Updated on 2025/05/23

写真a

 
GOTO Takeo
 
Organization
Graduate School of Medicine Department of Clinical Medical Science Professor
School of Medicine Department of Medical Science
Title
Professor
Affiliation
Institute of Medcine
Profile
1994 - 1999 Neurosurgical Resident, Osaka City University Medical Center 1999 - 2005 Assistant Professor, Neurosurgery, OCU 2005 -2019 Senior Assistant Professor,Neurosurgery, OCU 2019- 2020 Associate Professor, ,Neurosurgery, OCU 2020- Professor and Chairman,,Neurosurgery, OCU 2022- Professor and Chairman,,Neurosurgery, OMU Professional Memberships Japan Neurosurgical Society Board member of Japanese Society for Skull Base Surgery Board member of Japanese Congress for Brain Tumor Surgery Board member of Japanese Society for Neuroendoscopy Board member of Japan Society for Microvascular Decompression Surgery        Board member of Japanese Society for Microneurosurgical Anatomy        Board member of Japanese Society for hypothalamic and pituitary tumor        Board member of Japan Geriatric Neurosurgery Society 2022- Co-chairman, WFNS neuroendoscopy committee (World Federation of Neurosurgical Society) 2022- Board member of ISMINS (International Society on Minimally Invasive Neurosurgery) 2022- Board member of International Rhoton Society    2023- Board member of IANA( International Academy of Neurosurgical Anatomy)    2024- Active member of WANS( World Academy of Neurosurgical Surgeons)
Affiliation campus
Abeno Campus

Position

  • Graduate School of Medicine Department of Clinical Medical Science 

    Professor  2022.04 - Now

  • School of Medicine Department of Medical Science 

    Professor  2022.04 - Now

Degree

  • 博士(医学) ( Osaka City University )

Research Areas

  • Life Science / Neurosurgery

Research Interests

  • skull base surgery endoscopic surgery

Research subject summary

  • 脳腫瘍手術法の研究
    脳腫瘍手術機器の開発

Professional Memberships

  • 日本神経内視鏡学会

      Domestic

  • 日本間脳下垂体腫瘍学会

      Domestic

  • 日本脳腫瘍の外科学会

      Domestic

  • 日本頭蓋底外科学会

      Domestic

  • 日本脳神経外科学会

      Domestic

Committee Memberships (off-campus)

  • Co-chairman  

    2022.01 - Now 

  • 理事   日本脳腫瘍の外科学会  

    2021.04 - Now 

  • 理事   日本整容脳神経外科学会  

    2021.04 - Now 

  • 理事   日本頭蓋底外科学会  

    2020.04 - Now 

  • 日本間脳下垂体腫瘍学会学術評議員   日本間脳下垂体腫瘍学会  

    2019 - Now 

  • 日本神経血管減圧術学会運営委員   日本神経血管減圧術学会  

    2016 - Now 

▼display all

Awards

  • 第二回杉田賞

    2022   NPO法人脳神経外科手術器機センター  

  • 大阪市医学会市長賞

    2002  

Education

  • Osaka City University     Graduated/Completed

    1998.04 - 1994.03

Papers

  • Simple Reconstruction Method of Dural Defects for Minimal Anterior and Posterior Combined Transpetrosal Approach.

    Niantiarno FH, Morisako H, Nagahama A, Ikegami M, Goto T

    World neurosurgery   196   123795   2025.03( ISSN:1878-8750

  • Characteristics of optic canal invasion in the large midline non-tuberculum sellae anterior skull base meningiomas and the surgical outcomes.

    Duangprasert G, Nimmannitya P, Yindeedej V, Noiphithak R, Goto T

    Acta neurochirurgica   167 ( 1 )   31   2025.02( ISSN:0001-6268

  • Preoperative interhemispheric coherence as a potential predictive marker for seizure outcome after total corpus callosotomy in nonlesional generalized epilepsy: a scalp EEG study.

    Yindeedej V, Uda T, Nishijima S, Inoue T, Kuki I, Fukuoka M, Nukui M, Okazaki S, Kunihiro N, Umaba R, Goto T

    Journal of neurosurgery. Pediatrics   35 ( 2 )   174 - 180   2025.02( ISSN:1933-0707

  • An Application of Combined Transpetrosal Approach With Microneurovascular Transposition in Recurrent Trigeminal Neuralgia Caused by Dolichoectatic Vertebral Artery.

    Yindeedej V, Nimmannitya P, Duangprasert G, Noiphithak R, Goto T

    World neurosurgery   194   123499   2025.02( ISSN:1878-8750

  • The impact of spheno-occipital synchondrosis exposure via extended endoscopic endonasal surgery on midface growth in pediatric patients.

    Beniwal M, Morisako H, Sasaki T, Ikegami M, Nagahama A, Tanoue Y, Sakamoto H, Goto T

    Journal of neurosurgery. Pediatrics   35 ( 1 )   38 - 45   2025.01( ISSN:1933-0707

  • 術前画像診断で髄膜腫との鑑別が困難であった錐体天幕部髄膜メラニン細胞腫の1例

    石本 幸太郎, 森迫 拓貴, 坂本 竜司, 佐々木 強, 後藤 剛夫

    脳神経外科速報   35 ( 1 )   e16 - e24   2025.01( ISSN:0917-1495

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    髄膜メラニン細胞腫は,髄膜のメラノサイトから発生する稀な良性腫瘍である.今回,我々は錐体天幕部髄膜メラニン細胞腫の1例を経験したため,文献的考察を加えて報告する.症例は47歳女性で,歩行障害のために来院した.錐体天幕部に境界明瞭な髄外腫瘍を認め,髄膜腫と考え,腫瘍塞栓と開頭腫瘍摘出術を行った.術中所見では,腫瘍と周囲の硬膜に黒色の色素沈着を認めた.病理診断結果は髄膜メラニン細胞腫であった.ほぼ全摘出であり,わずかな残存部にガンマナイフ治療を行った.4年間の経過観察中に再発を認めていない.髄膜メラニン細胞腫は悪性転化を生じることがあり,全摘出を目指した手術療法と追加放射線療法を考慮する必要がある.(著者抄録)

  • Comparison of clinical and radiological characteristics of inflammatory and non-inflammatory Rathke cleft cysts.

    Matsushita S, Shimono T, Maeda H, Tsukamoto T, Horiuchi D, Oura T, Ishibashi K, Takita H, Tatekawa H, Atsukawa N, Goto T, Miki Y

    Japanese journal of radiology   43 ( 1 )   32 - 42   2025.01( ISSN:1867-1071

  • Comparison of clinical and radiological characteristics of inflammatory and non-inflammatory Rathke cleft cysts(タイトル和訳中)

    Matsushita Shu, Shimono Taro, Maeda Hiroyuki, Tsukamoto Taro, Horiuchi Daisuke, Oura Tatsushi, Ishibashi Kenichi, Takita Hirotaka, Tatekawa Hiroyuki, Atsukawa Natsuko, Goto Takeo, Miki Yukio

    Japanese Journal of Radiology   43 ( 1 )   32 - 42   2025.01( ISSN:1867-1071

  • Brain mapping for lower-grade glioma around Wernicke's area.

    Yindeedej V, Nakajo K, Tanoue Y, Ichinose T, Goto T

    Neurosurgical focus: Video   12 ( 1 )   V3   2025.01

  • Endoscopic Parasagittal Vertical Hemispherotomy: A 2-Dimensional Operative Video.

    Koh S, Uda T, Kunihiro N, Umaba R, Ishimoto K, Kawashima T, Tanoue Y, Goto T

    Operative neurosurgery (Hagerstown, Md.)   2024.12( ISSN:2332-4252

  • 虚血性脳卒中を呈し急速に増大したP4解離性後大脳動脈瘤に対する親動脈閉塞術 症例報告(Parent Artery Occlusion for a Dissecting Posterior Cerebral Artery Aneurysm in the P4 Segment Presenting with Ischemic Stroke and Rapid Growth: A Case Report)

    Ishimoto Kotaro, Matsuzaki Jo, Iwata Ryoichi, Yamamoto Naoki, Yamagata Toru, Ikuno Hiromichi, Nishikawa Misao, Goto Takeo

    NMC Case Report Journal   11 ( 1 )   103 - 108   2024.12

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    症例は70歳男性。前日から出現した右側頭痛および視野欠損のため当院に救急搬送された。頭部MRIで右後頭葉虚血性脳梗塞を認め、右後大脳動脈閉塞およびP4 segmentへの動脈瘤形成が明らかになった。解離性後大脳動脈瘤と診断し、アスピリン内服を開始した。1週間以内に解離性動脈瘤は急速に増大した。そこで、動脈瘤破裂の予防策としてコイルを用いた血管内親動脈閉塞術を施行した。動脈瘤への血流は完全に遮断された。治療後、右後頭葉の既知の梗塞は拡大したが、新たな神経症状は出現しなかった。術後3日目に退院し、アスピリン治療を中止した。治療6ヵ月後のデジタルサブトラクション血管造影で解離性後大脳動脈瘤の再発はみられなかった。

  • Endoscopic Keyhole Approach Is Useful in the Diagnosis and Removal of Cystic Cerebellar Hemangioblastoma: A Case Report(タイトル和訳中)

    Takagawa Masanari, Tanoue Yuta, Ikegami Masaki, Morisako Hiroki, Ichinose Tsutomu, Goto Takeo

    NMC Case Report Journal   11 ( 1 )   383 - 387   2024.12

  • Effects of thienopyridine class antiplatelets on bleeding outcomes following robot-assisted radical prostatectomy

    Kubota M.

    Scientific Reports   14 ( 1 )   2024.12

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  • Purely Endoscopic Subtemporal Keyhole Approach for Trigeminal Schwannomas: Surgical Techniques and Early Results.

    Sasaki T, Morisako H, Beniwal M, Ikeda S, Nagahama A, Ikegami M, Ohata K, Goto T

    Operative neurosurgery (Hagerstown, Md.)   2024.11( ISSN:2332-4252

  • 症例 中頭蓋底に発生し神経周囲進展を呈した骨内異型髄膜腫の1例

    道脇 唯人, 下野 太郎, 堀内 大右, 後藤 剛夫, 田中 さやか, 加藤 拓実, 金子 哲也, 三木 幸雄

    臨床放射線   69 ( 6 )   835 - 839   2024.11( ISSN:00099252

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  • 中頭蓋底に発生し神経周囲進展を呈した骨内異型髄膜腫の1例

    道脇 唯人, 下野 太郎, 堀内 大右, 後藤 剛夫, 田中 さやか, 加藤 拓実, 金子 哲也, 三木 幸雄

    臨床放射線   69 ( 6 )   835 - 839   2024.11( ISSN:0009-9252

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    症例は82歳女性で、前医で子宮頸癌のフォロー中に撮影された頭部MRIで中頭蓋底腫瘤を指摘され、精査目的に当院紹介となった。画像所見から髄膜腫や孤立性神経線維性腫瘍、神経鞘腫/悪性末梢神経腫瘍など多岐にわたる疾患が鑑別に挙げられ、経鼻内視鏡下腫瘍摘出術が施行された。腫瘍は比較的柔らかく、肉眼的には全切除が行われた。中頭蓋硬膜や咬筋が露出され、腫瘍が摘除されたことを確認、腫瘍は硬膜と明らかな連続や浸潤はなく、硬膜自体への手術操作は行われなかった。HE染色では、類円形核を有する腫瘍細胞の密な増殖がみられ、明瞭な核小体・小細胞化を認め、異型髄膜腫、WHO grade 2と診断された。手術後に放射線治療が施行され、術後2年間再発なく経過している。

  • Location-based selection of the surgical approach to preserve the hippocampus in lesion-associated temporal lobe epilepsy.

    Nishijima S, Uda T, Yindeedej V, Kawashima T, Tanoue Y, Inoue T, Kuki I, Fukuoka M, Nukui M, Okazaki S, Kunihiro N, Umaba R, Goto T

    Clinical neurology and neurosurgery   246   108546   2024.11( ISSN:0303-8467

  • Frontal lobe disconnection: How I do it.

    Yindeedej V, Uda T, Kunihiro N, Goto T

    Acta neurochirurgica   166 ( 1 )   429   2024.10( ISSN:0001-6268

  • Awake Craniotomy in Epilepsy Surgery: A Case Series and Proposal for Three Different Scenarios.

    Uda T, Tanoue Y, Kawashima T, Yindeedej V, Nishijima S, Kunihiro N, Umaba R, Ishimoto K, Goto T

    Brain sciences   14 ( 10 )   2024.09( ISSN:2076-3425

  • Purely endoscopic subtemporal keyhole anterior transpetrosal approach to access the petrous apex region: surgical techniques and early results.

    Morisako H, Sasaki T, Ikegami M, Tanoue Y, Ohata H, Goudihalli SR, Fernandez-Miranda JC, Ohata K, Goto T

    Journal of neurosurgery   141 ( 3 )   752 - 761   2024.09( ISSN:0022-3085

  • 【良性脳腫瘍】最小合併経錐体到達法を中心とした大型錐体斜台部髄膜腫に対する外科治療

    森迫 拓貴, 後藤 剛夫

    脳神経外科ジャーナル   33 ( 9 )   600 - 609   2024.09( ISSN:0917-950X

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    大型錐体斜台部髄膜腫は大部分の病変が病理学的に良性であることを考慮すると,最大限腫瘍の減量を図り,必要に応じて放射線療法を追加することで良好な脳神経機能の温存と病変の局所制御が得られると期待できる.しかしながら,その摘出術は病変が深部に位置することや病変周囲に種々の重要構造物が存在するため,今なお脳神経外科手術の中でも手技が難しい病変の1つとされている.当施設では錐体骨削除を最小限とする最小合併経錐体到達法を主に用いて大型錐体斜台部髄膜腫を摘出しており,その手術手技の詳細について報告する.(著者抄録)

  • Vertical Parasagittal Hemispherotomy.

    Yindeedej V, Uda T, Kunihiro N, Umaba R, Takagawa M, Sugiyama J, Goto T

    World neurosurgery   189   47 - 52   2024.09( ISSN:1878-8750

  • [Endoscopic Approaches in Skull Base Surgery].

    Goto T

    No shinkei geka. Neurological surgery   52 ( 5 )   1083 - 1090   2024.09( ISSN:0301-2603 ( eISSN:18821251

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  • Total Corpus Callosotomy via Posterior Approach with Endoscopic-Alone Technique.

    Yindeedej V, Uda T, Kawashima T, Tanoue Y, Sakuma S, Morimoto E, Goto T

    World neurosurgery   188   77   2024.08( ISSN:1878-8750

  • Changes in interhemispheric coherence after total corpus callosotomy: a scalp EEG study in children with non-lesional generalized epilepsy.

    Yindeedej V, Uda T, Nishijima S, Inoue T, Kuki I, Fukuoka M, Nukui M, Okazaki S, Kunihiro N, Umaba R, Goto T

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery   40 ( 8 )   2483 - 2489   2024.08( ISSN:0256-7040

  • Endoscopic trans-orbital approach for the tumor-related epilepsy at the temporal tip.

    Tanoue Y, Uda T, Kawashima T, Yindeedej V, Goto T

    Neurosurgical focus: Video   11 ( 1 )   V9   2024.07

  • [Surgical Approaches for Cerebellopontine Angle/Petroclival Meningiomas].

    Morisako H, Goto T

    No shinkei geka. Neurological surgery   52 ( 4 )   749 - 761   2024.07( ISSN:0301-2603 ( eISSN:18821251

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  • Successful surgical treatment of oculomotor palsy due to schwannoma of the cavernous sinus in a 7-year-old girl: a case report.

    Ishino N, Ishibashi K, Kunihiro N, Yamanaka K, Inoue T, Goto T

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery   40 ( 6 )   1931 - 1936   2024.06( ISSN:0256-7040

  • Evaluation of cranial nerve involvement in chordomas and chondrosarcomas: a retrospective imaging study.

    Oura T, Shimono T, Horiuchi D, Goto T, Takita H, Tsukamoto T, Tatekawa H, Ueda D, Matsushita S, Mitsuyama Y, Atsukawa N, Miki Y

    Neuroradiology   66 ( 6 )   955 - 961   2024.06( ISSN:0028-3940

  • Application and Advantages of the Trans-Unco-Discal (TUD) Approach for Cervical Spondylotic Myelopathy and Radiculopathy: Classification and Modification of Surgical Technique Based on the Location of Spinal Cord and/or Nerve Root Compression.

    Nishikawa M, Naito K, Yoshimura M, Yamagata T, Iseda K, Hara M, Ikuno H, Ohata K, Goto T

    Journal of clinical medicine   13 ( 9 )   2024.05( ISSN:2077-0383

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  • Usefulness of Opening the Diaphragma Sellae Before Transecting Interclinoidal Ligament for Endoscopic Endonasal Transoculomotor Triangle Approach: Technical Nuances and Surgical Outcomes.

    Deng S, Morisako H, Beniwal M, Sasaki T, Ikegami M, Ikeda S, Teranishi Y, Goto T

    World neurosurgery   185   e731 - e740   2024.05( ISSN:1878-8750

  • A scoping review of seizure onset pattern in SEEG and a proposal for morphological classification.

    Yindeedej V, Uda T, Tanoue Y, Kojima Y, Kawashima T, Koh S, Uda H, Nishiyama T, Takagawa M, Shuto F, Goto T

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia   123   84 - 90   2024.05( ISSN:0967-5868

  • [Endoscopic Surgery for Skull Base Tumors].

    Sasaki T, Goto T

    No shinkei geka. Neurological surgery   52 ( 2 )   327 - 334   2024.03( ISSN:0301-2603 ( eISSN:18821251

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  • 経鼻内視鏡手術を中心とした小児頭蓋咽頭腫に対する積極的な病変切除と治療成績

    森迫 拓貴, 池上 方基, 田上 雄大, 一ノ瀬 努, 坂本 博昭, 後藤 剛夫

    小児の脳神経   49 ( 1 )   26 - 32   2024.02( ISSN:0387-8023

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    小児頭蓋咽頭腫に対する外科的切除では,摘出率の向上により再発率を抑え,加えて視機能温存や周囲組織への障害を最小限にすることが必要であるが,病変が血管穿通枝,視神経視交叉や視床下部と近接しているため,安全に摘出することは容易ではない.近年,頭蓋咽頭腫に対しては経鼻内視鏡手術が基本アプローチとなっており,小児症例においてもその傾向にある.当院では2014年4月以降経鼻内視鏡下での積極的な病変摘出を基本方針としており,当院での小児症例に対する経鼻内視鏡手術を中心とした病変切除の実際と治療成績について報告する.(著者抄録)

  • Aggressive resection for pediatric craniopharyngiomas via an endoscopic endonasal approach

    Morisako Hiroki, Ikegami Masaki, Tanoue Yuta, Ichinose Tsutomu, Sakamoto Hiroaki, Goto Takeo

    Nervous System in Children   49 ( 1 )   26 - 32   2024( ISSN:03878023 ( eISSN:2435824X

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    <p><i>Objective</i>: In surgical resection of pediatric craniopharyngioma, reducing the recurrence rate by improving the resection rate, preserving visual function, and minimizing damage to surrounding vital structures is necessary. Endoscopic endonasal surgery has recently become the primary surgical approach for craniopharyngiomas. Hereby, we report on the resection of these lesions via endoscopic endonasal surgery for pediatric cases at our hospital.</p><p><i>Materials and Methods</i>: Between 2014 and 2022, 22 cases of pediatric craniopharyngioma underwent endoscopic endonasal surgery. Eleven cases were primary; another 11 were recurrences. The average age for this group was 11.4 years. Nine cases were retrochiasmatic type, and 4 cases were of third ventricle type lesions; the tumors were resected by thoroughly drilling the dorsum Sella, upper clivus, and the posterior clinoid process. Furthermore, one case of a large multilobulated lesion with significant lateral extension was resected using an endoscope endonasal approach combined with a microscopic transcranial approach.</p><p><i>Results</i>: Based on the degree of tumor resection, total resection was achieved in 18 cases (initial 11 cases, recurrence 7 cases) and subtotal resection in 4 cases (initial 0 cases, recurrence 4 cases). Visual and cognitive function improved or at least preserved in all cases. Postoperative cerebrospinal fluid leakage was observed in 4 cases. The pituitary stalk was preserved during surgery in 6 cases, postoperative anterior pituitary function was maintained in 2 cases, and posterior lobe function was preserved in 3 cases. At an average follow-up period of 50 months, no recurrence was observed in all 11 of the 11 initially diagnosed cases. However, tumor recurrence was encountered in 2 of 7 total resection cases and 2 of 4 subtotal resection cases in 11 recurrent diagnosed cases.</p><p><i>Conclusion:</i> Even significantly large lesions that have extended to the anterior skull base or the anterior brainstem/third ventricle can be treated with endoscopic endonasal surgery alone, provided the lesion is located in the midline. Nevertheless, combining endoscopic endonasal and transcranial surgery may be necessary if the tumor has extended laterally beyond the internal carotid artery, oculomotor nerve, or posterior communicating artery.</p>

    DOI: 10.34544/jspn.49.1_26

  • Parent Artery Occlusion for a Dissecting Posterior Cerebral Artery Aneurysm in the P4 Segment Presenting with Ischemic Stroke and Rapid Growth: A Case Report

    ISHIMOTO Kotaro, MATSUZAKI Jo, IWATA Ryoichi, YAMAMOTO Naoki, YAMAGATA Toru, IKUNO Hiromichi, NISHIKAWA Misao, GOTO Takeo

    NMC Case Report Journal   11 ( 0 )   103 - 108   2024( ISSN:2188-4226 ( eISSN:21884226

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    <p>A dissecting aneurysm in the P4 segment of the posterior cerebral artery (PCA) is extremely rare, and its treatment is sometimes challenging. Endovascular parent artery occlusion (PAO) was performed for an unruptured P4 segment dissecting PCA aneurysm presenting with ischemic stroke and rapid growth. A 70-year-old man was rushed to our emergency department due to a right-sided headache and a visual field defect. Head magnetic resonance imaging showed a right occipital lobe ischemic stroke, with right PCA occlusion and aneurysm formation in the P4 segment. The diagnosis was PCA dissection in the calcarine artery, and oral aspirin was started. Within a week, the dissecting aneurysm had enlarged progressively to 6.2 mm in diameter. Thus, PAO with coils was performed as a preventive measure against aneurysm rupture, assuming that complication risks were low because the tributary area of the dissecting PCA had already infarcted. A 6-Fr guiding sheath was introduced from the right brachial artery to the right vertebral artery, and a microcatheter/microguidewire was placed into the true lumen of the calcarine artery distal to the aneurysm. PAO with coils was performed, and the blood flow to the aneurysm was completely obliterated. After the treatment, the known infarction in the right occipital lobe was enlarged, but no new neurological symptoms developed. The patient was discharged independently on postoperative day 3. Treatment for a distal PCA dissecting aneurysm is challenging. PAO with coils is one of the reasonable choices, especially when a visual field defect has already developed.</p>

    DOI: 10.2176/jns-nmc.2023-0267

    PubMed

  • Investigating the Factor Structure of the Japanese Version of the Interpersonal Reactivity Index

    Himichi T.

