研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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胸部大動脈ステントグラフト治療の既往がある急性主幹動脈閉塞症に対しsurgical embolectomyが奏功した1例 Open Access

村松佑亮, 布施佑太郎, 太田慎次, 中村茂和, 栗本太志, 渡邉和彦, 齋藤竜太

脳卒中 44 巻 ( 6 ) 頁： 664 - 669 2022年

記述言語：日本語出版者・発行元：一般社団法人日本脳卒中学会

症例は83歳男性．突然の右半身麻痺および失語を呈し，当院に救急搬送された．来院時，全失語，右半身完全麻痺の状態であった．頭部造影CTと脳MRIで左MCA急性閉塞を認めた．機械的血栓回収療法を検討したが，胸部大動脈瘤に対するステントグラフト留置（thoracic endovascular aortic repair: TEVAR）の既往があり，経大動脈的アプローチは困難と予測された．そのため，緊急で顕微鏡下のsurgical embolectomyを施行した．術後症状は著明に改善し，NIHSS 3点，mRS 2点で自宅退院となった．発症から来院までの時間が短いMCA急性閉塞症に対して，機械的血栓回収療法のリスクが高い場合にsurgical embolectomyを行い，良好な転帰を得た．急性期脳主幹動脈閉塞に対して，大動脈アプローチが困難と予想される場合には，surgical embolectomyをはじめから治療の選択肢に加えることを検討してもよいかもしれない．

DOI： 10.3995/jstroke.11028

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Delayed Recurrence of Choroid Plexus Carcinoma in the Sacral Spinal Cord 17 Years after Its Initial Presentation. Open Access

Nagai A, Kanamori M, Shimoda Y, Watanabe M, Saito R, Kumabe T, Aizawa T, Tominaga T

NMC case report journal 9 巻 ( 0 ) 頁： 301 - 306 2022年

Diagnosis and Treatment Strategies for Arachnoiditis Ossificans Following Subarachnoid Hemorrhage: A Case Report. Open Access

Nagashima Y, Nishimura Y, Ito H, Nishii T, Oyama T, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 295 - 299 2022年

Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report. Open Access

Hanyu T, Nishihori M, Izumi T, Motomura K, Ohka F, Goto S, Araki Y, Yokoyama K, Uda K, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 289 - 294 2022年

Contrast-Enhanced Magnetic Resonance Imaging Suggested a Possibility of Transvenous Embolization in the Superior Petrosal Sinus Dural Arteriovenous Fistula: A Case Report Open Access

Nishihori, M; Izumi, T; Tsukada, T; Kato, Y; Uda, K; Yokoyama, K; Araki, Y; Saito, R

JOURNAL OF NEUROENDOVASCULAR THERAPY 16 巻 ( 3 ) 頁： 163 - 169 2022年

Atypical Incomplete Detachment Following PulseRider Deployment Open Access

Goto, S; Izumi, T; Nishihori, M; Araki, Y; Yokoyama, K; Uda, K; Saito, R

JOURNAL OF NEUROENDOVASCULAR THERAPY 16 巻 ( 8 ) 頁： 409 - 412 2022年

頚椎症性脊髄症が疑われたACTH単独欠損症の1例

齋藤剛, 吉田光宏, 中林規容, 相見有理, 石田衛, 濱﨑一, 寺尾和一, 中嶋祥子, 苗代朋樹, 齋藤竜太

脊髄外科 36 巻 ( 1 ) 頁： 88 - 93 2022年

Laminectomy triggers symptomatic growth of spinal schwannoma in a patient with schwannomatosis. 国際誌 Open Access

Oyama T, Nishimura Y, Nagashima Y, Nishii T, Hara M, Takayasu M, Sakakibara A, Saito R

Surgical neurology international 13 巻頁： 261 - 261 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Schwannomatosis (SWN) is genetically similar to neurofibromatosis type 2 (NF2) and represents a NF2 gene mutation. Previous studies have shown that these mutations in both neurons and Schwann cells can lead to the development of schwannomas after nerve crush injuries. Here, we reviewed the potential pathoanatomical mechanisms for the development of a trauma-induced spinal schwannomas in a 55-year-old male with SWN. Case Description: A 49-year-old male had originally undergone a L3-L5 lumbar laminectomy for stenosis; the schwannomas seen on the preoperative magnetic resonance imaging (MRI) were not resected. Now at age 55, he newly presented with low back pain and numbness in the left L5 dermatome, and he was diagnosed with an L4 vertebral level cauda equina tumor on MRI. Following gross-total resection, the histopathological assessment revealed a Ki-67 labeling index 5-10% in hotspots (i.e., slightly higher than the normal range of schwannomas) and a 20% mosaic loss of SMARCB1. Based on these criteria, he was diagnosed as having SWN. Conclusion: In this patient with SWN, compression/physical trauma to nerves of the cauda equina during the L3-L5 laminectomy 6 years ago likely caused the progression of schwannoma.

