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  1. Article ; Online: Syndrome of inappropriate secretion of antidiuretic hormone as an initial sign of primary central nervous system lymphomas in the hypothalamus.

    Oishi, Masahiro / Hayashi, Yasuhiko / Sasagawa, Yasuo / Oikawa, Nozomu / Nakada, Mitsutoshi

    Acta neurologica Belgica

    2022  Volume 123, Issue 2, Page(s) 415–422

    Abstract: Background: Primary central nervous system lymphoma (PCNSL) rarely originates in the hypothalamus. Hypothalamic PCNSL can present with various symptoms specific to dysfunction of the hypothalamus, including consciousness disturbance, cognitive ... ...

    Abstract Background: Primary central nervous system lymphoma (PCNSL) rarely originates in the hypothalamus. Hypothalamic PCNSL can present with various symptoms specific to dysfunction of the hypothalamus, including consciousness disturbance, cognitive impairment, hypopituitarism, and diabetes insipidus (DI). However, it remains unclear whether syndrome of inappropriate secretion of antidiuretic hormone (SIADH) can present as an initial sign of hypothalamic PCNSL.
    Methods: Ninety-nine patients with PCNSL were diagnosed between January 2006 and December 2020 at our institutes. The initial symptoms and signs, hypothalamic-pituitary functions, serum sodium (Na) value, Karnofsky Performance Status (KPS) score on admission, and duration from onset to diagnosis were retrospectively investigated from the medical charts.
    Results: Eight and 91 patients had hypothalamic PCNSL (hypothalamic group) and PCNSL located in other regions (control group), respectively. Patients' pathological diagnoses were diffuse large B-cell lymphoma (97 patients) and intravascular lymphoma (two patients). Six patients presented with hyponatremia derived from SIADH or suspected SIADH, and one presented with DI. Statistically significant differences between the hypothalamic and control groups were detected only in the preoperative serum Na values and KPS scores.
    Conclusion: SIADH can be an initial presentation of hypothalamic PCNSL. Early detection of hypothalamic PCNSL from SIADH may lead to proper management and improved prognosis.
    MeSH term(s) Humans ; Inappropriate ADH Syndrome/complications ; Inappropriate ADH Syndrome/diagnosis ; Retrospective Studies ; Hyponatremia/etiology ; Hyponatremia/diagnosis ; Vasopressins ; Hypothalamus/diagnostic imaging ; Hypothalamus/pathology ; Diabetes Insipidus/pathology
    Chemical Substances Vasopressins (11000-17-2)
    Language English
    Publishing date 2022-06-18
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 127315-2
    ISSN 2240-2993 ; 0300-9009
    ISSN (online) 2240-2993
    ISSN 0300-9009
    DOI 10.1007/s13760-022-01985-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor.

    Shimizu, Yu / Miyashita, Katsuyoshi / Oikawa, Nozomu / Kobayashi, Masaaki / Tohma, Yasuo

    Surgical neurology international

    2021  Volume 12, Page(s) 64

    Abstract: Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to ... ...

    Abstract Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to guarantee the best surgical approach for these lesions.
    Case description: Here, we report an extremely rare case of a right frontal mass mimicking a brain tumor, in which the surgery unveiled a CTIA of the right middle cerebral artery (MCA). A 56-year-old woman presented with right hemiparesis and mild headache. Magnetic resonance imaging (MRI) revealed a right frontal mass with peripheral edema. The lesion enhanced on initial and follow-up MRI of the brain. Subsequent vascular studies and metastatic workup were negative. A temporal craniotomy with neuronavigation (Brain Lab AG, Germany) was performed and an intraoperative diagnosis of a thrombosed aneurysm along the branch of the MCA was established. The aneurysm was successfully trapped and resected. The patient did not exhibit any postoperative neurological deficits.
    Conclusion: This is the rare report of a ring enhanced completely thrombosed aneurysm due to vasa vasorum which is misdiagnosed as metastatic brain tumor. In case of an intracranial ring enhanced mass with signs of intralesional hemorrhage and peripheral edema, CTIA should be considered as a possible differential diagnosis.
    Language English
    Publishing date 2021-02-17
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_582_2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Panhypopituitarism caused by an unruptured giant cavernous internal carotid artery aneurysm compressing the pituitary gland treated with a flow-diverting stent: A case report.

    Oikawa, Nozomu / Misaki, Kouichi / Aono, Daisuke / Nambu, Iku / Hayashi, Yasuhiko / Uchiyama, Naoyuki / Nakada, Mitsutoshi

    Surgical neurology international

    2022  Volume 13, Page(s) 378

    Abstract: Background: Internal carotid artery (ICA) aneurysms extending into the intrasellar region that mimics pituitary tumors and leads to pituitary dysfunction are relatively rare. The treatment for aneurysms includes surgery and endovascular procedures. ... ...