    Japanese Psychological Research   2024( ISSN:00215368

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  • Endoscopic Keyhole Approach Is Useful in the Diagnosis and Removal of Cystic Cerebellar Hemangioblastoma: A Case Report

    TAKAGAWA Masanari, TANOUE Yuta, IKEGAMI Masaki, MORISAKO Hiroki, ICHINOSE Tsutomu, GOTO Takeo

    NMC Case Report Journal   11 ( 0 )   383 - 387   2024( ISSN:2188-4226 ( eISSN:21884226

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    <p>Intracranial cystic lesions such as hemangioblastoma (HB) are commonly found incidentally; however, they can be difficult to diagnose because they require various differential diagnoses. A contrast-enhanced mural nodule on magnetic resonance imaging (MRI) is typical and can be diagnosed preoperatively; however, some small nodules cannot be visualised and only cysts may be seen, complicating preoperative diagnosis. In such cases, thorough observation of the cysts is necessary for a definitive diagnosis. To achieve this, minimally invasive surgery, such as endoscopic keyhole surgery, is required. Herein, we report the case of a man in his 50s who presented with an unstable gait, and experienced dizziness for several months. Preoperative MRI revealed a cystic lesion in the left cerebellar hemisphere, without a mural nodule. Although there was no diagnostic evidence of HB, we suspected that the symptoms were caused by this cystic lesion because of its recent occurrence. Upon detecting a mural nodule, we diagnosed it as a cerebellar HB and completely resected it using an endoscopic keyhole approach. The patient's symptoms alleviated postoperatively. The endoscopic keyhole approach may be useful as a less invasive procedure for diagnosing and removing cystic cerebellar HBs, especially for lesions that are difficult to diagnose using preoperative imaging.</p>

    DOI: 10.2176/jns-nmc.2024-0178

    PubMed

  • The Symptomatic Calcification and Ossification of the Ligamentum Flavum in the Spine: Our Experience and Review of the Literature.

    Nishikawa M, Yoshimura M, Naito K, Yamagata T, Goto H, Hara M, Ikuno H, Goto T

    Journal of clinical medicine   13 ( 1 )   2023.12( ISSN:2077-0383

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  • Angiographic Evaluation of the Feeding Artery in Skull Base Meningioma.

    Arima H, Watanabe Y, Tanoue Y, Morisako H, Kawakami T, Ichinose T, Goto T

    Journal of clinical medicine   12 ( 24 )   2023.12( ISSN:2077-0383

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  • Use of an Endoscope Reduces the Size of Craniotomy Without Increasing Operative Time Compared With Conventional Microscopic Corpus Callosotomy.

    Yindeedej V, Uda T, Kawashima T, Koh S, Tanoue Y, Kojima Y, Kunihiro N, Umaba R, Goto T

    Operative neurosurgery (Hagerstown, Md.)   25 ( 6 )   505 - 511   2023.12( ISSN:2332-4252

  • Endoscopic endonasal approach to remove pediatric intraventricular tumors of the third ventricle.

    Tanoue Y, Morisako H, Sasaki T, Ikegami M, Goto T

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery   39 ( 12 )   3397 - 3406   2023.12( ISSN:0256-7040

  • Surgical strategy and outcomes of intra-3<sup>rd</sup>-ventricle type of craniopharyngiomas resected via an endoscopic endonasal approach

    Folia Endocrinologica Japonica   99 ( S.HPT )   72 - 75   2023.08( ISSN:00290661 ( eISSN:2186506X

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  • 経鼻内視鏡手術による第三脳室型頭蓋咽頭腫に対する手術戦略と治療成績について

    森迫 拓貴, 池上 方基, 児嶌 悠一郎, 佐々木 強, 田上 雄大, 後藤 剛夫

    日本内分泌学会雑誌   99 ( Suppl.HPT )   72 - 75   2023.08( ISSN:0029-0661

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    当院で2016~2022年に経鼻内視鏡手術を行った第三脳室型頭蓋咽頭腫19例の手術方法と治療成績について報告した。手術方法は、Extended approachを基本術式として鞍背や後床突起の削除を追加することで、視交叉後方から第三脳室に広いワーキングスペースを確保した。腫瘍摘出に際しては30度内視鏡を用いて、第三脳室底を尾側より広く観察し、視交叉へ術操作が極力加わらないようにした。治療成績は、腫瘍摘出度がGross total resection(GTR)17例、Nearly total resection(NTR)1例、Subtotal resection(STR)1例であった。術後に視機能が改善したものが8例、不変が11例であった。術後髄液漏を2例に認め、いずれも修復術を要した。術後観察期間は平均41.6ヵ月で、腫瘍再発をGTRの17例中2例(12%)とSTRの1例中1例(100%)に認めた。再発した3例には腫瘍摘出術を追加し、局所制御が得られている。当院で2000~2015年に開頭顕微鏡手術を行った第三脳室型頭蓋咽頭腫15例の治療成績と比較すると、多段階での手術を要した症例の割合が減少し、術後の視機能改善率が向上していた。

  • Endoscopic Supraorbital Eyebrow Approach for Medium-Sized Tuberculum Sellae Meningiomas: A Cadaveric Stepwise Dissection, Technical Nuances, and Surgical Outcomes.

    Sasaki T, Morisako H, Ikegami M, Wardhana DW, Fernandez-Miranda JC, Goto T

    World neurosurgery   176   e40 - e48   2023.08( ISSN:1878-8750

  • [Surgical Approaches to Craniopharyngiomas].

    Goto T

    No shinkei geka. Neurological surgery   51 ( 4 )   672 - 678   2023.07( ISSN:0301-2603 ( eISSN:18821251

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  • 大理石骨病に続発した三叉神経痛に対して前経錐体到達法による微小血管減圧術が有用であった症例

    池田 祥平, 大畑 裕紀, 森迫 拓貴, 一ノ瀬 努, 後藤 剛夫

    脳神経外科速報   33 ( 4 )   e15 - e21   2023.07( ISSN:0917-1495

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    症例は44歳女性で、15年前に頭痛精査を受け、孤発性の大理石骨病と診断された。10年前から左上顎の歯肉の疼痛が出現し、三叉神経痛の診断を受けていた。薬物療法、ガンマナイフ治療などを受けるも改善に乏しく、手術目的に当院紹介となった。顔面神経をモニタリングで確認しながら、硬膜外から錐体骨を削除して橋前槽に術野を作成し、三叉神経圧痕周囲の骨を十分に削除して三叉神経の錐体骨辺縁の骨肥厚による三叉神経の牽引を解除したのち、メッケル腔を開放した。その結果、三叉神経の神経根侵入部(REZ)を圧迫する上小脳動脈を確認、三叉神経REZよりテフロンフェルトを用いて偏位させた。さらに卵円孔の骨性狭窄を認めたため、卵円孔周囲の骨削除も行った。術後に右三叉神経領域の軽度の感覚鈍麻を認めたが、それ以外の神経所見の新規出現はなく、三叉神経痛はNRS 10から3に改善した。

  • Electrode Tip Shift During the Stereotactic Electroencephalography Evaluation Period with Boltless Suture Fixation.

    Yindeedej V, Uda T, Kawashima T, Koh S, Tanoue Y, Kojima Y, Goto T

    World neurosurgery   175   e1210 - e1219   2023.07( ISSN:1878-8750

  • In Reply to the Letter to the Editor Regarding: "Endoscopic Contralateral Interhemispheric Transfalcine Keyhole Approach for Large Falcine Meningiomas".

    Sakaeyama Y, Morisako H, Ohata H, Nakajo K, Valenzuela JC, Fernandez-Miranda JC, Goto T

    World neurosurgery   173   292 - 293   2023.05( ISSN:1878-8750

  • Intraparenchymal and Subarachnoid Hemorrhage in Stereotactic Electroencephalography Caused by Indirect Adjacent Arterial Injury: Illustrative Case.

    Kawashima T, Uda T, Koh S, Yindeedej V, Ishino N, Ichinose T, Arima H, Sakuma S, Goto T

    Brain sciences   13 ( 3 )   2023.03( ISSN:2076-3425

  • How to disconnect the splenium and fornix in posterior quadrant disconnection, hemispherotomy, and subtotal hemispherotomy.

    Uda H, Uda T, Kunihiro N, Nakajo K, Umaba R, Kawashima T, Tanoue Y, Koh S, Goto T

    Acta neurochirurgica   165 ( 3 )   743 - 745   2023.03( ISSN:0001-6268

  • [Surgical Treatment of Mesial Temporal Lobe Epilepsy Focusing on Anatomical Understanding]. Reviewed

    Uda T, Kunihiro N, Tanoue Y, Kojima Y, Kawashima T, Umaba R, Uda H, Koh S, Goto T

    No shinkei geka. Neurological surgery   51 ( 1 )   105 - 114   2023.01( ISSN:0301-2603 ( eISSN:18821251

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  • Endoscopic Endonasal Transpterygoid Approach for Resection of Carotid Sympathetic Plexus Schwannomas: A Cadaveric Stepwise Dissection, Technical Nuances and Surgical Outcomes.

    Wardhana DW, Morisako H, Sasaki T, Ikegami M, Teranishi Y, Fernandez-Miranda JC, Goto T

    World neurosurgery   169   e221 - e229   2023.01( ISSN:1878-8750

  • Surgical Strategy in Modification of the Transpetrosal Approach to Avoid Postoperative Venous Complications: A Report of 74 Consecutive Cases.

    Nimmannitya P, Goto T, Nagahama A, Tanoue Y, Terakawa Y, Kawashima T, Morisako H, Ohata K

    Acta neurochirurgica. Supplement   130   25 - 36   2023( ISSN:0065-1419

  • [Endoscopic Endonasal Surgery for Pediatric Suprasellar Tumors].

    Morisako H, Goto T

    No shinkei geka. Neurological surgery   50 ( 6 )   1323 - 1331   2022.11( ISSN:0301-2603 ( eISSN:18821251

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  • Modified Transpetrosal-Transtentorial Approach for Resection of Large and Giant Petroclival Meningioma: Technical Nuance and Surgical Experiences.

    Haq IBI, Wahyuhadi J, Suryonurafif A, Arifianto MR, Susilo RI, Nagm A, Goto T, Ohata K

    Journal of neurological surgery. Part A, Central European neurosurgery   83 ( 6 )   578 - 587   2022.11( ISSN:2193-6315

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  • Endoscopic Contralateral Interhemispheric Transfalcine Keyhole Approach for Large Falcine Meningiomas.

    Sakaeyama Y, Morisako H, Ohata H, Nakajo K, Valenzuela JC, Fernandez-Miranda JC, Goto T

    World neurosurgery   166   e237 - e244   2022.10( ISSN:1878-8750

  • Surgical Management of Chiari Malformation Type I and Instability of the Craniocervical Junction Based on Its Pathogenesis and Classification

    NISHIKAWA Misao, BOLOGNESE Paolo A., YAMAGATA Toru, NAITO Kentarou, SAKAMOTO Hiroaki, HARA Mistuhiro, OHATA Kenji, GOTO Takeo

    Neurologia medico-chirurgica   62 ( 9 )   400 - 415   2022.09( ISSN:0470-8105 ( eISSN:13498029

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    <p>We investigated the mechanism underlying Chiari malformation type I (CM-I) and classified it according to the morphometric analyses of posterior cranial fossa (PCF) and craniocervical junction (CCJ). Three independent subtypes of CM-I were confirmed (CM-I types A, B, and C) for 484 cases and 150 normal volunteers by multiple analyses. CM-I type A had normal volume of PCF (VPCF) and occipital bone size. Type B had normal VPCF and small volume of the area surrounding the foramen magnum (VAFM) and occipital bone size. Type C had small VPCF, VAFM, and occipital bone size. Morphometric analyses during craniocervical traction test demonstrated instability of CCJ. Foramen magnum decompression (FMD) was performed in 302 cases. Expansive suboccipital cranioplasty (ESCP) was performed in 102 cases. Craniocervical posterolateral fixation (CCF) was performed for CCJ instability in 70 cases. Both ESCP and FMD showed a high improvement rate of neurological symptoms and signs (84.4%) and a high recovery rate of the Japanese Orthopaedic Association (JOA) score (58.5%). CCF also showed a high recovery rate of the JOA score (69.7%), with successful joint stabilization (84.3%). CM-I type A was associated with other mechanisms that caused ptosis of the brainstem and cerebellum (CCJ instability and traction and pressure dissociation between the intracranial cavity and spinal canal cavity), whereas CM-I types B and C demonstrated underdevelopment of the occipital bone. For CM-I types B and C, PCF decompression should be performed, whereas for small VPCF, ESCP should be performed. CCF for CCJ instability (including CM-I type A) was safe and effective.</p>

    DOI: 10.2176/jns-nmc.2022-0078

    PubMed

  • Primary Experiences with Robot-assisted Navigation-based Frameless Stereo-electroencephalography: Higher Accuracy than Neuronavigation-guided Manual Adjustment

    KOJIMA Yuichiro, UDA Takehiro, KAWASHIMA Toshiyuki, KOH Saya, HATTORI Masato, MITO Yuki, KUNIHIRO Noritsugu, IKEDA Shohei, UMABA Ryoko, GOTO Takeo

    Neurologia medico-chirurgica   62 ( 8 )   361 - 368   2022.08( ISSN:0470-8105 ( eISSN:13498029

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    <p>The use of robot-assisted frameless stereotactic electroencephalography (SEEG) is becoming more common. Among available robotic arms, Stealth Autoguide (SA) (Medtronic, Minneapolis, MN, USA) functions as an optional instrument of the neuronavigation system. The aims of this study were to present our primary experiences with SEEG using SA and to compare the accuracy of implantation between SA and navigation-guided manual adjustment (MA). Seventeen electrodes from two patients who underwent SEEG with SA and 18 electrodes from four patients with MA were retrospectively reviewed. We measured the distance between the planned location and the actual location at entry (De) and the target (Dt) in each electrode. The length of the trajectory did not show a strong correlation with Dt in SA (Pearson's correlation coefficient [r] = 0.099, p = 0.706) or MA (r = 0.233, p = 0.351). De and Dt in SA were shorter than those in MA (1.99 ± 0.90 vs 4.29 ± 1.92 mm, p = 0.0002; 3.59 ± 2.22 vs 5.12 ± 1.40 mm, p = 0.0065, respectively). SA offered higher accuracy than MA both at entry and target. Surgical times per electrode were 38.9 and 32 min in the two patients with SA and ranged from 51.6 to 88.5 min in the four patients with MA. During the implantation period of 10.3 ± 3.6 days, no patients experienced any complications.</p>

    DOI: 10.2176/jns-nmc.2022-0010

    PubMed

  • Surgical Management of Chiari Malformation Type I Associated with Syringomyelia: Outcome of Surgeries Based on the New Classification and Study of Cerebrospinal Fluid Dynamics.

    Nishikawa M, Yamagata T, Naito K, Kunihiro N, Sakamoto H, Hara M, Ohata K, Goto T

    Journal of clinical medicine   11 ( 15 )   2022.08( ISSN:2077-0383

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  • ロボット支援ナビゲーションをベースとした、フレームレス定位的頭蓋内脳波の初期経験 ニューロナビゲーションガイド下手動制御よりも高精度な手法(Primary Experiences with Robot-assisted Navigation-based Frameless Stereo-electroencephalography: Higher Accuracy than Neuronavigation-guided Manual Adjustment)

    Kojima Yuichiro, Uda Takehiro, Kawashima Toshiyuki, Koh Saya, Hattori Masato, Mito Yuki, Kunihiro Noritsugu, Ikeda Shohei, Umaba Ryoko, Goto Takeo

    Neurologia medico-chirurgica   62 ( 8 )   361 - 368   2022.08( ISSN:0470-8105

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    ニューロナビゲーションシステムであるロボットアームStealth Autoguide(SA)を用いた定位的頭蓋内脳波(SEEG)電極挿入術と、ナビゲーションガイド下手動制御(MA)による脳深部電極挿入術を行い、焦点局在の精度を比較した。2021年3月~6月までに、著者らの医療施設で、脳深部電極挿入術後にてんかん手術が行われた患者6例(男性1例、女性5例、年齢10~59歳)を対象に、SAを受けた患者2例の17電極と、MAを受けた患者4例の18電極を後方視的に調べた。術前計画による各電極の刺入点の位置と実際に電極が挿入された位置との距離(De)、目標点の位置と実際に電極が挿入された位置との距離(Dt)を測定した。その結果、SAを用いた患者ではDeとDtがMAを用いた患者よりも短く、刺入点、目標点の位置がともに高精度であった。また、SAを用いた患者の手術時間は32~38.9分と、MAを用いた患者の施術時間51.6~88.5分に比べ短時間で、有害事象の面でも、平均挿入期間10.3±3.6日の間に合併症を発症した患者も0例であった。以上より、SEEGにおいて、SAはナビゲーションガイド下MAよりも脳深部電極挿入の位置が高精度で、短時間の施術時間で、焦点局在診断が達成されることが確認された。

  • 連載 海外での手術経験から学ぶ-手術環境・道具・技術そして心の重要性 vol. 5 海外での手術経験から学んだ3つの教訓

    後藤 剛夫

    Neurological Surgery 脳神経外科   50 ( 4 )   902 - 907   2022.07( ISSN:03012603 ( eISSN:18821251

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  • 放射線治療を必要とした脳腫瘍手術におけるコラーゲン使用吸収性人工硬膜の安全性に関する検討

    鈴木 まりお, 近藤 聡英, 都築 俊介, 末永 潤, 森迫 拓貴, 藤尾 信吾, 遠藤 俊毅, 渡邉 督, 川俣 貴一, 山本 哲哉, 後藤 剛夫, 吉本 幸司, 金森 政之, 岩味 健一郎, 園田 順彦

    脳神経外科速報   32 ( 4 )   e11 - e17   2022.07( ISSN:0917-1495

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    術前後放射線治療を必要とした脳腫瘍手術におけるコラーゲン吸収性人工硬膜の安全性を、髄液漏発生頻度を指標として検討した。脳腫瘍手術のうち、吸収性人工硬膜であるDuraGenを用いて硬膜閉鎖したもののその後の経過において放射線治療を追加せざるを得なかった症例、放射線治療後の手術においてDuraGenを使用せざるを得なかった114例(男性57例、女性57例、中央値51歳)を対象とした。脳脊髄液漏は5例(4.4%)に認められ、42~90歳で男性1名、女性4名であり、原疾患はそれぞれ膠芽腫、退形成性髄膜腫、異型性髄膜腫、軟骨肉腫、頭蓋咽頭腫で、いずれもテント上硬膜の閉鎖にDuraGenが用いられていた。髄液漏を認めた5例のうち2例は感染の関与が示唆されたため、外科的にDuraGen除去および硬膜再建術が施行された。DuraGenを用いて硬膜閉鎖を行っても、放射線治療により追加手技を要するような髄液漏発生リスクは増加しないと考えられた。

  • Visualization of Resected Area in Endonasal Endoscopic Approach versus Transcranial Approach for Skull Base Meningiomas by Voxel-Based-Lesion Mapping.

    Uda H, Uda T, Kinoshita M, Kishima H, Tanoue Y, Nagahama A, Kawashima T, Ohata H, Nakajo K, Morisako H, Goto T

    Brain sciences   12 ( 7 )   2022.06( ISSN:2076-3425

  • Disconnection surgery to cure or palliate medically intractable epileptic spasms: a retrospective study.

    Koh S, Uda T, Kunihiro N, Kuki I, Inoue T, Kawashima T, Uda H, Umaba R, Nakajo K, Nakanishi Y, Sakuma S, Seto T, Okazaki S, Kawawaki H, Goto T

    Journal of neurosurgery. Pediatrics   29 ( 6 )   693 - 699   2022.06( ISSN:1933-0707

  • [How to Use a High-Speed Drill and an Ultrasonic Aspirator During Skull Base Surgery].

    Morisako H, Goto T

    No shinkei geka. Neurological surgery   50 ( 3 )   650 - 654   2022.05( ISSN:0301-2603 ( eISSN:18821251

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  • [The Combined Petrosal Approach].

    Goto T

    No shinkei geka. Neurological surgery   50 ( 3 )   605 - 613   2022.05( ISSN:0301-2603 ( eISSN:18821251

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  • 症例 錐体斜台部に発生したsolitary fibrous tumorの1例 Reviewed

    田代 茜子, 下野 太郎, 光山 容仁, 後藤 剛夫, 田中 里可子, Maciej Pas, 茂木 祥子, 三木 幸雄

    臨床放射線   67 ( 3 )   293 - 297   2022.03( ISSN:00099252

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  • 錐体斜台部に発生したsolitary fibrous tumorの1例

    田代 茜子, 下野 太郎, 光山 容仁, 後藤 剛夫, 田中 里可子, Maciej Pas, 茂木 祥子, 三木 幸雄

    臨床放射線   67 ( 3 )   293 - 297   2022.03( ISSN:0009-9252

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    症例は60歳代女性で、1年前にふらつきと右聴力低下が出現して前医を受診し、聴力評価で進行性の聴力低下を指摘され、CTで右錐体部腫瘍を認めた。今回、CTで腫瘍の増大を認めたため治療目的で当院受診となった。比較的長い経過やT1強調像の軽度高信号・強い増強効果を呈することからsolitary fibrous tumorが最も疑われ、錐体部腫瘍に対する開頭腫瘍摘出術が施行された。腫瘍は易出血性であり、内頸動脈から直接小さな栄養血管が分布していた。内耳道に進展していたが内耳道の硬膜は保たれており、内耳道の硬膜を破綻せずに圧排発育していた。病理所見では紡錘形細胞の増殖とstaghorn様血管を認め、腫瘍内には石灰化は認めなかった。最終病理診断はsolitary fibrous tumor WHO grade 2であった。

  • 大型分葉状小児頭蓋咽頭腫に対して経鼻内視鏡下経頭蓋顕微鏡下同時腫瘍摘出術が有用であった1例

    大畑 裕紀, 森迫 拓貴, 一ノ瀬 努, 坂本 博昭, 後藤 剛夫

    小児の脳神経   47 ( 1 )   36 - 40   2022.02( ISSN:0387-8023

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    トルコ鞍内から鞍上部,後頭蓋,シルビウス裂内へと進展する,単一アプローチでは摘出が困難と考えられた大型分葉状頭蓋咽頭腫に対して経鼻内視鏡下経頭蓋顕微鏡下同時手術を施行した小児例を経験したので報告した.大型分葉状頭蓋咽頭腫に対して経鼻経頭蓋同時手術を行うことで,シルビウス裂内ののう胞性腫瘍,腫瘍被膜を周囲構造物と確実に剥離して腫瘍を安全に全摘出することが可能であった.小児例であっても,著明な外側進展を有する症例に対しては経鼻アプローチと経頭蓋アプローチの合併手術は有用と考えられた.(著者抄録)

  • Maximum 11C-methionine PET uptake as a prognostic imaging biomarker for newly diagnosed and untreated astrocytic glioma.

    Nakajo K, Uda T, Kawashima T, Terakawa Y, Ishibashi K, Tsuyuguchi N, Tanoue Y, Nagahama A, Uda H, Koh S, Sasaki T, Ohata K, Kanemura Y, Goto T

    Scientific reports   12 ( 1 )   546   2022.01

  • TSC2 somatic mosaic mutation, including extra-tumor tissue, may be the developmental cause of solitary subependymal giant cell astrocytoma.

    Sasaki T, Uda T, Kuki I, Kunihiro N, Okazaki S, Niida Y, Goto T

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery   38 ( 1 )   77 - 83   2022.01( ISSN:0256-7040

  • A case of a large, multilobulated, pediatric craniopharyngioma with tumor resection via a combined simultaneous endoscopic endonasal and microscopic transcranial approach

    Ohata Hiroki, Morisako Hiroki, Ichinose Tsutomu, Sakamoto Hiroaki, Goto Takeo

    Nervous System in Children   47 ( 1 )   36 - 40   2022( ISSN:03878023 ( eISSN:2435824X

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    <p>Craniopharyngiomas arise from Rathke’s pouch. They are histopathologically benign tumors. However, they are one of the most difficult tumors to treat. The surgical strategy is crucial and depends on the location and size of the tumor. Herein, we present a case of a large, multilobulated, pediatric craniopharyngioma with tumor resection via a combined simultaneous endoscopic endonasal and microscopic transcranial approach.</p><p>A 5-year-old girl presented with right optic nerve dysfunction and oculomotor nerve palsy. The imaging findings showed a large multilobulated tumor in the sella, which extended to the suprasellar area, posterior fossa, and right Sylvian fissure with calcification and cyst formation. The preoperative diagnosis was craniopharyngioma. It would not have been possible to perform radical resection of the tumor via only one corridor. Tumor resection was performed via a combined simultaneous endoscopic endonasal and microscopic transcranial approach. All tumor capsules, included in the Sylvian fissure, were completely observed and resected. The two surgical corridors provided a wide operative view. All neurovascular structures were preserved, and gross total resection was achieved.</p>

    DOI: 10.34544/jspn.47.1_36

  • Case report and review of the literature of primary central nervous system lymphoma of the fourth ventricle.