DOI： 10.25259/SNI_453_2022

The preoperative focal cerebral blood flow status may be associated with slow flow in the bypass graft after combined surgery for moyamoya disease. 査読有り Open Access

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

Surgical neurology international 13 巻頁： 511 2022年

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

Background: The aim of this study was to investigate the association between early postoperative slow flow in bypass grafts and preoperative focal cerebral blood flow (CBF) in patients who underwent combined surgery for moyamoya disease (MMD). Methods: The subjects were 18 patients (22 surgeries) who underwent single photon emission computed tomography (SPECT) before surgery. The CBF value of the middle cerebral artery territory was extracted from the SPECT data, and the value relative to the ipsilateral cerebellar CBF (relative CBF, or RCBF) was calculated. The association between RCBF and early postoperative slow flow in the bypass graft was investigated. In addition, the correlation between the revascularization effect and preoperative RCBF was analyzed. Results: In four of 22 surgeries (18.2%), slow flow in the bypass graft was identified in the early postoperative period. Preoperative RCBF in the slow flow and patent groups was 0.86 ± 0.15 and 0.87 ± 0.15, respectively, with no significant difference (P = 0.72). The signal intensity of four slow-flowed bypasses was improved in all cases on magnetic resonance angiography images captured during the chronic phase (mean of 3.3 months postoperatively). The revascularization scores were 2 ± 0.82 and 2.1 ± 0.68 in the slow flow and patent groups, respectively, and did not differ significantly (P = 0.78). A significant correlation was not observed between preoperative RCBF and the revascularization effect. Conclusion: No significant association was observed between preoperative RCBF and early postoperative slow flow in bypass grafts in patients with MMD undergoing combined surgery. Given the high rate of improved depiction of slow-flowed bypass in the chronic postoperative phase, the conceptual significance of an opportune surgical intervention is to maintain CBF by supporting the patient's own intracranial-extracranial conversion function.

DOI： 10.25259/SNI_772_2022

Downward penetrating endplate screw technique under O-arm navigation posterior fusion in patients with osteoporotic vertebral body fractures associated with diffuse idiopathic skeletal hyperostosis. 国際誌 Open Access

Shiraishi D, Yamamoto Y, Motonori I, Nishimura Y, Hara M, Saito R, Takayasu M

Surgical neurology international 13 巻頁： 436 - 436 2022年

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

Background: A downward penetrating endplate screw (PES) technique combined with caudal anchor screws inserted in the upward direction under O-arm navigation (i.e., crossing screw technique) avoided screw backout and proximal junctional kyphosis (PJK) in three patients with osteoporotic vertebral body fractures and diffuse idiopathic skeletal hyperostosis (DISH). Methods: The PES techniques were utilized for patients with T12 (one patient) and L1 (two patients) spontaneous fusion across the targeted vertebrae, with minimal damage to the involved endplates/intervertebral discs. The average number of instrumented vertebrae was 5.3. Results: There were no perioperative complications over the mean follow-up period of 28.7 months; no screw loosening, and no PJK. Conclusion: The PES technique prevented screw backout, and PJK in three patients with lumbar osteoporotic vertebral fractures and DISH.

