用いた塞栓術後に再発した脊髄動静脈瘻の1手術例
- 兵庫県外科医会, Jul. 2003, 兵庫県全外科医会会誌, 38(4) (4), 44 - 44, Japanese脳血管攣縮に対する塩酸パパベリン動注療法の総括
- (NPO)日本脳神経外科救急学会, Jan. 2003, 日本脳神経外科救急学会プログラム・抄録集, 8回, 103 - 103, Japanese診断過程において急性増悪を来たした高血圧性脳内出血の一例
- 脳血管内治療, Nov. 2020, Japanese, (NPO)日本脳神経血管内治療学会低濃度NBCAを用いた感染性脳動脈瘤に対する治療
- 第44回 日本脳卒中学会学術集会, Mar. 2019, Japanese, 横浜, Domestic conference神経ネットワークを用いた頚動脈狭窄症手術前後における認知機能の評価Oral presentation
- 第29回日本間脳下垂体腫瘍学会, Feb. 2019, Japanese, 大阪, Domestic conference視機能障害で発症した鞍部・傍鞍部炎症性疾患に対する経鼻内視鏡手術成績Oral presentation
- ISC2019, Feb. 2019, English, Hawaii, International conferenceThe Evaluation of Cognitive Function Using Neural Network Analysis Before and After Revascularization Surgery for Internal Carotid Artery StenosisPoster presentation
- 第34回 日本脳神経血管内治療学会学術総会, Nov. 2018, Japanese, 仙台, Domestic conference神経ネットワークを用いた頚動脈ステント留置術前後における認知機能の評価Oral presentation
- 第34回日本脳神経血管内治療学会総会, Nov. 2018, Japanese, 仙台, Domestic conference海綿静脈洞部硬膜動静脈瘻に対する上眼静脈アプローチの有用性Poster presentation
- 第25回日本神経内視鏡学会, Oct. 2018, Japanese, 新潟, Domestic conference内視鏡下経蝶形骨洞的手術における内頚動脈損傷回避のための取り組みOral presentation
- 第77回日本脳神経外科学会総会, Oct. 2018, Japanese, 仙台, Domestic conference頭蓋内動脈からの腫瘍術前塞栓術の検討Poster presentation
- 第77回 日本脳神経外科学会学術総会, Oct. 2018, Japanese, 仙台, Domestic conference神経ネットワークを用いた頚動脈狭窄症手術前後における認知機能の評価Oral presentation
- 第25回日本神経内視鏡学会, Oct. 2018, Japanese, 新潟, Domestic conference斜台下部病変に対する経鼻内視鏡下手術における下鼻甲介粘膜下骨切除の有用性についてOral presentation
- 日本脳神経外科学会 第77回学術総会, Oct. 2018, Japanese, 仙台, Domestic conference視機能障害で発症した鞍部・傍鞍部炎症性疾患に対する経鼻内視鏡手術成績Oral presentation
- 日本脳神経外科学会第77回学術総会, Oct. 2018, Japanese, 仙台, Domestic conference交通性水頭症を合併する聴神経鞘腫におけるADCを用いた腫瘍摘出術後の水頭症改善予測Oral presentation
- EANS2018, Oct. 2018, English, Brussels, International conferenceThe usefulness of intraoperative constructive interference in steady-state MRI sequencing during endoscopic transsphenoidal surgery for pituitary adenomasPoster presentation
- 第46回 日本磁気共鳴医学会大会, Sep. 2018, Japanese, 金沢, Domestic conference超高磁場術中MRIの有用性[Invited]Invited oral presentation
- 第18回 術中画像情報学会, Jun. 2018, Japanese, 松本, Domestic conference経鼻内視鏡手術における術中CISS画像の有用性についてOral presentation
- STROKE2018, Mar. 2018, Japanese, 日本脳卒中学会, 福岡, Domestic conference頭蓋頚椎移行部硬膜動静脈瘻の治療後に脊髄硬膜動静脈瘻の流出路が変化した1例Oral presentation
- 第43回 日本脳卒中学会学術集会, Mar. 2018, Japanese, 日本脳卒中学会学術, 福岡, Domestic conferenceSpinal Dural Arteriovenous Fistula術前診断における4D-MRAの有用性Oral presentation
- 第3回 関西Strokeセミナー, Feb. 2018, Japanese, 関西Strokeセミナー, 大阪, Domestic conference当院における虚血性脳血管障害に対する取り組みPublic discourse
- 第55回近畿脳神経血管内手術法ワークショップ, Jan. 2018, Japanese, 近畿脳神経血管内手術法ワークショップ, 大阪, Domestic conference出血発症multiple DAVFの1例Oral presentation
- 第33回日本脳神経血管内治療学会総会, Nov. 2017, Japanese, 日本脳神経血管内治療学会, 東京, Domestic conferenceTransarterial embolization for intracranial dural arteriovenous fistula: comparison of NBCA with OnyxOral presentation
- 第33回 日本脳神経血管内治療学会学術総会, Nov. 2017, Japanese, 日本脳神経血管内治療学会, 東京, Domestic conferenceSHOURYUを用いた中大脳動脈瘤に対するコイル塞栓術と治療成績Poster presentation
- 日本脳神経外科学会第 76 回学術総会, Oct. 2017, Japanese, 日本脳神経外科学会, 名古屋, 【目的】頸動脈疾患・損傷に対する治療はCEA/CASをはじめとして基本的な手技であるが, トラブルに遭遇すると悲惨な結果となることもある. 当施設の経験をもとに, そのような事態を回避する方法やその予防を検討した.【方法】過去10年間の頸動脈疾患の治療経験 (CEA 188, CAS 127, 頸動脈再建 3など) からトラブルシューティングが必要であった代表症例の術中動画を検討し安全な対策や予防の確立を試みた.【結果】(1) 高度の石灰化症例の動脈遮断：総頸動脈が高度に石灰化している, Domestic conference頸動脈病変治療におけるトラブルシューティングとリスク回避Public symposium
- 一般社団法人日本脳神経外科学会第76回学術総会, Oct. 2017, Japanese, 日本脳神経外科学会, 名古屋, Domestic conference手術解剖に基づいた傍正中部頭蓋底病変への経鼻内視鏡下アプローチ[Invited]Nominated symposium
- 第76回日本脳神経外科学会総会, Oct. 2017, Japanese, 日本脳神経外科学会, 名古屋, Domestic conferenceUsefulness of 3D-DSA fusion imaging in patients with dAVFPoster presentation
- 日本脳神経外科学会第76回学術総会, Oct. 2017, Japanese, 日本脳神経外科学会, 名古屋, 目的：経鼻内視鏡下手術についても術中MRIの有用性が報告されているが、3T術中MRIの報告は依然少ない。当科での経鼻内視鏡手術における3T術中MRIの使用経験をもとに、その有用性を検討した。対象と方法：当施設にて、3T術中MRI（MAGNETOM Skyra, Siemens）を導入した2015年3月以降、2017年5月現在までの2年2か月間において、120例の術中MRI検査を施行した。このうち、術中MRIを施行した経鼻内視鏡手術40例を対象とした。内訳は、下垂体腺腫21例、頭蓋咽頭腫8例（再発による同一患者1名）、脊索腫・軟骨肉腫5例、その他6例であった。いずれも同一術者（M.T.）にて執刀された。術中MRIの使用適否は、大型腫瘍や側方進展、隔壁形成・多房性腫瘤、再発例など摘出操作困難が予測される症例について、原則として術者判断にて決定された。術中, Domestic conferenceTransnasal Endoscopic Surgery with 3T-intraoperative MRIOral presentation