    Abstract Background: Internal carotid artery (ICA) aneurysms extending into the intrasellar region that mimics pituitary tumors and leads to pituitary dysfunction are relatively rare. The treatment for aneurysms includes surgery and endovascular procedures. However, functional recovery of the pituitary gland is difficult.
    Case description: We report a case of a 43-year-old woman who presented with severe headaches and generalized malaise. Magnetic resonance imaging (MRI) revealed a giant unruptured cavernous ICA aneurysm that pushed the pituitary stalk contralaterally. A baseline endocrinological examination suggested panhypopituitarism. Hypopituitarism was treated with hormone replacement therapy, which improved the patient's symptoms of headaches and malaise after 4 days. The aneurysm was treated using a pipeline flow-diverting stent. Two years later, the aneurysm had reduced to half of its maximum diameter, and the pituitary stalk was visible on MRI. Hormone loading tests 1 week postoperatively showed almost no response. At postoperative 6 months, there was a trend toward improvement.
    Conclusion: Flow-diverting stent deployment is useful for large or giant carotid artery aneurysms with pituitary gland compression.
    Language English
    Publishing date 2022-08-26
    Publishing country United States
    Document type Case Reports
    ISSN 2229-5097
    ISSN 2229-5097
    DOI 10.25259/SNI_548_2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Intraoperative rupture of intracerebral aneurysm immediately after meningioma resection: a case report.

    Tanaka, Shingo / Kobayashi, Masaaki / Ichinose, Toshiya / Oikawa, Nozomu / Kinoshita, Masashi / Yoshikawa, Akifumi / Uchiyama, Naoyuki / Nakada, Mitsutoshi

    BMC neurology

    2022  Volume 22, Issue 1, Page(s) 135

    Abstract: Background: Meningiomas and unruptured cerebral aneurysms (UCAs) rarely coexist. However, the treatment strategy remains to be fully elucidated. This report is a first report that UCA related to the tumor feeder intraoperatively ruptured when the ... ...

    Abstract Background: Meningiomas and unruptured cerebral aneurysms (UCAs) rarely coexist. However, the treatment strategy remains to be fully elucidated. This report is a first report that UCA related to the tumor feeder intraoperatively ruptured when the meningioma was resected.
    Case presentation: Herein, we present a case of meningioma coexisting with contralateral UCA related to a tumor feeder. Immediately after the meningioma was resected, intraoperative acute brain swelling due to rupture of the contralateral aneurysm appeared. The swollen brain protruding into the epidural space was resected, following contralateral ruptured aneurysm was performed by endovascular surgery. Intensive neurological treatment was administered and the patient gradually recovered.
    Conclusion: This report highlights the possibility of intraoperative UCA rupture related to the tumor feeder when the meningioma is resected.
    MeSH term(s) Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/etiology ; Aneurysm, Ruptured/surgery ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Meningeal Neoplasms/complications ; Meningeal Neoplasms/diagnostic imaging ; Meningeal Neoplasms/surgery ; Meningioma/complications ; Meningioma/diagnostic imaging ; Meningioma/surgery ; Neurosurgical Procedures/adverse effects
    Language English
    Publishing date 2022-04-11
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041347-6
    ISSN 1471-2377 ; 1471-2377
    ISSN (online) 1471-2377
    ISSN 1471-2377
    DOI 10.1186/s12883-022-02664-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Non-occlusive mesenteric ischemia during bevacizumab treatment for glioblastoma: a case report.

    Oikawa, Nozomu / Kinoshita, Masashi / Yamamura, Minako / Uno, Takehiro / Ichinose, Toshiya / Sabit, Hemragul / Hayashi, Tomoyuki / Inoue, Dai / Harada, Kenichi / Nakada, Mitsutoshi

    Acta neurochirurgica

    2022  Volume 164, Issue 10, Page(s) 2767–2771

    Abstract: Glioblastoma is one of the most aggressive brain tumors in adults. The standard treatment is radiotherapy and chemotherapy based on the Stupp regimen after maximal safe resection. One effective chemotherapeutic drug is bevacizumab, which can prolong ... ...

    Abstract Glioblastoma is one of the most aggressive brain tumors in adults. The standard treatment is radiotherapy and chemotherapy based on the Stupp regimen after maximal safe resection. One effective chemotherapeutic drug is bevacizumab, which can prolong progression-free survival in glioblastoma patients but not overall survival. Adverse events of bevacizumab include hypertension, proteinuria, delayed wound healing, bleeding of the nose and gums, and thromboembolism resulting in gastrointestinal perforation. Herein, we describe an autopsy case of a patient with glioblastoma who died from non-occlusive mesenteric ischemia that was presumably caused by bevacizumab.
    MeSH term(s) Adult ; Angiogenesis Inhibitors/adverse effects ; Bevacizumab/adverse effects ; Brain Neoplasms/surgery ; Glioblastoma/drug therapy ; Humans ; Mesenteric Ischemia/chemically induced ; Mesenteric Ischemia/drug therapy
    Chemical Substances Angiogenesis Inhibitors ; Bevacizumab (2S9ZZM9Q9V)
    Language English
    Publishing date 2022-07-30
    Publishing country Austria
    Document type Case Reports ; Journal Article
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-022-05328-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.180: Show issues Location:
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  6. Article ; Online: Endodermal Cyst with a Non-enhancing Nodule in the Quadrigeminal Cistern Developed in an Octogenarian.

