Tadashi Kanda

Toyohashi Sozo College

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Systemic angitis associated with abnormal rete mirabile and occlusion of the bilateral carotid arteries

Nosotchu (1980)

Shotai Kobayashi Yoshiaki Tazaki Tadashi Kanda H Koga

症例は36歳の主婦.脳出血にて死亡.剖検にて脳底部に無数の異常血管を認め, 内頚動脈は両側終末部で癩痕化し, 閉塞は起始部に及んでいた.内膜は硝子化を伴なった著明な線維性肥厚を示し, 内弾性板の断裂, 中膜の著明な菲薄化を認めた.アテローム, 炎症細胞は認められなかった.大動脈は特に弓部でアテローム斑が著明であり, 横隔膜穿通部に骨化を認めた.内膜肥厚の強い部位では中膜菲薄化, 外膜線維化, 栄養血管の内膜肥厚が著明であった.同様の変化を弓部分枝, 肺動脈等に認めた.以上の所見から本例の動脈病変は高安病と類似した血管炎と考えられる.しかし, 本例では内頚動脈終末部にも同様の機序によると思われる病変を認めた点で異なる.したがって広汎な全身性動脈炎が小児期に生じた可能性が強く, ウイリス輪閉塞症との関連からも興味深い症例と考えられる.

10.3995/jstroke.2.42

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[Interhemispheric subdural empyema diagnosed by CT and cured by antibiotic therapy (author's transl)].

PubMed (1981)

I Hayakawa Motonari Fukui Norihisa Furuhashi Tadashi Kanda Yuichi Tazaki

Subdural empyema

Antibiotic Therapy

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[Visual hallucination in the hemianopic field caused by dural arteriovenous malformation].

PubMed (1994)

Tetsuya Inafuku Fumihiko Sakai Tetsuya Sakamoto Tadashi Iizuka Tadashi Kanda

We presented a 65-year-old man with the right occipital dural arteriovenous malformation (AVM) who first experienced photopsia in his left inferior quadrantanopic field and then developed formed hallucinations 8 days later. His visual hallucinations disappeared with saccadic eye movements. EEG showed no epileptic discharge. MRI revealed hyperintensity in the right medial occipital lobe on proton density image. 123I-IMP SPECT during the hallucinations revealed decrease of regional cerebral blood flow (r-CBF) not only in the right medial occipital lobe but also in the right lateral occipital and in the right medial temporal lobe. Both left inferior quadrantanopia and visual hallucinations disappeared following the treatment of the dural AVM by transarterial embolizations. Because the lesion on MRI improved after the treatment, we considered that the lesion was brain edema, not infarction. Additionally decreased r-CBF in the temporo-occipital lesion on SPECT improved after the treatment, we emphasized the role of the temporo-occipital lesion as the cause of visual hallucinations in the hemianopic field.

Occipital lobe

Hemianopsia

Arteriovenous malformation

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Citations (8)

Cerebral blood flow and metabolism in moyamoya disease (occlusion of the circle of Willis).

PubMed (1977)

Shin-Ichiro Ebihara Fumio Gotoh Tadashi Kanda Fumio Yamaguchi K Nakahara

Circle of Willis

Moyamoya Disease

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Citations (5)

Wallenberg's syndrome associated with pseudoxanthoma elasticum

Nosotchu (1980)

Yasutaka Shimizu Shotai Kobayashi Norihisa Furuhashi Tadashi Kanda Yoshiaki Tazaki

弾力線維性仮性黄色腫 (PXE) は皮膚症状, 眼症状, 全身血管系症状を3主徴とする遺伝性疾患である。我々はWallenberg症候群を呈したPXEの1例を経験した.症例は38歳の男性で昭和52年脳梗塞に罹患し, 昭和53年6月再び脳梗塞を起こし本院に入院した.入院時, Wallenberg症候群を呈し, 脳血管写にて両側前下小脳動脈, 右後下小脳動脈は造影されなかった.皮膚生検によりPXEと診断し, 脳幹梗塞はPXEに起因するものと推定した.本邦で最初にPXEの中枢神経症状合併例が報告された1957年以後の報告例230例を検討し, 中枢神経症状合併例を23例10%に認めた.若年者に多く, 中枢神経症状は極めて多彩で, 脳血管写では内頚動脈病変を認めるものが多かった.出血性病変を確認したものはなく, 梗塞性病変が多かった.原因不明の若年性脳血管障害をみた場合, 本症を愈頭におき, 皮膚症状, 眼症状に注意を払うべきであることを強調した.

Pseudoxanthoma Elasticum

10.3995/jstroke.2.262

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Citations (3)

Differences in the localization of hematomas by age and sex in spontaneous intracerebral hemorrhage.

Nosotchu (1993)

Nobuaki Tamai Tadashi Kanda Takahiro Iizuka Norio Kitai Takashi Hata

脳出血の血腫部位と加齢の関係について検討した.対象は脳出血により入院した644例 (平均年齢58.9±12.4歳) である.50歳代までは男性の患者数は女性の2倍以上多いが, その差は加齢と共に縮小し, 70歳以上では消失した.CT上の血腫部位別にみると被殻233例 (55.6±11.3歳), 視床167例 (61.3±10.9歳), 橋69例 (53.9±9.4歳), 小脳61例 (67.6±9.9歳), 皮質下78例 (60.6±16.7歳) であった.被殻出血と橋出血の平均年齢は, 視床出血及び小脳出血と比べ有意に低値を示した (いずれもp<0.001).被殻出血は特に若年の男性に多く39歳以下で60%を占め, 一方視床出血は40歳から増加した.橋出血が若年に多いのに対して, 小脳出血は70歳以上の高齢者に多く, この傾向は女性においてより明確であった.血腫部位別に基礎疾患としての高血圧の頻度をみると, 被殻 (91%), 橋 (91%), 視床 (84%), 小脳 (72%) の順であり, 被殻出血と橋出血は, 視床及び橋出血よりも高血圧の影響をより強く受けるものと推定された.