DOI： 10.25259/SNI_762_2022

脊椎脊髄疾患における3Dプリンター活用の実際と現状

永島吉孝, 西村由介, 赤堀翔, 竹内和人, 宇田憲司, 伊藤洋, 齋藤竜太

脊髄外科 36 巻 ( 3 ) 頁： 296 - 301 2022年

覚醒下手術中痙攣発作コントロールにおけるレベチラセタム・ペランパネル併用療法の有効性について

本村和也, 齋藤竜太

神経治療学 39 巻 ( 4 ) 頁： 655 - 655 2022年

壊血病により非外傷性硬膜外血腫に至った1例

滝戸悠平, 長倉正宗, 加藤美穂子, 齋藤竜太

小児の脳神経 47 巻 ( 3 ) 頁： 309 - 313 2022年

記述言語：日本語出版者・発行元：一般社団法人日本小児神経外科学会

壊血病はVit.C欠乏により易出血性を呈する疾患であるが，先進国では食料事情の改善でほとんど認められなくなった．症例は4歳女児，下肢の疼痛症状で歩行困難となり骨髄炎や歯肉腫脹を来していた．頭痛が出現し外傷歴のない硬膜外血腫を指摘され手術を施行した．入院経過中に極度の偏食であることが判明し，Vit.C欠乏が示唆され壊血病の診断に至った．Vit.Cの補充により急速に症状は改善し良好な転帰を得た．本疾患は多彩な症状を呈し診断困難な場合があるが，偏食などの病歴を把握し診断・治療へつなげることが重要である．

DOI： 10.34544/jspn.47.3_309

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Unilateral laminotomy for bilateral decompression and balloon kyphoplasty to decompress lumber canal stenosis aggravated by osteoporotic vertebral compression fractures: A technical note. 国際誌 Open Access

Nagashima Y, Nishimura Y, Ishii M, Nishii T, Fukaya N, Oyama T, Abe T, Kato H, Tsukamoto E, Tanei T, Saito R

Surgical neurology international 13 巻頁： 538 - 538 2022年

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

Background: The optimal treatment of lumbar canal stenosis (LCS) associated with osteoporotic vertebral fractures (OVFs) remains unclear. Here, we have combined a minimally invasive unilateral laminotomy for bilateral decompression (ULBD) alone with balloon kyphoplasty (BKP) for LCS aggravated by OVF. Methods: ULBD with BKP was performed in three patients who showed LCS associated with OVFs on MR images with progressive lower extremity neurological deficits. Clinical outcomes were assessed using the numerical rating scale (NRS) and the Japanese Orthopaedic Association (JOA) score. Radiological outcomes were evaluated using multiple parameters (i.e., fractured vertebral body height, lumbar lordosis [LL], and focal angle of the fractured vertebral body). Results: Over 6 postoperative months, the NRS and JOA scores were clearly improved while radiological parameters remained maintained (i.e., loss of fractured vertebral body height was only 0.3-1.4 mm in all cases). Two of the three cases showed restoration of LL and focal angle postoperatively. Conclusion: The combination of ULBD with BKP is an effective option for LCS aggravated by OVF.

DOI： 10.25259/SNI_971_2022

(11)C-methionine- and (18)F-FDG-PET double-negative metastatic brain tumor from lung adenocarcinoma with paradoxical high (18)F-FDG uptake: A case report. 国際誌 Open Access

Tanahashi K, Hirano M, Chalise L, Tsugawa T, Okumura Y, Hase T, Ohka F, Motomura K, Takeuchi K, Nagata Y, Nakahara N, Hashimoto N, Saito R

Surgical neurology international 13 巻頁： 372 - 372 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Imaging with 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and 11C-methionine (MET)-PET can delineate primary and metastatic brain tumors. Lesion size affects the sensitivity of both scans and histopathological features can also influence FDG-PET, but the effects on MET-PET have not been elucidated. Case Description: We report an unusual case of metastatic brain tumors without accumulation of FDG or MET, contrasting with high FDG uptake in the primary lung lesion. The brain lesions were identified as adenocarcinoma with a more mucus-rich background, contributing to the indistinct accumulation of both FDG and MET. Conclusion: Histopathological characteristics can affect both MET and FDG accumulation, leading to findings contradicting those of the primary lesion.

