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Article: [Presurgical Simulation for Brain Arteriovenous Malformation].

Takahashi, Jun C

2024 Volume 52, Issue 2, Page(s) 380–388

Abstract: Surgical extirpation of brain arteriovenous malformations(AVMs)requires precise pre-surgical simulation. Utilizing image software, widely used with picture archiving and communication systems(PACS), surgeons can generate simulation images that precisely ... ...

Abstract	Surgical extirpation of brain arteriovenous malformations(AVMs)requires precise pre-surgical simulation. Utilizing image software, widely used with picture archiving and communication systems(PACS), surgeons can generate simulation images that precisely illustrate the proper feeders, passing arteries, and drainers. The crucial steps for creating informative simulation images include: (1)the free rotation of reconstructed 3D digital subtraction angiography(DSA)images; (2)removal of irrelevant arteries(the most important procedure); and(3)construction of stereo imagery of the "core images." This article presents a detailed description of these procedures.
MeSH term(s)	Humans ; Intracranial Arteriovenous Malformations/diagnostic imaging ; Intracranial Arteriovenous Malformations/surgery ; Imaging, Three-Dimensional/methods ; Angiography, Digital Subtraction/methods ; Arteries ; Brain/diagnostic imaging
Language	Japanese
Publishing date	2024-03-21
Publishing country	Japan
Document type	English Abstract ; Journal Article
ZDB-ID	197053-7
ISSN	1882-1251 ; 0301-2603
ISSN (online)	1882-1251
ISSN	0301-2603
DOI	10.11477/mf.1436204923
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Zs.MO 268: Show issues

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Article: [Complications of Superficial Temporal Artery-Middle Cerebral Artery Anastomosis and Their Prevention: Technical Note].

Takahashi, Jun C

No shinkei geka. Neurological surgery

2022 Volume 50, Issue 4, Page(s) 788–796

Abstract: Complications of the superficial temporal artery-middle cerebral artery(STA-MCA)bypass procedure include skin necrosis, MCA vessel wall injury, and thrombotic occlusion of the anastomotic site. First, deprivation of the STA per se induces ischemia of the ...

Abstract	Complications of the superficial temporal artery-middle cerebral artery(STA-MCA)bypass procedure include skin necrosis, MCA vessel wall injury, and thrombotic occlusion of the anastomotic site. First, deprivation of the STA per se induces ischemia of the skin flap. Skin incisions must be designed carefully to avoid isolating some areas from the blood supply. Secondly, the MCA walls can be extremely thin in moyamoya disease; therefore, the fragile vascular walls must be manipulated gently. The MCA walls should not be grasped directly by forceps. Thirdly, intraluminal thrombi can develop after the completion of the anastomosis. Heparin should be administered intravenously as soon as possible when intraluminal thrombi are detected, followed by aspirin loading via a nasogastric tube. Platelet(white)thrombi are fragile and easily disrupted with mechanical vibration. It is essential to treat them before they develop into a large, firm fibrin thrombus that completely occludes the anastomotic site, which would require suture cutting and surgical thrombus removal.
MeSH term(s)	Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Cerebral Revascularization/adverse effects ; Cerebral Revascularization/methods ; Humans ; Middle Cerebral Artery/surgery ; Moyamoya Disease/surgery ; Temporal Arteries/surgery
Language	Japanese
Publishing date	2022-08-10
Publishing country	Japan
Document type	Journal Article
ZDB-ID	197053-7
ISSN	1882-1251 ; 0301-2603
ISSN (online)	1882-1251
ISSN	0301-2603
DOI	10.11477/mf.1436204622
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Article ; Online: Experience With Tirabrutinib in the Treatment of Primary Central Nervous System Lymphoma that Is Difficult to Treat With Standard Treatment.

Yoshioka, Hiromasa / Okuda, Takeshi / Nakao, Takayuki / Fujita, Mitsugu / Takahashi, Jun C

Anticancer research

2022 Volume 42, Issue 8, Page(s) 4173–4178

Abstract: Background/aim: Standard treatment options for primary central nervous system lymphoma (PCNSL) include high-dose methotrexate (HD-MTX)-based drug therapy and whole-brain radiation therapy. However, there are many cases in which these standard treatment ... ...

