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  1. Article: Acute epidural vertex hematoma with good hemostasis using delayed surgery after monitoring of coagulation and fibrinolytic parameters: A case report.

    Kotani, Saki / Murakami, Nobukuni / Doi, Tomoyuki / Ogawa, Takahiro / Hashimoto, Naoya

    Surgical neurology international

    2023  Volume 14, Page(s) 73

    Abstract: Background: The appropriate timing and method of surgery for vertex epidural hematoma (VEDH) are uncertain due to the presentation and slow symptomatic exacerbation caused by bleeding from a venous origin involving the injured superior sagittal sinus ( ... ...

    Abstract Background: The appropriate timing and method of surgery for vertex epidural hematoma (VEDH) are uncertain due to the presentation and slow symptomatic exacerbation caused by bleeding from a venous origin involving the injured superior sagittal sinus (SSS). Coagulation and fibrinolytic disorders that occur after traumatic brain injury also worsen bleeding. For these reasons, it is challenging to decide the surgical procedure and timing of surgery.
    Case description: A 24-year-old man involved a car accident and was transported to our emergency department. He was unconscious but not lethargic. Computed tomography showed VEDH overlying the SSS, and hematoma increased temporarily. Due to abnormal coagulation and fibrinolysis at admission, he underwent intentionally delayed surgery after control of coagulation and fibrinolysis. Bilateral parasagittal craniotomy was chosen to ensure hemostasis from the torn SSS. The patient improved without complications and was discharged with no neurological deficit. This case indicates that this surgical strategy is favorable for VEDH with slow symptomatic progression.
    Conclusion: VEDH is mostly caused by bleeding from the injured SSS secondary to diastatic fracture of sagittal suture. Intentionally delayed surgical intervention using bilateral parasagittal craniotomy after stabilization of coagulation and fibrinolysis is favorable for prevention of further hemorrhage and good hemostasis.
    Language English
    Publishing date 2023-02-24
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_1010_2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical Significance of Stiffness during Endoscopic Surgery for Intracerebral Hemorrhage: A Retrospective Study.

    Kishida, Kengo / Maruyama, Daisuke / Kotani, Saki / Murakami, Nobukuni / Hashimoto, Naoya

    Neurologia medico-chirurgica

    2023  Volume 63, Issue 12, Page(s) 563–570

    Abstract: Studies regarding hematoma stiffness and removal difficulty are scarce. This study explored the association between hematoma stiffness and surgical results of endoscopic hematoma removal for intracerebral hemorrhage. It also aimed to clarify factors ... ...

    Abstract Studies regarding hematoma stiffness and removal difficulty are scarce. This study explored the association between hematoma stiffness and surgical results of endoscopic hematoma removal for intracerebral hemorrhage. It also aimed to clarify factors associated with hematoma stiffness. We classified intracerebral hematoma as either soft or firm stiffness by retrospectively evaluating operative videos by two neurosurgeons. The interobserver reliability of the classification was assessed by calculating the κ values. We investigated the relationship between hematoma stiffness and surgical results. Favorable hematoma removal (FHR) was defined as a residual hematoma volume of ≤15 mL or removal rate of ≥70%. Furthermore, we compared the background characteristics, imaging findings, and laboratory data between the two groups. Forty patients were included in this study. The mean baseline hematoma volume was 69.9 mL (range, 41.3-97.6 mL). FHR was accomplished in 35 cases (87.5%). Thirty-four patients (85%) were in the soft hematoma group (group S). Six patients (15%) were in the firm hematoma group (group F). Classification of hematoma stiffness demonstrated an excellent degree of interobserver agreement (κ score = 0.91). Patients in group S had a high FHR rate (p = 0.018) and short endoscopic procedure times (p = 0.00034). The island sign was present in group S (p = 0.030). Patients in group F had significantly high fibrinogen levels (p = 0.049) and low serum total calcium (p = 0.032), hemoglobin (p = 0.041), and hematocrit (p = 0.011) levels. Hematoma stiffness during endoscopic surgery for intracerebral hemorrhage correlates with surgical results, including the endoscopic procedure time and accomplishing rate of FHR.
    MeSH term(s) Humans ; Retrospective Studies ; Clinical Relevance ; Reproducibility of Results ; Treatment Outcome ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/surgery ; Hematoma/diagnostic imaging ; Hematoma/surgery
    Language English
    Publishing date 2023-11-08
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 604061-5
    ISSN 1349-8029 ; 0470-8105
    ISSN (online) 1349-8029
    ISSN 0470-8105
    DOI 10.2176/jns-nmc.2023-0043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 865: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  3. Article: Bacterial meningitis caused by nontraumatic cerebrospinal fluid rhinorrhea with aqueductal stenosis: A case report.