DOI： 10.25259/SNI_264_2022

Spinal Cord Stimulation for Neuropathic Pain following a Spinal Cord Lesion with Past Spinal Surgical Histories Using a Paddle Lead Placed on the Rostral Side of the Lesion: Report of Three Cases. Open Access

Fukaya N, Tanei T, Nishimura Y, Hara M, Hata N, Nagashima Y, Maesawa S, Araki Y, Saito R

NMC case report journal 9 巻 ( 0 ) 頁： 349 - 355 2022年

Atypical radiographic case of arachnoid web without scalpel sign. 国際誌 Open Access

Nagashima Y, Nishimura Y, Ito H, Oyama T, Nishii T, Gonda T, Kato H, Saito R

Surgical neurology international 13 巻頁： 108 - 108 2022年

記述言語：英語出版者・発行元：Surgical Neurology International

Background: Spinal arachnoid webs (SAW) occur when abnormally thickened bands of arachnoid membranes commonly located dorsal to the thoracic spine cause blockage of normal cerebrospinal fluid (CSF) flow, resulting in focal cord compression and myelopathy. The pathognomonic MR finding for SAW is the "positive scalpel sign"comprised of an enlarged dorsal CSF space with a normal ventral subarachnoid space. The main differential diagnostic consideration for SAW is idiopathic spinal cord herniation (ISCH); however, for ISCH, MR studies classically demonstrate ventral displacement of the spinal cord through an anterior dural defect. Here, we describe a 60-year-old female with an atypical SAW at the T3-T4 level (i.e., the preoperative MR failed to demonstrate the "positive scalpel sign"). Nevertheless, at surgery, intraoperative ultrasonography confirmed that SAW was present and was decompressed/marsupialized/removed. Case Description: A 60-year-old female presented with sensory impairment to both lower extremities. The thoracic MR images showed an enlarged dorsal CSF space at the T3-T4 level but without the "scalpel sign"suggesting "interruption"of CSF flow by thickened bands of focal dorsal arachnoidal tissues. Although the initial preoperative diagnosis was ISCH, intraoperative ultrasound (IOUS) confirmed the presence of a thickened arachnoid band, confirming the diagnosis of a SAW that was appropriately decompressed/resected. Conclusion: Correctly, establishing the preoperative diagnosis of a SAW based on MR imaging may sometimes be difficult as the typical "scalpel sign"may not be present in all patients. Notably, in cases like this one, IOUS may critically confirm the diagnosis of SAW thus leading to appropriate SAW decompression/removal.

DOI： 10.25259/SNI_179_2022

Clinical and Radiological Clues of Traumatic Craniocervical Junction Injuries Requiring Occipitocervical Fusion to Early Diagnosis 国際誌 Open Access

Shiraishi, D; Nishimura, Y; Aguirre-Carreno, I; Hara, M; Yoshikawa, S; Eguchi, K; Nagashima, Y; Ito, H; Haimoto, S; Yamamoto, Y; Ginsberg, HJ; Takayasu, M; Saito, R

NEUROSPINE 18 巻 ( 4 ) 頁： 741 - 748 2021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：Neurospine

Objective: The purpose of this study is to find the clinical and radiographic characteristics of traumatic craniocervical junction (CCJ) injuries requiring occipitocervical fusion (OC fusion) for early diagnosis and surgical intervention. Methods: We retrospectively reviewed 12 patients with CCJ injuries presenting to St. Mi-chaels Hospital in Toronto who underwent OC fusion and looked into the following vari-ables; (1) initial trauma data on emergency room arrival, (2) associated injuries, (3) imaging characteristics of computed tomography (CT) scan and magnetic resonance imaging (MRI), (4) surgical procedures, surgical complications, and neurological outcome. Results: All patients were treated as acute spinal injuries and underwent OC fusion on an emergency basis. Patients consisted of 10 males and 2 females with an average age of 47 years (range, 18–82 years). All patients sustained high-energy injuries. Three patients out of 6 patients with normal BAI (basion-axial interval) and BDI (basion-dens interval) values showed visible CCJ injuries on CT scans. However, the remaining 3 patients had no clear evidence of occipitoatlantal instability on CT scans. MRI clearly described several findings indicating occipitoatlantal instability. The 8 patients with normal values of ADI (atlanto-dens interval interval) demonstrated atlantoaxial instability on CT scan, however, all MRI more clearly and reliably demonstrated C1/2 facet injury and/or cruciate ligament injury. Conclusion: We advocate measures to help recognize CCJ injury at an early stage in the present study. Occipitoatlantal instability needs to be carefully investigated on MRI in addition to CT scan with special attention to facet joint and ligament integrity.