- 第76回 日本脳神経外科学会学術総会, Oct. 2017, Japanese, 日本脳神経外科学会, 東京, Domestic conferenceグリオーマ手術における術中MRSによる残存病変同定に関する検討Poster presentation
- 日本脳神経外科学会第 76 回学術総会, Oct. 2017, Japanese, 日本脳神経外科学会, 名古屋, 【目的】MRAの任意血管信号の選択的除去が可能なpencil beam presaturation pulse (BeamSAT)を用いて、対側ICAおよび椎骨動脈の信号除去し、病側ICAのみの”ICA-selective MRA”を作成することができる。これによりWillis動脈輪の前方部(前大脳動脈(ACA):A1部および前交通動脈(Acom))の詳細な血流評価を行い、内頚動脈遮断時虚血耐性の予測を試みた。【方法】術中一時内頚動脈遮断を行った、頚部内頚動脈狭窄症手術症例45例(CEA:30例、CAS:, Domestic conferenceBeamSAT MRAによる内頚動脈狭窄症 手術時の虚血耐性評価Oral presentation
- 第4回日本心血管脳卒中学会学術集会, Jun. 2017, Japanese, 日本心血管脳卒中学会, 福岡, 【目的】MRAの血管信号の選択的除去が可能なpencil beam presaturation pulse (BeamSAT)を用いて内頚動脈(ICA)遮断時の虚血耐性の予測を試みた。【方法】頚動脈狭窄症で病側ICA信号をBeamSATで除去した画像を、元のMRAよりsubtractionすることで、病側ICAのみを描出する”ICA-selectiveMRA”を作成した。頚動脈狭窄症34例(CEA22例、CAS 12例)の術前に、BeamSAT法でのAcom血流および従来のMRAで後交通動脈(Pcom)血, Domestic conferenceBeamSAT MRIによる 内頚動脈狭窄症手時の虚血耐性評価Oral presentation
- 第29回日本頭蓋底外科学会, Jun. 2017, Japanese, 日本頭蓋底外科学会, 松本, Domestic conference3T-術中MRI支援下経鼻内視鏡下手術の有用性と問題点についてOral presentation
- 第46回日本脳卒中の外科学会, Mar. 2017, Japanese, 日本脳卒中の外科学会, 大阪, Domestic conferenceEmbolization for spinal arteriovenous fistulaPoster presentation
- The 17th Annual Meeting of the Japanese Society of Intraoperative Imaging, Mar. 2017, Japanese, Japan Society of Intraoperative Imaging, 鹿児島, Domestic conferenceグリオーマ手術における術中MRSの現状と近未来Public symposium
- STROKE 2017, Mar. 2017, Japanese, The Japan Stroke Society, 大阪, Domestic conferenceCS dAVFに対するTVE後の留置コイルと外転神経麻痺に関する検討Oral presentation
- 第 42 回日本脳卒中学会学術集会, Mar. 2017, Japanese, 日本脳卒中学会, 大阪, 【序言】pencil Beam型presaturation pulse(BeamSAT Pulse)の使用でMRI血管信号の選択的除去が可能となり、選択除去されたMRA(BeamSAT MRA)を、通常のMRAからsubtractionすることで、Beam SAT pulseが付加された血管のみを描出でき(Sub-BeamSAT MRA)、特に前交通動脈(Acom)の血流の評価に有用である。そこで，本法によるAcom血流評価と頚動脈狭窄症手術における内頚動脈遮断時虚血耐性の関連を検討した．【方法】内頚動脈, Domestic conferenceBeamSAT MRAによる内頚動脈狭窄症 手術時の虚血耐性評価と脳内酸素飽和度 測定による検証Oral presentation
- 第32回日本脳神経血管内治療学会総会, Nov. 2016, Japanese, 日本脳神経血管内治療学会, 神戸, 【緒言】頭蓋内硬膜動静脈瘻（dAVF）に対する経静脈的塞栓術（TVE）は確立された治療であるが，欧米ではOnyxによる経動脈的塞栓術（TAE）の普及によりdAVFの治療が大きく変わりつつある．本邦でのdAVFに対するOnyxの保険適応が目前に迫る今，当科における頭蓋内dAVFに対する治療を検討し，液体塞栓物質によるTAEの役割について報告する．【対象】2007年4月以降に経験した脊髄を除く頭蓋内dAVF 88例を対象とした．部位は海綿静脈洞（CS）38例，横-S状静脈洞（TS-SS） 29例，舌下神経管（ACC）4例，テント（Tent）7例，上矢状静脈洞(SSS)5例，前頭蓋底（ACB）1例，中頭蓋窩（MF） 1例，直静脈洞（SS）2例，後頭静脈洞（OS）1例．【結果】CSはコイルによるTAE1例をのぞき全例TVEで根治を得た．TS-SS 24/29, Domestic conference頭蓋内硬膜動静脈瘻における液体塞栓物質の役割：Onyx時代を目前にしてPoster presentation
- 第59回日本脳循環代謝学会学術集会, Nov. 2016, Japanese, 日本脳循環代謝学会, 徳島, Domestic conferenceTerritorial Arterial Spin Labelingを用いた頸動脈狭窄症患者における術前後の灌流域評価Oral presentation
- The 32nd Annual Meeting of The Japanese Society for Neuroendovascular Therapy, Nov. 2016, Japanese, The Japanese Society for Neuroendovascular Therapy, 神戸, Domestic conferencePenumbra 5MAX ACE導入前後での急性期再開通療法の治療成績の比較Poster presentation
- 第59回日本脳循環代謝学会学術集会, Nov. 2016, Japanese, 日本脳循環代謝学会, 徳島, Domestic conferenceBeamSAT MRIを用いた 内頚動脈狭窄症手術時の一時遮断に 対する、不耐性予測因子の検討Public symposium
- The 75th Annual Meeting of the Japan Neurosurgical Society, Oct. 2016, Japanese, The Japan Neurosurgical Society, 福岡, Domestic conferenceグリオーマ手術における術中MRSの有用性に関する検討Oral presentation
- 第72回日本脳神経外科学会近畿支部学術集会, Sep. 2016, Japanese, 日本脳神経外科学会, 大阪, Domestic conference大腿動脈グラフトの外科的露出・直接穿刺により一期的に治療しえた頚動脈・腕頭動脈狭窄の1例Oral presentation
- 第75回日本脳神経外科学会総会, Sep. 2016, Japanese, 日本脳神経外科学会, 福岡, 【緒言】鎖骨下動脈の慢性完全閉塞（Chronic total occulusion: CTO）に対する血行再建術は，我々脳神経外科医が治療する機会も多い．しかしながら，頭頸部の血管内治療ではCTO病変が治療対象となることはほとんどなく，そのデバイス選択に関して議論されることは少ない．我々のデバイス選択，治療結果につき報告する．【対象】2006年以降に当科及び関連施設で治療した左鎖骨下動脈病変23例のうち，CTO病変8例を対象とした．治療適応は鎖骨下動脈盗血症候群を呈する症例，ないしは血圧左右差20mmHg以上を有する症例とした．椎骨動脈のプロテクションを併用した経大腿動脈経由(TFA)でステント留置を行うことを基本とし，CTOの通過方法により二群に分けて検討した．前期群は頭頸部領域で使用する0.014-0.016 inchマイクロガイドワイヤーでTF, Domestic conference鎖骨下動脈慢性完全閉塞症に対するデバイス選択Poster presentation
- 第21回日本脳腫瘍の外科学会, Sep. 2016, Japanese, 日本脳腫瘍の外科学会, 東京, Domestic conferenceグリオーマ摘出術における3.0-Tesla術中MRスペクトロスコピーの有用性の検討Oral presentation
- 日本脳神経外科学会第 75 回学術総会, Sep. 2016, Japanese, 日本脳神経外科学会, 福岡, Domestic conferenceCEA/CAS による相補的な治療に おける高難度症例の治療と成績Public symposium
- 日本脳神経外科学会第 75 回学術総会, Sep. 2016, Japanese, 日本脳神経外科学会, 福岡, Domestic conferenceBeamSAT MRIを用いた 内頚動脈狭窄症手術時の一時遮断に 対する、不耐性予測因子の検討Oral presentation
