Faculty Profiles - TAOKA Toshiaki

Effective second stent placement on down-the-barrel view for a stent assisted coil embolization of vertebral artery fusiform aneurysm: case report

Successful intravenous rt-PA treatment for a patient with basilar artery occlusion manifesting ischemic neurogenic stunned myocardium and ataxic breathing. Reviewed

Tomoyuki Taguchi, Masayuki Fujioka, Shingo Ito, Yasushi Motoyama, Hiroyuki Nakase, Toshiaki Taoka, Kazuo Okuchi

Neurosurgical Emergency Vol. 19 page： 220 - 225 2014

WADA Takeshi, TAKAYAMA Katsutoshi, TAOKA Toshiaki, NAKAGAWA Hiroyuki, MYOUCHIN Kaoru, KIMURA Ryouta, KUROKAWA Shinichiro, KICHIKAWA Kimihiko

Journal of Neuroendovascular Therapy Vol. 8 ( 4 ) page： 218 - 223 2014

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for Neuroendovascular Therapy

Objective: We report a case of a fusiform aneurysm of vertebral artery, treated by second stent placement using stent-in-stent technique on down-the-barrel view (DBV) for a stent assisted coil embolization. Case presentation: A 60-year-old woman had a fusiform aneurysm of the right vertebral artery growing up in size during 1 year follow up. Stent-assisted coil embolization using an Enterprise stent was performed. During coil embolization with the initial Enterprise stent, coil migration to the parent artery was seen on DBV. The second Enterprise stent was deployed in a stent-in-stent manner. Following deployment of the second stent, coil migration to the parent artery disappeared with preserving the vessel lumen. Complete occlusion of the aneurysm and good patency of the parent artery were seen on 3 months’ follow up angiogram. Conclusion: Second stent placement using stent-in-stent technique may be effective for management of coil herniation to the parent vessel during stent-assist coil embolization for fusiform vertebral artery aneurysm.

DOI： 10.5797/jnet.cr.13050

CiNii Research

A Mismatch Between the Abnormalities in Diffusion- and Susceptibility-Weighted Magnetic Resonance Imaging May Represent an Acute Ischemic Penumbra with Misery Perfusion International journal

Masayuki Fujioka, Kazuo Okuchi, Asami Iwamura, Toshiaki Taoka, Bo K. Siesjo

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES Vol. 22 ( 8 ) page： 1428 - 31 2013.11

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Susceptibility-weighted imaging (SWI) has recently attracted attention for its ability to investigate acute stroke pathophysiology. SWI detects an increased ratio of deoxyhemoglobin to oxyhemoglobin in cerebral venous compartments, which can illustrate cerebral misery perfusion with a compensatory increase of oxygen extraction fraction in the hypoperfused brain. In this study we make the first case report of blunt cervical trauma leading to a stroke, demonstrating the disparity between diffusion-weighted imaging (DWI) and SWI changes, or DWI-SWI mismatch, in the acute ischemic brain. The area of mismatch between a smaller DWI cytotoxic edema and a larger SWI misery perfusion in our patient matured into a complete infarction with time. The DWI-SWI mismatch may signify the presence of an ischemic penumbra, and provide information about viability of the brain tissue at risk of potential infarction if without early reperfusion.

DOI： 10.1016/j.jstrokecerebrovasdis.2012.12.009

Unilateral oculomotor nerve palsy as an initial presentation of bilateral chronic subdural hematoma: Case report

Matsuda R., Hironaka Y., Kawai H., Park Y., Taoka T., Nakase H.

Neurologia Medico-Chirurgica Vol. 53 ( 9 ) page： 616 - 619 2013.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Neurologia Medico-Chirurgica

Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy. © 2013 by The Japan Neurosurgical Society.

