研究者詳細 - 竹内　和人

論文 - 竹内　和人

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Imaging features and consideration of progression pattern of diffuse hemispheric gliomas, H3 G34-mutant 国際誌 Open Access

Kibe, Y; Chalise, L; Ohka, F; Motomura, K; Nakahara, N; Aoki, K; Deguchi, S; Shiba, Y; Takeuchi, K; Iwami, K; Yamaguchi, J; Shimizu, H; Maeda, S; Takido, Y; Yamamoto, R; Okuno, Y; Sakai, A; Karube, K; Saito, R

ACTA NEUROPATHOLOGICA COMMUNICATIONS 13 巻 ( 1 ) 頁： 43 - 43 2025年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Acta Neuropathologica Communications

Diffuse hemispheric glioma H3 G34-mutant (DHG) has been identified as a distinct pediatric-type high-grade glioma, according to the World Health Organization (WHO) classification of central nervous system tumors. Widely accepted treatment options include surgery, radiation, and conventional chemotherapy. However, the efficacy of the surgical resection remains unclear. Although there are some reports, a comprehensive understanding of the clinical characteristics, pathogenesis, and outcomes of DHG is insufficient to evaluate the efficacy of maximal tumor resection. We retrospectively analyzed nine cases of DHG, focusing on imaging features and progression patterns. Initial Magnetic Resonance Imaging (MRI) revealed T2/FLAIR high lesions with minimal or no contrast enhancement in all cases. The lesions exhibited T2/FLAIR hyperintensities and focal diffusion restriction in the deep white matter, with most showing high methionine accumulation, suggesting deep white matter infiltration at the time of diagnosis. The extent of white matter infiltration in tumor resection cases was significantly negatively correlated with the extent of resection (EOR). In addition, cases with EOR of 90% or more had significantly longer progression-free survival (PFS) and overall survival (OS). However, achieving an EOR of 90% or more was possible in fewer than half of the cases, primarily in those with relatively limited white matter involvement. Histopathological findings of the tumor obtained by initial resection and autopsy revealed extensive deep white matter infiltration, with one patient demonstrating tumor invasion into the brainstem at death. Our study highlights early deep white matter infiltration of DHGs, complicating surgical resection, and potentially contributing to a poor prognosis. While EOR may influence survival to some extent, residual lesions extensively infiltrate the white matter and eventually invade the brainstem and contralateral brain, thereby contributing to mortality. These findings underscore the challenges of managing DHGs and emphasize the need for further research on effective therapeutic strategies, particularly to understand and target their unique progression patterns.

DOI： 10.1186/s40478-025-01945-w

Endoscope-assisted brain tumor removal overcomes the restriction of using intraoperative open magnetic resonance imaging in the suboccipital approach Open Access

Sasaki, K; Ohka, F; Motomura, K; Nagata, Y; Takeuchi, K; Saito, R

NAGOYA JOURNAL OF MEDICAL SCIENCE 87 巻 ( 1 ) 頁： 168 - 172 2025年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Nagoya Journal of Medical Science

Intraoperative magnetic resonance imaging (iMRI) plays a crucial role in improving the precision of brain tumor surgeries. However, the use of iMRI can impose certain limitations on intraoperative head positioning. In regular microscopic surgery, head positioning is of utmost importance because an appropriate surgical field is important for the efficacy and safety of surgery. Therefore, in cases where adequate head positioning is difficult, usually, iMRI will not be utilized. Herein, we report an adult case of cerebellar astrocytoma whose tumor extended to the culmen of the cerebellum. Upon surgery via the suboccipital approach, the positional limitations imposed by iMRI led to an insufficient vertex-down position and limited surgical field, which hampered the removal of the upper portion of the tumor. However, this concern could be overcome when used in combination with an endoscope. The potential of iMRI applications is anticipated to be enhanced by overcoming positional limitations through combined endoscopic surgery. The use of multimodality in surgery is an optimal example of how surgical support equipment can also improve surgical outcomes. Here, we report on the new possibilities offered by multimodality.