- 第75回日本脳神経外科学会学術総会, Sep. 2016, Japanese, 日本脳神経外科学会, 福岡, Domestic conferencePerioperative assessment of cerebral perfusion territories through arterial spin labeling magnetic resonance imaging in patients with carotid stenosisOral presentation
- the 16th European Congress of Neurosurgery, Sep. 2016, English, European Association of Neurosurgery societies, Athens, Greece, International conferencePerioperative assessment of cerebral perfusion territories through arterial spin labeling magnetic resonance imaging in patients with carotid stenosisPoster presentation
- 第31回日本脳神経外科国際学会フォーラム, Jul. 2016, Japanese, 日本脳神経外科同時通訳団, 福岡, Domestic conferenceナビゲータ・術中MRIを併用した経鼻内視鏡下手術[Invited]Invited oral presentation
- The 16th Annual Meeting of the Japanese Society of Intraoperative Imaging, Jul. 2016, Japanese, Japan Society of Intraoperative Imaging, 松山, Domestic conferenceグリオーマ手術における術中MRSの有用性に関する検討Oral presentation
- 第3回日本心血管脳卒中学会学術集会, Jun. 2016, Japanese, 日本心血管脳卒中学会, 品川, Domestic conference頸動脈狭窄症に対する CEA と CAS の相補的な適応選択とそ の成績[Invited]Nominated symposium
- 第3回日本心血管脳卒中学会学術集会, Jun. 2016, Japanese, 日本心血管脳卒中学会, 品川, Domestic conference頚動脈狭窄病変におけるMRI・BeamSAT 画像による選択的脳血管灌流領域評価 による術中虚血耐性の予測Oral presentation
- 第45回 日本脳卒中の外科学会学術集会, Apr. 2016, Japanese, 脳卒中の外科学会, 札幌, Domestic conference高齢者の頚動脈狭窄症に対する治療成績からみた周術期管理の留意点の検討Oral presentation
- Stroke 2016, Apr. 2016, Japanese, The Japan stroke society, 札幌, Domestic conferenceAcetazolamide を用いない各種脳循環動態評価法の臨床的有用性 の検証Public symposium
- International Stroke Conference 2016, Feb. 2016, English, American Heart Association, American Stroke Association, Los Angeles, USA, International conferenceLong-term outcomes of carotid endarterectomy and carotid artery stenting: real-world status of single institute in japanPoster presentation
- The 31st Annual Meeting of the Japanese Society for Neuroendovascular Therapy, Nov. 2015, Japanese, The Japanese Society for Neuroendovasucular Therapy, 岡山, Domestic conference海綿静脈洞部硬膜動静脈瘻(CS dAVF)に対する経静脈的塞栓術(TVE)Oral presentation
- 第31回日本脳神経血管内治療学会総会, Nov. 2015, Japanese, 日本脳神経血管内治療学会, 岡山, 【緒言】硬膜動静脈瘻（dAVF）の治療では経静脈的塞栓術（TVE）が第一選択となるが，罹患静脈洞の血栓化等によりそのアプローチが妨げられる場合もある．isolated sinusを呈する横-S状静脈洞（TS/SS）部dAVFに対する当科での治療戦略を報告する．【対象】2008年以降治療したTS/SS部dAVF 25例中，isolated sinusを呈した11例を対象とした．年齢は53-83歳，男性7例，女性4例，発症様式は脳出血9例，痙攣1例，1例は急性期脳梗塞の精査で発見．罹患静脈洞は左側 8例，右側 3例．【結果】小切開による静脈洞直接穿刺によるTVEを行った症例が1例．発症時の血腫が大きく，開頭血腫除去が必要となった1例に対しては，開頭時に露出された静脈洞に対して直接穿刺TVEを行っている．アプローチ困難と考えられた1例に対してはOnyxによ, Domestic conferenceTreatment strategy for patients with isolated transverse sigmoid sinus dural arteriovenous fistulasPoster presentation
- 第27回脳循環代謝学会総会, Oct. 2015, Japanese, 日本脳循環代謝学会, 富山, Domestic conference頸動脈狭窄病変におけるMRI・BeamSAT撮像による選択的脳血管灌流領域の評価Oral presentation
- 一般社団法人・日本脳神経外科学会第74回学術総会, Oct. 2015, Japanese, 日本脳神経外科学会, 札幌, Domestic conference傍斜台部病変に対する経鼻内視鏡下手術 ―各病変首座に応じた進入経路の選択―Oral presentation
- 日本脳神経外科学会第74回学術総会, Oct. 2015, Japanese, 日本脳神経外科学会, 札幌, Domestic conferenceClinical outcomes of intrathecal baclofen therapy in our institutePoster presentation
- 日本脳神経外科学会 第74回学術総会, Oct. 2015, Japanese, 日本脳神経外科学会, 札幌, Domestic conference自施設の短期及び長期治療成績と文献資料に基づく頸動脈狭窄症の治 療戦略Oral presentation
- 日本脳神経外科学会 第74回学術総会, Oct. 2015, Japanese, 日本脳神経外科学会, 札幌, 【緒言】頭蓋内硬膜動静脈瘻（dAVF）に対する塞栓術では，多くの症例で経静脈的塞栓術（TVE）が選択され，根治が得られることが多い．しかし，TVEが困難なため経動脈的塞栓術（TAE）が第一選択になる場合や，TVEで根治出来なかった場合にTAEの追加が必要になる場合もある．当科における頭蓋内dAVFに対する治療を検討し，液体塞栓物質を用いたTAEの役割について報告する．【対象】2007年4月以降に当科及び関連病院で経験した脊髄を除く頭蓋内dAVF 72例．部位は海綿静脈洞（CS）部 35例，横-S状静脈洞（TS-SS）部 23例，舌下神経管（ACC）部 4例，テント（T）部 4例，上矢状静脈洞(SSS)部 3例，前頭蓋底（ACB）部 1例，中頭蓋窩（MF）部 1例，直静脈洞（SS）部 1例．【結果】CS部はコイルを用いたTAE1例をのぞき全例TVEで治, Domestic conferenceUsefulness of gule embolization for the treatment of dural arteriovenous fistulasPoster presentation
- 第27回日本脳循環代謝学会総会, Oct. 2015, Japanese, 日本脳循環代謝学会, 富山, Domestic conference頚動脈狭窄病変におけるMRI・BeamSAT撮像による選択的脳血管灌流領域の評価Oral presentation
- The 74th Annual Meeting of the Japan Neurosurgical Society, Oct. 2015, Japanese, The Japan Neurosurgical Society, 北海道, Domestic conference海綿静脈洞部硬膜動静脈瘻(CS dAVF)に対する経静脈的塞栓術(TVE)Oral presentation
- 第13回日本Awake surgery学会, Sep. 2015, Japanese, 日本Awake surgery学会, 名古屋, Domestic conference初発・再発時に覚醒下手術を2度行った優位半球言語野近傍グリオーマの1例Oral presentation