DOI： 10.2176/nmc.cr2012-0339

Unilateral Oculomotor Nerve Palsy as an Initial Presentation of Bilateral Chronic Subdural Hematoma: Case Report Reviewed

Ryosuke Matsuda, Yasuo Hironaka, Hisashi Kawai, Young-Su Park, Toshiaki Taoka, Hiroyuki Nakase

NEUROLOGIA MEDICO-CHIRURGICA Vol. 53 ( 9 ) page： 616 - 619 2013.9

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN NEUROSURGICAL SOC

Isolated oculomotor nerve palsy is well known as a symptom of microvascular infarction and intracranial aneurysm, but unilateral oculomotor nerve palsy as an initial manifestation of chronic subdural hematoma (CSDH) is a rare clinical condition. We report a rare case of an 84-year-old woman with bilateral CSDH who presented with unilateral oculomotor nerve palsy as the initial symptom. The patient, who had a medical history of minor head injury 3 weeks prior, presented with left ptosis, diplopia, and vomiting. She had taken an antiplatelet drug for lacunar cerebral infarction. Computed tomography (CT) of the head showed bilateral CSDH with a slight midline shift to the left side. She underwent an urgent evacuation through bilateral frontal burr holes. Magnetic resonance angiography (MRA) after evacuation revealed no intracranial aneurysms, but constructive interference in steady-state (CISS) magnetic resonance imaging (MM) revealed that the left posterior cerebral artery (PCA) ran much more anteriorly and inferiorly compared with the right PCA and the left oculomotor nerve passed very closely between the left PCA and the left superior cerebellar artery (SCA). There is the possibility that the strong compression to the left uncus, the left PCA, and the left SCA due to the bilateral CSDH resulted in left oculomotor nerve palsy with an initial manifestation without unconsciousness. Unilateral oculomotor nerve palsy as an initial presentation caused by bilateral CSDH without unconsciousness is a rare clinical condition, but this situation is very important as a differential diagnosis of unilateral oculomotor nerve palsy.

DOI： 10.2176/nmc.cr2012-0339

Longitudinal white matter changes in Alzheimer's disease: A tractography-based analysis study

Soichiro Kitamura, Kuniaki Kiuchi, Toshiaki Taoka, Kazumichi Hashimoto, Shotaro Ueda, Fumihiko Yasuno, Masayuki Morikawa, Kimihiko Kichikawa, Toshifumi Kishimoto

BRAIN RESEARCH Vol. 1515 page： 12 - 8 2013.6

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Alzheimer's disease (AD) classically presents with gray matter atrophy, as well as feature significant white matter abnormalities. Previous evidence indicates the overall burden of these pathological changes continues to advance as the disease progresses. The aim of this study was to investigate whether pathological alterations of white matter tracts correlate with the course of AD disease progression. 35 AD patients and 29 normal controls were recruited to the study and administered baseline magnetic resonance diffusion tensor imaging (DTI) acquisition and a cognitive function assessment at the time of initial evaluation. Subjects were re-evaluated with secondary DTI scan and cognitive function assessment at intervals of about 1.5 years on average. For the DTI acquired scans, we calculated diffusion tensor parameters, fractional anisotropy (FA), apparent diffusion coefficient (ADC), radial diffusivity (DR), and axial diffusivity (DA) along with the uncinate fasciculus (UNC), the inferior longitudinal fasciculus (ILF), and the inferior occipitofrontal fasciculus (IOFF). Compared to baseline, a significant mean FA reduction of the bilateral UNC, as well as a significant mean DR increase of the left UNC, was evident in AD patients at follow-up. Compared with normal controls, AD patients exhibited significant diffusion parameter abnormalities in their UNC, ILF, and IOFF. Taken together, these results indicate that progressive pathological white matter alterations can be quantified using the DTI parameters utilized here and may prove to be a useful biological marker for monitoring the pathophysiological course of AD. (C) 2013 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.brainres.2013.03.052

Unilateral Optic Nerve Hypoplasia with Contralateral Optic Pathway Hypoplasia: A Case Report Reviewed International journal

Tomo Nishi, Eiichi Yukawa, Toshiaki Taoka, Nahoko Ogata

NEURO-OPHTHALMOLOGY Vol. 37 ( 3 ) page： 116 - 119 2013.6

Language：English Publishing type：Research paper (scientific journal) Publisher：INFORMA HEALTHCARE

Optic nerve hypoplasia is diagnosed by the ophthalmoscopic appearance of the fundus of the eye and by standard magnetic resonance imaging of the brain. The ability to study eyes with optic nerve hypoplasia by magnetic resonance diffusion tensor imaging has improved the evaluation of the optic pathways. The authors report a case of unilateral optic nerve hypoplasia with hypoplasia of the contralateral optic pathway. The entire visual pathway of this patient was examined by magnetic resonance and magnetic resonance diffusion tensor imaging. The images show a decrease of the volume of the optic radiation contralateral to the optic nerve abnormality and also pre- and post-chiasmal abnormalities.