DOI： 10.18999/nagjms.87.1.168

Endoscopic Cystoventricular Stenting in Awake Patients with Electrical Stimulation Mapping for Convexity Cysts: Three Case Reports and a Systematic Review 査読有り国際誌 Open Access

Okumura, E; Takeuchi, K; Nagata, Y; Iwami, K; Motomura, K; Ohka, F; Sato, Y; Hirose, T; Saito, R

WORLD NEUROSURGERY 193 巻頁： 108 - 118 2025年1月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：World Neurosurgery

Surgical interventions for arachnoid cysts and glioependymal cysts primarily focus on cyst decompression and establishing communication with cerebrospinal fluid spaces. However, a standardized surgical strategy for symptomatic convexity cysts lacking surrounding cerebrospinal fluid space is still lacking due to the limited number of cases. This systematic review aims to evaluate surgical interventions for symptomatic convexity cysts and proposes a safe and effective treatment approach we have developed. A systematic review of the literature was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Surgical techniques were categorized into cystoperitoneal shunt, cyst excision, cyst fenestration, cyst ventriculostomy, and several uniquely modified methods. Using a method different from these previous reports, we performed endoscopic cystoventricular stenting via burr hole in 3 cases of convexity cysts. While traditional methods have proven effective, cystoperitoneal shunt may lead to malfunction, infection, and subdural hematoma; wall excision is invasive and increases morbidity risks. Fenestration and cystoventriculostomy have also reported cases of recurrence. Other methods also pose issues, including off-label use of instruments and inadequate consideration for removal. The method we performed for placing the stent catheter with multiple side holes demonstrated long-term effectiveness. Furthermore, the surgery was conducted with the patient fully awake, and the use of electrical stimulation mapping enabled preservation of higher neurocognitive functions, including language, working memory, and spatial cognition, at the puncture site. This novel approach offers advantages such as minimally invasive procedure, preservation of safe brain function, and long-term patency. Further studies are warranted to validate these findings and improve surgical strategies for convexity cysts.

DOI： 10.1016/j.wneu.2024.10.031

脳幹部海綿状血管奇形に対する内視鏡手術 Open Access

竹内和人, 永田雄一, 伊藤英治, 奥村衣里子, 原田英幸, 齋藤竜太

脳卒中の外科 53 巻 ( 2 ) 頁： 108 - 113 2025年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本脳卒中の外科学会

脳幹部海綿状血管奇形（BCM）治療における内視鏡利用の報告は，少数の症例報告に留まっている．内視鏡は，深部でも広く明るい視野が得られることから，深部病変であるBCMに対しても有効と考え，積極的に利用してきた．内視鏡治療を応用したBCM症例 32例（中脳 7例，橋 22例，延髄 3例）を後方視的に検討した．脳幹内部への進入ルートは，2 point methodを基本として主に近傍のsafe entry zoneを利用した．5例で経鼻術，27例で開頭術による摘出が行われた．そのうち25例で，手術corridorの確保目的に細径シリンダーが用いられた．30例（93.8％）でGTRが得られた．術後合併症は5例で認められた．術前平均KPS 62.2に対し，手術3カ月後は84.4であり，改善 26例，不変 5例，悪化 1例であった．また，1例で手術半年後に遅発性パーキンソン症候群を合併し，KPSの低下が認められた．一般的に，BCMに対する外科治療は，顕微鏡下に行われている．本研究における内視鏡下手術の治療成績は，既報と比較して良好な神経予後を示している．内視鏡を用いることで，手術経路の最小化と水中下手術が可能となり，これにより従来にないアプローチ方法を確立することができた．内視鏡の特徴的な手術法である水中での内部観察は，残存病変や止血の確認に非常に有効であった．内視鏡の利用には欠点も存在するため，さまざまな機器の開発，機器操作法の改良を行っている．内視鏡利用は，いまだ発展途上ではあるが，BCMに対する有用性・安全性が支持された．

DOI： 10.2335/scs.53.108

Open Access

CiNii Research

Myxoid Glioneuronal Tumours with PDGFRA p.K385 Mutations Causing Hydrocephalus and Successfully Treated with Neuroendoscopic Surgery: A Case Report and Literature Review. Open Access