Abstract	Background/aim: Standard treatment options for primary central nervous system lymphoma (PCNSL) include high-dose methotrexate (HD-MTX)-based drug therapy and whole-brain radiation therapy. However, there are many cases in which these standard treatment options are not tolerated for various reasons. In the present study, five cases of refractory/relapsed PCNSL that are difficult to treat with standard treatment were successfully treated by tirabrutinib. Patients and methods: A total of 5 patients (4 women, 1 man) with refractory (n=3) and relapsed (n=2) PCNSL were included. The patients had a median age of 76 years and a median Karnofsky performance status (KPS) of 40. The reasons why standard treatment cannot be given to these patients are the low KPS, renal dysfunction, and resistance to HD-MTX. Administration of a drug via the oral route was challenging in three patients; thus, these patients were administered tirabrutinib in suspension through a nasogastric tube. Results: Imaging findings showed that the patients achieved a 100% response rate to tirabrutinib, with a median survival of 8 months. As symptoms improved, 2 of the 3 patients who were initially administered tirabrutinib via a nasogastric tube were able to receive the drug via the oral route. Three patients developed adverse reactions; however, treatment was not interrupted because they were manageable. Conclusion: Tirabrutinib was effective in the treatment of patients who were unable to receive standard treatment options. Tirabrutinib may be considered one of the novel treatment strategies that could improve the prognosis of PCNSL patients in the future.
MeSH term(s)	Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Brain Neoplasms/drug therapy ; Central Nervous System ; Central Nervous System Neoplasms ; Cranial Irradiation ; Female ; Humans ; Imidazoles ; Lymphoma, Non-Hodgkin/drug therapy ; Male ; Methotrexate ; Pyrimidines ; Retrospective Studies
Chemical Substances	Imidazoles ; Pyrimidines ; tirabrutinib (LXG44NDL2T) ; Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2022-07-27
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.15917
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Zs.A 1642: Show issues

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Article ; Online: Quantitative regional cerebral blood flow measurement using near-infrared spectroscopy and indocyanine green in patients undergoing superficial temporal to middle cerebral artery bypass for moyamoya disease: a novel method using a frequency filter.

Tsukinaga, Akito / Yoshitani, Kenji / Ozaki, Takeo / Takahashi, Jun C / Ogata, Soshiro / Ohnishi, Yoshihiko

Journal of clinical monitoring and computing

2022 Volume 37, Issue 2, Page(s) 421–429

Abstract: Measuring regional cerebral blood flow (rCBF) after revascularization for moyamoya disease, as a type of ischemic cerebrovascular disease, is crucial. This study aims to validate our novel technology that combines near-infrared spectroscopy (NIRS) with a ...

Abstract	Measuring regional cerebral blood flow (rCBF) after revascularization for moyamoya disease, as a type of ischemic cerebrovascular disease, is crucial. This study aims to validate our novel technology that combines near-infrared spectroscopy (NIRS) with a frequency filter to extract the arterial component. We measured rCBF before and after revascularization for moyamoya disease and at the end of the surgery using NIRO-200NX (Hamamatsu Photonics, Japan) and indocyanine green (ICG). rCBF was calculated using Fick's principle, change in arterial ICG concentrations, and maximum arterial ICG concentration. rCBF measured with NIRS (rCBF_N) was compared with pre- and postoperative rCBF measured with SPECT (rCBF_S). Thirty-four procedures were analyzed. rCBF_N increased from baseline to end of the surgery (mean difference (MD), 2.99 ml/min/100 g; 95% confidence interval (CI), 0.40-5.57 ml/min/100 g on the diseased side; MD, 4.94 ml/min/100 g; 95% CI, 2.35-7.52 ml/min/100 g on the non-diseased side). Similar trends were observed for rCBF_S (MD, 3.98 ml/min/100 g; 95% CI, 2.30-5.67 ml/min/100 g on the diseased side; MD, 2.77 ml/min/100 g; 95% CI, 1.09-4.45 ml/min/100 g on the non-diseased side). Intraclass correlations 3 (ICC3s) between rCBF_N and rCBF_S were weak on the diseased side (ICC3, 0.25; 95% CI, -0.03-0.5; p = 0.07) and the non-diseased side (ICC3, 0.24; 95% CI, -0.05-0.5; p = 0.08). rCBF measurements based on this novel method were weakly correlated with rCBF measurements with SPECT.
MeSH term(s)	Humans ; Moyamoya Disease/diagnostic imaging ; Moyamoya Disease/surgery ; Indocyanine Green ; Middle Cerebral Artery ; Spectroscopy, Near-Infrared ; Cerebrovascular Circulation/physiology
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-09-27
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1418733-4
ISSN	1573-2614 ; 1387-1307 ; 0748-1977
ISSN (online)	1573-2614
ISSN	1387-1307 ; 0748-1977
DOI	10.1007/s10877-022-00916-z
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Article: Rigid but nonmetallic cranioplasty after pterional craniotomy: Technical note.