    Kotani, Saki / Takahashi, Yoshinobu / Morisako, Tamaki / Yamanaka, Takumi / Hashimoito, Naoya

    Surgical neurology international

    2022  Volume 13, Page(s) 439

    Abstract: Background: Nontraumatic cerebrospinal fluid (CSF) rhinorrhea associated with aqueductal stenosis is rare. The resulting CSF leakage may cause bacterial meningitis, and appropriately timed surgical treatment should be considered.: Case description: A ...

    Abstract Background: Nontraumatic cerebrospinal fluid (CSF) rhinorrhea associated with aqueductal stenosis is rare. The resulting CSF leakage may cause bacterial meningitis, and appropriately timed surgical treatment should be considered.
    Case description: A 28-year-old woman with obstructive hydrocephalus secondary to aqueductal stenosis presented with intermittent nasal discharge. CSF rhinorrhea was suspected, but she refused surgery. During the course of conservative treatment, she developed meningitis. Exacerbation of hydrocephalus and CSF rhinorrhea was suspected, and the patient underwent endoscopic third ventriculostomy after recovery from meningitis. Postoperatively, ventricular size decreased and CSF leakage completely resolved. There was no recurrence of hydrocephalus or rhinorrhea.
    Conclusion: Patients with intermittent CSF rhinorrhea due to exacerbation of hydrocephalus are at high risk for bacterial meningitis. Appropriately timed surgical treatment results in a favorable outcome.
    Language English
    Publishing date 2022-09-23
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_610_2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: [A comparative study of three cases of neuronal intranuclear inclusion disease (NIID)].

    Kotani, Saki / Fukazawa, Ryosuke / Takezawa, Hidesato / Banba, Masamichi / Sone, Jun / Fujii, Akihiro

    Rinsho shinkeigaku = Clinical neurology

    2021  Volume 61, Issue 3, Page(s) 194–199

    Abstract: All three patients were men in their 70s. All cases were solitary onset and the chief complaint was gait disturbance. All patients had miosis and limb and trunk ataxia, MMSE score was declined in two patients, and FAB score was declined in all patients. ... ...

    Abstract All three patients were men in their 70s. All cases were solitary onset and the chief complaint was gait disturbance. All patients had miosis and limb and trunk ataxia, MMSE score was declined in two patients, and FAB score was declined in all patients. Head MRI showed leukoencephalopathy, cerebellar atrophy, and DWI high intensity signal in corticomedullary junction. However, two of the three patients were not followed up without further examination. Skin biopsies in all cases showed ubiquitin-positive and p62-positive intranuclear inclusions. Genetic testing showed CGG repeat expansion of NOTCH2NLC. The diagnosis of neuronal intranuclear inclusion disease (NIID) was made based on the above findings in all cases. Most patients are diagnosed with NIID due to memory loss, but sometimes they are diagnosed due to gait disturbance with ataxia. It is important to proceed with the diagnosis by skin biopsy and genetic diagnosis based on the characteristic MRI findings of the head.
    MeSH term(s) Aged ; Ataxia/etiology ; Atrophy ; Biopsy ; Brain/diagnostic imaging ; Brain/pathology ; Gait Disorders, Neurologic/etiology ; Genetic Testing ; Humans ; Intranuclear Inclusion Bodies/genetics ; Intranuclear Inclusion Bodies/immunology ; Intranuclear Inclusion Bodies/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurodegenerative Diseases/complications ; Neurodegenerative Diseases/diagnosis ; Neurodegenerative Diseases/genetics ; Neurodegenerative Diseases/pathology ; Receptor, Notch2/genetics ; Skin/pathology ; Trinucleotide Repeat Expansion
    Chemical Substances NOTCH2 protein, human ; Receptor, Notch2
    Language Japanese
    Publishing date 2021-02-23
    Publishing country Japan
    Document type Case Reports ; Comparative Study ; Journal Article
    ZDB-ID 604200-4
    ISSN 1882-0654 ; 0009-918X
    ISSN (online) 1882-0654
    ISSN 0009-918X
    DOI 10.5692/clinicalneurol.cn-001549
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 1455: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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    Zs.MO 223: Show issues

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