Spontaneous intracerebral hemorrhage

10.3995/jstroke.15.12

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Central and peripheral noradrenergic activities in patients with acute stroke.

Nosotchu (1992)

Tadashi Kanda Kunihiko Azuma Tetsuya Inafuku Takashi Hata Yoshiaki Tazaki

脳卒中急性期には, 中枢及び末梢のノルアドレナリン系の機能充進がみられるが, この充進が中枢と末梢において随伴して起こるのか, あるいは充進の程度に解離があるのかどうかについて検討した.対象は脳卒中発作により発症後72時間以内の急性期に入院した.脳出血42例, 脳血栓症35例, 心原性脳塞栓症 (以下脳塞栓症) 15例であり, 血漿ノルエピネフリン (NE) ならびに血漿と髄液3-methoxy-4-hydroxyphenyl-glycol (MHPG) を測定し, 病型別に検討した.発症後14～28日の亜急性期においてはいずれの病型においても血漿MHPGと血漿NEの間に高い相関が認められるにもかかわらず, 発症後72時間以内の急性期においては脳塞栓症を除き相関を認めず, 急性期には病型によりノルアドレナリン系の機能充進の程度に中枢と末梢で解離があるものと推測された.

Acute stroke

Stroke

10.3995/jstroke.14.294

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Increase in cerebrospinal fluid and plasma levels of 3-methoxy-4-hydroxyphenylglycol in acute stroke.

Stroke (1991)

Tadashi Kanda Kunihiko Azuma Fumihiko Sakai Yuichi Tazaki

3-Methoxy-4-hydroxyphenylglycol is known to be a principal metabolite of brain norepinephrine and to be released into the blood and cerebrospinal fluid in association with activation of the central noradrenergic system. We examined changes in plasma and cerebrospinal fluid levels of 3-methoxy-4-hydroxyphenylglycol during acute stroke to see if there might be a correlation between these and the patient's clinical state.We measured plasma levels of 3-methoxy-4-hydroxyphenylglycol in 32 control subjects and in 50 patients with brain hemorrhage and 57 patients with brain infarction who were admitted to the hospital within 72 hours after onset. In addition, we estimated 3-methoxy-4-hydroxyphenylglycol concentrations in the cerebrospinal fluid of 37 patients with brain infarction and eight control patients.Mean +/- SEM values for plasma 3-methoxy-4-hydroxyphenylglycol in the patients with brain hemorrhage and those with brain infarction were 7.3 +/- 0.5 and 6.6 +/- 0.5 ng/ml, respectively. Both values were significantly higher than that obtained in the 32 control subjects (4.6 +/- 0.3 ng/ml, p less than 0.01). Plasma levels of 3-methoxy-4-hydroxyphenylglycol correlated well with state of consciousness and prognosis. The mean +/- SEM level of 3-methoxy-4-hydroxyphenylglycol in the cerebrospinal fluid of the 37 patients with brain infarction (10.9 +/- 0.6 ng/ml) was also significantly higher than that in the eight control patients (7.9 +/- 0.6 ng/ml, p less than 0.01).The observed increase in plasma and cerebrospinal fluid levels of 3-methoxy-4-hydroxyphenylglycol implies that the activity of the central noradrenergic neurons may be enhanced at the onset of stroke, and these levels may be related to some extent to the clinical state and prognosis of stroke patients.

Stroke

Acute stroke

10.1161/01.str.22.12.1525

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Citations (4)

Gender differences in locomotion activity after stroke

Nosotchu (2007)

Michinari Fukuda Tadashi Kanda Naoto Kamide Takahiro Iizuka Tsugio Akutsu

Gender differences in locomotion activity after stroke were investigated in 2,344 consecutive patients with stroke who were admitted to our hospital between January 1986 and December 2000. They included 625 patients with brain hemorrhage and 1,719 patients with brain infarction. The brain infarction was classified according to criteria based on the clinical findings into thrombotic infarction (n=594), lacunar infarction (n=608), and cardiogenic embolism (n=441). The locomotion activity evaluated at the time of discharge was classified into the following 5 categories: (1) no significant disability; (2) slight disability to walk; (3) assisted with cane or braces; (4) using a wheelchair; (5) bedridden. After brain hemorrhage, women showed worse ability to walk than men at discharge (P<0.05). After brain infarction, female patients also showed worse locomotion activity than male patients. Multiple regression analysis revealed that locomotion activity after brain infarction was influenced by gender in addition to age, size of lesion and systolic blood pressure on admission. These findings suggest that gender differences in locomotion activity exist after stroke, particularly after brain infarction.

Stroke

Brain infarction

10.3995/jstroke.29.727

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[A case of cirsoid aneurysm of the uterus].

PubMed (1986)

Yasuhiro Okamoto H Nomura Tadashi Kanda S Okamura Osamu Sugimoto

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Citations (1)