DOI： 10.3109/01658107.2013.785572

Transient Global Brain Ischemia Induces Striatal Neuronal Death of T1-Hyperintensity without Hemorrhage: Susceptibility-Weighted Imaging Study on Cardiac Arrest Survivors Reviewed

Semi-Jailing法が有用であったEnterprise sentを用いた内頸動脈瘤の2例

和田敬, 高山勝年, 中川裕之, 宮坂俊輝, 明珍薫, 坂本雅彦, 田岡俊昭, 吉川公彦, 中川一郎, 黒川紳一郎

IVR: Interventional Radiology Vol. 28 ( Suppl. ) page： 155 - 155 2013.4

Movement Disorders in Golfers Reviewed

Samish Dhungana, Joseph Jankovic

NEUROLOGY Vol. 80 page： 675 - 709 2013.2

Masayuki Fujioka, Tomoo Watanabe, Toshiaki Taoka, Kazuo Okuchi

STROKE Vol. 44 ( 2 ) 2013.2

脳幹背側症候群が疑われた一新生児例

堀沙恵香, 田岡俊昭, 明石敏昭, 坂本雅彦, 和田敬, 吉川公彦, 越智朋子, 内田優美子, 高橋幸博

Japanese Journal of Radiology Vol. 31 ( Suppl.I ) page： 58 - 58 2013.2

The Use of Susceptibility-Weighted Imaging as an Indicator of Retrograde Leptomeningeal Venous Drainage and Venous Congestion With Dural Arteriovenous Fistula: Diagnosis and Follow-up After Treatment

Ichiro Nakagawa, Toshiaki Taoka, Takeshi Wada, Hiroyuki Nakagawa, Masahiko Sakamoto, Kimihiko Kichikawa, Yasuo Hironaka, Yasushi Motoyama, Young-Su Park, Hiroyuki Nakase

NEUROSURGERY Vol. 72 ( 1 ) page： 47 - 54; discussion 55 2013.1

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

BACKGROUND: Retrograde leptomeningeal venous drainage (RLVD) in dural arteriovenous fistulas (DAVFs) is associated with intracerebral hemorrhage and non-hemorrhagic neurological deficits or death. Angiographic evidence of RLVD is a definite indication for treatment, but less invasive methods of identifying RLVD are required.
OBJECTIVE: To evaluate the efficacy of susceptibility-weighted magnetic resonance imaging (SWI) in detecting RLVD in DAVFs.
METHODS: We retrospectively identified 17 DAVF patients who had angiographic evidence of RLVD and received treatment. Conventional angiography and SWI were assessed at pretreatment and posttreatment time points. The presence of RLVD on SWI was defined as cortical venous hyperintensity, and the presence of venous congestion on SWI venograms was defined as increased caliber of cortical or medullary veins.
RESULTS: Cortical venous hyperintensity was identified in pretreatment SWI of 15 patients. Cortical venous hyperintensity was absent in early posttreatment SWI, consistent with the absence of RLVD in posttreatment angiography, in all but one of these patients. In 2 patients, cortical venous hyperintensity was identified during follow-up, indicating the recurrence of RLVD. Cortical venous hyperintensity was not identified in the pretreatment SWI of 2 patients despite angiographic evidence of RLVD. Venous congestion was identified in pretreatment SWI venograms of 11 patients and had an appearance similar to that identified from angiography. Venous congestive signs improved over the follow-up period.
CONCLUSION: The presence of SWI hyperintensity within the venous structure could be a useful indicator of RLVD in DAVF patients. Thus, SWI offers a noninvasive alternative to angiography for the identification of RLVD in pretreated and posttreated DAVF patients.