    Kojima Y, Nakajo K, Ichinose T, Morikawa Y, Osawa M, Goto T

    Surgical neurology international   13   529   2022( ISSN:2229-5097

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  • 頭蓋底外科手術の歴史と発展, 進歩について

    後藤 剛夫

    大阪市医学会雑誌   70   1 - 5   2021.12( ISSN:03864103

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    頭蓋底外科手術は病変が頭蓋内最深部に存在するため脳神経外科領域の中で最も治療困難な領域である. この分野については1970年代後半から80年代初めに様々な頭蓋底到達法が発表され, この治療が始まったと言える. ……

    CiNii Article

  • Surgical Aspects of Corpus Callosotomy.

    Uda T, Kunihiro N, Umaba R, Koh S, Kawashima T, Ikeda S, Ishimoto K, Goto T

    Brain sciences   11 ( 12 )   2021.12( ISSN:2076-3425

  • Osaka Sliding Knot Seals Dural Defect Simply in Extended Endoscopic Endonasal Approach

    Shimohonji Wataru, Morisako Hiroki, Ohata Hiroki, Valenzuela Johan Carlos, Sakaeyama Yuki, Goto Takeo

    World Neurosurgery   155   144 - 149   2021.11( ISSN:1878-8750

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    An extended endoscopic endonasal approach (EEA) has become standard for parasellar and midline skull base lesions. However, postoperative leakage of cerebrospinal fluid (CSF) can result from dural defects after lesion removal. We present a simple and effective technique, the Osaka sliding knot, to prevent CSF leakage. Between November 2018 and March 2021, ......

    DOI: 10.1016/j.wneu.2021.08.050

    PubMed

  • Endoscopic Transcortical Selective Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy: 2-Dimensional Operative Video.

    Uda T, Kawashima T, Hattori M, Kojima Y, Mito Y, Goto T

    Operative neurosurgery (Hagerstown, Md.)   21 ( 5 )   E443   2021.10( ISSN:2332-4252

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  • Usefulness of 4 hands endoscopic surgery by 2 neurosurgeons in endoscopic endonasal surgery

    Folia Endocrinologica Japonica   97 ( S.HPT )   78 - 79   2021.09( ISSN:00290661 ( eISSN:2186506X

  • Aggressive resection for craniopharyngiomas via endoscopic endonasal approach

    Folia Endocrinologica Japonica   97 ( S.HPT )   23 - 25   2021.09( ISSN:00290661 ( eISSN:2186506X

  • Consideration of surgical strategy for giant pituitary tumors

    Folia Endocrinologica Japonica   97 ( S.HPT )   4 - 6   2021.09( ISSN:00290661 ( eISSN:2186506X

  • 内視鏡下経鼻手術における脳神経外科医2人による4 hands endoscopic surgeryの有用性

    児嶌 悠一郎, 森迫 拓貴, 大畑 裕紀, 後藤 剛夫

    日本内分泌学会雑誌   97 ( Suppl.HPT )   78 - 79   2021.09( ISSN:0029-0661

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    内視鏡下経鼻手術において脳神経外科医2人による4 hands endoscopic surgeryを行った256例について検討した。その結果、4 handsによる内視鏡下経鼻手術は内視鏡手術操作に優れた脳神経外科医2人が協力することで円滑な進行と安全な腫瘍の摘出が可能であった。また、若手脳外科医がスコーピストを通じて内頸動脈露出、後床突起や錐体骨削除、腫瘍の剥離操作など熟練医の手技を学ぶことができ、更に拡大法を要する下垂体腺腫などを若手脳外科医が執刀する際の腫瘍摘出に生かされ、手術教育としても有用であった。

  • 経鼻内視鏡手術を中心とした頭蓋咽頭腫に対する積極的な病変切除と治療成績

    森迫 拓貴, 大畑 裕紀, 児嶋 悠一郎, 一ノ瀬 努, 後藤 剛夫

    日本内分泌学会雑誌   97 ( Suppl.HPT )   23 - 25   2021.09( ISSN:0029-0661

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    経鼻内視鏡手術を中心とした頭蓋咽頭腫に対する治療戦略と治療成績を報告した。対象は頭蓋咽頭腫51例(男性20例、女性31例、平均年齢42.0歳)で、初発症例30例と再発症例21例であった。基本的に経鼻内視鏡手術を第一選択としており、ウィリス動脈輪や各脳神経を超えて外側へ進展し、多分葉状となって脳実質へ大きく食い込んでいる病変には経鼻内視鏡手術に経頭蓋到達法を組み合わせる方針としている。腫瘍摘出度は肉眼的全摘出43例、亜全摘出7例、部分摘出1例で、視機能改善は28例、認知機能改善は8例にみられ、髄液漏の発生頻度は3.9%で、腫瘍再発は初発例の3例と再発例の7例に認めた。前頭蓋底や脳幹前面-第3脳室に進展した大型病変でも、正中の病変であれば経鼻内視鏡手術単独で対応できたが、腫瘍が内頸動脈や動眼神経、後交通動脈を超えて側方へ進展している場合には経鼻内視鏡手術と開頭手術の組み合わせが必要と考えられた。

  • Two-stage posterior decompression and fusion for tuberculous spondylitis after intravesical bacillus Calmette-Guerin instillation.

    Ohata H, Prakasa D, Goto H, Ohata K, Goto T, Nishikawa M

    Journal of craniovertebral junction & spine   12 ( 3 )   318 - 321   2021.07( ISSN:0974-8237

  • Deep Learning-based Angiogram Generation Model for Cerebral Angiography without Misregistration Artifacts.

    Ueda D, Katayama Y, Yamamoto A, Ichinose T, Arima H, Watanabe Y, Walston SL, Tatekawa H, Takita H, Honjo T, Shimazaki A, Kabata D, Ichida T, Goto T, Miki Y

    Radiology   299 ( 3 )   675 - 681   2021.06( ISSN:0033-8419

  • Petroclival meningiomas: update of current treatment and consensus by the EANS skull base section.

    Giammattei L, di Russo P, Starnoni D, Passeri T, Bruneau M, Meling TR, Berhouma M, Cossu G, Cornelius JF, Paraskevopoulos D, Zazpe I, Jouanneau E, Cavallo LM, Benes V, Seifert V, Tatagiba M, Schroeder HWS, Goto T, Ohata K, Al-Mefty O, Fukushima T, Messerer M, Daniel RT, Froelich S

    Acta neurochirurgica   163 ( 6 )   1639 - 1663   2021.06( ISSN:0001-6268

  • Phase-amplitude coupling of interictal fast activities modulated by slow waves on scalp EEG and its correlation with seizure outcomes of disconnection surgery in children with intractable nonlesional epileptic spasms.

    Uda T, Kuki I, Inoue T, Kunihiro N, Suzuki H, Uda H, Kawashima T, Nakajo K, Nakanishi Y, Maruyama S, Shibata T, Ogawa H, Okazaki S, Kawawaki H, Ohata K, Goto T, Otsubo H

    Journal of neurosurgery. Pediatrics   27 ( 5 )   572 - 580   2021.05( ISSN:1933-0707

  • Diagnostic Performance of [<sup>11</sup>C]Methionine Positron Emission Tomography in Newly Diagnosed and Untreated Glioma Based on the Revised World Health Organization 2016 Classification. Reviewed

    Nakajo K, Uda T, Kawashima T, Terakawa Y, Ishibashi K, Tsuyuguchi N, Tanoue Y, Nagahama A, Uda H, Koh S, Sasaki T, Ohata K, Kanemura Y, Goto T

    World neurosurgery   148   e471 - e481   2021.04( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2021.01.012

    PubMed

  • Diagnostic Performance of [^{11}C]Methionine Positron Emission Tomography in Newly Diagnosed and Untreated Glioma Based on the Revised World Health Organization 2016 Classification

    Nakajo Kosuke, Uda Takehiro, Kawashima Toshiyuki, Terakawa Yuzo, Ishibashi Kenichi, Tsuyuguchi Naohiro, Tanoue Yuta, Nagahama Atsufumi, Uda Hiroshi, Koh Saya, Sasaki Tsuyoshi, Ohata Kenji, Kanemura Yonehiro, Goto Takeo

    World Neurosurgery   148   e471 - e481   2021.04( ISSN:1878-8750

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    Background: The relationship between uptake of amino acid tracer with positron emission tomography (PET) and glioma subtypes/gene status is still unclear. / Objective: To assess the relationship between uptake of [^{11}C]methionine using PET and pathology, IDH (isocitrate dehydrogenase) mutation, 1p/19q codeletion, and TERT (telomerase reverse transcriptase) promoter status in gliomas. ...

    DOI: 10.1016/j.wneu.2021.01.012

    PubMed

  • Deep Learning-based Angiogram Generation Model for Cerebral Angiography without Misregistration Artifacts. Reviewed

    Ueda D, Katayama Y, Yamamoto A, Ichinose T, Arima H, Watanabe Y, Walston SL, Tatekawa H, Takita H, Honjo T, Shimazaki A, Kabata D, Ichida T, Goto T, Miki Y

    Radiology   203692   2021.03( ISSN:0033-8419

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1148/radiol.2021203692

    PubMed

  • Petroclival meningiomas: update of current treatment and consensus by the EANS skull base section Reviewed

    Giammattei Lorenzo, di Russo P., Starnoni D., Passeri T., Bruneau M., Meling T. R., Berhouma M., Cossu G., Cornelius J. F., Paraskevopoulos D., Zazpe I., Jouanneau E., Cavallo L. M., Benes V., Seifert V., Tatagiba M., Schroeder H. W. S., Goto T., Ohata K., Al-Mefty O., Fukushima T., Messerer M., Daniel R. T., Froelich S.

    ACTA NEUROCHIRURGICA   2021.03( ISSN:0001-6268

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1007/s00701-021-04798-z

  • Incidental finding of neurosyphilis with intracranial hemorrhage and cerebral infarction: A case report Reviewed

    Imoto Waki, Arima Hironori, Yamada Koichi, Kanzaki Toshiyuki, Nakagawa Chihiro, Kuwabara Gaku, Yamairi Kazushi, Shibata Wataru, Oshima Kazuhiro, Watanabe Tetsuya, Asai Kazuhisa, Kaneko Yukihiro, Kawaguchi Tomoya, Goto Takeo, Kakeya Hiroshi

    JOURNAL OF INFECTION AND CHEMOTHERAPY   27 ( 3 )   521 - 525   2021.03( ISSN:1341-321X

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    DOI: 10.1016/j.jiac.2020.10.001

    PubMed

  • 頭蓋内出血と脳梗塞を伴う神経梅毒の偶発所見 症例報告(Incidental finding of neurosyphilis with intracranial hemorrhage and cerebral infarction: A case report)

    Imoto Waki, Arima Hironori, Yamada Koichi, Kanzaki Toshiyuki, Nakagawa Chihiro, Kuwabara Gaku, Yamairi Kazushi, Shibata Wataru, Oshima Kazuhiro, Watanabe Tetsuya, Asai Kazuhisa, Kaneko Yukihiro, Kawaguchi Tomoya, Goto Takeo, Kakeya Hiroshi

    Journal of Infection and Chemotherapy   27 ( 3 )   521 - 525   2021.03( ISSN:1341-321X

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    症例は神経梅毒の49歳男性。道端で意識を失い、救急搬送された。CTとMRIにて脳出血、複数の脳梗塞と脳血管の径の不整が観察されたため、入院した日に脳出血に対する手術を行った。その原因は梅毒によることが疑われた。入院した日にペニシリンによる抗菌薬治療を開始し、血清と髄液試験の結果から次の週に梅毒と診断した。病状が改善したので、ベンジルペニシリンの3週間の注入療法とその後にアモキシシリン経口投与を行い、転院した。

  • Phase-amplitude coupling of interictal fast activities modulated by slow waves on scalp EEG and its correlation with seizure outcomes of disconnection surgery in children with intractable nonlesional epileptic spasms. Reviewed

    Uda T, Kuki I, Inoue T, Kunihiro N, Suzuki H, Uda H, Kawashima T, Nakajo K, Nakanishi Y, Maruyama S, Shibata T, Ogawa H, Okazaki S, Kawawaki H, Ohata K, Goto T, Otsubo H

    Journal of neurosurgery. Pediatrics   1 - 9   2021.02( ISSN:1933-0707

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    DOI: 10.3171/2020.9.PEDS20520

    PubMed

  • Minimal anterior and posterior combined transpetrosal approach for large petroclival meningiomas. Reviewed

    Morisako H, Ohata H, Shinde B, Nagahama A, Watanabe Y, Goto T

    Journal of neurosurgery   1 - 10   2021.02( ISSN:0022-3085

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3171/2020.8.JNS202060

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  • Specific Oscillatory Power Changes and Their Efficacy for Determining Laterality in Mesial Temporal Lobe Epilepsy: A Magnetoencephalographic Study Reviewed

    Tanoue Yuta, Uda Takehiro, Hoshi Hideyuki, Shigihara Yoshihito, Kawashima Toshiyuki, Nakajo Kosuke, Tsuyuguchi Naohiro, Goto Takeo

    FRONTIERS IN NEUROLOGY   12   617291   2021.02( ISSN:1664-2295

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3389/fneur.2021.617291

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  • Rationale and Design of BeatNF2 Trial: A Clinical Trial to Assess the Efficacy and Safety of Bevacizumab in Patients with Neurofibromatosis Type 2 Related Vestibular Schwannoma Reviewed

    Fujii Masazumi, Kobayakawa Masao, Saito Kiyoshi, Inano Akihiro, Morita Akio, Hasegawa Mitsuhiro, Mukasa Akitake, Mitsuhara Takafumi, Goto Takeo, Yamaguchi Shigeru, Tamiya Takashi, Nakatomi Hirofumi, Oya Soichi, Takahashi Fumiaki, Sato Taku, Bakhit Mudathir

    CURRENT ONCOLOGY   28 ( 1 )   726 - 739   2021.02( ISSN:1198-0052

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.3390/curroncol28010071

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  • Combination of p53 and Ki67 as a Promising Predictor of Postoperative Recurrence of Meningioma.

    Nagahama A, Yashiro M, Kawashima T, Nakajo K, Morisako H, Uda T, Naito K, Ichinose T, Ohata K, Goto T

    Anticancer research   41 ( 1 )   203 - 210   2021.01( ISSN:0250-7005

  • Pediatric giant cell reparative granuloma of the lower clivus: A case report and review of the literature.

    Nakamura H, Morisako H, Ohata H, Kuwae Y, Teranishi Y, Goto T

    Journal of craniovertebral junction & spine   12 ( 1 )   86 - 90   2021.01( ISSN:0974-8237

  • Pathogenesis and Surgical Treatment of Craniopharyngiomas Reviewed

    Goto Takeo, Ohata Hiroki, Morisako Hiroki

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   30 ( 1 )   41 - 47   2021( ISSN:0917-950X

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    <p>  Craniopharyngiomas are regarded as particularly challenging tumors for safe and complete removal due to their anatomical location and proximity to vital neurovascular structures. Therefore, in several articles, partial tumor removal followed by radiotherapy is recommended to avoid perioperative complications. These reports present sufficient tumor control with acceptable complications. However, tumor recurrence after long follow-up periods or the effects of radiation on the hypothalamus and visual pathway should be considered when determining the appropriate treatment for these tumors. Contrastingly, several clinical articles on the endoscopic endonasal approach (EEA) report satisfactory outcomes in patients with craniopharyngiomas. However, these clinical series do not have adequate follow-up periods. This article presents several treatment options for craniopharyngiomas.</p>

    DOI: 10.7887/jcns.30.41

    CiNii Article

  • Pathogenesis and Surgical Treatment of Craniopharyngiomas

    Goto Takeo, Ohata Hiroki, Morisako Hiroki

    Japanese Journal of Neurosurgery   30 ( 1 )   41 - 47   2021( ISSN:0917950X ( eISSN:21873100

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    <p>  Craniopharyngiomas are regarded as particularly challenging tumors for safe and complete removal due to their anatomical location and proximity to vital neurovascular structures. Therefore, in several articles, partial tumor removal followed by radiotherapy is recommended to avoid perioperative complications. These reports present sufficient tumor control with acceptable complications. However, tumor recurrence after long follow-up periods or the effects of radiation on the hypothalamus and visual pathway should be considered when determining the appropriate treatment for these tumors. Contrastingly, several clinical articles on the endoscopic endonasal approach (EEA) report satisfactory outcomes in patients with craniopharyngiomas. However, these clinical series do not have adequate follow-up periods. This article presents several treatment options for craniopharyngiomas.</p>

    DOI: 10.7887/jcns.30.41

    CiNii Article

  • Concept and Current Topics in Epilepsy Surgery

    Uda Takehiro, Kunihiro Noritsugu, Kawashima Toshiyuki, Umaba Ryoko, Nakajo Kosuke, Uda Hiroshi, Koh Saya, Tanoue Yuta, Ohata Kenji, Goto Takeo

    Japanese Journal of Neurosurgery   30 ( 7 )   496 - 503   2021( ISSN:0917950X ( eISSN:21873100

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    <p>  Since better outcomes for mesial temporal lobe epilepsy (MTLE) was reported in 2001, epilepsy surgeries have been established as a treatment for medically intractable epilepsy. Among them, five types of epilepsy surgery (amygdalohippocampectomy for MTLE, lesionectomy for focal epilepsy with or without apparent MRI lesions, hemispherotomy for hemispheric epilepsy, and callosotomy for drop attacks) are known as surgically remediable epileptic syndromes. Furthermore, in 2010, vagal nerve stimulation was approved as a palliative surgery for epilepsy in Japan.</p><p>  When the epileptogenic focus is undetermined in non-invasive evaluations such as scalp electroencephalography (EEG), MRI, and positron emission tomography, invasive evaluation using intracranial electrodes might be performed subsequently. Conventionally, subdural grid EEG was mainly used for detecting the epileptogenic focus ; however, the percentage of the use of depth electrodes with the stereotactic method of EEG implantation (SEEG) has been increasing recently. SEEG is supposed to be insufficient in terms of confirming cortical seizure propagation and performing functional mapping with electrical stimulation, but it has been widely adopted because of its low invasiveness. When planning the location of the electrodes, a hypothesis of the seizure focus and its propagation needs to be set up based on the anatomo-clinico-electrical correlation.</p><p>  When the epileptogenic focus is in a limited area of the brain, less invasive approaches should be selected for the removal of the lesion. On the other hand, when the epileptic network affects a wide part of the brain, surgeries based on the disconnection concept, such as corpus callosotomy, multi-lobe disconnection, and hemispherotomy, should be considered.</p><p>  Although unapproved in Japan, new concepts of surgery, such as focus coagulation, deep brain stimulation, and responsive neurostimulation, have become popular instead of focus resection, especially in cases of epilepsy originating from eloquent areas. Here, we describe the concept of epilepsy surgery and the current topics in this field.</p>

    DOI: 10.7887/jcns.30.496

    CiNii Article

  • Specific Oscillatory Power Changes and Their Efficacy for Determining Laterality in Mesial Temporal Lobe Epilepsy: A Magnetoencephalographic Study.

    Tanoue Y, Uda T, Hoshi H, Shigihara Y, Kawashima T, Nakajo K, Tsuyuguchi N, Goto T

    Frontiers in neurology   12   617291   2021( ISSN:1664-2295

  • AGGRESSIVE RESECTION FOR PEDIATRIC CRANIOPHARYNGIOMAS VIA ENDOSCOPIC ENDONASAL APPROACH Reviewed

    Morisako Hiroki, Goto Takeo, Ohata Hiroki, Sakamoto Hiroaki, Ohata Kenji

    NEURO-ONCOLOGY   22   442 - 442   2020.12( ISSN:1522-8517

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  • Comparison of the keyhole trans-middle temporal gyrus approach and transsylvian approach for selective amygdalohippocampectomy: A single-center experience Reviewed

    Uda Hiroshi, Uda Takehiro, Tanoue Yuta, Koh Saya, Kawashima Toshiyuki, Nakajo Kosuke, Ohata Kenji, Goto Takeo

    JOURNAL OF CLINICAL NEUROSCIENCE   81   390 - 396   2020.11( ISSN:0967-5868

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    Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.jocn.2020.10.019

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  • Changes in cognitive function after resection of lesions in the anterior part of the lateral ventricle via an interhemispheric transcallosal approach.

    Nakajo K, Uda T, Goto T, Morisako H, Nishijima S, Kawashima T, Tanoue Y, Nagahama A, Sasaki T, Ko S, Ohata K

    Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia   79   39 - 44   2020.09( ISSN:0967-5868

  • Surgical implementation and efficacy of endoscopic endonasal extradural posterior clinoidectomy.

    Ohata H, Goto T, Nagm A, Kannepalli NR, Nakajo K, Morisako H, Goto H, Uda T, Kawahara S, Ohata K

    Journal of neurosurgery   133 ( 1 )   135 - 143   2020.07( ISSN:0022-3085

  • 症例 頭蓋内外に複数の病変を認めたサルコイドーシスの1例 Reviewed

    光山 容仁, 下野 太郎, 塚本 太朗, 松島 央和, 後藤 剛夫, 岡橋 沙美, 佐々木 扶実, 三木 幸雄

    臨床放射線   65 ( 6 )   567 - 570   2020.06( ISSN:00099252

  • 頭蓋内外に複数の病変を認めたサルコイドーシスの1例 Reviewed

    光山 容仁, 下野 太郎, 塚本 太朗, 松島 央和, 後藤 剛夫, 岡橋 沙美, 佐々木 扶実, 三木 幸雄

    金原出版(株) 臨床放射線   65 ( 6 )   567 - 570   2020.06( ISSN:0009-9252

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    症例は40歳代男性で、約6ヵ月前より頭痛が出現しており、脳MRI検査で頭蓋内に腫瘤性病変を指摘されたため当院紹介となった。左小脳テントに沿って腫瘤を認め、単純CTで石灰化はみられず高濃度を呈し、MRIのT2強調像で低信号、T1強調像で等信号、拡散強調像で低信号、造影T1強調像で比較的均一に強い造影増強効果を認めた。診断目的に側頭筋生検が施行された。側顔筋膜は一見正常であったが小さな結節状の硬結を触れ、筋膜下の側頭筋内にも多数の小さな結節状の硬結を触れた。病理所見では筋肉内やその周囲の軟部組織にLanghans型の巨細胞を伴う類上皮肉芽腫が数珠状に形成されていた。病理診断はサルコイドーシスであった。FDG-PET/CTが行われ、両側肺門リンパ節の腫大、Th10レベルの脊柱管内の結節を認め、いずれの病変にもFDG集積がみられ、サルコイドーシス病変であると診断した。

  • 経鼻内視鏡手術において小児頭蓋咽頭腫を積極的に切除するための工夫 Reviewed

    森迫 拓貴, 後藤 剛夫, 坂本 博昭, 大畑 建治

    (一社)日本小児神経外科学会 小児の脳神経   45 ( 1 )   17 - 24   2020.02( ISSN:0387-8023

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    頭蓋咽頭腫は手術的に全摘出することが理想である。しかし、病変が血管穿通枝、視神経視交叉や視床下部と近接しているため、安全に摘出することは容易ではない。小児頭蓋咽頭腫への経鼻内視鏡手術の適応が広がっており、当院では2014年4月以降経鼻内視鏡下での病変摘出を基本方針としてきた。近年、視交叉後方型や第三脳室型の小児頭蓋咽頭腫に対しても経鼻内視鏡手術を積極的に選択し、比較的良好な結果が得られている。我々の手術手技の工夫およびその治療成績について報告する。(著者抄録)

  • Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events (vol 130, pg e251, 2019) Reviewed

    Hasegawa Mitsuhiro, Hatayama Toru, Kondo Akinori, Nagahiro Shinji, Fujimaki Takamitsu, Amagasaki Kenichi, Arita Kazunori, Date Isao, Fujii Yukihiko, Goto Takeo, Hanaya Ryosuke, Higuchi Yoshinori, Hongo Kazuhiro, Inoue Toru, Kasuya Hidetoshi, Kayama Takamasa, Kawashima Masatou, Kohmura Eiji, Maehara Taketoshi, Matsushima Toshio, Mizobuchi Yoshihumi, Morita Akio, Nishizawa Shigeru, Noro Shusaku, Saito Shinjiro, Shimano Hirofumi, Shirane Reizo, Takeshima Hideo, Tanaka Yuichiro, Tanabe Hidenori, Toda Hiroki, Yamakami Iwao, Nishiyama Yuya, Ohba Shigeo, Hirose Yuichi, Suzuki Takeya

    WORLD NEUROSURGERY   134   685 - 685   2020.02( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2019.10.081

    PubMed

  • Corrigendum to 'Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events' [World Neurosurgery 130 (2019) e251-e258].

