Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsTransient asystole during surgery for posterior fossa meningioma caused by activation of the trigeminocardiac reflex: three case reports.
Three patients undergoing surgery for cerebello-pontine angle meningioma suffered transient episodes of asystole. All patients exhibited return to the previous heart rate with cessation of surgical manipulations and administration of anticholinergic agents. ⋯ The possibility of activation of the TCR should be considered during surgical manipulation around the trigeminal nerve or the distribution of the trigeminal nerve branches. Transient bradycardia, hypotension, or asystole can occur regardless of whether there is pressure on the brainstem during posterior fossa meningioma surgery.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsTakotsubo cardiomyopathy induced by dobutamine infusion during hypertensive therapy for symptomatic vasospasm after subarachnoid hemorrhage -case report-.
A 65-year-old female with subarachnoid hemorrhage (SAH) developed takotsubo cardiomyopathy induced by dobutamine infusion for vasospasm 9 days after onset of SAH. She underwent neck clipping of the ruptured cerebral aneurysm on day 1. Course after surgery was uneventful, but she developed motor aphasia on day 9. ⋯ Therefore, generally, cardiac function is worst at the early stage of SAH, when sympathetic activity is highest, and recovers thereafter. Dobutamine infusion seems to have triggered the takotsubo cardiomyopathy in the present patient even 9 days after onset of SAH. Inotropic agents including dobutamine are often used during the course of SAH, and since takotsubo cardiomyopathy can occur in patients with SAH, this complication must be considered.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsDirect relief of levodopa-induced dyskinesia by stimulation in the area above the subthalamic nucleus in a patient with Parkinson's disease--case report.
A 71-year-old woman with a 25-year history of levodopa (LD)-responsive Parkinson's disease (PD) developed on-off motor fluctuation and severe peak dose dyskinesia. She underwent deep brain stimulation of the subthalamic nucleus (STN-DBS). ⋯ LD-induced dyskinesia can also be controlled via reduction of LD dosage as an indirect effect of STN-DBS. The present case provides evidence of the direct antidyskinetic effect of STN-DBS, and suggests that LD-induced dyskinesia can be inhibited by stimulation in the area above the STN.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsCavernous angioma associated with arteriovenous malformation of the brain--case report.
A 61-year-old man presented a rare case of cerebral cavernous angioma associated with cerebral arteriovenous malformation (AVM) manifesting as headache. Magnetic resonance imaging showed an AVM in the right occipital lobe and a cavernous angioma in the left middle fossa. The patient underwent left frontotemporal craniotomy with total resection of the left parasellar intra-axial tumor. ⋯ The histological diagnoses were cavernous angioma and AVM, respectively. Immunostaining for angiogenic growth factors and structural proteins revealed different expression patterns of alpha-smooth muscle actin in these structures. Expression of structural proteins may reflect differences in their pathogenesis.