DOI： 10.1227/NEU.0b013e318276f7cc

Carotid Wallstent placement difficulties encountered in carotid artery stenting Reviewed International journal

Kaoru Myouchin, Katsutoshi Takayama, Toshiaki Taoka, Hiroyuki Nakagawa, Takeshi Wada, Masahiko Sakamoto, Satoru Iwasaki, Shinichiro Kurokawa, Kimihiko Kichikawa

SPRINGERPLUS Vol. 2 ( 1 ) page： 468 - 468 2013

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER INTERNATIONAL PUBLISHING AG

Purpose: The present study aimed to identify the types of curved lesions that are difficult to place Carotid Wallstent (CWS).
Materials and methods: The study targeted 31 consecutive carotid artery (CA) stenosis underwent carotid artery stenting using CWS. CWS placement success rate, stenosis location, lesion tortuosity, and relationship with stent placement failures were investigated. Lesion tortuosity was defined as the angle formed by 2 tangential lines between internal CA and common CA from the inflection point (IP) was defined as the center of lesion curvature. Stenosed lesions were classified into type A or B. Type A was defined as if the distal end of the stenosis was located proximal to the IP at a distance >= 0.5 of a vertebral body based on the posterior height of the 3rd vertebral body, otherwise was type B.
Results: The stent placement success rate was 93.5% (29/31). The 2 unsuccessfully stented lesions, both lesions were significantly different from other lesions by having a lesion tortuosity less than 90 degrees and by belonging to type B.
Conclusion: Since CWS placement is difficult in patients with CA stenosis located close to the IP at a lesion tortuosity <= 90 degrees, open-cell stents should be considered as an alternative.

DOI： 10.1186/2193-1801-2-468

Obstacles encountered during transradial angiography from after radial artery puncture to the aortic arch International journal

Satoru Iwasaki, Kazuhiro Yokoyama, Kinya Furuichi, Hiroshi Okada, Akira Ohkura, Koichi Ide, Katsutoshi Takayama, Toshiaki Taoka, Kimihiko Kichikawa

SpringerPlus Vol. 2 ( 1 ) page： 1 - 8 2013

Language：English Publishing type：Research paper (scientific journal)

Objective: To elucidate the key points for safe performance of transradial angiography. Conclusions: Transradial angiography can be performed safely if attention is paid to the following points from after radial artery puncture to reaching the aortic arch: resistance during guide wire operation for sheath insertion after puncture
confirmation of the superficial brachial artery
guide wire resistance while guiding the catheter to the aortic arch
and aortic arch anomalies. © 2013 Iwasaki et al.

DOI： 10.1186/2193-1801-2-365

Unilateral Oculomotor Nerve Palsy as an Initial Presentation of Bilateral Chronic Subdural Hematoma: Case Report

MATSUDA Ryosuke, HIRONAKA Yasuo, KAWAI Hisashi, PARK Young-Su, TAOKA Toshiaki, NAKASE Hiroyuki

Neurologia medico-chirurgica Vol. 53 ( 9 ) page： 616 - 9 2013

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Neurosurgical Society

DOI： 10.2176/nmc.cr2012-0339

Pre-operative tractography of the facial nerve in vestibular schwannomas: inter-observer agreement with surgical findings Reviewed

CiNii Research

Gon{\c{c } }alves Pereira Pedro, Neto d'Almeida G, Escada P, Mana{\c{c } }as Rui, Taoka T

2013

Accuracy for predicting adhesion between meningioma and the brain by using brain surface motion imaging: comparison between single and double acquisition methods

Toshiaki Taoka, Syuichi Yamada, Masahiko Sakamoto, Toshiaki Akashi, Toshiteru Miyasaka, Tomoko Ochi, Takeshi Wada, Masato Uchikoshi, Hiroyuki Nakase, Kimihiko Kichikawa

NEURORADIOLOGY Vol. 54 ( 12 ) page： 1313 - 20 2012.12

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

The presence of adhesions between the brain and the meningioma is an important factor that determines the success of total surgical removal. Brain surface motion imaging enables assessment of the dynamics of brain surface motion. A subtraction image of pulse-gated heavily T2-weighted images in different phases of the cardiac cycle provides a stripe pattern on the surface of the pulsating brain. Thus, the lack of a stripe pattern on the surface of extraaxial tumor indicates the presence of tumor-brain adhesion. The purpose of the present experiment was to evaluate the accuracy of predicting tumor-brain adhesion using the original double acquisition method and the improved single acquisition method.
The subjects were 67 meningioma cases patients who were surgically treated after brain surface motion imaging. Thirty-three cases were evaluated using the double acquisition method and 34 cases were evaluated with the single acquisition method. In the double acquisition method, the two sets of images are acquired as two independent scans, and in the single acquisition method, the images are acquired serially as a single scan.
The findings for the double acquisition method agreed with the surgical findings in 23 cases (69.7 %), while findings from the single acquisition method agreed with the surgical findings in 26 cases (76.5 %).
Pre-surgical evaluation for tumor-brain adhesion by brain surface motion imaging provides helpful information for meningioma surgery, especially when using the single acquisition method.