Sanada, Yasuhiro / Tsuji, Kiyoshi / Hamada, Yuumi / Fujishima, Kazuhiro / Furukawa, Kentaro / Fukawa, Norihito / Kubota, Hisashi / Satow, Tetsu / Takahashi, Jun C

Surgical neurology international

2023 Volume 14, Page(s) 337

Abstract: Background: Given the popularity of pterional craniotomy, numerous modifications have been made to prevent postoperative deformities. With the advent of titanium plates, fixation has become both simple and excellent. However, titanium plates can cause ... ...

Abstract	Background: Given the popularity of pterional craniotomy, numerous modifications have been made to prevent postoperative deformities. With the advent of titanium plates, fixation has become both simple and excellent. However, titanium plates can cause skin problems, infection, or cause skull growth to fail. Methods: To develop a simple, cost-effective, and esthetically satisfactory fixation method, without the use of non-metallic materials, six young and older patients underwent pterional craniotomy. CranioFix Absorbable clamps were used to fix the bone flap in the frontal and temporal regions such that the frontal part was in close contact with the skull. After fixation, the bone chips and bone dust were placed in the bone gap and fixed with fibrin glue. We measured the computed tomography values of the reconstructed area and thickness of the temporal profiles postoperatively over time. Results: Bone fusion was achieved in all patients by 1 year after surgery. Both the thickness of the temporalis muscle and the thickness of the temporal profile had changed within 2 mm as compared with the preoperative state. Conclusion: Our simple craniotomy technique, gentle tissue handling, and osteoplastic cranioplasty yielded satisfactory esthetic results and rigidness in pterional craniotomy.
Language	English
Publishing date	2023-09-15
Publishing country	United States
Document type	Journal Article
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_577_2023
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Article ; Online: In Reply to the Letter to the Editor Regarding "Revascularization Surgery in Childhood Associated with a Low Incidence of Microbleeds in Adult Patients with Moyamoya".

Yamao, Yukihiro / Funaki, Takeshi / Takahashi, Jun C / Miyamoto, Susumu

World neurosurgery

2020 Volume 138, Page(s) 573

MeSH term(s)	Adult ; Cerebral Hemorrhage ; Cerebral Revascularization ; Child ; Humans ; Incidence ; Moyamoya Disease ; Vascular Surgical Procedures
Language	English
Publishing date	2020-06-07
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.03.092
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Article ; Online: Coiling for Ruptured Aneurysms in the Vasospasm Period: Safety and Efficacy Based on a Propensity Score Analysis.

Koiso, Takao / Satow, Tetsu / Hamano, Eika / Nishimura, Masaki / Takahashi, Jun C / Kataoka, Hiroharu

Journal of neuroendovascular therapy

2021 Volume 16, Issue 3, Page(s) 141–146

Abstract: Objective: To evaluate the efficacy and safety of interventional radiology (IVR) for aneurysmal subarachnoid hemorrhage (SAH) later than 3 days after onset.: Methods: A total of 71 patients between 2012 and 2017 who underwent endovascular coiling ... ...