- 15th INTERIM MEETINGOF THE WORLD FEDERATIONOF NEUROSURGICAL SOCIETIES, Sep. 2015, English, THE WORLD FEDERATIONOF NEUROSURGICAL SOCIETIES, Rome, Italy, International conferenceLong-term outcomes of carotid endarterectomy and carotid artery stenting for carotid artery stenosis: real-world status in japanOral presentation
- The 34th Annual Meeting of the Mt. Fuji Workshop on CVD, Aug. 2015, Japanese, The Mt. Fuji Workshop on CVD, 兵庫, Domestic conference急性M2閉塞に対するPenumbra ACEを用いたdirect aspirationの有用性Poster presentation
- 第45回兵庫県脳神経外科医懇話会, Jul. 2015, Japanese, 兵庫県脳神経外科懇話会, 神戸, Domestic conference当院における頚動脈狭窄症に対する血行再建術（CEA/CAS）の中長期成績と周術期抗血栓療法Keynote oral presentation
- The 18th Annual Congress of Japan Association of Neurosurgical Clinics, Jul. 2015, Japanese, The Japan Association of Neurosurgical Clinics, 兵庫, Domestic conference術中3Tesla MRIシステムの導入と初期使用経験Oral presentation
- 兵庫県脳神経外科懇話会, Jul. 2015, Japanese, 兵庫県脳神経外科懇話会, 兵庫, Domestic conference開頭腫瘍摘出術後に発症したヘパリン起因性血小板減少症の一例Oral presentation
- The 15th Annual Meeting of the Japan Society of Intraoperative Imaging, Jun. 2015, Japanese, The Japan Society of Intraoperative Imaging, 東京, Domestic conference術中3Tesla MRIシステムの導入と初期運用経験Oral presentation
- 第2回日本心血管脳卒中学会学術集会, Jun. 2015, Japanese, 日本心血管脳卒中学会, 徳島, Domestic conference80歳以上の高齢者の頚動脈狭窄症に対する血行再建術（CEA/CAS）の長期予後Oral presentation
- The 24th Conference on Neurosurgical Techniques and Tools, Apr. 2015, Japanese, Conference on Neurosurgical Techniques and Tools, 大阪, Domestic conferenceマルチデバイスに対応した画像統合機能を有する術中MRIシステムの導入[Invited]Nominated symposium
- Stroke 2015, Mar. 2015, Japanese, 日本脳卒中学会, 広島, Domestic conference当院におけるnon-sinus type dAVFに対する治療Oral presentation
- Stroke 2015, Mar. 2015, Japanese, 日本脳卒中学会, 広島, Domestic conference当院での急性期脳主幹動脈閉塞に対する再開通療法の治療成績 - 院内発症と院外発症例の比較検討 -Oral presentation
- Stroke 2015, Mar. 2015, Japanese, 日本脳卒中学会, 広島, Domestic conference頚動脈内膜剥離術 (CEA) と頚動 脈ステント (CAS) の中長期成績Oral presentation
- 第44回日本脳卒中の外科学会, Mar. 2015, Japanese, 日本脳卒中の外科学会, 広島, 【緒言】Wide neck動脈瘤に対してステント支援下脳動脈瘤コイル塞栓術の有用性が報告されている．現在，本邦で使用可能なステントは，closed cellタイプのEnterprise VRD（E）と，open cellタイプのNeurofrom EZ（N）であり，各々のステントの特性が異なる．我々は2例の脳底動脈瘤に対してYステント支援下脳動脈瘤塞栓術を施行し，その経過により二つのステント特性を良く示す結果が得られたので報告する．【症例】症例１は65歳，男性，最大径11.5mm，neck 8.8mmの脳底動脈瘤，症例2は71歳，男性，最大径8.7mm，neck 7.6mmの脳底動脈瘤に対して同一手技を用いてYステント支援下脳動脈瘤コイル塞栓術を施行した．瘤内にJail用マイクロカテーテルを留置した後に，左後大脳動脈（PCA）から脳底動脈（BA）へN, Domestic conferenceChanges of angioarchitecture after Y-stent-assisted coil embolization for cerebral aneurysmPoster presentation
- Stroke 2015, Mar. 2015, Japanese, 日本脳卒中学会, 広島, Domestic conferenceYステント支援下脳動脈瘤コイル塞栓術後に生じる血管構築変化に関する検討Oral presentation
- 第88回日本薬理学会, Mar. 2015, Japanese, 日本薬理学会, 名古屋, Domestic conferenceRadial migration of cerebellar granule neuron regulated by Rac through a new signaling pathway.Oral presentation
- 第30回日本脳神経血管内治療学会総会, Dec. 2014, Japanese, 日本脳神経血管内治療学会, 東京, 【緒言】特殊な先端形状と強力なバックアップ性能を有した8Fr NeuroEBUカテーテルは，主としてガイディングカテーテル（GC）留置困難症例においてエクスチェンジ用のサポートワイヤーを留置する目的で使用される．このカテーテルのサポート性能を生かすことで，症例によっては治療の際にGCとして使用することも可能であり，当科での経験を報告する．【対象・結果】GCを留置するためのサポートワイヤー留置目的で右側病変3例，左側病変1例に対してNeuroEBUを使用した．一方でNeuroEBUをGCとして5例の症例に使用．男性3例，女性2例，年齢62-80歳，頸動脈ステント留置（CAS）用のGCとして4例，左鎖骨下動脈閉塞症での閉塞部通過に際してのバックアップとして1例に使用．CASではType III arch症例でGC留置困難が予測される症例に対して使用を予定, Domestic conference血管内治療における8Fr NeuroEBUカテーテルの有用性Oral presentation
- 第30回日本脳神経血管内治療学会総会, Dec. 2014, Japanese, 日本脳神経血管内治療学会, 横浜, Domestic conferenceMiddle and Long-term Outcomes for Carotid Artery Stenosis with CEA or CASOral presentation
- 第30回 日本脳神経血管内治療学会学術総会, Dec. 2014, Japanese, 日本脳神経血管内治療学会, 横浜, Domestic conferenceTAEで治療し得たnon-sinus type dural AVFの2例Poster presentation
- 第21回日本神経内視鏡学会, Nov. 2014, Japanese, 日本神経内視鏡学会, 東京, Domestic conference硬膜外傍正中頭蓋底病変に対する経鼻内視鏡手術 -進入経路の解剖学的・臨床的検討-Public symposium
- 日本脳神経外科学会第73回学術総会, Oct. 2014, Japanese, 日本脳神経外科学会, 東京, Domestic conference錐体尖下部・斜台下部外側病変に対する経鼻内視鏡下アプローチPublic symposium
- 日本脳神経外科学会第 73 回学術総会, Oct. 2014, Japanese, 日本脳神経外科学会, 東京, Domestic conference頚動脈狭窄症に対する頚動脈内膜 剥離術 (CEA) と頚動脈ステント (CAS) の中長期成績Oral presentation
- 第73回 日本脳神経外科学会学術総会, Oct. 2014, Japanese, 日本脳神経外科学会, 東京, Domestic conference海綿静脈洞部硬膜動静脈瘻に対する経大腿静脈-顔面静脈-上眼静脈アプローチPoster presentation
- 第73回日本脳神経外科学会総会, Oct. 2014, Japanese, 日本脳神経外科学会, 東京, 【緒言】頸動脈ステント留置術（CAS）のラーニングカーブは比較的早いとされ，術者として独り立ちまでの期間，症例数も多くを必要としないと言われている．しかし，実際の臨床では様々なpitfallがあり，十分な経験を積むまでは指導者の役割も大きいと考える．当科におけるCASの術者育成とその治療成績について検討した．, Domestic conference安全に頸動脈ステント留置術を行うために指導者は必要かOral presentation