Wakisaka S, Nagata Y, Fukuoka T, Ohka F, Satake Y, Takeuchi K, Saito R

NMC case report journal 12 巻 ( 0 ) 頁： 361 - 367 2025年

Registry-Based Assessment of Shunt Operation Methods and Outcomes in Idiopathic Normal Pressure Hydrocephalus (RASHOMON Study): Protocol for a Multicenter Prospective Observational Cohort Study 査読有り国際誌 Open Access

Okumura, E; Takeuchi, K; Momota, H; Nagatani, T; Taoka, T; Aimi, Y; Hashizume, A; Okazaki, M; Saito, R

JMIR RESEARCH PROTOCOLS 14 巻頁： e80678 2025年

Isolation of ependymal cilia from mouse brain( vol 409, 110198, 2024) 国際誌 Open Access

Mizuno, A; Takeuchi, K; Nagata, Y; Harada, H; Yamamoto, T; Ishikawa, T; Maeda, S; Ohka, F; Ueno, H; Saito, R

JOURNAL OF NEUROSCIENCE METHODS 412 巻頁： 110293 - 110293 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neuroscience Methods

The authors regret that the affiliation information was incomplete in the original article. The correct and complete affiliation information should be as follows: Akihiro Mizunoa,b a Department of Neurosurgery, Komaki City Hospital, Aichi, Japan b Department of Neurosurgery, Nagoya University, Nagoya, Japan This research was conducted while the author was affiliated with Nagoya University. The addition of this affiliation is important for accurately reflecting the research context. The authors would like to apologize for any inconvenience caused.

DOI： 10.1016/j.jneumeth.2024.110293

DISTANT PARENCHYMAL RECURRENCE DURING LONG-TERM USE OF TTFIELDS TREATMENT FOR GLIOBLASTOMA Open Access

Takido, Y; Ohka, F; Deguchi, S; Motomura, K; Mitsuya, K; Shiba, Y; Takeuchi, K; Nagata, Y; Yamaguchi, J; Kibe, Y; Fuse, Y; Maeda, S; Shimizu, H; Nohira, S; Yamamoto, R; Ito, S; Nakamura, A; Saito, R

NEURO-ONCOLOGY 26 巻 2024年11月

ESTABLISHMENT OF PITUITARY NEUROENDOCRINE TUMOR (PITNET) ORGANOID MODELS Open Access

Maeda, S; Ohka, F; Kanamori, F; Okumura, Y; Takeuchi, K; Nagata, Y; Yamaguchi, J; Harada, H; Shimizu, H; Takido, Y; Saito, R

NEURO-ONCOLOGY 26 巻 2024年11月

INTRA-OPERATIVE GENETIC ANALYSES FOR DECISION-MAKING DURING TUMOR REMOVAL OF ADULT-TYPE DIFFUSE GLIOMA USING RAPID QUANTITATIVE PCR DEVICE Open Access

Ohka, F; Maeda, S; Shimizu, H; Motomura, K; Takeuchi, K; Nagata, Y; Deguchi, S; Shiba, Y; Yamaguchi, J; Takido, Y; Nakamura, A; Ito, S; Saito, R

NEURO-ONCOLOGY 26 巻 2024年11月

Exo- and endoscopic two-step approach for meningeal tumours invading the lateral wall of large dural venous sinuses: how I do it 国際誌 Open Access

Iwami, K; Watanabe, T; Takeuchi, K; Saito, R

ACTA NEUROCHIRURGICA 166 巻 ( 1 ) 頁： 397 - 397 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Acta Neurochirurgica

Background: Treating meningeal tumours invading the large dural venous sinuses is a subject of debate regarding the approach for removing the intra-sinus components. Additionally, directly observing the invasion site of tumours invading the lateral wall of the sinus is difficult. Method: We describe our exo- and endoscopic two-step approach (EETA): an exoscope is used to remove the extra-sinus component, while an endoscope is used to observe the invaded lateral wall and remove the intra-sinus component. Conclusion: EETA can be a viable option for treating meningeal tumours invading the venous sinus owing to its high resection rate and low invasiveness.