DOI： 10.1007/s00234-012-1054-4

Effect of Cilostazol in Preventing Restenosis after Carotid Artery Stenting Using the Carotid Wallstent: A Multicenter Retrospective Study

K. Takayama, T. Taoka, H. Nakagawa, K. Myouchin, T. Wada, M. Sakamoto, K. Furuichi, S. Iwasaki, S. Kurokawa, K. Kichikawa

AMERICAN JOURNAL OF NEURORADIOLOGY Vol. 33 ( 11 ) page： 2167 - 2170 2012.12

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER SOC NEURORADIOLOGY

BACKGROUND AND PURPOSE: Restenosis after CAS is a postoperative problem, with a reported frequency of approximately 2%-8%. However differences in stent design, procedure, and the antiplatelet agent appear to affect the incidence of restenosis. We assessed the frequency of restenosis and the effect of the antiplatelet agent CLZ in preventing restenosis after CAS by the standard procedure using the CWS.
MATERIALS AND METHODS: Between May 2010 and October 2011, 62 lesions in 60 consecutive patients underwent CAS using the CWS at 4 medical institutions, and all patients were followed clinically and assessed by sonography, 3D-CTA, or angiography at 3 and 6 months postoperatively. Restenosis was defined as >= 50% stenosis. The incidence of restenosis and the variation in the incidence of restenosis by the difference in type of antiplatelet agent between the CLZ group (n = 30; aspirin, 100 mg, and CLZ, 200 mg) and the non-CLZ group (n = 32; aspirin, 100 mg, and clopidogrel, 75 mg [n = 29]; or ticlopidine, 100 mg [n = 2] or 200 mg [n = 1]) were retrospectively investigated. Two antiplatelet agents were given starting 1 week preoperatively until at least 3 months postoperatively.
RESULTS: Restenosis occurred in 5 patients (8.3%), but all were cases of asymptomatic lesions in the follow-up period. All 5 patients with restenosis were in the non-CLZ group, with no cases of restenosis in the CLZ group; the difference was significant (P = .0239).
CONCLUSIONS: The restenosis rate after CAS by using the CWS was 8.3%. CLZ was associated with significant inhibition of restenosis.

DOI： 10.3174/ajnr.A3127

Visualizing non-Gaussian diffusion: Clinical application of q-space imaging and diffusional kurtosis imaging of the brain and spine

Hori M., Fukunaga I., Masutani Y., Taoka T., Kamagata K., Suzuki Y., Aoki S.

Magnetic Resonance in Medical Sciences Vol. 11 ( 4 ) page： 221 - 233 2012.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Magnetic Resonance in Medical Sciences

Recently, non-Gaussian diffusion-weighted imaging (DWI) techniques, including qspace imaging (QSI) and diffusional kurtosis imaging (DKI), have emerged as advanced methods to evaluate tissue microstructure in vivo using water diffusion. QSI and DKI have shown promising results in clinical applications, such as in the evaluation of brain tumors (e.g., grading gliomas), degenerative diseases (e.g., specific diagnosis of Parkinson disease), demyelinating diseases (e.g., assessment of normal-appearing tissue of multiple sclerosis), and cerebrovascular diseases (e.g., assessment of the microstructural environment of fresh infarctions). Representative metrics in clinical use are the full width at half maximum, also known as the mean displacement of the probability density function curve, which is derived from QSI, and diffusional kurtosis, which is derived from DKI. These new metrics may provide information on tissue structure in addition to that provided by conventional Gaussian DWI investigations that use the apparent diffusion coefficient and fractional anisotropy, recognized indices for evaluating disease and normal development in the brain and spine. In some clinical situations, sensitivity for detecting pathological conditions is higher using QSI and DKI than conventional DWI and diffusion tensor imaging (DTI) because DWI and DTI calculations are based on the assumption that water molecules follow a Gaussian distribution, whereas hindrance of the distribution of water molecules by complex and restricted structures in actual neural tissues produces distributions that are far from Gaussian. We review the technical aspects and clinical applications of QSI and DKI, focusing on clinical use and in vivo studies and highlighting differences from conventional diffusional metrics.

DOI： 10.2463/mrms.11.221