- 日本脳神経外科学会第 73 回学術総会, Oct. 2014, Japanese, 日本脳神経外科学会, 東京, Domestic conference80歳以上の高齢者頚動脈狭窄症に対する血行再建術(CEA/CAS)の中長期成績Oral presentation
- 第68回日本脳神経外科学会近畿支部学術集会, Sep. 2014, Japanese, 日本脳神経外科学会, 大阪, Domestic conferenceTVE後の意図しない皮質静脈逆流残存にTAE追加を要したTS-SS部硬膜動静脈瘻の1例Oral presentation
- 第20回 日本血管内治療学会総会, Jun. 2014, Japanese, 日本血管内治療学会, 和歌山, Domestic conference特発性頸部内頸動脈解離に対する急性期ステント留置術に関する検討Oral presentation
- 第26回日本頭蓋底外科学会, Jun. 2014, Japanese, 日本頭蓋底外科学会, 千葉, Domestic conference錐体尖下部・斜台下部外側病変に対する経鼻的内視鏡下手術Public symposium
- STROKE2014, Mar. 2014, Japanese, STROKE, 大阪, 【目的】当施設でのCEA/CASの成績を調査し無症候性頚動脈狭窄症に対する治療の現状と課題を検討した。【対象と方法】対象は当施設で7年間に施行した210例（CEA 125、CAS 85）、無症候性121例（CEA 69、CAS 52）、症候性89例（CEA 56、CAS 33）であった。RCTに基づき適応を決定。全麻不可はCASとした。【結果】(1) 無症候性群と症候性群の間で、年齢（70.9 vs 72.7）、男女比（103/18 vs 79/10）、狭窄率（75.1% vs 76.5%）、CEA/CAS比率（69/52 vs 56/33）に有意差なし。(2) 冠動脈疾患と大動脈疾患の罹患率は症候性群の方が高かったが（17% vs 25%）、有意差なし。(3) 無症候性から症候性となった5例はMRIやエコーでsoft plaqueであった。(4), Domestic conferenceStatus and problems of surgical treatment for asymptomatic carotid stenosisPublic symposium
- STROKE2014, Mar. 2014, Japanese, STROKE, 大阪, ＜緒言＞頭蓋頸椎移行部硬膜動静脈瘻(CCJ-DAVF)は直達手術により加療されることが多い。確実な治療のためには、術前診断、術中確認が重要と考える。当院での経験症例について考察する。＜方法＞2003年9月～ 2013年9月に当院で治療をおこなったCCJ-DAVFを対象とした。＜結果＞症例は6例、男性4例、女性2例、平均年齢69.5才（50-81才）であり、SAH発症が3例、myelopathy発症が3例であった。feederはいずれもC1 radiculomedullary artey、drainerはanterior spinal veinが4 例、lateral medullaryvein(LMV)が1例、LMV+transverse pontine veinが1例であった。診断にはMRI、DSAを用い、特に直近3例では3D-CTAまたは3D-D, Domestic conference当院での頭蓋頸椎移行部硬膜動静脈瘻6例の検討Oral presentation
- 第29回NPO法人 日本脳神経血管内治療学会学術総会, Nov. 2013, Japanese, 日本脳神経血管内治療学会, 新潟, 緒言:特発性頸部内頸動脈解離では内科的治療が推奨されるが、内科的治療抵抗性で塞栓症を繰り返す例や血行動態不安定性を示す例に対する血行再建の報告も散見される。特発性頸部内頸動脈解離3例を経験し、急性期血行再建の適応に関して検討した。症例1:55才女性、主訴は右耳鳴と左手痺れ、MRIでは右大脳半球急性期梗塞と右内頸動脈解離あり。DSAでは右頸部内頸動脈遠位部に47％狭窄(NACSET法)を認めたが灌流遅延(-)。内科的治療を行い、その後新たな症状はなく画像所見も改善。症例2:49才男性、左片麻痺で発症、エコーでは右内頸動脈血流低下、3D-CTAでは右内頸動脈狭窄(+)、ペースメーカーのためMRI不可。DSAでは右内頸動脈分岐部～cervical portionに至る解離があり灌流遅延(+)。直ちにステント留置施行、術後CTでは右大脳半球に梗塞を認めたが新, Domestic conference特発性頚部内頚動脈解離に対するステント留置術に関する検討Oral presentation
- 第29回NPO法人 日本脳神経血管内治療学会学術総会, Nov. 2013, Japanese, 日本脳神経血管内治療学会, 新潟, 【緒言】脊髄動静脈瘻(sAVF)に対する塞栓術を成功させるには，シャント近傍までマイクロカテーテルを誘導することが重要であり，そのためにはガイディングカテーテルのサポートが重要である．sAVFに対する我々の施設の治療結果を検討し，治療の際の工夫を報告する．【対象】2009年6月以降に当科において治療を行ったsAVF 13例，14病変（異なるレベルに生じた多発病変の1例を含む），男性12例，女性1例を対象とした．dural AVF 10例，perimedullary AVF 3例，病変の存在部位は胸髄6例，腰髄5例，仙髄2例．血管撮影に先行して64列MDCTを施行して病変レベルを同定し，診断血管撮影と同時セッションで経動脈的塞栓術(TAE)を施行した．【結果】14病変に対して15回のセッションで治療を行い，8/14病変（57%）でTAEのみで完全閉塞が, Domestic conferenceEmbolization for spinal arteriovenous fistulaOral presentation
- 第124回日本薬理学会近畿部会, Nov. 2013, Japanese, The Japanese Pharmacological Society, 京都, 【背景】Rhoファミリー低分子量G蛋白質であるRacは、細胞分裂・周期や細胞遊走などに関与することが知られている。一方、アストロサイトが中枢神経回路網の発生誘導・支持などに機能することは周知の事実であるが、神経損傷後の機能は複雑で、回復促進及び回復阻害のいずれの作用も報告がなされている。【方法】アストロサイト特異的Rac1 KOマウスを作製し、SPring8による微小放射線脳損傷及び圧挫による脊髄損傷を作製し、野生型マウスとの比較検討を行なった。【結果】小脳顆粒細胞に対する微小放射線脳損傷の検討では、 Rac1 KOマウスの損傷周囲のアストロサイトのGFAP染色性は低下し、小脳顆粒細胞の脱落幅も縮小していた（15.6μm vs 18.5μm）。BMS（Basso Mouse Scale）スコアを用いた脊髄損傷後の運動機能評価では、Rac1 KOマウス, Domestic conferenceアストロサイト特異的 Rac1 ノックアウト（KO）による神経損傷後の機能回復促進Oral presentation
- The 72nd Annual Meeting of the Japan Neurosurgical Society, Oct. 2013, Japanese, Annual Meeting of the Japan Neurosurgical Society, 横浜, 【背景】Rhoファミリー低分子量Gタンパク質の1つであるRacは、細胞極性決定、細胞遊走など様々な機能に関与しているが、不明な点も多い。一方、アストロサイトは中枢神経回路網の支持、発生誘導などの働きを有するが、神経損傷後の機能は複雑で、回復促進および回復阻害のいずれの作用も報告されている。本研究では、アストロサイト特異的Rac1ノックアウト (KO) マウスを作製し、神経損傷後のアストロサイトの機能について検討した。尚、我々は以前から高輝度放射光施設(SPring-8)のマイクロビームX線照射による微小脳損傷モデルを用いた検討を行っており、本研究においても併用した。【方法】アストロサイト特異的Rac1 KOマウスに対して、微小脳損傷および脊髄損傷を作成し、野生型マウスとの比較検討をおこなった。【結果】小脳に対する微小脳損傷の検討では、小脳顆粒細胞の脱, Domestic conference神経損傷後の機能回復には低分子量G蛋白質Rac1を介したアストロサイト制御が関与するPoster presentation
- The 72nd Annual Meeting of the Japan Neurosurgical Society, Oct. 2013, Japanese, Annual Meeting of the Japan Neurosurgical Society, 横浜, 【目的】当施設でのCEA/CASの成績を基にハイリスクの頚動脈狭窄症に対する治療の現状と課題を検討した.【対象と方法】対象は6.5年間に施行した196例（CEA115，CAS81）．RCTに基づき外科医と血管内治療医が相談し適応決定．負荷心電図と呼吸機能より全麻不可はCASとした.【結果】(1) 全成績：死亡率 CEA 0, CAS 1/81 (1.2%)．脳梗塞 CEA 3/115 (2.6%), CAS 3/81 (3.7%)．(2) 80歳以上29例 (14.8%) CEA 16 (脳梗塞 1 [6.3%]), CAS 13 (ARDSで死亡 1 [7.7%])．80歳未満 CEA 99 (脳梗塞 2 [2%]), CAS 68 (脳梗塞 3 [4.4%])．有意差なし. (3) 対側内頚動脈閉塞11例 (5.6%) CEA 6, CAS 5, Domestic conferenceハイリスクの頸動脈狭窄症に対する治療の現状と課題Public symposium