    Hasegawa M, Hatayama T, Kondo A, Nagahiro S, Fujimaki T, Amagasaki K, Arita K, Date I, Fujii Y, Goto T, Hanaya R, Higuchi Y, Hongo K, Inoue T, Kasuya H, Kayama T, Kawashima M, Kohmura E, Maehara T, Matsushima T, Mizobuchi Y, Morita A, Nishizawa S, Noro S, Saito S, Shimano H, Shirane R, Takeshima H, Tanaka Y, Tanabe H, Toda H, Yamakami I, Nishiyama Y, Ohba S, Hirose Y, Suzuki T

    World neurosurgery   134   685   2020.02( ISSN:1878-8750

  • 経鼻内視鏡手術において小児頭蓋咽頭腫を積極的に切除するための工夫

    森迫 拓貴, 後藤 剛夫, 坂本 博昭, 大畑 建治

    小児の脳神経   45 ( 1 )   17 - 24   2020.02( ISSN:0387-8023

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    頭蓋咽頭腫は手術的に全摘出することが理想である。しかし、病変が血管穿通枝、視神経視交叉や視床下部と近接しているため、安全に摘出することは容易ではない。小児頭蓋咽頭腫への経鼻内視鏡手術の適応が広がっており、当院では2014年4月以降経鼻内視鏡下での病変摘出を基本方針としてきた。近年、視交叉後方型や第三脳室型の小児頭蓋咽頭腫に対しても経鼻内視鏡手術を積極的に選択し、比較的良好な結果が得られている。我々の手術手技の工夫およびその治療成績について報告する。(著者抄録)

  • Therapeutic Strategy for Skull Base Tumors Reviewed

    Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   29 ( 1 )   17 - 24   2020( ISSN:0917-950X

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    <p>  Most skull base tumors are basically classified as pathologically benign tumors. However, their clinical courses are not usually benign due to anatomical proximity to critical neurovascular structures. It is thought that the extent of tumor removal is a significant factor for long tumor control, but at the same time, surgical radicality entails some risk that can lead to deterioration of the quality of life of the patient. Surgical outcomes depend largely on each institute and each neurosurgeon. Therefore, clinical evidence in the field of skull base tumor treatments is lacking. In this article, we briefly summarize recent clinical articles on skull base tumors and explain our strategy regarding treatment of skull base tumors.</p>

    DOI: 10.7887/jcns.29.17

    CiNii Article

  • Therapeutic Strategy for Skull Base Tumors

    Goto Takeo, Ohata Kenji

    Japanese Journal of Neurosurgery   29 ( 1 )   17 - 24   2020( ISSN:0917950X ( eISSN:21873100

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    <p>  Most skull base tumors are basically classified as pathologically benign tumors. However, their clinical courses are not usually benign due to anatomical proximity to critical neurovascular structures. It is thought that the extent of tumor removal is a significant factor for long tumor control, but at the same time, surgical radicality entails some risk that can lead to deterioration of the quality of life of the patient. Surgical outcomes depend largely on each institute and each neurosurgeon. Therefore, clinical evidence in the field of skull base tumor treatments is lacking. In this article, we briefly summarize recent clinical articles on skull base tumors and explain our strategy regarding treatment of skull base tumors.</p>

    DOI: 10.7887/jcns.29.17

    CiNii Article

  • Malignant transformation of a vestibular schwannoma to malignant peripheral nerve sheath tumor 10 years after Gamma Knife Surgery: Case report Reviewed

    Haq Irwan Barlian Immadoel, Goto Takeo, Kawashima Toshiyuki, Yamanaka Kazuhiro, Osawa Masahiko, Ohata Kenji, Mori Hisae

    INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT   18   2019.12

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    DOI: 10.1016/j.inat.2019.100529

  • Prosthesis Used in Microvascular Decompressions: A Multicenter Survey in Japan Focusing on Adverse Events Reviewed

    Hasegawa Mitsuhiro, Hatayama Toru, Kondo Akinori, Nagahiro Shinji, Fujimaki Takamitsu, Amagasaki Kenichi, Arita Kazunori, Date Isao, Fujii Yukihiko, Goto Takeo, Hanaya Ryosuke, Higuchi Yoshinori, Hongo Kazuhiro, Inoue Toru, Kasuya Hidetoshi, Kayama Takamasa, Kawashima Masatou, Kohmura Eiji, Maehara Taketoshi, Matsushima Toshio, Mizobuchi Yoshihumi, Morita Akio, Nishizawa Shigeru, Noro Shusaku, Saito Shinjiro, Shimano Hirofumi, Shirane Reizo, Takeshima Hideo, Tanaka Yuichiro, Tanabe Hidenori, Toda Hiroki, Yamakami Iwao, Nishiyama Yuya, Ohba Shigeo, Hirose Yuichi, Suzuki Takeya

    WORLD NEUROSURGERY   130   E251 - E258   2019.10( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2019.06.053

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  • 頭蓋底病変に対する3次元融合画像によるシミュレーションの有用性について Reviewed

    森迫 拓貴, 大畑 裕紀, 長濱 篤文, 後藤 剛夫, 大畑 建治

    日本脳神経CI学会 CI研究   41 ( 2 )   61 - 66   2019.09( ISSN:0918-7073

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    当施設では3次元融合画像によるシミュレーションを2014年3月に導入した。今回、2014年3月〜2018年1月に頭蓋底病変の摘出術を行った症例のうち、術前に摘出困難と予想された99例のシミュレーション成績を報告した。シミュレーションの方法は、まずMRIとCTの画像をもとに画像解析ソフト(Zed-ViewおよびSynapse-Vincent)を用いて3次元融合画像を作成する。次に3次元融合画像をstandard triangulated language形式で出力し、3次元マウスとデジタルクレイモデラーを用いて開頭から腫瘍摘出まで一連の手術シミュレーションを行う。成績は、全例で実際の術野と同様の3次元融合画像が得られ、病巣を中心とした微小解剖を容易に把握することができ、適切な手術到達法の選択や安全・確実な摘出が可能であった。代表例2例を提示した。

  • 小児頭蓋咽頭腫に対する積極的切除と治療成績 Reviewed

    森迫 拓貴, 後藤 剛夫, 高 沙野, 有馬 大紀, 坂本 博昭, 大畑 建治

    (一社)日本小児神経外科学会 小児の脳神経   44 ( 3 )   253 - 261   2019.09( ISSN:0387-8023

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    頭蓋咽頭腫は血管穿通枝と複雑に癒着し視神経視交叉や視床下部と近接しているため、安全に病変を全摘出することは容易でない。当院では小児頭蓋咽頭腫に対して積極的な切除を基本的な治療方針とし、2006年以降前医での治療歴がある再発7症例を含む22症例に対して摘出術を行った。術後下垂体機能の温存は困難であったが、記銘力や視機能は改善もしくは維持が得られた。腫瘍の局所制御については亜全摘出となった8例中4例に定位放射線照射を追加し、平均4.6年のフォロー期間で22例中8例に再発を認めたが、全摘出後の再発は14例中2例であり、亜全摘出後の再発は8例中6例であった。小児頭蓋咽頭腫に対しては長期の腫瘍制御が必要であるため、種々の手術到達法を駆使し、患者の機能を保ちつつ腫瘍の徹底切除を行うことが重要と考える。(著者抄録)

  • 拡大経鼻内視鏡手術による頭蓋咽頭腫の徹底切除について Reviewed

    後藤 剛夫, 森迫 拓貴, 中条 公輔, 有馬 大紀, 渡部 祐輔, 一ノ瀬 努, 大畑 建治

    (一社)日本内分泌学会 日本内分泌学会雑誌   95 ( Suppl.HPT )   5 - 8   2019.09( ISSN:0029-0661

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    当科では頭蓋咽頭腫に対し、可能な限り全摘出を目指した治療を行っている。今回、2014年1月以降に経鼻内視鏡手術を行った51例の成績を報告した。小児15例、成人36例で、腫瘍と視交叉との位置関係に基づいて腫瘍を分類すると鞍内型が4例、視交叉前方型7例、視交叉後方型25例、第三脳室内型14例、海綿静脈洞内再発1例であった。51例中50例(98%)で全摘出が可能であった。腫瘍切除のために両側後床突起切除を要したものが視交叉後方型で22例(88%)、第三脳室内型で14例(100%)あった。両側後床突起を削除することで術野の左右方向が大きく拡大するため、直線型手術器具が動眼神経や視索下面へ容易に到達できるようになり、安全な腫瘍剥離が可能であった。代表例1例を提示した。

  • Ectopic clival craniopharyngioma with intratumoral hemorrhage: A case report. Reviewed

    Horiuchi D, Shimono T, Doishita S, Goto T, Tanaka S, Miki Y

    Radiology case reports   14 ( 8 )   977 - 980   2019.08

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    DOI: 10.1016/j.radcr.2019.05.023

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  • p53 expression is a useful predictive marker for recurrence of meningioma Reviewed

    Nagahama Atsufumi, Yashiro Masakazu, Miki Yuichiro, Morisako Hiroki, Uda Takehiro, Goto Takeo, Takami Takehiro, Ohata Kenji

    CANCER RESEARCH   79 ( 13 )   2019.07( ISSN:0008-5472

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    DOI: 10.1158/1538-7445.AM2019-4901

  • Skull Base Dural Repair Using Autologous Fat as a Dural Substitute: An Efficient Technique Reviewed

    Bohoun Christian A., Goto Takeo, Morisako Hiroki, Nagahama Atsufumi, Tanoue Yuta, Ohata Kenji

    WORLD NEUROSURGERY   127   E896 - E900   2019.07( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2019.03.293

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  • Surgical implementation and efficacy of endoscopic endonasal extradural posterior clinoidectomy. Reviewed

    Ohata H, Goto T, Nagm A, Kannepalli NR, Nakajo K, Morisako H, Goto H, Uda T, Kawahara S, Ohata K

    Journal of neurosurgery   1 - 9   2019.05( ISSN:0022-3085

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    DOI: 10.3171/2019.2.JNS183278

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  • Sphenoorbital meningioma: surgical outcomes and management of recurrence. Reviewed

    Nagahama A, Goto T, Nagm A, Tanoue Y, Watanabe Y, Arima H, Nakajo K, Morisako H, Uda T, Ichinose T, Yamanaka K, Ohata K

    World neurosurgery   2019.03( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2019.02.123

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  • Posterior fossa choroid plexus papilloma with focal ependymal differentiation in an adult patient: A case report and literature review. Reviewed

    Matsushita S, Shimono T, Goto T, Doishita S, Kuwae Y, Miki Y

    Radiology case reports   14 ( 3 )   304 - 308   2019.03

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    DOI: 10.1016/j.radcr.2018.11.017

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  • Surgical Excision for Cavernous Sinus Tumors Reviewed

    Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   28 ( 7 )   398 - 406   2019( ISSN:0917-950X

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    <p>  Although stereotactic radiosurgery is a basic treatment for cavernous sinus tumors, surgical excision is required in patients with symptomatic tumors or recurrent tumors after radiotheraphy. Here, we present detailed anatomical knowledge of the cavernous sinus and surgical techniques for preservation of the third, fourth and sixth cranial nerves. Our surgical procedure for cavernous sinus tumor is an option for the treatment of cavernous sinus tumors.</p>

    DOI: 10.7887/jcns.28.398

    CiNii Article

  • Sympathetic Plexus Schwannoma of Carotid Canal: 2 Cases with Surgical Technique and Review of Literature Reviewed

    Goudihalli Sachin Ranganatha, Goto Takeo, Bohoun Christian, Nagahama Atsufumi, Tanoue Yuta, Morisako Hiroki, Kawahara Shinichi, Ohata Kenji

    WORLD NEUROSURGERY   118   63 - 68   2018.10( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2018.06.244

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  • 小児頭蓋咽頭腫に対する経鼻内視鏡手術の有用性 Reviewed

    森迫 拓貴, 後藤 剛夫, 渡部 祐輔, 中条 公輔, 坂本 博昭, 大畑 建治

    (一社)日本小児神経外科学会 小児の脳神経   43 ( 3 )   336 - 342   2018.09( ISSN:0387-8023

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    頭蓋咽頭腫は外科的全摘出が最良の治療であるが同時に視床下部障害、視機能障害、下垂体機能障害の危険を伴う。このため部分切除に放射線治療を組み合わせた治療が行われることも多い。近年は経鼻内視鏡手術が選択される傾向にあるが、やはり合併症回避のため部分摘出に終わることがある。我々は以前から頭蓋咽頭腫に対しては、下垂体機能は犠牲にしても、視床下部障害や視機能障害を来さず病変の全摘出を目指してきた。2014年より小児例にも積極的に経鼻内視鏡下での腫瘍徹底切除を行っているので治療成績を報告する。(著者抄録)

  • Collecting data about the transorbital endoscopic eyelid approach Reviewed

    Nagm Alhusain, Ogiwara Toshihiro, Goto Takeo, Hongo Kazuhiro, Ohata Kenji

    JOURNAL OF NEUROSURGERY   129 ( 1 )   275 - 276   2018.07( ISSN:0022-3085

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    DOI: 10.3171/2017.11.JNS172670

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  • Safe maximal resection of primary cavernous sinus meningiomas via a minimal anterior and posterior combined transpetrosal approach Reviewed

    Morisako Hiroki, Goto Takeo, Ohata Hiroki, Goudihalli Sachin Ranganatha, Shirosaka Keisuke, Ohata Kenji

    NEUROSURGICAL FOCUS   44 ( 4 )   E11   2018.04( ISSN:1092-0684

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    DOI: 10.3171/2018.1.FOCUS17703

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  • Contralateral Minimum Anterior and Posterior Combined Petrosal Approach for Retrochiasmatic Craniopharyngiomas: An Alternative Technique Reviewed

    Goudihalli Sachin Ranganatha, Morisako Hiroki, Prastarana Wimba, Goto Takeo, Ohata Hiroki, Ohata Kenji

    JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE   79 ( 2 )   S208 - S210   2018.02( ISSN:2193-6331

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    DOI: 10.1055/s-0037-1620248

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  • Treatment of Residual and Recurrent Meningiomas Reviewed

    Goto Takeo, Morisako Hiroki, Watanabe Yusuke, Nakajou Kousuke, Arima Hironori, Uda Takehiro, Kawahara Shinichi, Yamanaka Kazuhiro, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   27 ( 6 )   441 - 448   2018( ISSN:0917-950X

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    <p>  Meningiomas are one of the most frequent intracranial tumors and are basically treated with the surgical excision. But precisely how to treat residual and recurrent meningiomas remains a controversial point in several aspects such as repeated surgical excision and additional radiotherapy. Recent clinical studies have shown a significant relation between extent of tumor removal and recurrence-free survival and overall survival in all pathological grades of meningiomas. On the other hand, excessive removal of the tumor often caused unintended neurological deficits to the patients, which consequently exhausts additional treatment options. As a non-surgical option, radiotherapy apparently extended recurrence-free survival time in cases with WHO gradeⅠmeningiomas. But there are few reports suggesting the effectiveness of radiotherapy to extension of overall survival in all subtypes of meningioma. In this article, optimal treatment to residual and recurrent meningiomas is discussed based on clinical reviews and our experiences especially focusing on the extent of tumor removal and radiotherapy.</p>

    DOI: 10.7887/jcns.27.441

    CiNii Article

  • 【頭蓋底外科と橋海綿状血管腫】 脳幹部橋海綿状血管腫に対する経錐体到達法の有用性 Reviewed

    森迫 拓貴, 渡部 祐輔, 中条 公輔, 後藤 浩之, 後藤 剛夫, 大畑 建治

    (一社)日本脳卒中の外科学会 脳卒中の外科   45 ( 4 )   260 - 265   2017.07( ISSN:0914-5508

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    2008年〜2015年に外科的摘出を行った橋海綿状血管腫10例中、経錐体到達法を選択した8例(男性5例、女性3例、27〜64歳、平均46.9歳)を対象に、自験例を示し、同到達法の有用性について検討した。8例全例で出血による神経症状が術前にみられた。画像所見では病変または血腫による皮質脊髄路偏位を認め、軽度から重度の片麻痺が7例にみられた。その他、構音障害4例、失調3例、意識障害2例、眼球運動障害1例が認められた。手術によって全例で肉眼的全摘出ができた。術後、眼球運動が悪化した症例はなく、顔面神経麻痺や片麻痺の悪化もみられなかった。経錐体到達法は橋外側および腹側を広く観察でき、様々な方向から血管腫境界を観察でき、最小限の皮質切開で大きな血腫を切除できた。脳幹部橋海綿状血管腫に対する方法として有用な到達法と思われた。

  • Surgical strategy for craniopharyngiomas and the tumor-infundibulum relationship Response Reviewed

    Morisako Hiroki, Goto Takeo, Ohata Kenji

    NEUROSURGICAL FOCUS   43 ( 1 )   2017.07( ISSN:1092-0684

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    DOI: 10.3171/2017.3.FOCUS17180

  • Leu7に免疫陰性だがSchwann/2Eに免疫陽性の前頭蓋窩神経鞘腫様腫瘍(Schwannoma-like tumor in the anterior cranial fossa immunonegative for Leu7 but immunopositive for Schwann/2E) Reviewed

    Bohoun Christian Aiesse, Terakawa Yuzo, Goto Takeo, Tanaka Sayaka, Kuwae Yuko, Ohsawa Masahiko, Morisako Hiroki, Nakajo Kosuke, Sato Hidetoshi, Ohata Kenji, Yokoo Hideaki

    John Wiley & Sons Australia, Ltd NEUROPATHOLOGY   37 ( 3 )   265 - 271   2017.06( ISSN:0919-6544

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    症例1は26歳男性で、軽度の交通事故後に撮像された全身スクリーニングスキャンにより、頭蓋内腫瘍が偶発的に発見された。入院時の神経学的検査では、右側嗅覚障害が認められた以外は正常であったが、入院時MRIで、最大直径21.4×17.6mm大の前頭蓋窩右側に塊病変が認められ、右側直回に隣接し嚢胞成分を伴っていた。Frontobasalアプローチによる腫瘍摘出術を施行した。腫瘍塊の固形部分のみを全摘出し、術後MRIで全切除が確認された。退院後は、右側嗅覚障害以外の神経学的症状はなく経過は良好である。症例2は24歳女性で、失神エピソードの検査時に頭蓋内腫瘍が認められた。入院時の神経学的検査では、右側嗅覚障害以外に異常はみられなかったが、入院時MRIにより、右側前頭下部領域に位置する最大直径17.9×10.4mmの固形塊病変が認められた。前方開頭術による腫瘍摘出術を行い、術後MRIで全切除が確認された。術後経過は順調で、右側嗅覚覚障害が認められるのみで退院となった。なお、両例とも組織病理学的所見により、形態学的特徴から変性した神経鞘腫と考えられたが、免疫組織学的検討では共に、S-100、ネスチン、Schwann/2Eに陽性で、Leu7とEMAに陰性を示し、症例1では少数の散在細胞のみがKi-67陽性で、症例2では1〜7%がKi-67陽性であった。

  • Schwannoma-like tumor in the anterior cranial fossa immunonegative for Leu7 but immunopositive for Schwann/2E Reviewed

    Bohoun Christian Aisse, Terakawa Yuzo, Goto Takeo, Tanaka Sayaka, Kuwae Yuko, Ohsawa Masahiko, Morisako Hiroki, Nakajo Kosuke, Sato Hidetoshi, Ohata Kenji, Yokoo Hideaki

    NEUROPATHOLOGY   37 ( 3 )   265 - 271   2017.06( ISSN:0919-6544

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    DOI: 10.1111/neup.12357

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  • [Pre- and Intra-Operative Supporting Technology for Brain Tumors(4)Transpetrosal Approach for Petroclival Tumors]. Reviewed

    Goto T

    No shinkei geka. Neurological surgery   45 ( 2 )   175 - 186   2017.02( ISSN:0301-2603

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    DOI: 10.11477/mf.1436203472

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  • Usefulness of a Transpetrosal Approach for Surgical Resection of Pontine Cavernomas Reviewed

    MORISAKO Hiroki, WATANABE Yusuke, NAKAJO Kosuke, GOTO Hiroyuki, GOTO Takeo, OHATA Kenji

    The Japanese Society on Surgery for Cerebral Stroke, Surgery for Cerebral Stroke   45 ( 4 )   260 - 265   2017( ISSN:0914-5508

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    Surgical resection of pontine cavernomas remains a particularly formidable challenge in the neurosurgical field because of their deep-seated and eloquent locations. We report and discuss our experience and surgical approaches in the treatment of pontine cavernomas via a transpetrosal approach. We investigated eight cases of pontine cavernomas who underwent resection via an anterior or combined transpetrosal approach at our hospital between 2008 and 2015. These eight patients comprised six men and two women with a mean age of 46.9 years. All cases presented with neurological deficits caused by hemorrhage before surgery. We used an anterior transpetrosal approach in six cases and a combined transpetrosal approach in two. Gross total resection of the tumor was achieved in all cases. No postoperative complications, viz., worsening of facial nerve palsy, ocular movement disorder, or hemiplegia were noted in any patient. It is possible to obtain a wide surgical corridor from the ventral and lateral side via an anterior or combined tranpetrosal approach for treatment of pontine cavernomas. A small cortical incision with multi-directional dissection is the best approach to avoid additional neurological deficits. We conclude that resection of pontine cavernomas via a transpetrosal approach might be superior to other approaches to minimize postoperative neurological deficits.

    DOI: 10.2335/scs.45.260

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  • Aggressive surgery based on an anatomical subclassification of craniopharyngiomas Reviewed

    Morisako Hiroki, Goto Takeo, Goto Hiroyuki, Bohoun Christian Aisse, Tamrakar Samantha, Ohata Kenji

    NEUROSURGICAL FOCUS   41 ( 6 )   E10   2016.12( ISSN:1092-0684

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    DOI: 10.3171/2016.9.FOCUS16211

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  • Characteristic of optic canal invasion in 31 consecutive cases with tuberculum sellae meningioma Reviewed

    Nimmannitya Pree, Goto Takeo, Terakawa Yuzo, Sato Hidetoshi, Kawashima Toshiyuki, Morisako Hiroki, Ohata Kenji

    NEUROSURGICAL REVIEW   39 ( 4 )   691 - 697   2016.10( ISSN:0344-5607

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    DOI: 10.1007/s10143-016-0735-6

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  • Dural incision in the petrosal approach with preservation of the superior petrosal vein Reviewed

    Haq Irwan Barlian Immadoel, Susilo Rahadian Indarto, Goto Takeo, Ohata Kenji

    JOURNAL OF NEUROSURGERY   124 ( 4 )   1074 - 1078   2016.04( ISSN:0022-3085

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    DOI: 10.3171/2015.3.JNS141618

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  • Surgical Resectability of Skull Base Meningiomas Reviewed

    Goto Takeo, Ohata Kenji

    一般社団法人 日本脳神経外科学会 NEUROLOGIA MEDICO-CHIRURGICA   56 ( 7 )   372 - 378   2016( ISSN:0470-8105

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    With recent advances in surgical technology such as preoperative imaging, neuro-monitoring, and surgical instruments, the surgical resectability of intracranial meningiomas has increased over the last two decades. This study reviewed clinical articles regarding the surgical treatment of meningiomas to clarify the role of surgical excision, with a focus on skull base meningiomas. We sub-classified clinical articles about skull base meningiomas into two categories (anterior and middle fossa meningiomas; and posterior fossa meningiomas) and reviewed papers in each category. In cases with anterior and middle fossa meningiomas, surgical resectability has reached a sufficient level to maximize functional preservation. In cases of posterior fossa meningioma, however, surgical respectability remains insufficient even with full use of recent surgical modalities. Continuous refining of operative procedures is required to obtain more satisfactory outcomes, especially for posterior fossa meningioma. In addition, recent long-term outcomes of stereotactic radiosurgery (SRS) were acceptable for controlling the skull base meningiomas. Therefore, combination with surgical excision and SRS should be considered in complicated skull base meningiomas.