    Miyashita, Katsuyoshi / Oikawa, Nozomu / Kobayashi, Masaaki / Aida, Yasuhiro / Kitabayashi, Tomohiro / Shimizu, Yu / Tohma, Yasuo

    World neurosurgery

    2020  Volume 143, Page(s) 28–32

    Abstract: Background: Intracranial endodermal cysts are congenital lesions that generally develop in the cerebellopontine angle and ventral brainstem of the posterior fossa, whereas endodermal cysts in the quadrigeminal cistern are very rare. We report a rare ... ...

    Abstract Background: Intracranial endodermal cysts are congenital lesions that generally develop in the cerebellopontine angle and ventral brainstem of the posterior fossa, whereas endodermal cysts in the quadrigeminal cistern are very rare. We report a rare case of an endodermal cyst in the quadrigeminal cistern with a non-enhancing nodule that developed in patient over 80 years of age.
    Case description: An 85-year-old man presented to our hospital with progressing gait disturbance and urinary incontinence. Preoperative images showed a cystic mass lesion with a nodule in the quadrigeminal cistern and hydrocephalus. There was no enhanced portion in the lesion, and the intensity of the cyst on magnetic resonance imaging revealed a high protein concentration. Subtotal resection was performed due to the adhesion of the cyst to the brainstem. It was diagnosed as an endodermal cyst. The postoperative course was uneventful, and hydrocephalus improved.
    Conclusions: This is a rare case of an intracranial endodermal cyst in terms of location and age of onset compared with previous reports. This case demonstrates that endodermal cysts should be considered as a differential diagnosis for lesions in the quadrigeminal cistern with high protein concentration in the cyst and nodule representing chronic inflammation, regardless of enhancing effects.
    MeSH term(s) Aged, 80 and over ; Central Nervous System Cysts/complications ; Central Nervous System Cysts/diagnostic imaging ; Central Nervous System Cysts/pathology ; Central Nervous System Cysts/surgery ; Endoderm/pathology ; Gait Disorders, Neurologic/etiology ; Gait Disorders, Neurologic/physiopathology ; Humans ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/physiopathology ; Magnetic Resonance Imaging ; Male ; Subarachnoid Space/diagnostic imaging ; Subarachnoid Space/surgery ; Urinary Incontinence/etiology ; Urinary Incontinence/physiopathology
    Language English
    Publishing date 2020-07-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2020.07.086
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1159: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  7. Article ; Online: Recurrent Spinal Intramedullary Arachnoid Cyst: Case Report and Literature Review.

    Ichinose, Toshiya / Miyashita, Katsuyoshi / Tanaka, Shingo / Oikawa, Nozomu / Oishi, Masahiro / Nambu, Iku / Kinoshita, Masashi / Nakada, Mitsutoshi

    World neurosurgery

    2020  Volume 138, Page(s) 68–72

    Abstract: Background: Symptomatic intramedullary arachnoid cysts are rarely observed lesions, particularly in the pediatric age group. Treatment includes cyst fenestration or resection of the cyst wall, and recurrence after surgery has never been reported. We ... ...

    Abstract Background: Symptomatic intramedullary arachnoid cysts are rarely observed lesions, particularly in the pediatric age group. Treatment includes cyst fenestration or resection of the cyst wall, and recurrence after surgery has never been reported. We report a rare case of a spinal intramedullary arachnoid cyst, which recurred after cyst fenestration and required reoperation after a certain period.
    Case description: A 4-year-old boy presented to our hospital with tetraparesis and bladder and rectum disorder. A cystic intramedullary lesion in the cervical spinal cord was detected in preoperative imaging. An emergency fenestration of cyst was performed, and his symptoms were resolved immediately. One month after the operation, the symptoms and cyst recurred. The symptoms improved in the natural course without reoperation. However, the cyst increased in size and the symptoms recurred after 27 months from the first relapse and the cyst was removed urgently. The diagnosis was an arachnoid cyst. After the reoperation, the cyst has disappeared and not recurred.
    Conclusions: To the best of our knowledge, this is the first report of recurrence of an intramedullary arachnoid cyst. This case indicates the importance of considering the resection of cyst wall as possible because of the probability of cyst recurrence after fenestration, while careful observation is the option in the short term, especially for children or high-risk cases.
    MeSH term(s) Arachnoid Cysts/pathology ; Arachnoid Cysts/surgery ; Cervical Cord/pathology ; Child, Preschool ; Humans ; Male ; Recurrence ; Reoperation ; Spinal Cord Diseases/pathology ; Spinal Cord Diseases/surgery
    Language English
    Publishing date 2020-03-03
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2020.02.106
    Database MEDical Literature Analysis and Retrieval System OnLINE

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