DOI： 10.1007/s00701-024-06298-2

Cylinder tumor surgery in pediatric low-grade gliomas 査読有り国際誌

Jaimovich, SG; Takeuchi, K; Testa, VT; Okumura, E; Jaimovich, R; Cinalli, G

CHILDS NERVOUS SYSTEM 40 巻 ( 10 ) 頁： 3051 - 3063 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Child S Nervous System

Background: Periventricular pediatric low-grade gliomas (pLGG) present a surgical challenge due to their deep-seated location, accessibility, and relationship with the subcortical network connections. Minimally invasive parafascicular approaches with tubular brain retractors (port brain surgery) have emerged, in recent years, as an alternative to conventional microsurgical and endoscopic approaches for removal of periventricular tumors. Objectives: To describe the minimally invasive approach with tubular brain retractors for periventricular pLGG, its technique, applications, safety, and efficacy. Methods: In this article, we describe the port brain surgery techniques for periventricular pLGG as performed in different centers, with different commercialized tubular retractor systems. Illustrative cases followed by a literature review are analyzed, with a detailed description of different approaches or techniques, comparing their advantages and disadvantages with contemporary microsurgical and endoscopic approaches. Conclusions: The port brain surgery with micro-exoscopic vision and endoscopic assistance, for the treatment of deep-seated lesions such as periventricular pLGG, is an alternative for achieving a functionally safe—gross total or subtotal—tumor resection, obtaining adequate tissue for pathological examination. This technique could offer a new dimension for a less-invasive, safe, and effective access to deep-seated tumors, offering the possibility to lower morbidity in experienced hands.

DOI： 10.1007/s00381-024-06417-5

脳腫瘍の術中迅速遺伝子解析法の樹立

大岡史治, 前田紗知, 山口純矢, 清水大輝, 本村和也, 出口彰一, 芝良樹, 竹内和人, 永田雄一, 滝戸悠平, 齋藤竜太

日本癌治療学会学術集会抄録集 62回巻頁： O88 - 2 2024年10月

Isolation of ependymal cilia from mouse brain 査読有り国際誌 Open Access

Mizuno, A; Takeuchi, K; Nagata, Y; Harada, H; Yamamoto, T; Ishikawa, T; Maeda, S; Ohka, F; Ueno, H; Saito, R

JOURNAL OF NEUROSCIENCE METHODS 409 巻頁： 110198 - 110198 2024年9月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Neuroscience Methods

Background: Ependymal cilia play a major role in the circulation of cerebrospinal fluid. Although isolation of cilia is an essential technique for investigating ciliary structure, to the best of our knowledge, no report on the isolation and structural analysis of ependymal cilia from mouse brain is available. New method: We developed a novel method for isolating ependymal cilia from mouse brain ventricles. We isolated ependymal cilia by partially opening the lateral ventricles and gently applying shear stress, followed by pipetting and ultracentrifugation. Results: Using this new method, we were able to observe cilia separately. The results demonstrated that our method successfully isolated intact ependymal cilia with preserved morphology and ultrastructure. In this procedure, the ventricular ependymal cell layer was partially detached. Comparison with existing methods: Compared to existing methods for isolating cilia from other tissues, our method is meticulously tailored for extracting ependymal cilia from the mouse brain. Designed with a keen understanding of the fragility of the ventricular ependyma, our method prioritizes minimizing tissue damage during the isolation procedure. Conclusions: We isolated ependymal cilia from mouse brain by applying shear stress selectively to the ventricles. Our method can be used to conduct more detailed studies on the structure of ependymal cilia.

DOI： 10.1016/j.jneumeth.2024.110198

神経内視鏡画像における機能性下垂体腫瘍を含めた手術支援AIシステムの構築

布施佑太郎, 竹内和人, 橋本典明, 永田雄一, 永谷哲也, 竹内一郎, 齋藤竜太

日本内分泌学会雑誌 100 巻 ( S.HPT ) 頁： 19 - 21 2024年8月

The Potential Role of Preoperative Posterior Cerebral Artery Involvement in Predicting Postoperative Transient Neurological Deficits and Ischemic Stroke After Indirect Revascularization in Patients With Moyamoya Disease 査読有り国際誌