    DOI: 10.2176/nmc.ra.2015-0354

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  • 術前3Dシミュレーションに基づいた摘出困難な頭蓋底腫瘍に対する手術戦略 Reviewed

    森迫 拓貴, 後藤 剛夫, 佐藤 英俊, 宇田 武弘, 山中 一浩, 大畑 建治

    日本脳神経CI学会 CI研究   37 ( 2 )   73 - 78   2015.09( ISSN:0918-7073

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    シミュレーションソフトウェア導入以降に摘出術を行った術前に摘出が困難と予想された頭蓋底腫瘍を対象とした。MRI、CT画像をもとに画像解析ソフトを用いて三次元融合画像を作成した。三次元融合画像を三次元デジタルクレイモデラーを用いて、開頭から腫瘍摘出まで一連の手術シミュレーションを行い、解剖学位置関係の把握、手術到達法の決定およびリスク予測について検討した。頭蓋底手術88例中49例(55.7%)でモデルを作成した。疾患の内訳は、頭蓋咽頭腫17例、髄膜腫15例、神経鞘腫11例、その他6例であった。全例で実際の術野とほぼ同じ三次元融合画像を得られた。術前カンファレンスで実際にシミュレーションを提示しながら症例検討を行うことで、他者との情報共有が得られ、適切な手術到達法の選択が可能であった。手術到達側の静脈還流や病巣を中心とした三次元解剖を容易に把握することができ、リスク予測と合併症回避に有用であった。

  • Petroclival meningiomas resected via a combined transpetrosal approach: surgical outcomes in 60 cases and a new scoring system for clinical evaluation Reviewed

    Morisako Hiroki, Goto Takeo, Ohata Kenji

    JOURNAL OF NEUROSURGERY   122 ( 2 )   373 - 380   2015.02( ISSN:0022-3085

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    DOI: 10.3171/2014.8.JNS132406

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  • Principles and Pitfalls of Orbitozygomatic Approach Reviewed

    Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   24 ( 11 )   738 - 744   2015( ISSN:0917-950X

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    &emsp;&emsp;The orbitozygomatic approach is a well-known and well established basic surgical procedure that has been performed in most neurosurgical institutes. But there remain several misunderstandings about the procedure itself and the indications for using the approach. In this article we present surgical tips for the procedure step by step along with the actual surgical steps.<br>&emsp;&emsp;Obtaining wide exposure of the anterior clinoid process in the epidural field is a key surgical step for safe and easy clinoidectomy and opening the optic canal. An appropriately designed dural incision can provide safe mobilization of the sylvian vein which can offer wide and shallow epidural surgical field around the parasellar area.<br>&emsp;&emsp;In our experience of skull base tumor surgeries, we have found that retrochiasmatic craniopharyngiomas of small or medium size and large paraclinoid meningiomas will be suitable candidate for the approach

    DOI: 10.7887/jcns.24.738

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  • 大型石灰化を伴う頭蓋咽頭腫に対する手術 Reviewed

    森迫 拓貴, 後藤 剛夫, 國廣 誉世, 川上 太一郎, 寺川 雄三, 露口 尚弘, 大畑 建治

    (一社)日本内分泌学会 日本内分泌学会雑誌   90 ( Suppl.HPT )   49 - 51   2014.09( ISSN:0029-0661

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    当院で手術を行った大型石灰化を伴う頭蓋咽頭腫8例について検討した。腫瘍体積の10%以上の石灰化を31例で認め、50%以上の石灰化を8例に認めた。基本的な手術戦略は、術前の画像評価に従い4つのタイプに細分類化し、病変に応じて最適な手術到達法を選択、外科的全摘出を優先して必要に応じ多段階手術を行うこととした。また、石灰化部位は縦割して漸次摘出した。対象は細分類で視交叉後方型6例、トルコ鞍内型1例、視交叉前方型1例であった。5例で2期的な手術を施行し、手術到達法(重複あり)は6例で経錐体到達法、4例で経眼窩頬骨到達法、2例で経大脳半球間裂経終板到達法、1例で経蝶形骨洞到達法を選択した。腫瘍摘出度は3例で肉眼的全摘出が可能で、その他の5例は亜全摘出であった。視機能の異常は5例で改善、3例で不変であった。術後経過観察期間は0.6〜17.0年で、2例で腫瘍の再発を認め、うち1例は術後2.6年で腫瘍死した。

  • Staged 'intentional' bridging vein ligation: a safe strategy in gaining wide access to skull base tumors Reviewed

    Savardekar Amey R., Goto Takeo, Nagata Takashi, Ishibashi Kenichi, Terakawa Yuzo, Morisako Hiroki, Ohata Kenji

    ACTA NEUROCHIRURGICA   156 ( 4 )   671 - 679   2014.04( ISSN:0001-6268

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    DOI: 10.1007/s00701-014-2028-6

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  • 橋海綿状血管腫に対する経錐体到達法 Reviewed

    金城 雄太, 後藤 剛夫, 寺川 雄三, 川上 太一郎, 森迫 拓貴, 露口 尚弘, 山中 一浩, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   23 ( 4 )   341 - 347   2014.04( ISSN:0917-950X

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    脳幹部海綿状血管腫は頭蓋内海綿状血管腫の9〜35%を占め、特に脳幹部では橋に好発する。また出血率、再出血率ともに他部位に比して高く、症候性のものは摘出術が考慮される。摘出に関してはさまざまな到達法が報告されているが、経錐体到達法を用いた橋海綿状血管腫の手術に関する報告は多くない。われわれは、術後の神経症状の悪化や新たな症状発現を防ぐためには正常脳組織への侵襲を最小限にする到達法を選択することが重要であると考えており、その点で、小さな皮質切開でかつ多方向性に病変を直視下に観察することを可能にする経錐体到達法は、橋海綿状血管腫の手術において有用な到達法になる可能性があると思われる。(著者抄録)

  • Surgical outcomes of the minimum anterior and posterior combined transpetrosal approach for resection of retrochiasmatic craniopharyngiomas with complicated conditions Reviewed

    Kunihiro Noritsugu, Goto Takeo, Ishibashi Kenichi, Ohata Kenji

    JOURNAL OF NEUROSURGERY   120 ( 1 )   1 - 11   2014.01( ISSN:0022-3085

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    DOI: 10.3171/2013.10.JNS13673

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  • Preservation of Labyrinthine Structures While Drilling the Posterior Wall of the Internal Auditory Canal in Surgery of Vestibular Schwannomas via the Retrosigmoid Suboccipital Approach Reviewed

    Savardekar Amey, Nagata Takashi, Kiatsoontorn Kraiyot, Terakawa Yuzo, Ishibashi Kenichi, Goto Takeo, Ohata Kenji

    WORLD NEUROSURGERY   82 ( 3-4 )   474 - 479   2014( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2014.02.029

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  • Surgical Strategy for Craniopharyngiomas based on Anatomical Classification Reviewed

    Goto Takeo, Kunihiro Noritsugu, Morisako Hiroki, Kawakami Taichirou, Terakawa Yuzou, Tsuyuguchi Naohiro, Yamanaka Kazuhiro, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   23 ( 1 )   12 - 19   2014( ISSN:0917-950X

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    &emsp;&emsp;Even with the wealth of recent advances in surgical equipment and techniques, the surgical excision of craniopharyngiomas remains challenging due to their anatomical location and proximity to critical neurovascular structures. Although various surgical approaches to remove craniopharyngiomas have been described, including the pterional, orbitopterional, orbitozygomatic, transbasal subfrontal, frontobasal interhemispheric, and transnasal transsphenoidal, designating the optimal surgical approach remains controversial. In this article, we presented our sub-classification of craniopharynigiomas based on the anatomical location of the tumor. In addition, the most appropriate surgical approach to the lesion is discussed for these anatomical sub-classifications.

    DOI: 10.7887/jcns.23.12

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  • Transpetrosal Approach for Pontine Cavernous Malformations Reviewed

    Kaneshiro Yuta, Goto Takeo, Terakawa Yuzo, Kawakami Taichiro, Morisako Hiroki, Tsuyuguchi Naohiro, Yamanaka Kazuhiro, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   23 ( 4 )   341 - 346   2014( ISSN:0917-950X

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    &emsp;&emsp;Brainstem cavernous malformations account for 9-35% of all intracranial cavernous malformations and most brainstem cavernous malformations arise from the pons. Pontine cavernous malformations remain surgically challenging because of their deep-seated and eloquent locations. Although several approaches have been reported to remove pontine cavernous malformations, there are only a few reports available regarding the transpetrosal approach in pontine cavernous malformation surgery. Here, we report our experience in treating patients with pontine cavernous malformations by the transpetrosal approach. Furthermore, alternate surgical approaches to pontine cavernous malformations will be discussed.<br>&emsp;&emsp;A total of six cases were included in this study. There were four men and two women with an average age of 46.2 years. All cases presented neurological deficits caused by hemorrhage before surgery. The anterior transpetrosal approach was used in four and a combined transpetrosal approach was used in two cases. Gross total removal was achieved in all cases with an acceptable surgical outcome.<br>&emsp;&emsp;We consider that a small cortical incision which allows multi-direction dissection is the most important factor to avoid additional neurological deficits in cavernous malformation surgeries. Therefore, the transpetrosal approach can be used to minimize neurological deficits after removal of pontine lesions.

    DOI: 10.7887/jcns.23.341

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  • 11C-メチオニンPETを用いた髄膜腫の進行と再発の解析(Analysis of progression and recurrence of meningioma using 11C-methionine PET) Reviewed

    Ikeda Hidetoshi, Tsuyuguchi Naohiro, Kunihiro Noritsugu, Ishibashi Kenichi, Goto Takeo, Ohata Kenji

    (一社)日本核医学会 Annals of Nuclear Medicine   27 ( 8 )   772 - 780   2013.10( ISSN:0914-7187

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    11C-メチオニン(MET)PETを対象に、髄膜腫の進行と再発に関連する危険因子をレトロスペクティブに評価した。1995〜2010年に大阪市立大学病院で頭蓋内髄膜腫と診断された患者73名から得た37症例(男性14名、女性23名、平均54.5±12.9歳)を対象とした。33名は外科術を施され、4名は観察下にあり、いずれも外科術や観察前にMET PET検査を受診した。腫瘍切除の程度、腫瘍部位、WHO等級、Ki-67標識指標、MET取込の病変-正常組織比率(LN比)と髄膜腫の進行や再発との関連性を調べた。追跡期間中に外科術患者6名で再発が認められ、観察下患者2名で進行が認められた。単変量解析からMET取込の高LN比が有意な危険因子であることが示された。MET取込のLN比のROC曲線解析からAUCは0.754で、カットオフ値を3.18に設定すると再発や進行の予測性能が最大(感度63%、特異性79%)となることが示された。

  • Analysis of progression and recurrence of meningioma using C-11-methionine PET Reviewed

    Ikeda Hidetoshi, Tsuyuguchi Naohiro, Kunihiro Noritsugu, Ishibashi Kenichi, Goto Takeo, Ohata Kenji

    ANNALS OF NUCLEAR MEDICINE   27 ( 8 )   772 - 780   2013.10( ISSN:0914-7187

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    DOI: 10.1007/s12149-013-0747-z

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  • The role of C-11-methionine positron emission tomography in prediction of meningioma recurrence and progression Reviewed

    Terakawa Y., Tsuyuguchi N., Abe J., Ikeda H., Goto T., Ohata K.

    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING   40   S456 - S456   2013.10( ISSN:1619-7070

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  • Preoperative Evaluation of the Petrosal Vein With Contrast-Enhanced PRESTO Imaging in Petroclival Meningiomas to Establish Surgical Strategy Reviewed

    Morisako Hiroki, Goto Takeo, Chokyu Isao, Ishibashi Kenichi, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   53 ( 7 )   490 - 495   2013.07( ISSN:0470-8105

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  • 側頭骨錐体斜台部髄膜腫における外科戦略を確立するための錐体静脈の造影PRESTO画像を用いた術前評価(Preoperative Evaluation of the Petrosal Vein With Contrast-Enhanced PRESTO Imaging in Petroclival Meningiomas to Establish Surgical Strategy) Reviewed

    Morisako Hiroki, Goto Takeo, Chokyu Isao, Ishibashi Kenichi, Ohata Kenji

    (一社)日本脳神経外科学会 Neurologia medico-chirurgica   53 ( 7 )   490 - 495   2013.07( ISSN:0470-8105

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    側頭骨錐体斜台部髄膜腫14例の術前に、造影(CE)principles of echo-shifting with a train of observations(PRESTO) MRIを用いて腫瘍と錐体静脈との関係について調べ、CT、3D-CT血管造影、従来のCE-MRI血管造影及びconstructive interference in steady-state(CISS) MRIの感度と比較した。その結果、11例において、術中に錐体静脈が同定できた。術前に腫瘍と錐体静脈との解剖学的関連が同定できたのは、CE PRESTO-MRI 10例、3D-CT血管造影5例、CE-MRI血管造影5例、CISS-MRI4例であった。全例で外科的血管合併症は認めなかった。

  • Simple and safe exposure of the sigmoid sinus with presigmoid approaches Reviewed

    Goto Takeo, Ishibashi Kenichi, Morisako Hiroki, Nagata Takashi, Kunihiro Noritugu, Ikeda Hidetoshi, Ohata Kenji

    NEUROSURGICAL REVIEW   36 ( 3 )   477 - 481   2013.07( ISSN:0344-5607

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    DOI: 10.1007/s10143-013-0451-4

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  • Imaging appearance of petrous apex dermoid cysts containing little or no fat Reviewed

    Ageshio Naomi, Shimono Taro, Goto Takeo, Ohata Kenji, Ohsawa Masahiko, Wakasa Kenichi, Miki Yukio

    JAPANESE JOURNAL OF RADIOLOGY   31 ( 2 )   133 - 137   2013.02( ISSN:1867-1071

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    DOI: 10.1007/s11604-012-0150-z

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  • 殆どまたは全く脂肪を含有しない錐体尖類皮嚢腫の外観画像(Imaging appearance of petrous apex dermoid cysts containing little or no fat) Reviewed

    Ageshio Naomi, Shimono Taro, Goto Takeo, Ohata Kenji, Ohsawa Masahiko, Wakasa Kenichi, Miki Yukio

    (公社)日本医学放射線学会 Japanese Journal of Radiology   31 ( 2 )   133 - 137   2013.02( ISSN:1867-1071

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    症例1は小児期の外傷後右側難聴を有する52歳男性で、右顔面の知覚異常歴があった。症例2は右三叉神経痛の悪化を主訴とする44歳男性で、神経学的検査により右顔面の感覚減少と右耳難聴が示された。頭部コンピューター断層撮影(CT)により、錐体尖において、脂肪が殆どまたは全く認められない明確な低減衰病変が示され、症例1では骨浸食と硬化性乳様突起炎と関連し、症例2は錐体尖の骨浸食と関連していた。各磁気共鳴(MR)画像において、見かけの拡散係数(ADC)の減少を伴わず、脂肪抑制されない高信号領域であることが示され、症例1では錐体尖のコレステリン腫および類表皮嚢腫、症例2は硬膜間の類表皮嚢腫であると予測診断された。2症例とも切除術が行われ、病理組織学的に症例1は脂質を含まない類皮嚢腫であり、症例2は脂肪分泌腺と脂肪を有する類皮嚢腫であると診断された。本症例は非常に稀であり、硬膜間の類表皮嚢腫と誤診断されやすいことに留意すべきである。

  • Analysis of Venous Drainage from Sylvian Veins in Clinoidal Meningiomas Reviewed

    Nagata Takashi, Ishibashi Kenichi, Metwally Hussam, Morisako Hiroki, Chokyu Isao, Ichinose Tsutomu, Goto Takeo, Takami Toshihiro, Tsuyuguchi Naohiro, Ohata Kenji

    WORLD NEUROSURGERY   79 ( 1 )   116 - 123   2013.01( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2011.05.022

    PubMed

  • Preoperative evaluation of the petrosal vein with contrast-enhanced PRESTO imaging in petroclival meningiomas to establish surgical strategy. Reviewed

    Morisako H, Goto T, Chokyu I, Ishibashi K, Ohata K

    一般社団法人 日本脳神経外科学会 Neurologia medico-chirurgica   53 ( 7 )   490 - 5   2013( ISSN:0470-8105

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    The present detailed radiological study investigated the relationship between petroclival meningiomas and petrosal veins with contrast-enhanced (CE) principles of echo-shifting with a train of observations (PRESTO) imaging to assess the potential contribution of the findings to the surgical strategy. Fourteen patients (13 women and 1 man) with unilateral petroclival meningiomas underwent microsurgical resection at Osaka City University Hospital between April 2009 and February 2011. Preoperatively, patients were examined using computed tomography (CT) and magnetic resonance (MR) imaging, including CE PRESTO imaging, focusing on the relationship between the tumor and the petrosal vein, and compared to the sensitivity of three-dimensional CT (3D-CT) venography or conventional MR imaging, including CE MR venography and constructive interference in steady-state (CISS) MR imaging. In 11 of 14 cases, we could identify the petrosal veins with intraoperative findings. In 10 of these 14 cases, the anatomical relationship between the tumor and the petrosal vein was detected preoperatively with CE PRESTO imaging, compared to 5 of 14 cases with 3D-CT venography, 5 of 14 cases with CE MR venography, and only 4 of 14 cases using CISS MR imaging. CE PRESTO imaging compares favorably to other approaches. There was no venous complication related to the surgery in any of the cases. CE PRESTO imaging is a non-invasive and useful method to assess the status of the petrosal vein in patients with petroclival meningiomas.<br>

    DOI: 10.2176/nmc.53.490

    PubMed

    CiNii Article

  • 再発頭蓋咽頭腫に対する頭蓋底アプローチの治療成績 Reviewed

    國廣 誉世, 後藤 剛夫, 石橋 謙一, 大畑 建治

    (一社)日本内分泌学会 日本内分泌学会雑誌   88 ( Suppl. )   14 - 16   2012.08( ISSN:0029-0661

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    頭蓋咽頭腫において、手術単独で再発した13例(A群)と手術と放射線を施行後に再発した12例(B群)を対象に、摘出度、合併症、手術後の再発率、視機能(Visual Impairment Scale)、下垂体機能(Pituitary Craniorharyngioma Clinical Status Scale)、高次脳機能(WAIS-III)を初発群38例と比較した。その結果、A群は初発例に比べて腫瘍摘出度と再発率が低かったが有意差はなかった。また、合併症率、視機能および高次脳機能は初発例と変わらず良好な結果が得られた。一方、B群は初発群に比べて合併症率に差はなかったが、全摘出度と視機能が有意に低かった。また、高次脳機能は経過観察期間中に徐々に増悪する傾向にあった。以上より、再発頭蓋咽頭腫であっても、頭蓋底アプローチを用いることで安全な全摘出が可能と思われた。手術で全摘出を目指す治療は長期的なQOLを維持するために重要な治療と考えられた。

  • Oncogenic osteomalacia associated with mesenchymal tumor in the middle cranial fossa: a case report. Reviewed

    Chokyu I, Ishibashi K, Goto T, Ohata K

    Journal of medical case reports   6   181   2012.07

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    DOI: 10.1186/1752-1947-6-181

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  • Analysis of Venous Drainage from Sylvian Veins in Clinoidal Meningioma(Microneurosurgical Anatomy) Reviewed

    Ishibashi Kenichi, Ichinose Tsutomu, Nagata Takashi, Morisako Hiroki, Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese journal of neurosurgery   20 ( 2 )   25 - 30   2011.10( ISSN:0917950X

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    Skull base meningiomas can occasionally obstruct the basal venous sinuses as the tumor growth. We therefore analyzed the venous draining pattern from sylvian veins in clinoidal meningiomas. Between 1995 and 2007, twenty patients with clinoidal meningioma underwent surgical intervention at our institute. Venous drainage from sylvian veins was categorized into three patterns, including cortical type, sphenobasal type and sphenoparietal type, according to the main draining vein. Preoperative angiographic evaluation showed 14 patients (70%) as cortical type, 5 patients (25%) as sphenobasal type and 1 patient (5%) as sphenoparietal type. Postoperative clinical courses revealed that dominant sphenobasal sinuses were successfully preserved by skull base techniques in all of the sphe-nobasal type patients. One sphenoparietal type patient developed a brain contusion conceivably, by the obstruction of the dominant sphenoparietal sinus during tumor resection. Drainers from sylvian veins to the skull base should be carefully evaluated preoperatively and must be preserved, if dominant, in the surgery of clinoidal meningioma.

    CiNii Article

  • Detailed Surgical Procedures and Indication for the Combined Transpetrosal Approach(Microneurosurgical Anatomy) Reviewed

    Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese journal of neurosurgery   20 ( 2 )   186 - 193   2011.10( ISSN:0917950X

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    A combined trans-petrosal approach which includes some degree of anterior petrosectomy and presigmoid posterior petrosectomy is quite an effective procedure for petroclival lesions, offering a wide and shallow surgical field. Several petrosal approach variations have been reported by master skull base surgeons and a detailed anatomy of the temporal bone has been obtained by cadaveric studies. These achievements enhanced the surgical safety and standardization of the procedure. But there still remain some critical risks in the procedure such as CSF leakage, sigmoid sinus injury and damaging the facial and cochlea nerves at petrosectomy. In this report, tips for the procedure including the way to harvest the fascia-pericranial flap to prevent CSF leakage, to expose sigmoid sinus safely, to perform safe petrosectomy and to resect the petroclival tumors caring critical vascular and nerve structures, will be minutely presented. A fascia-pericranial flap with a pedicle of sternocleid mastoid muscle has completely prevented CSF leakage and the following infections. Dissecting the sinus wall at an antegrade direction has enabled the safe and quick exposure of the sigmoid sinus. Both the mastoid antrum and endlymphatic sac are crucial landmarks for detecting the semi-circular canals. Opening Meckel's cave encourages large transposition of the trigeminal nerve which enlarges the exposure of the tumor at the area between the trigeminal and facial-acoustic nerve band. Surgical results of the combined transpetrosal approach have been satisfactorily improved by the accumulated modifications of the procedure.