Abstract	Objective: To evaluate the efficacy and safety of interventional radiology (IVR) for aneurysmal subarachnoid hemorrhage (SAH) later than 3 days after onset. Methods: A total of 71 patients between 2012 and 2017 who underwent endovascular coiling were divided into two groups according to the timing of treatment: Group E (treated within 3 days after onset) and group D (treated between 4 and 14 days after onset), and the outcomes between two groups were compared. A case-matched study was conducted to minimize the selection bias lying in this cohort. Results: There were 56 (78.9%) and 15 (21.1%) patients in groups E and D, respectively. In group D, all patients arrived at the hospital later than 3 days after onset. The rates of patients with WFNS grade 1, 2, 3 and the presence of vasospasm upon the access route to the targeted aneurysm at the time of IVR were significantly higher in group D than in group E (93.3% vs 60.7%; p = 0.027, 33.3% vs 3.6%; p = 0.0037, respectively). There were no significant differences in the rate of intraprocedural complications, symptomatic vasospasm, delayed cerebral infarction due to vasospasm, retreatment, or modified Rankin Scale (mRS) at discharge. After propensity score matching, there were no significant differences in the outcomes between two groups. Conclusion: Prompt coiling for patients with ruptured aneurysms who arrived later than 3 days after onset can be safely performed, even if they had vasospasm upon the access route.
Language	English
Publishing date	2021-08-14
Publishing country	Japan
Document type	Journal Article
ISSN	2186-2494
ISSN (online)	2186-2494
DOI	10.5797/jnet.oa.2021-0034
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Article ; Online: A Case of Direct Carotid-Cavernous Fistulae Successfully Treated by Bidirectional Double Catheter Technique: A Technical Note.

Hamano, Eika / Satow, Tetsu / Hori, Takamitsu / Takahashi, Jun C / Kataoka, Hiroharu

Journal of neuroendovascular therapy

2021 Volume 16, Issue 6, Page(s) 307–312

Abstract: Objective: Ruptured carotid-cavernous aneurysms (CCAs) are known to result in direct carotid-cavernous fistula (CCF). Although endovascular treatment is recognized as the first-line treatment for direct CCF, obliteration is sometimes difficult because ... ...

Abstract	Objective: Ruptured carotid-cavernous aneurysms (CCAs) are known to result in direct carotid-cavernous fistula (CCF). Although endovascular treatment is recognized as the first-line treatment for direct CCF, obliteration is sometimes difficult because of the high-flow shunt. In this report, we present a case of a direct CCF treated by the combination of transarterial and transvenous approaches. Case presentation: A 57-year-old woman presented with conjunctival chemosis, exophthalmos, and tinnitus. Ophthalmological examination revealed increased intraocular pressure. DSA demonstrated a direct CCF due to a right ruptured CCA with retrograde shunted flow through the superior ophthalmic vein (SOV), superficial middle cerebral vein, basal vein of Rosenthal, and middle temporal vein. Two microcatheters were guided into the shunt segment from the internal carotid artery and SOV. In addition, a balloon catheter was placed at the neck of the aneurysm to assist coiling. Coil embolization for the CCF was performed using two microcatheters in the opposite direction, which enabled compact and tight packing of the shunt segment with only six coils. The CCF was eliminated. Two-year-follow-up MRA revealed no recurrence. Conclusion: The bidirectional double catheter technique is a useful approach to obliterate a shunt in a short segment with minimal coils.
Language	English
Publishing date	2021-09-22
Publishing country	Japan
Document type	Case Reports
ISSN	2186-2494
ISSN (online)	2186-2494
DOI	10.5797/jnet.cr.2021-0052
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Article ; Online: Effectiveness of Palliative Cerebrospinal Fluid Shunting for Patients With Leptomeningeal Carcinomatosis-related Hydrocephalus.