- The 25th Annual Meeting of Japanese Society for Skull Base Surgery, Jun. 2013, Japanese, Annual Meeting of Japanese Society for Skull Base Surgery, 名古屋, 経鼻的内視鏡手術は、その特殊な術野のため新たな解剖学的知識の習得を必要とする。海綿静脈洞を中心とした傍鞍部はそのフロンティア領域のひとつとも言えるが、本法の頭蓋底腫瘍への適応拡大に際しては同部位の解剖学的知識の習得がより重要と考え、屍体献体を用いた検討を行った。ホルマリン固定した18献体において実際の手術を忠実に再現するよう経鼻的内視鏡下に傍鞍部へのアプローチは内頚動脈の背側(medial)、腹側(lateral)の各corridorに分けて検討し、斜視鏡も用いた手術における実際の留意点を、特に内頚動脈および脳神経との関連において提示する。Optico-carotid recessなどの骨上の指標を対応する硬膜内解剖であるproximal/distal ringと対比させ、proximal ringの内側への延長と推測される、内頚動脈C3部から鞍隔膜, Domestic conferenceSurgical anatomy for endoscopic transasal skull base surgery[Invited]Nominated symposium
- 第12回日本頸部脳血管治療学会, Jun. 2013, Japanese, 日本頸部脳血管治療学会, 東京, 【症例】60歳男性 CABG目的で当院に紹介入院となった冠動脈3枝病変の不安定狭心症患者.狭心症発作は寒冷刺激や食後に胸痛で出現し,(CCSクラスIII)入院後も頻発していたため心臓血管外科入院時より持続ヘパリン静注を行っていた.術前検査の頚動脈エコーにて無症候性両側高度内頚動脈狭窄(右ICA-PSV390.3 cm/sec（等～高輝度,潰瘍あり）,左ICA-PSV 330 cm/sec（低～等輝度）)を指摘され,当科紹介となった.MR plaque imagingでは,T1で等信号,T2で高信号であり,stable plaqueの所見であった.また,大動脈弓部に及ぶ著明なshaggy aortaであり,CKDステージ4の腎機能障害を認めていた.心臓血管外科が頚動脈狭窄の治療優先を強く希望するためCABGに先行して頚動脈狭窄の治療を行うこととした.全, Domestic conferenceCABG直前に指摘された両側高度内頚動脈狭窄症の一例Oral presentation
- 第12回日本頸部脳血管治療学会, Jun. 2013, Japanese, 日本頸部脳血管治療学会, 東京, 【目的】最近のCRESTなどのstudyの結果は、高齢者頚動脈狭窄症に対してCASよりもむしろCEAの周術期治療成績が優れていることが示されているが、長期予後は明らかではない。今回われわれは、当施設での超高齢者頚動脈狭窄症に対する血行再建術の中長期予後を検討した。【対象と方法】2006年8月から2012年12月に当施設で施行した181例の頚動脈狭窄症に対する血行再建術のうち、80歳以上を超高齢者としてCEAとCASの治療成績および中長期予後を検討した。CEAまたはCASの選択は、高齢者であっても心肺合併症や高位病変などのリスクがない限りCEA firstを原則とした。【結果】181例中27例が80歳以上の超高齢者群であった。治療法のうちわけは、CEA 15例、CAS 12例であった。超高齢者群において、症候性狭窄、年齢と狭窄率は、CEA群（73.3%, Domestic conference80歳以上の超高齢者頚動脈狭窄症に対する血行再建術(CEA/CAS)の中長期予後Oral presentation
- 第26回日本老年脳神経外科学会, Mar. 2013, Japanese, 日本老年脳神経外科学会, 東京, 高齢者のくも膜下出血の予後は一般的に不良と言われ、その治療適応、手段などについて未だ議論が絶えない。我々はこれまで80歳以上の高齢者においても全身状態に問題がなければ重症度に関わらず積極的に急性期開頭クリッピング術を第一選択としてきた。その治療成績について検討する。【方法】2007年4月より2012年6月までに急性期破裂脳動脈瘤クリッピング術を施行したのは219例で、内80歳以上の37例（17％）を対象とした。原則来院24時間以内にクリッピング術を施行、術後の血圧管理はnormotensionとし積極的なtriple H療法は行わず。また2010年3月以降の18例は80歳未満の症例と異なり術後脳血管攣縮予防のための低分子デキストランの点滴は行わずに管理。また同時期からくも膜下出血術後には年齢を問わず脳血管攣縮予防の観点からシロスタゾール内服を行った。, Domestic conference80歳以上高齢者くも膜下出血直達術の治療成績Public symposium
- Japanese Journal of Radiology, Feb. 2013, Japanese, (公社)日本医学放射線学会眼窩内から海綿静脈洞にみられたSolitary fibrous tumorの1例
- 第28回日本血管内治療学会学術総会, Nov. 2012, Japanese, 日本血管内治療学会, 仙台, 【緒言】当科では腎機能障害，造影剤アレルギー等を有する患者に対して，造影剤を使用せずに超音波ガイド下頸動脈ステント留置術（CAS）を行ってきた．当科での治療成績を検討し，問題点を報告する．【対象および方法】腎機能障害や造影剤アレルギーの既往がある患者で，頸動脈エコーで病変部が明瞭に観察出来る（石灰化に乏しい症例）場合に超音波ガイド下CASを考慮した．大動脈弓及び下肢のMRAにより，アプローチルートを決定した．【結果】10例の患者に対して，11回の超音波ガイド下CASを施行（1例でCarotid Wallstentの短縮により，追加ステントを要した）．64-86歳，全例男性，無症候性8例，症候性2例，造影剤使用不可の原因は慢性腎不全9例，ヨード造影剤アレルギーの既往1例であった．TAA術前の1例は右上腕動脈経由，他の9例は大腿動脈経由でdistal p, Domestic conference超音波ガイド下頚動脈ステント留置術Oral presentation
- 第28回日本血管内治療学会学術総会, Nov. 2012, Japanese, 日本血管内治療学会, 仙台, 【目的】最近のCRESTなどのstudyの結果は高齢者の頚動脈狭窄症に対してCASよりもむしろCEAの成績が優れていることが示されている。今回われわれは、当施設での高齢者頚動脈狭窄症に対する血行再建術の治療成績を検討した。【対象と方法】2006年8月から2012年5月に当施設で施行した164例の頚動脈狭窄症に対する血行再建術のうち、75歳以上を高齢者として、CEAとCASの治療成績を検討した。【結果】164例中65例(39.6%)が75歳以上の高齢者群であった。治療法のうちわけは、高齢者群でCAS 23例(35.4%)、CEA 42例(64.6%)、非高齢者群でCAS 42例(42.4%)、CEA 57例(57.6%)であった。高齢者群において、症候性狭窄、年齢と狭窄率は、CAS群(34.8%、78.7±3.1歳、75.9±9.5%)とCEA群(66, Domestic conference高齢者の頚動脈狭窄症に対する血行再建術(CEA/CAS)の治療成績Oral presentation
- 第28回日本血管内治療学会学術総会, Nov. 2012, Japanese, 日本血管内治療学会, 仙台, 【緒言】海綿静脈洞部硬膜動静脈瘻（CS dAVF）に対する塞栓術では，罹患静脈洞へのアプローチルートの選択と，シャント部位の正確な診断による手術戦略が必要である．当科における最近の治療成績を検討し，治療の際に重要なポイントを報告する．【対象】2007年4月以降に当科及び関連病院で経験したCS dAVF 26例．40-88歳，女/男：19/7例．可能な限り選択的シャント閉塞を行い，必要に応じてsinus packing (SP)を追加．前期（〜2010年3月）と3D-DSA導入後の後期（2010年4月〜）で手術戦略の変化を検討した．【結果】26例に29回の治療を行い，全ての症例でシャントの閉塞を得た．25例に対してTVEを行い，同側IPS経由21例（21/22例:95%），FV-SOV経由3例（IPS経由不成功1例）．2例にTAEのみ施行（TVE不成功, Domestic conference海綿静脈洞部硬膜動静脈瘻に対する塞栓術Oral presentation