    CiNii Article

  • Bilateral subfrontal approach for tuberculum sellae meningiomas in long-term postoperative visual outcome Clinical article Reviewed

    Chokyu Isao, Goto Takeo, Ishibashi Kenichi, Nagata Takashi, Ohata Kenji

    JOURNAL OF NEUROSURGERY   115 ( 4 )   802 - 810   2011.10( ISSN:0022-3085

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    DOI: 10.3171/2011.5.JNS101812

    PubMed

  • Middle Skull Base Approach With Posterolateral Mobilization of the Geniculate Ganglion to Access the Clival Regions Reviewed

    Morisako Hiroki, Goto Takeo, Nagata Takashi, Chokyu Isao, Ichinose Tsutomu, Ishibashi Kenichi, Takami Toshihiro, Ohata Kenji

    NEUROSURGERY   69 ( 1 Suppl Operative )   88 - 94   2011.09( ISSN:0148-396X

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    DOI: 10.1227/NEU.0b013e318211490f

    PubMed

  • Three-Dimensional Video Presentation of Microsurgery by the Cross-Eyed Viewing Method Using a High-Definition Video System -Technical Note- Reviewed

    Terakawa Yuzo, Ishibashi Kenichi, Goto Takeo, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   51 ( 6 )   467 - 471   2011.06( ISSN:0470-8105

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  • 高精細ビデオシステムを用いた交差視表示方法による顕微手術の三次元プレゼンテーション 技術ノート(Three-Dimensional Video Presentation of Microsurgery by the Cross-Eyed Viewing Method Using a High-Definition Video System: Technical Note) Reviewed

    Terakawa Yuzo, Ishibashi Kenichi, Goto Takeo, Ohata Kenji

    (一社)日本脳神経外科学会 Neurologia medico-chirurgica   51 ( 6 )   467 - 471   2011.06( ISSN:0470-8105

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    顕微手術の三次元(3D)ビデオ録画は従来の二次元ビデオシステムよりもプレゼンテーションおよび教育にとってより有望なツールであるが、以前の3Dビデオシステムは3D画像の処理が複雑で、光学装置がなければ可視化できないため広く採用されていない。顕微手術の3Dビデオプレゼンテーションに対する新技術開発について述べた。高精細(HD)ビデオカメラを搭載した顕微鏡で顕微手術を録画し、3Dカメラアダプターを用いて右眼および左眼視野を単一HDデータとして同時に記録する。顕微鏡の右眼と左眼の視野は右側と左側に別々に表示される。次いで、手術ビデオは右眼視野を左側、左眼視野を右側に表示するよう、ビデオ編集ソフトウェアで編集する。編集したビデオを交差視表示法により表示することにより、光学器械なしに顕微手術の3Dビデオを作成できる。3D顕微手術ビデオは特に深度に関してより正確な視野と顕微手術解剖のよりよい理解を提供する。

  • Tentorial Schwannoma Mimicking Meningioma : Case Report Reviewed

    NAGATA Takashi, GOTO Takeo, ICHINOSE Tsutomu, TSUYUGUCHI Naohiro, OHATA Kenji

    一般社団法人 日本脳神経外科学会 Neurologia medico-chirurgica = 神経外科   51 ( 5 )   382 - 385   2011.05( ISSN:04708105

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    A 58-year-old woman presented with a rare tentorial schwannoma manifesting as a chief complaint of headache. Magnetic resonance imaging showed an infratentorial extra-axial mass lesion with both cystic and solid components and dural tail sign. The tumor was easily separated from the surrounding structures, and the origin was apparently the tentorial branch of the trigeminal nerve. Tentorial schwannoma should be considered in the differential diagnosis of mixed cystic and solid mass lesions associated with the tentorium around the ambient cistern.<br>

    DOI: 10.2176/nmc.51.382

    CiNii Article

  • 髄膜腫に類似したテント神経鞘腫 症例報告(Tentorial Schwannoma Mimicking Meningioma: Case Report) Reviewed

    Nagata Takashi, Goto Takeo, Ichinose Tsutomu, Tsuyuguchi Naohiro, Ohata Kenji

    (一社)日本脳神経外科学会 Neurologia medico-chirurgica   51 ( 5 )   382 - 385   2011.05( ISSN:0470-8105

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    58歳女。頭痛を主訴に受診した。30年前に副甲状腺機能亢進症で手術した既往があった。頭部MRIで左小脳橋角部に約20mm大の嚢胞および固形成分を含む腫瘤を認め、T1強調画像で低信号、T2強調画像で不均質な信号を呈し、造影剤で不均質に増強され、dural tail signを呈した。腫瘍境界は明瞭で内耳道への浸潤はなかった。外側後頭下retrosigmoid開頭術を施行した。腫瘍はテントから発生し、主にテント下くも膜外スペースに存在し、側頭葉錐体骨端、錐体静脈に接していることが分かった。腫瘍亜全摘を施行し、テントの一部も切除した。組織学的診断は典型的な神経鞘腫で、発生源は三叉神経テント枝であった。術後2年経過し、腫瘍の再発は認めなかった。

  • Tentorial Schwannoma Mimicking Meningioma-Case Report Reviewed

    Nagata Takashi, Goto Takeo, Ichinose Tsutomu, Tsuyuguchi Naohiro, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   51 ( 5 )   382 - 385   2011.05( ISSN:0470-8105

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  • Pituitary Apoplexy Causing Internal Carotid Artery Occlusion : Case Report Reviewed

    CHOKYU Isao, TSUYUGUCHI Naohiro, GOTO Takeo, CHOKYU Kimihiko, CHOKYU Masahiro, OHATA Kenji

    一般社団法人 日本脳神経外科学会 Neurologia medico-chirurgica = 神経外科   51 ( 1 )   48 - 51   2011.01( ISSN:04708105

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    A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage.<br>

    DOI: 10.2176/nmc.51.48

    CiNii Article

  • Pituitary Apoplexy Causing Internal Carotid Artery Occlusion -Case Report- Reviewed

    Chokyu Isao, Tsuyuguchi Naohiro, Goto Takeo, Chokyu Kimihiko, Chokyu Masahiro, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   51 ( 1 )   48 - 51   2011.01( ISSN:0470-8105

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  • 内頸動脈閉塞を引き起こした下垂体卒中 症例報告(Pituitary Apoplexy Causing Internal Carotid Artery Occlusion: Case Report) Reviewed

    Chokyu Isao, Tsuyuguchi Naohiro, Goto Takeo, Chokyu Kimihiko, Chokyu Masahiro, Ohata Kenji

    (一社)日本脳神経外科学会 Neurologia medico-chirurgica   51 ( 1 )   48 - 51   2011.01( ISSN:0470-8105

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    50歳男。突然の頭痛、右眼瞼下垂、左片麻痺、視力障害が出現した。CTでトルコ鞍及び鞍上部に結節性腫瘤と急性脳虚血の早期徴候を認め、MRIで腫瘤が両側海綿静脈を圧迫し、右内頸動脈の海綿静脈洞部を閉塞している所見と、右中大脳動脈領域の梗塞も認めた。急性期にはステロイドを用いた保存的治療を行い、反復MRI検査で腫瘍サイズの減少に伴い内頸動脈が再開通する所見を認めた。腫瘍は経蝶骨アプローチで除去し、慢性期において非分泌性下垂体腺腫と確定診断した。手術により眼球運動は完全に回復した。

  • Pituitary apoplexy causing internal carotid artery occlusion--case report. Reviewed

    Chokyu I, Tsuyuguchi N, Goto T, Chokyu K, Chokyu M, Ohata K

    Neurologia medico-chirurgica   51 ( 1 )   48 - 51   2011( ISSN:0470-8105

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    PubMed

  • Three-dimensional video presentation of microsurgery by the cross-eyed viewing method using a high-definition video system. Reviewed

    Terakawa Y, Ishibashi K, Goto T, Ohata K

    一般社団法人 日本脳神経外科学会 Neurologia medico-chirurgica   51 ( 6 )   467 - 71   2011( ISSN:0470-8105

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    Three-dimensional (3-D) video recording of microsurgery is a more promising tool for presentation and education of microsurgery than conventional two-dimensional video systems, but has not been widely adopted partly because 3-D image processing of previous 3-D video systems is complicated and observers without optical devices cannot visualize the 3-D image. A new technical development for 3-D video presentation of microsurgery is described. Microsurgery is recorded with a microscope equipped with a single high-definition (HD) video camera. This 3-D video system records the right- and left-eye views of the microscope simultaneously as single HD data with the use of a 3-D camera adapter: the right- and left-eye views of the microscope are displayed separately on the right and left sides, respectively. The operation video is then edited with video editing software so that the right-eye view is displayed on the left side and left-eye view is displayed on the right side. Consequently, a 3-D video of microsurgery can be created by viewing the edited video by the cross-eyed stereogram viewing method without optical devices. The 3-D microsurgical video provides a more accurate view, especially with regard to depth, and a better understanding of microsurgical anatomy. Although several issues are yet to be addressed, this 3-D video system is a useful method of recording and presenting microsurgery for 3-D viewing with currently available equipment, without optical devices.<br>

    DOI: 10.2176/nmc.51.467

    PubMed

    CiNii Article

  • Tentorial schwannoma mimicking meningioma. Reviewed

    Nagata T, Goto T, Ichinose T, Tsuyuguchi N, Ohata K

    Neurologia medico-chirurgica   51 ( 5 )   382 - 5   2011( ISSN:0470-8105

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    PubMed

  • Pathological findings of fusiform dilation of the internal carotid artery following radical dissection of a craniopharyngioma Reviewed

    Nagata Takashi, Goto Takeo, Ichinose Tsutomu, Mitsuhashi Yutaka, Tsuyuguchi Naohiro, Ohata Kenji

    JOURNAL OF NEUROSURGERY-PEDIATRICS   6 ( 6 )   567 - 571   2010.12( ISSN:1933-0707

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    DOI: 10.3171/2010.9.PEDS10280

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  • The role of radical microsurgical resection in multimodal treatment for skull base meningioma Reviewed

    Ichinose Tsutomu, Goto Takeo, Ishibashi Kenichi, Takami Toshihiro, Ohata Kenji

    JOURNAL OF NEUROSURGERY   113 ( 5 )   1072 - 1078   2010.11( ISSN:0022-3085

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    DOI: 10.3171/2010.2.JNS091118

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  • Microroll Retractor for Surgical Resection of Brainstem Cavernomas Reviewed

    Ichinose Tsutomu, Goto Takeo, Morisako Hiroki, Takami Toshihiro, Ohata Kenji

    WORLD NEUROSURGERY   73 ( 5 )   520 - 522   2010.05( ISSN:1878-8750

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    DOI: 10.1016/j.wneu.2010.06.049

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  • 5. The Surgical Indication and the Detailed Procedures of the Combined-transpetrosal Approach(PS2-1 The 24th Microneurosurgical Anatomy Seminar "Selection of Surgical Approach and Pitfall",Plenary Session,Surgery Revisited,The 30th Annual Meeting of The Japanese Congress of Neurological Surgeons) Reviewed

    Goto Takeo

    The Japanese Congress of Neurological Surgeons, Japanese journal of neurosurgery   19 ( 0 )   2010.04( ISSN:0917950X

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  • Detailed Surgical Procedures and Indication for the Combined Transpetrosal Approach(<SPECIAL ISSUE>Selection of Surgical Approach and Pitfall II) Reviewed

    Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   19 ( 11 )   802 - 809   2010( ISSN:0917-950X

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    A combined trans-petrosal approach which includes some degree of anterior petrosectomy and presigmoid posterior petrosectomy is quite an effective procedure for petroclival lesions, offering a wide and shallow surgical field. Several petrosal approach variations have been reported by master skull base surgeons and a detailed anatomy of the temporal bone has been obtained by cadaveric studies. These achievements enhanced the surgical safety and standardization of the procedure. But there still remain some critical risks in the procedure such as CSF leakage, sigmoid sinus injury and damaging the facial and cochlea nerves at petrosectomy. In this report, tips for the procedure including the way to harvest the fascia-pericranial flap to prevent CSF leakage, to expose sigmoid sinus safely, to perform safe petrosectomy and to resect the petroclival tumors caring critical vascular and nerve structures, will be minutely presented. A fascia-pericranial flap with a pedicle of sternocleid mastoid muscle has completely prevented CSF leakage and the following infections. Dissecting the sinus wall at an antegrade direction has enabled the safe and quick exposure of the sigmoid sinus. Both the mastoid antrum and endlymphatic sac are crucial landmarks for detecting the semi-circular canals. Opening Meckel's cave encourages large transposition of the trigeminal nerve which enlarges the exposure of the tumor at the area between the trigeminal and facial-acoustic nerve band. Surgical results of the combined transpetrosal approach have been satisfactorily improved by the accumulated modifications of the procedure.

    DOI: 10.7887/jcns.19.802

    CiNii Article

  • Primary Squamous Cell Carcinoma of the Frontal Sinus Treated With En Bloc Resection-Case Report Reviewed

    Ichinose Tsutomu, Goto Takeo, Motomura Hisashi, Terakawa Yuzo, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   49 ( 10 )   481 - 483   2009.10( ISSN:0470-8105

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  • Primary squamous cell carcinoma of the frontal sinus treated with en bloc resection: case report. Reviewed

    Ichinose T, Goto T, Motomura H, Terakawa Y, Ohata K

    一般社団法人 日本脳神経外科学会 Neurologia medico-chirurgica   49 ( 10 )   481 - 3   2009.10( ISSN:0470-8105

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    A 66-year-old man presented with an extremely rare primary frontal sinus squamous cell carcinoma who was successfully treated by the extreme radical extended frontobasal approach. The tumor was resected en bloc with a clear margin and the large defect of the frontal region was reconstructed using a rectus abdominis myocutaneous flap. The tumor was well controlled without adjuvant therapy, and no recurrence or metastasis had occurred 2 years after the operation. Frontal sinus malignancy can be resected by the extreme radical extended frontobasal approach. The rectus abdominis myocutaneous flap is useful for the large defect of the skin and frontal base.<br>

    DOI: 10.2176/nmc.49.481

    PubMed

    CiNii Article

  • Complication Avoidance and Management in Posteriorly Instrumented C1-2 Fusion Reviewed

    TAKAMI Toshihiro, ICHINOSE Tsutomu, ISHIBASHI Kenichi, GOTO Takeo, TSUYUGUCHI Naohiro, OHATA Kenji

    23 ( 1 )   121 - 127   2009.04( ISSN:09146024

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  • Primary Intramedullary Spinal Cord Germinoma : Diagnostic Challenge and Treatment Strategy : Two Case Reports Reviewed

    YAMAGATA Toru, TAKAMI Toshihiro, TSUYUGUCHI Naohiro, GOTO Takeo, WAKASA Kenichi, OHATA Kenji

    社団法人日本脳神経外科学会 Neurologia medico-chirurgica = 神経外科   49 ( 3 )   128 - 133   2009.03( ISSN:04708105

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    Two patients presented with primary intramedullary spinal cord germinoma (PISCG). Neither diagnosis was correct at initial evaluation, and both underwent surgical verification of the tumor. Based on the histological diagnosis, both patients were treated successfully by combination of chemotherapy and radiotherapy. These cases illustrate the unexpected occurrence of PISCG and treatment strategy.<br>

    DOI: 10.2176/nmc.49.128

    CiNii Article

  • Anomalous Origin of the Anterior Choroidal Artery Reviewed

    Nishio A., Yoshimura M., Yamauchi S., Masamura S., Kawakami T., Goto T., Mitsuhashi Y., Ohata K.

    INTERVENTIONAL NEURORADIOLOGY   15 ( 1 )   73 - 76   2009.03( ISSN:1591-0199

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  • Primary Intramedullary Spinal Cord Germinoma: Diagnostic Challenge and Treatment Strategy -Two Case Reports Reviewed

    Yamagata Toru, Takami Toshihiro, Tsuyuguchi Naohiro, Goto Takeo, Wakasa Kenichi, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   49 ( 3 )   128 - 133   2009.03( ISSN:0470-8105

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  • Complication Avoidance and Management in Posteriorly Instrumented C1-2 Fusion Reviewed

    Takami Toshihiro, Ichinose Tsutomu, Ishibashi Kenichi, Goto Takeo, Tsuyuguchi Naohiro, Ohata Kenji

    The Japanese Society of Spinal Surgery, Spinal Surgery   23 ( 1 )   121 - 127   2009( ISSN:0914-6024

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    <p>  <b>Objective</b> : Once atlantoaxial joint instability has been detected, the goal of surgery is to reduce pathological subluxation, decompress neural elements and maintain vertebral column alignment. Herain, the surgical technique for internal fixation and fusion at the atlantoaxial joint is presented with an emphasis on complication avoidance.</p><p>  <b>Patients and methods</b> : The patient record included a total of 12 patients with the atlantoaxial instability (11 male and 1 female), who underwent surgery over the past four years. The age of the patients ranged from 16 to 75 years old. Patients were classified into 7 in trauma group, and 5 in rheumatoid arthritis or degeneration group based on their etiology. Goel-Harms method with a cancellous screw and rod system was preferably used. In the cases of retroodontoid pseudotumor with chronic atlantoaxial instability, the posterior C1 arch was resected and combined with posterior fusion.</p><p>  <b>Results and conclusion</b> : None of the patients demonstrated neurological deterioration after surgery. All of the patients with retroodontoid pseudotumor demonstrated neurological recovery with gradually diminishing pseudotumor. In one case treated by Megerl method, revision surgery was accomplished to achieve complete bone fusion. To avoid the surgical complications, selection and safe placement of C2 anchor screws, sufficient exposure of the lateral atlantoaxial joint, and fusion technique are key elements for successful surgery.</p>

    DOI: 10.2531/spinalsurg.23.121

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  • Preoperative embolization for skull base meningiomas Reviewed

    NISHIO Akimasa, MITSUHASHI Yutaka, GOTO Takeo, ISHIBASHI Kenichi, ICHINOSE Tsutomu, KAWAKAMI Taichiro, MORINO Michiharu, OHATA Kenji

    The Japanese Society for Neuroendovascular Therapy, Journal of Neuroendovascular Therapy   3 ( 3 )   165 - 173   2009( ISSN:1882-4072

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    <b>Objective</b>: To evaluate the effectiveness of preoperative embolization for skull base meningiomas.<br><b>Method</b>: Forty-one patients with skull base meningiomas, three posterior clinoid meningiomas, three cavernous meningiomas, and thirty five petroclival meningiomas were evaluated. They were divided into two groups: Group A had 17 patients who had undergone successful predominant feeder embolization and group B had 24 patients for whom predominant feeder embolization had failed or had intentionally not been attempted. Change of C-reactive protein (CRP) level, MRI enhancement, and operative tumor characters were compared between two groups.<br><b>Result</b>: 13 cases in group A showed an increase of CRP level, while there were no CRP level changes in group B. Eleven cases in group A demonstrated a diminished MRI enhancement, whereas two of the five cases in group B with supplement feeder embolization showed the same finding. Intraoperative tumor softening and/or whitening was recognized in 10 cases in group A and in 4 cases in group B. These differences were statistically significant (p<0.05).<br><b>Conclusion</b>: Dominant feeder embolization for skull base meningiomas, even if they are branches of internal carotid arteries, is useful to diminish operative bleeding and facilitate dissection.

    DOI: 10.5797/jnet.3.165

    CiNii Article

  • Surgical Treatment for the Brainstem Cavernomas(<Topics>Treatment Strategy for Brainstem Cavernous Angioma) Reviewed

    ICHINOSE Tsutomu, GOTO Takeo, ISHIBASHI Kenichi, TAKAMI Toshihiro, YOSHIMURA Masaki, UDA Takehiro, OHATA Kenji, Tsutomu ICHINOSE, Takeo GOTO, Kenichi ISHIBASHI, Toshihiro TAKAMI, Masaki YOSHIMURA, Takehiro UDA, Kenji OHATA, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City General Medical Center, Department of Neurosurgery Yamamoto Dai-san Hospital, Department of Neurosurgery Osaka City University Graduate School of Medicine

    36 ( 6 )   415 - 420   2008.11( ISSN:09145508

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  • Importance of fixation angle in posterior instrumented occipitocervical fusion Reviewed

    Takami Toshihiro, Ichinose Tsutomu, Ishibashi Kenichi, Goto Takeo, Tsuyuguchi Naohiro, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   48 ( 6 )   279 - 282   2008.06( ISSN:0470-8105

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  • Importance of fixation angle in posterior instrumented occipitocervical fusion. Reviewed

    Takami T, Ichinose T, Ishibashi K, Goto T, Tsuyuguchi N, Ohata K

    社団法人 日本脳神経外科学会 Neurologia medico-chirurgica   48 ( 6 )   279 - 82; discussion 282   2008.06( ISSN:0470-8105

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    Occipitocervical fusion with the head in a functionally neutral position is critically important. Various methods have been proposed for measuring the angle of the craniovertebral junction based on lateral radiography. We describe a simple and reliable measurement of fixation angle during occipitocervical fusion using the line parallel to the bony palate and the posterior longitudinal line of the C2 vertebra. The normal range of the angle of the craniovertebral junction was measured in 30 normal healthy volunteers, 15 males and 15 females aged from 17 to 77 years (mean 45.1 years), without symptoms of neck pain or limitations of neck movement. The angle ranged from 85 to 118 degrees. The mean angle was 97.1 degrees in males and 102.6 degrees in females, with overall mean &plusmn; standard deviation of 99.9 &plusmn; 8.1 degrees. Careful adjustment of the angle of the craniovertebral junction can help to avoid postoperative complications such as dysphagia, dyspnea, and subaxial subluxation.<br>

    DOI: 10.2176/nmc.48.279

    PubMed

    CiNii Article

  • (3)解剖に基づく手術の要点(2) : 前床突起部髄膜腫の手術(2. Part 1: cavernous sinus,PS2-1 第22回微小脳神経外科解剖セミナー『頭蓋底静脈』,プレナリーセッション,脳神経外科の夢と志,第28回日本脳神経外科コングレス総会) Reviewed

    大畑 建治, 後藤 剛夫, 石橋 謙一, 一ノ瀬 努

    日本脳神経外科コングレス 脳神経外科ジャーナル   17 ( 0 )   2008.04( ISSN:0917950X

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  • Analysis of Venous Drainage from Sylvian Veins in Clinoidal Meningioma(<SPECIAL ISSUES>Veins of the Skull Base (1): Cavernous Sinus) Reviewed

    Ishibashi Kenichi, Ichinose Tsutomu, Nagata Takashi, Morisako Hiroki, Goto Takeo, Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   17 ( 9 )   673 - 678   2008( ISSN:0917-950X

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    Skull base meningiomas can occasionally obstruct the basal venous sinuses as the tumor growth. We therefore analyzed the venous draining pattern from sylvian veins in clinoidal meningiomas. Between 1995 and 2007, twenty patients with clinoidal meningioma underwent surgical intervention at our institute. Venous drainage from sylvian veins was categorized into three patterns, including cortical type, sphenobasal type and sphenoparietal type, according to the main draining vein. Preoperative angiographic evaluation showed 14 patients (70%) as cortical type, 5 patients (25%) as sphenobasal type and 1 patient (5%) as sphenoparietal type. Postoperative clinical courses revealed that dominant sphenobasal sinuses were successfully preserved by skull base techniques in all of the sphenobasal type patients. One sphenoparietal type patient developed a brain contusion conceivably, by the obstruction of the dominant sphenoparietal sinus during tumor resection. Drainers from sylvian veins to the skull base should be carefully evaluated preoperatively and must be preserved, if dominant, in the surgery of clinoidal meningioma.