Yoshioka, Hiromasa / Okuda, Takeshi / Nakao, Takayuki / Fujita, Mitsugu / Takahashi, Jun C

Anticancer research

2021 Volume 41, Issue 8, Page(s) 4169–4172

Abstract: Background/aim: Leptomeningeal carcinomatosis (LMC) with hydrocephalus is particularly difficult to treat, and its prognosis is extremely poor. The therapeutic outcomes of 14 patients with LMC-associated hydrocephalus who were treated with cerebrospinal ...

Abstract	Background/aim: Leptomeningeal carcinomatosis (LMC) with hydrocephalus is particularly difficult to treat, and its prognosis is extremely poor. The therapeutic outcomes of 14 patients with LMC-associated hydrocephalus who were treated with cerebrospinal fluid shunting are reported. Patients and methods: The study subjects were 14 LMC patients with solid primary cancer who had developed hydrocephalus. Results: Postoperatively, both symptoms and Karnofsky performance status improved in 100% of patients. Postoperative therapy consisted of whole-brain radiotherapy in 4 cases and molecular targeted therapy in 4, with 6 patients not receiving any postoperative treatment. Median overall survival was 3.7 months, with no significant difference between those who underwent postoperative therapy and those who did not. However, two of those who received molecular targeted therapy survived for more than one year. Conclusion: Cerebrospinal fluid shunting for LMC-associated hydrocephalus is an effective therapeutic procedure from the palliative viewpoint. Patients for whom molecular targeted therapy is indicated may have better long-term survival.
MeSH term(s)	Adult ; Aged ; Cerebrospinal Fluid Shunts ; Female ; Humans ; Hydrocephalus/etiology ; Hydrocephalus/mortality ; Hydrocephalus/surgery ; Hydrocephalus/therapy ; Kaplan-Meier Estimate ; Male ; Meningeal Carcinomatosis/complications ; Meningeal Carcinomatosis/mortality ; Meningeal Carcinomatosis/surgery ; Meningeal Carcinomatosis/therapy ; Middle Aged ; Molecular Targeted Therapy ; Palliative Care ; Peritoneal Cavity
Language	English
Publishing date	2021-07-13
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.15221
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Article ; Online: Usefulness of Craniograms in Discriminating Coiled Intracranial Aneurysms Requiring Retreatment.

Yasuda, Ryuta / Satow, Tetsu / Hashimura, Naoki / Nishimura, Masaki / Takahashi, Jun C / Kataoka, Hiroharu

Neurologia medico-chirurgica

2021 Volume 62, Issue 3, Page(s) 118–124

Abstract: While endovascular coil embolization has become one of the major therapeutic modalities for intracranial aneurysms, long-term imaging follow-up is required because of the higher rate of retreatment compared with surgical clipping. The purpose of this ... ...

Abstract	While endovascular coil embolization has become one of the major therapeutic modalities for intracranial aneurysms, long-term imaging follow-up is required because of the higher rate of retreatment compared with surgical clipping. The purpose of this study was to show the usefulness of craniograms to discriminate coiled intracranial aneurysms that required retreatment. Under the study protocol approved by institutional review board, a retrospective review of the medical record was done regarding coil embolization for intracranial aneurysms performed between January 2014 and December 2018. Coil embolization performed as the initial treatment and followed up for more than 1 year without additional treatment, and those performed as retreatment after the initial coil embolization performed at our institution were recruited. Craniograms obtained just after the initial treatment were compared with those obtained just before the additional treatment in the retreated cases and compared with the latest ones in the non-recurrence cases. Correlation between the morphological changes in the coil mass on the craniograms and retreatments was evaluated. During the study period, 288 coil embolization procedures for intracranial aneurysms were performed. From these, 191 treatments that were followed up for more than 1 year without any additional treatments and 30 retreatments were included. Morphological change of the coil mass was observed in 4 of the 191 non-recurrence treatments and 26 of the 30 retreatments, which was significantly correlated with retreatments (p <0.001). Craniogram was a useful modality in following up the coiled intracranial aneurysms to detect those required retreatments.
MeSH term(s)	Embolization, Therapeutic/methods ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/surgery ; Intracranial Aneurysm/therapy ; Recurrence ; Retreatment ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-12-08
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/nmc.oa.2021-0225
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