- 第28回日本血管内治療学会学術総会, Nov. 2012, Japanese, 日本血管内治療学会, 仙台, 【目的】NF Iに合併する動静脈瘻としては椎骨動静脈瘻の報告が多い。今回われわれは、NF Iに合併した出血発症のOccipital-Internal jugular arteriovenous fistula (AVF) の1例を経験したため報告する。【症例】70歳、女性。無症候であったが、就眠中に突然左頚部痛と左頚部腫脹が出現して当院受診した。全身にcafe-au-lait spot、neurofibromaを多数認めNerurofibromatosis type I（NF I） と考えられた。頭頚部CT、MRIにて左頚部皮下に腫瘤性病変と周囲の筋層への出血を認めた。血管撮影では、左後頭動脈を流入動脈として偽性動脈瘤と考えられる拡大した腔を通過し、内頚静脈を導出静脈とするAVFを認めた。第4病日に血管内治療を施行し、経動脈的、経静脈的にアプローチし, Domestic conferenceNerurofibromatosis type(NFI)に合併し、出血による頚部腫脹で合併したOccipital-Internal jugular arteriovenous fistula(AVF)の1例Oral presentation
- The 71st Annual Meeting of the Japan Neurosurgical Society, Oct. 2012, Japanese, Japan Neurosurgical Society, 大阪, 【目的】SAPPHIRE studyの結果を受け、高齢者の頚動脈狭窄症に対する血行再建術としては CASが適応であるとされてきた。しかし、その後のCRESTなどのstudyの結果は高齢者において はむしろCEAの成績が優れていることが示されている。今回われわれは、当施設での超高齢者 頚動脈狭窄症に対する血行再建術の治療成績を検討した。【対象と方法】2006年8月から2012 年5月に当施設で施行した164例の頚動脈狭窄症に対する血行再建術のうち、80歳以上を超高齢 者として、CEAとCASの治療成績を検討した。CEAまたはCASの選択は、高齢者であっても心肺合 併症や高位病変などのリスクがない限りCEA firstを原則とした。【結果】164例中24例 (14.6%)が80歳以上であり、CEA 15例(全CEA症例の15.2%, Domestic conference超高齢者の頚動脈狭窄症に対する血行再建術(CEA/CAS)の治療成績Oral presentation
- The 71st Annual Meeting of the Japan Neurosurgical Society, Oct. 2012, Japanese, Japan Neurosurgical Society, 大阪, 【緒言】当院における脊髄動静脈瘻の治療戦略と治療成績について報告する。【方法】2009年 以降MRI検査で脊髄動静脈瘻(SAVF)が疑われた場合、まずmultidetector row CT angiography (MDCTA)にて高位診断を行った後に脊髄血管撮影を施行した。マイクロカテーテ ルがシャント近傍まで到達できた症例については血管内治療を同時に施行し、血管内治療不成 功例は外科手術を施行した。外科手術ではドップラー血流計、最近の症例は蛍光血管撮 影、MEPモニタリングを併用した。【結果】2009年以降に治療したSAVFは12例 (DAVF9例、PMAVF3例)であった。病変高位は胸椎9例、腰椎2例、仙椎1例で、全例うっ血性脊 髄症で発症し、全例で下肢のしびれと対麻痺を認め、10例で排尿障害も認めた。PMAV, Domestic conference脊髄動静脈瘻の治療戦略と治療成績Poster presentation
- 第27回日本脳脊髄外科学会, Jun. 2012, Japanese, 日本脳脊髄外科学会, 幕張, 【緒語】当院での脊髄動静脈瘻(SAVF)の治療戦略と治療成績について報告する。【対象と方法】2008年以降に当院で治療したSAVF12例（DAVF9例、PMAVF3例）を検討した。男性10例、女性2例で年齢は39歳〜87歳（平均64.2歳）であった。2週間以内の急性発症が2例、6か月以内の緩徐進行が4例、6ヶ月から7年の経過で緩徐進行が5例であった。全例で下肢のしびれと対麻痺を認め、10例で排尿障害も認めた。高位診断では3D-CTAにて行い、胸椎8例、腰椎3例、仙椎1例であった。シャント部位の診断は脊髄血管撮影にて行った。3D-CTAにてマイクロカテーテルがシャント近くまで容易に到達できると思われる症例や脊髄前面にシャントが存在知る症例については血管内治療を先行することとした。【結果】7例に塞栓術を選択したが、うち2例は不成功（1例は流入動脈塞栓に終, Domestic conference当院での脊髄動静脈瘻の治療成績Poster presentation
- 第11回日本頸部脳血管内治療学会, Jun. 2012, Japanese, 日本頸部脳血管内治療学会, 名古屋, 【目的】腎機能障害，造影剤アレルギー等を有する患者に対して，造影剤を使用することなく超音波ガイド下で頸動脈ステント留置術（CAS）を行ってきた．本治療を行う上での注意点，当科での成績を報告する．【対象および方法】腎機能障害や造影剤アレルギーの既往がある場合に超音波ガイド下CASを考慮した．MRAにより大動脈弓及び下肢のアクセスルートを評価し，頸動脈エコーで病変部が明瞭に観察出来る症例（石灰化に乏しい症例）を対象とした．【結果】6例の患者に対して，超音波ガイド下CASを施行した．64-75歳，全例男性，無症候性5例，症候性1例，造影剤使用不可の原因は慢性腎不全5例，ヨード造影剤アレルギーの既往1例であった．腹部大動脈瘤術前の1例は，右上腕動脈経由，他の5例は大腿動脈経由でdistal balloon protection下でCASを行った．ガイディング, Domestic conference超音波ガイド下頸動脈ステント留置術-安全に施行するために-Oral presentation
- 第11回日本頸部脳血管内治療学会, Jun. 2012, Japanese, 日本頸部脳血管内治療学会, 名古屋, 【目的】過去5年間151例の経験に基づき，CEAとCAS施行の際に有用かという観点から画像診断法を検討した．【対象と方法】過去5年間に当施設で施行したCEA 89例とCAS 62例を対象としCTA, 頚動脈エコー，MRIの治療施行における有用性を検討した．【結果】CTA：石灰化の評価のみならず3次元再構成により狭窄の高位と周囲の解剖学的構造を容易に把握でき，CEAの施行に極めて有用であった．このためCEA予定患者ではDSAを施行しなくなった．エコー：簡便ながら，プラーク性状把握，とくにmobile plaqueの検出に有用であった．CAS後にはMRIで評価できないため術後評価に有用であった．また，腎機能低下患者に対する造影剤非使用のエコーガイド下CASには必須であった．Plaque MRI：プラークの性状把握に非常に有用であり，とくにプラーク内出血を, Domestic conference頚動脈内膜剥離術(CEA)と頚動脈ステント（CAS)の施行に有用な画像診断法Oral presentation
- 第30回日本脳腫瘍病理学会、第4回国際脳腫瘍病理シンポジウム, May 2012, Japanese, 日本脳腫瘍病理学会, 名古屋, IL-10はリンパ腫の発生、維持に関与している可能性が報告されている。そこで我々は、髄液中IL-10値とB細胞分化マーカーとの関連性について検討した。（対象および方法）治療前の髄液採取が施行され、組織診断された頭蓋内び慢性大細胞性Ｂ細胞リンパ腫29例（4例は全身性悪性リンパ腫の頭蓋内進展）を対象とした。リンパ腫の分化マーカーとしてCD10, Bcl-6, MUM1を用い、腫瘍組織に対して免疫染色を行い、陰性、弱陽性、陽性と発現量を評価した。また、腫瘍細胞でのIL-10の発現も免疫染色で検討した。髄液中IL-10値を高値群と低値群とに分け、2群間でIL-10、分化マーカーの発現量に差が無いかを統計学的に検討した。（結果）男性21例、女性8例、平均年齢65歳（36～83歳）。治療前の髄液中IL-10中央値は42 pg/ml(<2~1280p, Domestic conference頭蓋内び慢性大細胞性Bリンパ腫における髄液中IL-10値とB細胞分化マーカーとの関連性Oral presentation
- 第30回日本脳腫瘍病理学会、第4回国際脳腫瘍病理シンポジウム, May 2012, Japanese, 日本脳腫瘍病理学会, 名古屋, （緒言）硬膜付着部を持たない後頭蓋窩髄膜腫は極めて稀である。今回、われわれは硬膜付着部を持たない後頭蓋窩髄膜腫の2症例を経験した。（症例1）36歳、女性。左上肢しびれにて発症、10ヶ月の経過の後、歩行障害が出現した。頭部MRIでは延髄背側から小脳下方に造影効果を伴う境界明瞭で内部不均一な4.6cm大の腫瘤性病変を認めた。腫瘍摘出術を施行、術中所見では、腫瘍は第4脳室内への進展はなく、脈絡組織との連続性も認めず、発生母地はinferior tela～延髄背側と考えられた。組織学的には類円形核と淡明な胞体を有する多角形の異型細胞が敷き石状に増殖する像で、EMA(+), GFAP(-), S-100(-), synaptophysin(-), PAS(+)であり、clear cell meningiomaと診断された。（症例2）58歳、男性。2ヶ月間持続す, Domestic conference硬膜付着を有しない後頭蓋窩髄膜腫の2例Oral presentation