    DOI: 10.7887/jcns.17.673

    CiNii Article

  • Surgical Treatment for the Brainstem Cavernomas Reviewed

    ICHINOSE Tsutomu, GOTO Takeo, ISHIBASHI Kenichi, TAKAMI Toshihiro, YOSHIMURA Masaki, UDA Takehiro, OHATA Kenji

    The Japanese Society on Surgery for Cerebral Stroke, Surgery for Cerebral Stroke   36 ( 6 )   415 - 420   2008( ISSN:0914-5508

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    We reviewed 9 cases of brainstem cavernomas and evaluated the approach for each lesion, accessibility, respectability, and pre- and post operative neurological status. The dorsal lesions were treated with posterior approaches, such as the occipital transtentorial approach or trans-4th ventricle approach. The ventral lesions were treated with anterior approaches using skull base technique, but we needed some technique to access ventral lesions. We used transposition of the cranial nerve and VA, which lay across the surface of the cavernomas in 2 cases, and we performed two-staged surgery in 1 case. In all cases, we were able to access and remove the lesions safely.<br> Dorsal lesions with traditional posterior approaches and the ventral lesions require a skull-base approach and additional technique based on consideration of local anatomy and surrounding structures.<br>

    DOI: 10.2335/scs.36.415

    CiNii Article

  • Posterior C1-2 Fixation With Cancellous Screw and Rod System for Retro-odontoid Pseudotumor Associated With Chronic Atlantoaxial Subluxation : Technical Note Reviewed

    TAKAMI Toshihiro, GOTO Takeo, TSUYUGUCHI Naohiro, NISHIKAWA Misao, OHATA Kenji

    社団法人 日本脳神経外科学会 Neurologia medico-chirurgica = 神経外科   47 ( 4 )   189 - 193   2007.04( ISSN:04708105

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    Posterior C1-2 fixation with individual screw placement in C-1 and C-2 was performed in three patients presenting with progressive myelopathy caused by retro-odontoid pseudotumor associated with chronic atlantoaxial subluxation. Postoperatively, all patients demonstrated neurological recovery with gradually diminishing pseudotumor. Posterior C1-2 fixation with the cancellous screw and rod system is a safe and reliable method, and can be used to treat retro-odontoid pseudotumor associated with chronic atlantoaxial subluxation.<br>

    DOI: 10.2176/nmc.47.189

    CiNii Article

  • Posterior C1-2 Fixation with cancellous screw and rod system for retro-odontoid pseudotumor associated with chronic atlantoaxial subluxation. Technical note. Reviewed

    Takami T, Goto T, Tsuyuguchi N, Nishikawa M, Ohata K

    Neurologia medico-chirurgica   47 ( 4 )   189 - 93; discussion 193   2007.04( ISSN:0470-8105

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  • Posterior C1-2 fixation with cancellous screw and rod system for retro-odontoid pseudotumor associated with chronic atlantoaxial subluxation - Technical note Reviewed

    Takami Toshihiro, Goto Takeo, Tsuyuguchi Naohiro, Nishikawa Misao, Ohata Kenji

    NEUROLOGIA MEDICO-CHIRURGICA   47 ( 4 )   189 - 193   2007.04( ISSN:0470-8105

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  • 7. Role of Surgery : Petroclival Meningioma(Part 2:Skull base meningioma, PS3-1 Focus of Multimodality Treatment/AVM & Skull Base Meningioma, The 27^<th> Annual Meeting of The Japanese Congress of Neurological Surgeons) Reviewed

    Ohata Kenji

    The Japanese Congress of Neurological Surgeons, Japanese Journal of Neurosurgery   16 ( 4 )   2007( ISSN:0917-950X

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    DOI: 10.7887/jcns.16.323_3

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  • Schwannoma of the oculomotor nerve Reviewed

    Ohata Kenji, Takami Toshihiro, Goto Takeo, Ishibashi Kenichi

    NEUROLOGY INDIA   54 ( 4 )   437 - 439   2006.12( ISSN:0028-3886

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  • Schwannoma of the oculomotor nerve. Reviewed

    Ohata K, Takami T, Goto T, Ishibashi K

    Neurology India   54 ( 4 )   437 - 9   2006.12( ISSN:0028-3886

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    DOI: 10.4103/0028-3886.28125

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  • Sudden appearance of transdural anastomosis from middle meningeal artery to superior cerebellar artery during preoperative embolization of meningioma. Reviewed

    Ohata K, Nishio A, Takami T, Goto T

    Neurology India   54 ( 3 )   328   2006.09( ISSN:0028-3886

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  • Sudden appearance of transdural anastomosis from middle meningeal artery to superior cerebellar artery during preoperative embolization of meningioma Reviewed

    Ohata Kenji, Nishio Akimasa, Takami Toshihiro, Goto Takeo

    NEUROLOGY INDIA   54 ( 3 )   328 - 328   2006.09( ISSN:0028-3886

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  • Comparison of neuropsychological outcomes after selective amygdalohippocampectomy versus anterior temporal lobectomy Reviewed

    Morino Michiharu, Uda Takehiro, Naito Kentaro, Yoshimura Masaki, Ishibashi Kenichi, Goto Takeo, Ohata Kenji, Hara Mitsuhiro

    EPILEPSY & BEHAVIOR   9 ( 1 )   95 - 100   2006.08( ISSN:1525-5050

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    DOI: 10.1016/j.yebeh.2006.04.017

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  • The anterolateral partial vertebrectomy approach for ventrally located cervical intramedullary cavernous angiomas Reviewed

    Nishikawa Misao, Ohata Kenji, Ishibashi Kenichi, Takami Toshihiro, Goto Takeo, Hara Mitsuhiro

    NEUROSURGERY   59 ( 1 )   58 - 62   2006.07( ISSN:0148-396X

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    DOI: 10.1227/01.NEU.0000219930.65161.AD

    PubMed

  • Characterization of Plaque in the Internal Carotid Artery : Comparison Neuroradiological Findings with Pathological Findings Reviewed

    NISHIKAWA Misao, NISHIO Akimasa, TAKAMI Toshihiro, GOTO Takeo, UEDA Makiko, HARA Mitsuhiro, Misao NISHIKAWA, Akimasa NISHIO, Toshihiro TAKAMI, Takeo GOTO, Makiko UEDA, Mitsuhiro HARA, Departments of Neurosurgery Osaka City University Graduate School of Medicine, Departments of Neurosurgery Osaka City University Graduate School of Medicine, Departments of Neurosurgery Osaka City University Graduate School of Medicine, Departments of Neurosurgery Osaka City University Graduate School of Medicine, Departments of Pathophysiology Osaka City University Graduate School of Medicine, Departments of Neurosurgery Osaka City University Graduate School of Medicine

    34 ( 3 )   199 - 205   2006.05( ISSN:09145508

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  • Surgical management of petroclival chordomas: Report of eight cases Reviewed

    Takami T, Ohata K, Goto T, Tsuyuguchi N, Nishio A, Hara M

    SKULL BASE-AN INTERDISCIPLINARY APPROACH   16 ( 2 )   85 - 92   2006.05( ISSN:1531-5010

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    DOI: 10.1055/s-2006-934109

    PubMed

  • Treatment of a Fusiform Middle Cerebral Artery Aneurysm at M1 Part Which Cause Cerebral Infarction at Its Perforating Area : A Case Report Reviewed

    GOTO Takeo, OHATA Kenji, NISHIO Akimasa, NAITOH Kentarou, HARA Mitsuhiro, Takeo GOTO, Kenji OHATA, Akimasa NISHIO, Kentarou NAITOH, Mitsuhiro HARA, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine, Department of Neurosurgery Osaka City University Graduate School of Medicine

    The Japanese Society on Surgery for Cerebral Stroke, Surgery for Cerebral Stroke   34 ( 1 )   59 - 63   2006.01( ISSN:09145508

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    We report the case of a fusiform middle cerebral artery aneurysm at the M1 segment, which was successfully treated with proximal occlusion after a bypass surgery. A 48-year-old-male was admitted with a chief complaint of repeated left hemiparesis. Cerebral angiography showed a fusiform aneurysm at the M1 segment on the right side, corresponding to the ischemic symptom. We performed the occlusion of M1 at its most proximal segment after the high flow bypass from external carotid artery to M2 with a radial artery graft. <br> The post-operative course was uneventful, and the patient was discharged 10 days after operation. Follow-up imaging studies showed the prominent thrombus formation inside the aneurysm keeping the blood flow from the aneurysmal wall to the M1 perforators intact. <br> This surgical result supports the hypothesis that the spontaneous fusiform MCA aneurysm might be caused by dissection and the reversing of blood flow inside the dissected artery might make the dissection subside.<br>

    DOI: 10.2335/scs.34.59

    CiNii Article

  • Falcotentorial meningioma: surgical outcome in 14 patients Reviewed

    Goto T, Ohata K, Morino M, Takami T, Tsuyuguchi N, Nishio A, Hara M

    JOURNAL OF NEUROSURGERY   104 ( 1 )   47 - 53   2006.01( ISSN:0022-3085

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  • Falcotentorial meningioma: surgical outcome in 14 patients. Reviewed

    Goto T, Ohata K, Morino M, Takami T, Tsuyuguchi N, Nishio A, Hara M

    Journal of neurosurgery   104 ( 1 )   47 - 53   2006.01( ISSN:0022-3085

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    DOI: 10.3171/jns.2006.104.1.47

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  • Characterization of Plaque in the Internal Carotid Artery: Comparison Neuroradiological Findings with Pathological Findings Reviewed

    NISHIKAWA Misao, NISHIO Akimasa, TAKAMI Toshihiro, GOTO Takeo, UEDA Makiko, HARA Mitsuhiro

    The Japanese Society on Surgery for Cerebral Stroke, Surgery for Cerebral Stroke   34 ( 3 )   199 - 205   2006( ISSN:0914-5508

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    We evaluate the morphology of the carotid plaque using echogram, CT scan and MRI and compare those neuroradiological findings with histological findings of the plaque. <br> We evaluated 14 cases operated with carotid endoarterectomy for carotid stenosis. We estimated the findings of the echogram, enhanced CT scan and black blood MRI (BB MRI), in comparison with the histological findings of the carotid plaque. <br> Echogram, enhanced CT scan and MRI clearly demonstrated the plaque in cervical carotid stenosis. In most cases, echograms could show the plaque, but in some cases could not due to the back shadow caused by plaque calcification. Enhanced CT scan clearly demonstrated the calcification and the neovasculization in plaque. BB MRI clearly showed the carotid plaque. Low-intensity lesions in T1 and T2 weighted images showed hard and fibrous plaque. High-intensity lesions in T1 and T2 weighted images showed soft plaque with lipoprotein and/or hemorrhage. <br> This study demonstrates the potential of a systemic approach to atherosclerotic plaque with enhanced CT scan and BB MRI compared with histological findings of the carotid plaque. These estimations elucidate the growth mechanism of carotid plaque.<br>

    DOI: 10.2335/scs.34.199

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  • [Role of image guided surgery with navigation system for the skull base lesion]. Reviewed

    Goto T, Ohata K, Hara M

    Nihon rinsho. Japanese journal of clinical medicine   63 Suppl 9   341 - 6   2005.09( ISSN:0047-1852

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  • Microsurgical interruption of dural arteriovenous fistula at the foramen magnum Reviewed

    Takami T, Ohata K, Nishio A, Nishikawa M, Goto T, Tsuyuguchi N, Hara M

    JOURNAL OF CLINICAL NEUROSCIENCE   12 ( 5 )   580 - 583   2005.06( ISSN:0967-5868

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    DOI: 10.1016/j.jocn.2005.02.003

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  • Experience of using Navigation System in Spinal Surgery Reviewed

    Nishikawa Misao, Ohata Kenji, Takami Toshihiro, Goto Takeo, Hara Mitsuhiro

    The Japanese Society of Spinal Surgery, Spinal surgery : official journal of the Japanese Society of Spinal Surgery   19 ( 2 )   127 - 136   2005.06( ISSN:09146024

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    We report our experience of using a navigation system in spinal surgery, and assess its usefulness. Forty cases were operated upon using a navigational system, and 33 were operated upon using conventional methods, without a navigational system. There were significantly fewer complications when the navigation system was used than when it was not. We mostly used the navigation system for cases having anomalies and/or severe deformation of the spine requiring instrumentation (transarticular screw, pedicle screw) and bony resection. The system increased the accuracy of spinal instrumentation and decreased the risk of neurovascular injury. Navigation-assisted surgery improves the accuracy of spinal instrumentation and bony resection because it provides a multidimentional view of anatomnical relationships during surgery.

    CiNii Article

  • Surgery for the Mass Lesion Ventrally located in the Cranio-Vertebral Junction Reviewed

    NISHIKAWA Misao, OHATA Kenji, TAKAMI Toshihiro, GOTO Takeo, HARA Mitsuhiro

    The Japanese Society of Spinal Surgery, Spinal surgery : official journal of the Japanese Society of Spinal Surgery   19 ( 1 )   29 - 38   2005.03( ISSN:09146024

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    We report the results of surgical treatment of lesions in the cranio-vertebral junction and qualify the decision to use a surgical approach. 40 cases were treated. In consideration of the location of the lesion, relationship to lower cranial nerves and vertebral artery, some cases were added large suboccipital craniotomy, condylar resection and/or resection for transverse process of atlas and axis. We could remove the lesion totally in 88% of the cases. All of the cases had improvement in neurological symptoms. Subtotal removal was performed in three cases, because the tumor had adhesion to the brain stem or lower cranial nerves. For the lesions in the craniovertebral junction, the basic approach was dorsolateral approach, for the lesion extending to the spinal canal was performed hemilaminectomy of the atlas and axis. In consideration of the location of the lesion, the relationship to lower cranial nerves and the vertebral artery, suboccipital craniotomy, condylar resection and/or resection of transverse process of the atlas and axis should be added. For the intramedullary lesion, we should make the approach more laterally to get to the lesion directly.

    CiNii Article

  • 左後床突起周囲から発生した髄膜腫の一例(ES-2 脳腫瘍, 脊椎脊髄疾患, 第25回 日本脳神経外科コングレス総会) Reviewed

    大畑 建治, 後藤 剛夫, 内藤 堅太郎, 高見 俊宏, 原 充弘

    日本脳神経外科コングレス 脳神経外科ジャーナル   14 ( 4 )   2005( ISSN:0917-950X

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    DOI: 10.7887/jcns.14.280_2

    CiNii Article

  • Experience of using Navigation System in Spinal Surgery Reviewed

    Nishikawa Misao, Ohata Kenji, Takami Toshihiro, Goto Takeo, Hara Mitsuhiro

    The Japanese Society of Spinal Surgery, Spinal Surgery   19 ( 2 )   127 - 136   2005( ISSN:0914-6024

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    We report our experience of using a navigation system in spinal surgery, and assess its usefulness. Forty cases were operated upon using a navigational system, and 33 were operated upon using conventional methods, without a navigational system. There were significantly fewer complications when the navigation system was used than when it was not. We mostly used the navigation system for cases having anomalies and/or severe deformation of the spine requiring instrumentation (transarticular screw, pedicle screw) and bony resection.<br>The system increased the accuracy of spinal instrumentation and decreased the risk of neurovascular injury. Navigation-assisted surgery improves the accuracy of spinal instrumentation and bony resection because it provides a multidimentional view of anatomnical relationships during surgery.

    DOI: 10.2531/spinalsurg.19.127

    CiNii Article

  • Surgery for the Mass Lesion Ventrally located in the Cranio-Vertebral Junction Reviewed

    Nishikawa Misao, Ohata Kenji, Takami Toshihiro, Goto Takeo, Hara Mitsuhiro

    The Japanese Society of Spinal Surgery, Spinal Surgery   19 ( 1 )   29 - 38   2005( ISSN:0914-6024

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    We report the results of surgical treatment of lesions in the cranio-vertebral junction and qualify the decision to use a surgical approach.<br>40 cases were treated. In consideration of the location of the lesion, relationship to lower cranial nerves and vertebral artery, some cases were added large suboccipital craniotomy, condylar resection and/or resection for transverse process of atlas and axis. We could remove the lesion totally in 88% of the cases. All of the cases had improvement in neurological symptoms. Subtotal removal was performed in three cases, because the tumor had adhesion to the brain stem or lower cranial nerves.<br>For the lesions in the craniovertebral junction, the basic approach was dorsolateral approach, for the lesion extending to the spinal canal was performed hemilaminectomy of the atlas and axis. In consideration of the location of the lesion, the relationship to lower cranial nerves and the vertebral artery, suboccipital craniotomy, condylar resection and/or resection of transverse process of the atlas and axis should be added. For the intramedullary lesion, we should make the approach more laterally to get to the lesion directly.

    DOI: 10.2531/spinalsurg.19.29

    CiNii Article

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Books and Other Publications

  • Tentrial meningioma

    Morisako H, Goto T, Ohata K( Role: Contributor)

    Springer  2019 

  • Strategies, Posterior clinoid

    Morisako H, Goto T, Ohata K( Role: Contributor)

    Thieme, New York  2019 

  • Orbitozygomatic infratemporal approach to parasellar meningiomas

    Ohata K, Goto T( Role: Contributor)

    Elsevier  2018 

  • カダバーと動画で学ぶ頭蓋底アプローチ

    井川 房夫, 川原 信隆, 後藤 剛夫, 栗栖 薫( Role: Sole author)

    中外医学社  2017  ( ISBN:9784498228849

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    CiNii Books

  • Vertebral artery management in craniovertebral junction surgery

    Ohata K, Goto T( Role: Contributor)

    Thieme Stuttgart  2012 

  • Posterior clinoid meningiomas

    Goto T, Ohata K( Role: Contributor)

    Springer  2011 

  • Orbitozygomatic infratemporal approach to parasellar meningiomas

    Ohata K, Sheikh B, El-Naggar A, Goto T, Takami T, Hakuba A( Role: Contributor)

    Elsevier  2006 

  • A Case of Cavernous Hemangioma in the Brachium Pontis

    Ohata K, Takami T, Goto T( Role: Contributor)

    Thieme New York Stuttgart,  2005 

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MISC

  • 【良性脳腫瘍のすべて 分類 診断 手術 治療】(V章)手術(疾患) 髄膜腫 錐体斜台部髄膜腫

    長濱 篤文, 森迫 拓貴, 後藤 剛夫

    脳神経外科速報   ( 2024増刊 )   90 - 96   2024.10( ISSN:0917-1495

  • 解剖を中心とした脳神経手術手技 頭蓋底外科における内視鏡の役割

    後藤 剛夫

    Neurological Surgery   52 ( 5 )   1083 - 1090   2024.09( ISSN:0301-2603

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    <文献概要>I はじめに 頭蓋底良性腫瘍は,髄膜腫,神経鞘腫,下垂体腫瘍,頭蓋咽頭腫,脊索腫,軟骨肉腫など,どの腫瘍であっても,神経機能を温存した上での最大切除が治療の基本となる.こうした頭蓋底腫瘍を安全に摘出するため,経眼窩頬骨弓到達法,経錐体到達法,経後頭顆到達法など,さまざまな顕微鏡下頭蓋底到達法が報告されてきた.これらの到達法によりある程度腫瘍が安全に摘出できるため,手術到達法としてはほぼ確立したのではないかと考えられていた.しかし,近年の内視鏡手術の発展により,頭蓋底腫瘍に対する到達法は大きく変化している.今回は頭蓋底手術のなかでも,特に頭蓋底良性腫瘍に対する内視鏡手術の役割について,経鼻内視鏡手術,小開頭内視鏡手術の2つに焦点を当てて説明する.

  • 【微小解剖を知って術野をつくる】てんかん外科手術に必要な解剖学的知識

    宇田 武弘, 國廣 誉世, 田上 雄大, 川嶋 俊幸, Vich Yindeedej, 児嶌 悠一郎, 馬場 良子, 後藤 剛夫

    脳神経外科ジャーナル   33 ( 7 )   460 - 467   2024.07( ISSN:0917-950X

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    代表的なてんかん外科術式である,「内側側頭葉てんかんに対する海馬扁桃体摘出術」,「脳梁離断術」について,手術を安全に行うために必要な解剖学的知識(構造,血管,脳機能局在,白質線維)を中心にイラスト,術中写真を用いて解説する.また,これらの術式に対する神経内視鏡手術の導入とその妥当性について述べる.従来の顕微鏡手術での術野と神経内視鏡手術での術野を対比し,深部で確認すべき重要な解剖学的指標を示す.(著者抄録)

  • 【髄膜腫の現在-最新の知識を活かした最善の治療のために】髄膜腫-部位別の手術法 小脳橋角部・錐体斜台部髄膜腫に対する手術アプローチ

    森迫 拓貴, 後藤 剛夫

    Neurological Surgery   52 ( 4 )   749 - 761   2024.07( ISSN:0301-2603

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    <文献概要>Point・小脳橋角部や錐体斜台部に位置する髄膜腫の外科切除では,脳損傷,神経血管障害,脳幹損傷などを回避しながら摘出度を向上させることが求められる.・手術到達法は最小前後合併経錐体到達法,前経錐体到達法,外側後頭下到達法などが挙げられるが,おのおのの利点や欠点を理解することは重要である.・合併症回避のためのアプローチ選択,各アプローチにおける解剖や手術手技について実際の症例を中心に提示し解説する.

  • 【ITを駆使した術前シミュレーション-トラブル回避と時短手術習得】合併症対策のための術前シミュレーション 頭蓋底腫瘍における内視鏡手術

    佐々木 強, 後藤 剛夫

    Neurological Surgery   52 ( 2 )   327 - 334   2024.03( ISSN:0301-2603

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    <文献概要>Point ・内視鏡および周辺器具の発達に伴い,頭蓋底腫瘍に対する経鼻あるいは経頭蓋の内視鏡手術が普及しつつある.・頭蓋底腫瘍は,しばしばさまざまな重要な神経血管組織に近接しているため,安全に摘出を行うためには,適切なアプローチルートを検討することが重要である.・安全かつ最大限の腫瘍摘出を行うために,当院で普段行っている術前シミュレーションについて報告する.

  • 基本をマスター!脳神経外科手術のスタンダード 傍鞍部髄膜腫・動脈瘤に対するDolenc approach

    後藤 浩之, 後藤 剛夫, 大畑 建治

    脳神経外科速報   34 ( 1 )   106 - 113   2024.01( ISSN:0917-1495

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    <ポイント!><POINT 1>前床突起と周囲構造物の臨床解剖を理解する.<POINT 2>髄膜腫の発生母地と発生部硬膜の切断範囲を検討する<.POINT 3>動脈瘤手術においては中枢側内頸動脈の確保の部位(頸部またはC3)について検討する.(著者抄録)

  • 【下垂体腫瘍診療の新フェーズ-変革期の疫学・診断・治療における必須知識】下垂体腫瘍の治療 頭蓋咽頭腫に対する外科手術

    後藤 剛夫

    Neurological Surgery   51 ( 4 )   672 - 678   2023.07( ISSN:0301-2603

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    <文献概要>Point ・頭蓋咽頭腫は,放射線治療を併用しても長期の腫瘍制御が非常に難しい疾患である.・腫瘍制御のためには初回手術が非常に重要である.・年齢,患者背景を考えた外科的治療戦略が重要である.

  • 【脳神経外科医が知っておきたい-てんかんのすべて】脳神経外科医が知っておきたいてんかん治療 内側側頭葉てんかんに対する外科治療-手術に必要となる解剖学的理解を中心に

    宇田 武弘, 國廣 誉世, 田上 雄大, 児嶌 悠一郎, 川嶋 俊幸, 馬場 良子, 宇田 裕史, 高 沙野, 後藤 剛夫

    Neurological Surgery   51 ( 1 )   105 - 114   2023.01( ISSN:0301-2603

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    <文献概要>Point ・内側側頭葉てんかんに対する海馬扁桃体摘出術は有効な外科治療である.・手術アプローチには前側頭葉切除,経シルビウス裂到達法,経皮質到達法などが用いられる.・海馬硬化がなく記銘力が保たれている優位側例では海馬多切術も有効である.

  • 【小児脳神経外科-エキスパートはこうしている】小児脳腫瘍 小児鞍上部腫瘍 経鼻内視鏡

    森迫 拓貴, 後藤 剛夫

    Neurological Surgery   50 ( 6 )   1323 - 1331   2022.11( ISSN:0301-2603

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    <文献概要>Point ・近年,高精細な内視鏡システムの普及や周辺機器・器具の開発向上に伴って,鞍上部や斜台正中部の腫瘍に対しても経鼻内視鏡手術が中心となってきている.・特に小児鞍上部腫瘍の代表である頭蓋咽頭腫では,長期の腫瘍制御のために記銘力や視機能を温存して腫瘍を積極的に摘出することが重要であり,経鼻内視鏡手術では腫瘍の発生部位,視床下部,視交叉下面などが広く観察できる利点が生かされる.・本稿では,小児経鼻内視鏡手術における手術セッティングやデバイス,手技の実際について解説する.