DOI： 10.14245/ns.2142860.430

Two cases of solitary fibrous tumor/hemangiopericytoma with different clinical features according to the World Health Organization classification: case report and review of the literature. 国際誌 Open Access

Nishii T, Nagashima Y, Nishimura Y, Ito H, Oyama T, Matsuo M, Sakakibara A, Shimada S, Saito R

Journal of spine surgery (Hong Kong) 7 巻 ( 4 ) 頁： 532 - 539 2021年12月

記述言語：英語出版者・発行元：Journal of Spine Surgery

Solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) have been classified as one entity by the World Health Organization in 2016 due to gene fusion between NAB2 and STAT6. In the Central Nervous System (CNS), a hypocellular, collagenized tumor with a classic SFT phenotype is considered grade I, whereas more densely cellular tumors mostly corresponding to the HPC phenotype are classified as grade II or III (anaplastic) depending in mitotic count (<5 vs. >5 mitoses per 10 high-power fields). Herein, we report two cases of targeted SFT/HPC in which pathological differences and WHO grading affect clinical features. A 75-year-old woman presented with headache and had an intradural extramedullary tumor at the C1 to C2 level. The tumor was well-circumscribed and attached only to the dura mater. It was totally removed and diagnosed SFT/HPC grade I. In contrast, a 68-year-old woman presented with numbness in the right upper limb and had an intradural extramedullary tumor at the medulla to C3 levels The tumor was irregularly marginated and strongly adherent to the spinal cord and involved the vertebral artery. It was sub totally removed and diagnosed SFT/HPC grade II. To the best of our knowledge, there are only 12 cases of SFT/HPC at the craniocervical junction, including the present two cases, of which four that were adherent to the spinal cord or involved the vertebral artery were grade II or III. Although the location of the tumor was almost the same, there were significant differences in the intraoperative findings according to the WHO grading.

DOI： 10.21037/jss-21-83

Resting State Networks Related to the Maintenance of Good Cognitive Performance During Healthy Aging 国際誌 Open Access

Maesawa, S; Mizuno, S; Bagarinao, E; Watanabe, H; Kawabata, K; Hara, K; Ohdake, R; Ogura, A; Mori, D; Nakatsubo, D; Isoda, H; Hoshiyama, M; Katsuno, M; Saito, R; Ozaki, N; Sobue, G

FRONTIERS IN HUMAN NEUROSCIENCE 15 巻頁： 753836 - 753836 2021年11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：Frontiers in Human Neuroscience

Purpose: Maintenance of cognitive performance is important for healthy aging. This study aims to elucidate the relationship between brain networks and cognitive function in subjects maintaining relatively good cognitive performance. Methods: A total of 120 subjects, with equal number of participants from each age group between 20 and 70 years, were included in this study. Only participants with Addenbrooke’s Cognitive Examination – Revised (ACE-R) total score greater than 83 were included. Anatomical T1-weighted MR images and resting-state functional MR images (rsfMRIs) were taken from all participants using a 3-tesla MRI scanner. After preprocessing, several factors associated with age including the ACE-R total score, scores of five domains, sub-scores of ACE-R, and brain volumes were tested. Morphometric changes associated with age were analyzed using voxel based morphometry (VBM) and changes in resting state networks (RSNs) were examined using dual regression analysis. Results: Significant negative correlations with age were seen in the total gray matter volume (GMV, r = −0.58), and in the memory, attention, and visuospatial domains. Among the different sub-scores, the score of the delayed recall (DR) showed the highest negative correlation with age (r = −0.55, p < 0.001). In VBM analysis, widespread regions demonstrated negative correlation with age, but none with any of the cognitive scores. Quadratic approximations of cognitive scores as functions of age showed relatively delayed decline compared to total GMV loss. In dual regression analysis, some cognitive networks, including the dorsal default mode network, the lateral dorsal attention network, the right / left executive control network, the posterior salience network, and the language network, did not demonstrate negative correlation with age. Some regions in the sensorimotor networks showed positive correlation with the DR, memory, and fluency scores. Conclusion: Some domains of the cognitive test did not correlate with age, and even the highly correlated sub-scores such as the DR score, showed delayed decline compared to the loss of total GMV. Some RSNs, especially involving cognitive control regions, were relatively maintained with age. Furthermore, the scores of memory, fluency, and the DR were correlated with the within-network functional connectivity values of the sensorimotor network, which supported the importance of exercise for maintenance of cognition.

DOI： 10.3389/fnhum.2021.753836

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