- 第63回日本脳神経外科学会近畿支部学術集会, Apr. 2012, Japanese, 日本脳神経外科学会近畿支部, 大阪, 【緒語】一過性皮質盲は血管撮影後1日以内に発症し、多くは1ヶ月以内に自然回復する。発症頻度は血管撮影の0.3~1.0%と報告されている。症状は両側性の皮質盲でその他に異常を認めない。今回、未破裂動脈瘤コイル塞栓術後に発症した一例を経験したので報告する。【症例】67歳女性。近医での頭部CTで脳底動脈瘤が疑われ、頭部MRIを撮影したところ脳底動脈先端部と右中大動脈分岐部に動脈瘤を指摘され当科紹介となった。約10mm大の脳底動脈先端部瘤に対してコイル塞栓術を行うこととなった。術前脳血管撮影で両側のVAGと3DDSAを行い、合併症なく検査を終了した。造影剤使用量は120mlであった。後日、コイル塞栓術を行った。合計12本のコイルで動脈瘤は完全閉塞を得ることが出来た。造影剤の使用量は270mlであった。手術終了直後から「目の見え方がおかしい」と訴えがあり、1時, Domestic conference非イオン性造影剤による一過性皮膚盲の一例Oral presentation
- STROKE2012, Apr. 2012, Japanese, 日本脳卒中学会、日本脳卒中の外科学会, 福岡, <緒言>細菌性脳動脈瘤は、高頻度に破裂をきたし致死率が高いことが知られている。今回、われわれは過去5年間に経験した例について検討をおこなった。<対象>2006年8月から2011年7月に当科で治療された破裂細菌性脳動脈瘤例を対象とした。<結果>対象例は4例で、同時期に当院で治療をおこなった破裂脳動脈瘤例の5.1％（4/78）に相当した。男性1例、女性3例、平均年齢66.8才(61-73才)で、発症様式は、脳出血2例、くも膜下出血(SAH)2例であった。SAH例はいずれも手術待機中に再出血を認めた。1例はSAH発症翌日で手術室入室直前に脳出血をきたした。他の1例はSAH発症6日後、他院で入院精査中に脳出血を起こし、その後当院にて加療した。動脈瘤の部位は、遠位中大脳動脈が3, Domestic conference破裂細菌性脳動脈瘤に対する治療についてPoster presentation
- STROKE2012, Apr. 2012, Japanese, 日本脳卒中学会、日本脳卒中の外科学会, 福岡, 【目的】頸動脈内膜剥離術（CEA）高危険群患者に対して頸動脈ステント留置術（CAS）を考慮する際に，腎機能障害や造影剤アレルギーがある場合は治療対象から除外されることもある．当科では，このような症例に対して，造影剤を使用することなく超音波ガイド下で頸動脈ステントを行っており，本治療の実際と成績を報告する．【対象および方法】CEA高危険群としてCASを考慮した患者で，腎機能障害や造影剤アレルギーの既往がある場合に超音波ガイド下CASを考慮した．大腿動脈経由を基本とし，アクセスルートをMRAで評価，頸動脈エコーで病変部が明瞭に観察出来る症例（石灰化に乏しい症例）を本治療の対象とした．【結果】6例の患者に対して，超音波ガイド下CASを施行した．64-75歳，全例男性，無症候性5例，症候性1例，造影剤使用不可の原因は慢性腎不全5例，ヨード造影剤アレルギーの既, Domestic conference造影剤を使用しない超音波ガイド下頸動脈ステント留置術Oral presentation
- 第25回日本老年脳神経外科学会, Mar. 2012, Japanese, 日本老年脳神経外科学会, 東京, Domestic conference80歳以上の高齢者のくも膜下出血ー破裂脳動脈瘤クリッピング術の治療成績ーOral presentation
- 第27回日本脳神経血管内治療学会学術総会, Nov. 2011, Japanese, 日本脳神経血管内治療学会, 幕張, Domestic conferenceコンプライアントバルンの様々な場面での有用性Oral presentation
- 第29回日本脳腫瘍学会学術集会, Nov. 2011, Japanese, 日本脳腫瘍学会, 岐阜, Domestic conferenceSupratentorial extraventricular ependymomaの2例Oral presentation
- 社団法人日本脳神経外科学会第70回学術総会, Oct. 2011, Japanese, 日本脳神経外科学会, 横浜, Domestic conference高齢者（80歳以上）の破裂脳動脈瘤クリッピング術の治療成績Poster presentation
- 第12回日本分子脳神経外科学会, Oct. 2011, Japanese, 日本分子脳神経外科学会, 横浜, Domestic conference高輝度放射光を用いたノックアウトマウスの微小脳損傷モデル：小脳顆粒細胞の脱落に低分子量Gタンパク質Racが関与するOral presentation
- 社団法人日本脳神経外科学会第70回学術総会, Oct. 2011, Japanese, 日本脳神経外科学会, 横浜, Domestic conference高輝度放射光を用いたノックアウトマウスの微小脳損傷モデル：小脳顆粒細胞の脱落に低分子量Gタンパク質Racが関与するPoster presentation
- STROKE2011（第36回日本脳卒中学会総会、第40回日本脳卒中の外科学会、第27回スパズム・シンポジウム）, Aug. 2011, Japanese, 日本脳卒中学会、日本脳卒中の外科学会、スパズム・シンポジウム, 東京, Domestic conferenceImprovement of diagnosis and treatment of cerebral sinus thrombosisOral presentation
- STROKE2011（第36回日本脳卒中学会総会、第40回日本脳卒中の外科学会、第27回スパズム・シンポジウム）, Aug. 2011, Japanese, 日本脳卒中学会、日本脳卒中の外科学会、スパズム・シンポジウム, 東京, Domestic conferenceSubarachnoid hemorrhage caused by a dissection of the internal carotid artery accompanied by the contralateral internal artery occlusionPoster presentation
- 第63回近畿脊髄外科研究会, Mar. 2011, Japanese, 近畿脊髄外科研究会, 大阪, Domestic conference超高齢者脊髄硬膜動静脈瘻の一例Oral presentation
- 日本脳神経外科学会第69回学術集会, Oct. 2010, Japanese, 日本脳神経外科学会, 福岡, Domestic conference転移性脳腫瘍の手術と集学的加療についてPoster presentation
- 第60回日本脳神経外科学会近畿支部学術集会、第11回近畿脳神経血管内治療学会, Sep. 2010, Japanese, 日本脳神経外科学会近畿支部, 大阪, Domestic conference中硬膜動静脈瘻の1例Oral presentation
- STROKE2010（第35回日本脳卒中学会総会、第39回日本脳卒中の外科学会、第26回スパズム・シンポジウム）, Apr. 2010, Japanese, 日本脳卒中学会、日本脳卒中の外科学会, 岩手, Domestic conference当院集中治療室におけるチーム医療の現状ーくも膜下出血後のスパズムに対する治療に関してーOral presentation
- 第59回日本脳神経外科学会近畿支部学術集会、第71回近畿脳腫瘍研究会, Apr. 2010, Japanese, 日本脳神経外科学会, 大阪, Domestic conferenceのう胞性病変を伴ったparasagittal meningeal hemangiopericytomaの一例Oral presentation
- 第67回社団法人日本脳神経外科学会総会, Oct. 2008, Japanese, 社団法人日本脳神経外科学会総会, 岩手, Domestic conference内頚動脈近位部動脈瘤の手術手技に対する考察Oral presentation
- 第67回社団法人日本脳神経外科学会総会, Oct. 2008, Japanese, 社団法人日本脳神経外科学会総会, 岩手, Domestic conference脊髄損傷後のTransforming Growth Factor-beta1阻害は運動機能回復を促進するOral presentation
- 第56回日本脳神経外科会近畿支部学術集会・第68回近畿脳腫瘍研究会, Sep. 2008, Japanese, 日本脳神経外科会近畿支部・近畿脳腫瘍研究会, 大阪, Domestic conference診断に苦慮した側頭葉内部動静脈奇形の1例Oral presentation
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2025 - 31 Mar. 2028虚血時のカルベノキソロンの神経保護作用におけるDRD2の機能解明と脳梗塞治療への応用
- 日本学術振興会, 科学研究費助成事業 基盤研究(C), 基盤研究(C), 神戸大学, 01 Apr. 2022 - 31 Mar. 2025カルベノキソロンの作用を通して行う脳虚血の包括的メカニズムの解明と治療法の探究
- 学術研究助成基金助成金／基盤研究(C), Apr. 2017 - Mar. 2020Competitive research funding
- 学術研究助成基金助成金／若手研究(B), Apr. 2015 - Mar. 2017, Principal investigatorCompetitive research funding
- 学術研究助成基金助成金／若手研究(B), Apr. 2013 - Mar. 2015, Principal investigatorCompetitive research funding