  • ■脳神経外科 現在の覚醒下手術の適応,検査可能な脳機能について【重要な脳機能局在に隣接する病変に適応があり,多彩な脳機能を検査できる】

    中田 光俊, 後藤 剛夫

    日本医事新報   ( 5143 )   50 - 51   2022.11( ISSN:0385-9215

  • 脳腫瘍に対する小開頭内視鏡手術の適応について 内視鏡カメラの手前に安全な手術空間が確保できる症例が小開頭内視鏡手術の良い適応と考える

    後藤 剛夫, 阿久津 博義

    日本医事新報   ( 5138 )   57 - 58   2022.10( ISSN:0385-9215

  • Chiari奇形I型と頭蓋頸椎移行部不安定症の成因と分類に基づく外科的治療(Surgical Management of Chiari Malformation Type I and Instability of the Craniocervical Junction Based on Its Pathogenesis and Classification)

    Nishikawa Misao, Bolognese Paolo A., Yamagata Toru, Naito Kentarou, Sakamoto Hiroaki, Hara Mistuhiro, Ohata Kenji, Goto Takeo

    Neurologia medico-chirurgica   62 ( 9 )   400 - 415   2022.09( ISSN:0470-8105

  • 海外での手術経験から学ぶ 手術環境・道具・技術そして心の重要性(vol. 5) 海外での手術経験から学んだ3つの教訓

    後藤 剛夫

    Neurological Surgery   50 ( 4 )   902 - 907   2022.07( ISSN:0301-2603

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    <文献概要>はじめに 今回は筆者が海外での手術経験を通じて学んだことについて具体例を交えて紹介する.あくまで個人的な経験談となるため,なんの科学的根拠もない話になるが,これから国際交流や,海外での手術を経験される機会のある若手の先生に役立つ話を述べたいと思う.海外での手術経験を通して私が特に学んだことは,1)私の専門とする頭蓋底外科手術は手術器機および治療チーム依存性が高く,決して個人の力でよい成績が出ているわけではない.2)現地での手術教育が目的のため,発展途上国では日本で行っているとおりの頭蓋底手術法にこだわらず,現地での手術器機を用いて,今後も現地で行うことが可能な手術方法に変更する.3)患者に対して日本と同様の治療責任を負っていることを自覚する.の3点である.それぞれについて具体的にエピソードを交えて紹介する.

  • 【一生使える頭蓋底外科の"知"と"技"】基本的頭蓋底手術アプローチの概要とコツ 代表的症例の手術ビデオとともに Combined petrosal approach

    後藤 剛夫

    Neurological Surgery   50 ( 3 )   605 - 613   2022.05( ISSN:0301-2603

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    <文献概要>Point ・必要最低限の骨削除でcombined petrosal approachを行うための解剖の理解・手術手技に合わせた側頭骨解剖の理解・テント切開とメッケル腔開放の重要性の理解

  • 【神経解剖を理解した脳腫瘍手術 戦略と合併症対応】脳腫瘍手術戦略 小脳橋角部

    森迫 拓貴, 後藤 剛夫

    脳神経外科速報   32 ( 3 )   347 - 356   2022.05( ISSN:0917-1495

  • 【一生使える頭蓋底外科の"知"と"技"】頭蓋底外科short topics 頭蓋底外科手術におけるハイスピードドリルと超音波吸引器の使い方

    森迫 拓貴, 後藤 剛夫

    Neurological Surgery   50 ( 3 )   650 - 654   2022.05( ISSN:0301-2603

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    <文献概要>Point ・脳神経外科手術では,多種多様な手術器具・機器が日々開発され,その進歩は手術戦略に影響を与え,手術精度の向上に寄与している.・特に頭蓋底外科手術においては,ハイスピードドリルや超音波吸引器は安全で確実な病変の摘出に大きく寄与しており,これらの特性を習熟し適切に使いこなすことが肝要である.・本稿では頭蓋底外科手術におけるハイスピードドリルの安全な使い方,超音波吸引器の吸引および骨切モードの使い方について解説する.

  • 頭蓋底外科手術の歴史と発展、進歩について

    後藤 剛夫

    大阪市医学会雑誌   70   1 - 5   2021.12( ISSN:0386-4103

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    頭蓋底外科手術は病変が頭蓋内最深部に存在するため脳神経外科領域の中で最も治療困難な領域である。この分野については1970年代後半から80年代初めに様々な頭蓋底到達法が発表され、この治療が始まった言える。当時発表された頭蓋底外科手術の原型となる手術到達法の多くが大阪市立大学より発表されており、この分野での当施設の貢献度は大きい。頭蓋底外科の黎明期から発展期、その後手術の低侵襲化を経て現在は内視鏡下頭蓋底外科手術も行われている。本論文では頭蓋底外科の発展経緯について報告する。(著者抄録)

  • 高齢者における各種疾患コンセプト 高齢者頭蓋底髄膜腫に対する手術

    後藤 剛夫

    Geriatric Neurosurgery   34   13 - 17   2021.11( ISSN:1343-4233

  • 【てんかんと機能外科】てんかん外科の手術概念と最近の話題

    宇田 武弘, 國廣 誉世, 川嶋 俊幸, 馬場 良子, 中条 公輔, 宇田 裕史, 高 沙野, 田上 雄大, 大畑 建治, 後藤 剛夫

    脳神経外科ジャーナル   30 ( 7 )   496 - 503   2021.07( ISSN:0917-950X

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    難治性てんかんに対する外科手術は有用な治療手段である。非侵襲的検査において焦点の局在同定が困難な場合、頭蓋内電極を用いた精査が行われる。従来は硬膜下電極を用いることが一般的であったが、近年では定位的手法で挿入した頭蓋内電極で焦点診断を行うことが諸外国で増加している。てんかん焦点が局在している場合、より低侵襲な手術が望ましい。一方で、広範囲のてんかんネットワークが発作に関与している場合、脳梁や脳葉の離断を概念とした手術を考慮する必要がある。本邦未導入であるが、近年では局所の凝固術や、視床前核への深部脳刺激、反応性発作起始領域刺激などの新規治療も行われるようになってきている。(著者抄録)

  • 専門医に求められる最新の知識 脳腫瘍 頭蓋底良性腫瘍における経鼻内視鏡手術の現状

    後藤 剛夫

    脳神経外科速報   31 ( 3 )   512 - 517   2021.05( ISSN:0917-1495

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    近年頭蓋底良性腫瘍に対して経鼻内視鏡下に腫瘍摘出が行われる機会が増えている。一方、どのような腫瘍に対して経鼻内視鏡手術を選択するかの明確な適応は定まっていない。今回は経鼻内視鏡手術が効果的な疾患の大まかな概念を紹介するとともに、個別の疾患に対する経鼻内視鏡手術の現状を紹介した。施設、術者の内視鏡手術の習熟度に合わせて、従来の頭蓋底到達法と経鼻内視鏡手術を適切に選択して神経機能を温存した上での最大切除を目指すことが重要である。(著者抄録)

  • 【頭蓋底腫瘍の治療オプション-開頭手術・内視鏡手術・放射線治療】傍鞍部~錐体斜台部(脊索腫と軟骨肉腫)内視鏡手術の適応、方法、利点と限界

    後藤 剛夫

    Clinical Neuroscience   39 ( 4 )   470 - 474   2021.04( ISSN:0289-0585

  • 【良性脳腫瘍】頭蓋咽頭腫の病態理解と手術 Reviewed

    後藤 剛夫, 大畑 裕紀, 森迫 拓貴

    日本脳神経外科コングレス 脳神経外科ジャーナル   30 ( 1 )   41 - 47   2021.01( ISSN:0917-950X

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    頭蓋咽頭腫はウィリス動脈輪の内側に発生し、視交叉下面、視床下部に癒着しているため、手術摘出が最も難しい腫瘍の1つである。また症例は比較的少なく1施設での経験数は少ない。部分摘出と放射線照射によってこの疾患が安全に治療できるようになったとする報告もあるが、長期成績は十分とはいえまい。一方経鼻内視鏡手術の発展により腫瘍切除度、手術安全度が向上したとする報告もあるが一方で長期成績はまだわからない。また下垂体機能温存に関しては経鼻手術を用いても達成は困難な状況である。この疾患の治療は現在も非常に難しいことを十分に理解して患者個々の条件に応じた最適な治療を選択する必要がある。(著者抄録)

  • 【良性脳腫瘍】頭蓋咽頭腫の病態理解と手術

    後藤 剛夫, 大畑 裕紀, 森迫 拓貴

    脳神経外科ジャーナル   30 ( 1 )   41 - 47   2021.01( ISSN:0917-950X

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    頭蓋咽頭腫はウィリス動脈輪の内側に発生し、視交叉下面、視床下部に癒着しているため、手術摘出が最も難しい腫瘍の1つである。また症例は比較的少なく1施設での経験数は少ない。部分摘出と放射線照射によってこの疾患が安全に治療できるようになったとする報告もあるが、長期成績は十分とはいえまい。一方経鼻内視鏡手術の発展により腫瘍切除度、手術安全度が向上したとする報告もあるが一方で長期成績はまだわからない。また下垂体機能温存に関しては経鼻手術を用いても達成は困難な状況である。この疾患の治療は現在も非常に難しいことを十分に理解して患者個々の条件に応じた最適な治療を選択する必要がある。(著者抄録)

  • 【難治疾患克服への可能性-エビデンスのない領域への挑戦-】頭蓋底腫瘍に対する治療戦略 Reviewed

    後藤 剛夫, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   29 ( 1 )   17 - 24   2020.01( ISSN:0917-950X

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    Publishing type:Article, review, commentary, editorial, etc. (scientific journal)  

    頭蓋底腫瘍は病理学的には比較的良性の疾患が多い。しかし神経、重要血管との位置関係から、手術摘出が困難であり、臨床的には必ずしも良性の経過をとらない。また腫瘍の最大切除が長期腫瘍制御に重要であるが、一方手術合併症により患者の予後を悪化させる場合もある。術者および施設ごとに手術成績が大きく異なるため、一般に治療エビデンスを証明しにくい領域である。今回はわれわれが考える頭蓋底腫瘍の治療戦略について説明する。(著者抄録)

  • 【難治疾患克服への可能性-エビデンスのない領域への挑戦-】頭蓋底腫瘍に対する治療戦略

    後藤 剛夫, 大畑 建治

    脳神経外科ジャーナル   29 ( 1 )   17 - 24   2020.01( ISSN:0917-950X

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    頭蓋底腫瘍は病理学的には比較的良性の疾患が多い。しかし神経、重要血管との位置関係から、手術摘出が困難であり、臨床的には必ずしも良性の経過をとらない。また腫瘍の最大切除が長期腫瘍制御に重要であるが、一方手術合併症により患者の予後を悪化させる場合もある。術者および施設ごとに手術成績が大きく異なるため、一般に治療エビデンスを証明しにくい領域である。今回はわれわれが考える頭蓋底腫瘍の治療戦略について説明する。(著者抄録)

  • 【脳神経外科キャリアビジョン Subspecialty:私の選択】ようこそ、私たちのsubspecialtyへ 脳腫瘍(下垂体、頭蓋底外科)日本の手術治療成績、技術は世界のトップレベル Reviewed

    後藤 剛夫

    (株)メディカ出版 脳神経外科速報   29 ( 10 )   1046 - 1049   2019.10( ISSN:0917-1495

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  • 【みらいを救う脳神経外科手術-解剖に基づいた脳神経の温存-】海綿静脈洞部の手術 動眼、滑車、外転神経の温存について Reviewed

    後藤 剛夫, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   28 ( 7 )   398 - 406   2019.07( ISSN:0917-950X

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    海綿静脈洞部腫瘍に対する治療としては定位放射線治療の役割が大きい。しかし放射線照射後の再発や症候性腫瘍ではときに外科的切除が必要になることがある。海綿静脈洞部髄膜腫、軟骨肉腫の2つの疾患について解剖学的特徴を踏まえた腫瘍切除について解説した。髄膜腫については後方から腫瘍に到達する最小合併経錐体到達法が有用であった。また内側海綿静脈洞部髄膜腫、海綿静脈洞部軟骨肉腫は経鼻内視鏡手術での摘出が有用であった。手術適応をよく検討すれば、動眼、滑車、外転神経機能を温存して腫瘍減圧ができることを説明した。(著者抄録)

  • 頭蓋咽頭腫が再発する可能性は? 再発率は腫瘍の切除度に最も依存しており、小児と成人に差はない Reviewed

    森迫 拓貴, 後藤 剛夫

    (株)日本医事新報社 日本医事新報   ( 4919 )   59 - 60   2018.08( ISSN:0385-9215

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  • 【良性脳腫瘍の課題と展望】 残存・再発髄膜腫の治療と放射線治療のタイミング Reviewed

    後藤 剛夫, 森迫 拓貴, 渡部 祐輔, 中条 公輔, 有馬 大紀, 宇田 武弘, 川原 慎一, 山中 一浩, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   27 ( 6 )   441 - 448   2018.06( ISSN:0917-950X

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    髄膜腫は頭蓋内腫瘍の中でも頻度が高く、脳神経外科医にとって遭遇する機会が多い腫瘍である。初期治療として手術切除が選択されることに異論はないと思われるが、残存、再発腫瘍についてどのように治療を行うかは意見の一致をみていない。最近の論文でも手術切除度が腫瘍無再発期間や生存率に関連していることは明らかであるが、一方過度な切除は患者に重篤な合併症をきたし、かえって生存期間を短縮させるなどの問題もある。放射線照射はWHO grade I髄膜腫に対して腫瘍無再発期間を有意に延長させる効果があることが多くの論文で示されている。しかし生存期間を延長させることは示されていない。WHO grade II、III髄膜腫ではさらに放射線の効果そのものに否定的な論文もある。本論文では最近の論文および自験例をもとに残存、再発腫瘍をどのように治療すべきかについて考察した。(著者抄録)

  • 基本をマスター 脳神経外科手術のスタンダード 頭蓋底腫瘍 深部静脈、神経損傷回避を目指した手術アプローチ Reviewed

    後藤 剛夫

    (株)メディカ出版 脳神経外科速報   28 ( 4 )   344 - 351   2018.04( ISSN:0917-1495

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    <POINT 1>深部静脈損傷を回避するためには、大きな深部静脈が手術到達経路を遮ることのない到達法を選択する必要がある。<POINT 2>脳神経機能を温存するためには腫瘍から脳神経を剥離するのではなく、脳神経から腫瘍を剥離する操作が重要となる。<POINT 3>腫瘍に巻き込まれた脳神経を同定するためには、正常解剖を指標にした早期の脳神経同定が重要である。(著者抄録)

  • 脳腫瘍の手術のための術前・術中支援 錐体斜台部腫瘍に対する経錐体到達法 Reviewed

    後藤 剛夫

    (株)医学書院 Neurological Surgery   45 ( 2 )   175 - 186   2017.02( ISSN:0301-2603

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  • 【頭蓋底手術・奥義開陳】 頭蓋底手術の神髄を知る Transpetrosal approaches Reviewed

    後藤 剛夫

    (株)メディカ出版 脳神経外科速報   26 ( 10 )   1026 - 1033   2016.10( ISSN:0917-1495

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    Transpetrosal approachesは、脳幹腹側、錐体斜台部、視交叉後方病変に対して、比較的広く浅い術野を得ることができる有用な到達法である。Anterior petrosal approach、posterior petrosal approachのいずれの場合も、硬膜剥離を十分行い錐体骨を広く露出することが、安全、迅速な錐体骨削除に不可欠である。また血液のない術野を心がけ、解剖学的指標の視認性を向上させることも重要である。これらを心がけると、比較的安全に行い得る手術手技である。(著者抄録)

  • 頭蓋底髄膜腫の外科的切除の可能性(Surgical Resectability of Skull Base Meningiomas) Reviewed

    Goto Takeo, Ohata Kenji

    (一社)日本脳神経外科学会 Neurologia medico-chirurgica   56 ( 7 )   372 - 378   2016.07( ISSN:0470-8105

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  • 【アプローチの基本とピットフォール】 Orbitozygomatic approachの基本とピットフォール Reviewed

    後藤 剛夫, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   24 ( 11 )   738 - 744   2015.11( ISSN:0917-950X

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    Orbitozygomatic approachは広く普及した頭蓋底到達法であるが、広く普及したがゆえに、手術の細かなコツあるいは適応について語られる機会が減少している。今回は手術解剖の知識を中心に同到違法を行う手順を解説した。(著者抄録)

  • 【術式別決定版 脳神経外科手術とケア パーフェクトガイド 術前→術中→術後ケアまでの流れとケアポイントをみっちり凝縮!】 (第1章)脳神経外科手術とは 脳神経外科の手術体位と特徴 Reviewed

    森迫 拓貴, 後藤 剛夫, 大畑 建治

    (株)メディカ出版 Brain Nursing   ( 2015春季増刊 )   22 - 26   2015.02( ISSN:0910-8459

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  • 各種疾患 脳腫瘍 頭蓋咽頭腫の治療選択 Reviewed

    森迫 拓貴, 後藤 剛夫, 大畑 建治

    (株)中外医学社 Annual Review神経   2015   160 - 168   2015.01

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    頭蓋咽頭腫(craniopharyngioma)は胎生期の頭蓋咽頭管の遺残から発生する良性腫瘍で,全脳腫瘍の2〜4%,小児では5〜10%を占める.頭蓋咽頭腫に対する治療は,種々の顕微鏡下経頭蓋到達法的手術や内視鏡下経鼻的手術による外科的切除,分割照射や定位放射線照射などの放射線治療,嚢胞内薬物療法などオプションが増えており議論が多い.病理学的特徴を考慮すると手術によって全摘出することが理想である.しかし,腫瘍は重要血管穿通枝と複雑に癒着し,視神経視交叉や視床下部と近接しており,安全に摘出することは容易ではない.このため基本的な治療方針は,種々の到達法を駆使し,患者の機能を保ちつつ腫瘍の徹底切除を行う.亜全摘出例や再発例に対しては,分割照射や定位放射線照射などの放射線治療を行う.内分泌補充に関しては内分泌内科専門医との連係および長期的経過観察が重要である.(著者抄録)

  • 基本をマスター 脳神経外科手術のスタンダード 錐体斜台部髄膜腫の手術のポイント Reviewed

    後藤 剛夫, 大畑 建治

    (株)メディカ出版 脳神経外科速報   24 ( 11 )   1176 - 1183   2014.11( ISSN:0917-1495

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    <POINT1>三叉神経内側に付着部がある狭義の錐体斜台部髄膜腫に対しては、脳幹との剥離、顔面神経、聴神経機能温存、いずれの観点からも経錐体法が有用である。<POINT2>手術法が複雑に見える錐体斜台部髄膜腫であっても、大まかな腫瘍摘出の手順は一定である。(著者抄録)

  • 【神経症候群(第2版)-その他の神経疾患を含めて-】 腫瘍性疾患 脳神経および脊髄神経腫瘍 シュワン細胞腫 Reviewed

    森迫 拓貴, 後藤 剛夫, 大畑 建治

    (株)日本臨床社 日本臨床   別冊 ( 神経症候群III )   185 - 189   2014.06( ISSN:0047-1852

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  • 【良性脳腫瘍の基本的治療方針-機能温存のために-】 頭蓋咽頭腫に対する手術到達法選択の重要性 Reviewed

    後藤 剛夫, 國廣 誉世, 森迫 拓貴, 川上 太一郎, 寺川 雄三, 露口 尚弘, 山中 一浩, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   23 ( 1 )   12 - 19   2014.01( ISSN:0917-950X

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    術前画像診断や、手術手技、手術機器が進歩した現在も頭蓋咽頭腫に対する治療は非常に難しく、議論が分かれるところである。また手術法についても、経蝶形骨洞到達法、経眼窩頬骨弓到達法、経大脳間裂経終板到達法、経側脳室到達法、さらに経錐体到達法などさまざまな報告がなされている。われわれは頭蓋咽頭腫を発生部位に基づいて、4つに細分類し、病変に応じた手術法を選択している。本論文では、われわれの細分類および手術法選択基準を紹介した。(著者抄録)

  • 基本をマスター 脳神経外科手術のスタンダード 経錐体到達法の基本手技 Reviewed

    後藤 剛夫, 大畑 建治

    (株)メディカ出版 脳神経外科速報   23 ( 11 )   1200 - 1205   2013.11( ISSN:0917-1495

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    <POINT1>S状静脈洞は、乳様骨を削除する前に乳様骨内板から静脈洞を剥離すると安全かつ迅速に露出できる。<POINT2>狭い術野で錐体骨を削除すると、迷路損傷、蝸牛損傷などを起こしやすい。中頭蓋底側、後頭蓋窩側の両方で硬膜を十分剥離して、錐体骨を露出させた後に、骨削除を行うと安全に骨削除が可能になる。(著者抄録)

  • 【頭蓋底外科の挑戦】 鞍結節部髄膜腫に対する顕微鏡下徹底切除の治療成績 Reviewed

    大畑 建治, 後藤 剛夫

    (株)フォレストプリンコム Medical Torch   8 ( 1 )   24 - 25   2012.08( ISSN:1880-2796

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    鞍結節部髄膜腫(tuberculum sellae meningioma)は両側視神経管の間に存在する小さな骨隆起である鞍結節を中心に発育する腫瘍である。このため両側視神経を内側から外側に圧排し視力視野障害を来す疾患である。また時に発育とともに前交通動脈とその穿通枝を巻き込みながら発育する。筆者らは以前からこの腫瘍に対し、腫瘍発育部に到達しやすく、また両側視神経・視交叉・前交通動脈との離が最も確実な両側前頭開頭による腫瘍切除を行っている。基本的にこの「両側前頭下到達法」で腫瘍を切除し、腫瘍が前交通動脈を巻き込んでいる場合には「経大脳間裂到達法」を併用している。(著者抄録)

  • 【これだけは押さえて超安心!新人ナースのための脳神経疾患と治療】 疾患編 脳腫瘍 Reviewed

    後藤 剛夫

    (株)メディカ出版 Brain Nursing   27 ( 4 )   336 - 339   2011.04( ISSN:0910-8459

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    <看護のポイント>■脳腫瘍は脳実質内腫瘍と脳実質外腫瘍の2つに大別されます。■脳実質内腫瘍では手術の役割は限定的で、多くの場合その後に放射線療法、化学療法を考慮する必要があります。■脳実質外腫瘍は、手術治療により治癒が可能な疾患です。しかし、手術が患者に大きな合併症を強いることのないように、十分な治療計画を立てなければいけない疾患です。(著者抄録)

  • 【手術アプローチの選択とピットフォール】 合併経錐体到達法の適応と手術の実際について Reviewed

    後藤 剛夫, 大畑 建治

    日本脳神経外科コングレス 脳神経外科ジャーナル   19 ( 11 )   802 - 809   2010.11( ISSN:0917-950X

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Grant-in-Aid for Scientific Research

  • 脊髄回復可能閾値の定量測定と手術法の定量評価

    Grant-in-Aid for Young Scientists(B)  2004.04

Joint research

  • 神経線維腫症II型に対するベバシズマブの有効性および安全性を検討する多施設共同無作為化二重盲検比較治験

    日本医療研究開発機構  2019.04

Outline of education staff

  • 良性脳腫瘍の外科的治療を中心に指導

Charge of on-campus class subject

  • Training of neurosurgical operation

    2024     Graduate school

  • Practice of neurosurgery

    2024     Graduate school

  • Exercises of neurosurgery

    2024     Graduate school

  • Advanced course of Neurosurgery 2

    2024     Graduate school

  • Advanced course of Neurosurgery 1

    2024     Graduate school

  • Basic Course of Clinical Medicine

    2024     Graduate school

  • Clinical Medicine

    2024     Graduate school

  • 現代の医療

    2024   Weekly class   Graduate school

  • 脳神経外科

    2019     Undergraduate

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  • 2019

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    Original item:第7回北京国際頭蓋底手術シンポジウムで教育講演を行った

  • 2019

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    Original item:第23回インドネシア脳神経外科学会総会において頭蓋底手術および内視鏡下頭蓋底手術の教育講演を行った

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