Araki, Y; Yokoyama, K; Uda, K; Kanamori, F; Takayanagi, K; Ishii, K; Nishihori, M; Goto, S; Tsukada, T; Takeuchi, K; Tanahashi, K; Nagata, Y; Nishimura, Y; Tanei, T; Nagashima, Y; Muraoka, S; Izumi, T; Seki, Y; Saito, R

WORLD NEUROSURGERY 187 巻頁： E610 - E619 2024年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：World Neurosurgery

Objective: Transient neurological deficits (TNDs) are known to develop after direct bypass for Moyamoya disease and may be risk factors for subsequent stroke. However, the factors involved in the development of TNDs and stroke after indirect revascularization alone, including their association with subsequent stroke, remain unclear. The purpose of this study was to investigate this issue. Methods: The subjects of the study were 30 patients with Moyamoya disease who underwent a total of 40 indirect revascularization procedures at our institution. Clinical and radiological data were collected retrospectively. To examine factors associated with the development of postoperative TND/stroke/asymptomatic disease, the clinical characteristics of each group were statistically compared. Results: The mean age at surgery was 7 years (range 1–63). TNDs developed after surgery in 9 out of 40 patients (22.5%). Stroke in the acute postoperative period occurred in 3 patients (7.5%), all of whom experienced cerebral infarctions. Demographic data and preoperative clinical information were not different between the groups. However, posterior cerebral artery involvement on preoperative imaging was significantly associated with the development of TNDs and stroke (P = 0.006). Furthermore, postoperative stroke was associated with unfavorable outcomes (P = 0.025). Conclusions: Posterior cerebral artery involvement is significantly associated with the occurrence of TNDs. In contrast, TNDs after indirect revascularization have little relationship with the subsequent development of stroke. TNDs usually resolve without new strokes, and a better understanding of this particular pathology could help establish an optimal treatment regimen.

DOI： 10.1016/j.wneu.2024.04.135

Case report: Endoscopic endonasal transposterior clinoid approach for resection of posterior clinoid process meningioma: technical notes and literature review 査読有り国際誌 Open Access

Awyono, S; Takeuchi, K; Ito, E; Nagata, Y; Golden, N; Mahadewa, TGB; Saito, R

FRONTIERS IN ONCOLOGY 14 巻頁： 1368277 - 1368277 2024年6月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Frontiers in Oncology

Background: Posterior clinoid process (PCP) meningioma is an exceedingly rare entity. It remains the most challenging skull base lesion for neurosurgeons due to its treacherous location that insinuates amongst critical neurovascular structures. This article will describe the technical notes using the endoscopic endonasal approach that provide the earliest devascularization and detachment of the tumor PCP meningioma. Methods: We are introducing the surgical implementation of an endoscopic endonasal approach to removing PCP meningioma. Furthermore, we perform a literature review of posterior clinoid process meningioma that undergoes surgical intervention, then summarize the benefits and limitations of each approach. Results: We present a case of right PCP meningioma that was removed using an endoscopic endonasal approach through the transposterior clinoid corridor in a 52-year-old-woman. We describe the technical notes in performing this approach to have the earliest devascularization and detachment of the tumor by performing posterior clinoidectomy. Safe tumor removal is performed with a wide and clear view of the surrounding neurovascular structure. Based on our database search, we found nine articles reported on the surgical management of PCP meningiomas, with a total number of 15 cases. All of the reported cases performed the tumor removal using the transcranial approach. Conclusion: The endoscopic endonasal transposterior clinoid approach circumvents all disadvantages faced by the traditional transcranial approach, providing the earliest approach to devascularized and detaching the tumor from its attachment at PCP. This approach demonstrates safety and efficacy, making it an acceptable alternative for PCP meningioma resections.

DOI： 10.3389/fonc.2024.1368277

症例機能性ゴナドトロピン産生下垂体腫瘍が原因で生じた卵巣囊胞に対しくり返し卵巣腫瘍摘出術が行われた1例

太田肇, 三宅菜月, 太田幸希, 村岡彩子, 竹内和人, 大須賀智子

産科と婦人科 91 巻 ( 5 ) 頁： 593 - 597 2024年5月