Faculty Profiles - HARUMA Jun

Papers - HARUMA Jun

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Depolarization time and extracellular glutamate levels aggravate ultraearly brain injury after subarachnoid hemorrhage

Satoshi Murai, Tomohito Hishikawa, Yoshimasa Takeda, Yasuko Okura, Miki Fushimi, Hirokazu Kawase, Yu Takahashi, Naoya Kidani, Jun Haruma, Masafumi Hiramatsu, Kenji Sugiu, Hiroshi Morimatsu, Isao Date

Scientific Reports 12 ( 1 ) 2022.12

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Early brain injury after aneurysmal subarachnoid hemorrhage (SAH) worsens the neurological outcome. We hypothesize that a longer duration of depolarization and excessive release of glutamate aggravate neurological outcomes after SAH, and that brain hypothermia can accelerate repolarization and inhibit the excessive release of extracellular glutamate and subsequent neuronal damage. So, we investigated the influence of depolarization time and extracellular glutamate levels on the neurological outcome in the ultra-early phase of SAH using a rat injection model as Experiment 1 and then evaluated the efficacy of brain hypothermia targeting ultra-early brain injury as Experiment 2. Dynamic changes in membrane potentials, intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and extracellular glutamate levels were observed within 30 min after SAH. A prolonged duration of depolarization correlated with peak extracellular glutamate levels, and these two factors worsened the neuronal injury. Under brain hypothermia using pharyngeal cooling after SAH, cerebral perfusion pressure in the hypothermia group recovered earlier than that in the normothermia group. Extracellular glutamate levels in the hypothermia group were significantly lower than those in the normothermia group. The early induction of brain hypothermia could facilitate faster recovery of cerebral perfusion pressure, repolarization, and the inhibition of excessive glutamate release, which would prevent ultra-early brain injury following SAH.

DOI： 10.1038/s41598-022-14360-1

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Other Link： https://www.nature.com/articles/s41598-022-14360-1

Treatment outcome of coil embolization for distal anterior cerebral artery aneurysms: A single-center experience. International journal

Satoshi Murai, Yuki Ebisudani, Ryu Kimura, Hisanori Edaki, Yu Sato, Yoko Yamaoka, Kazuhiko Nishi, Jun Haruma, Masafumi Hiramatsu, Tomohito Hishikawa, Kenji Sugiu, Isao Date

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 31 ( 12 ) 106811 - 106811 2022.12

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

OBJECTIVE: In recent years, endovascular treatment has become the treatment of choice for distal anterior cerebral artery (DACA) aneurysms. In this study, we report the outcomes of coil embolization for DACA aneurysms. METHODS: Eighteen DACA aneurysms in 16 patients treated with endovascular treatment between January 2010 and December 2020 were included in this study. We retrospectively analyzed patient characteristics, data on aneurysms, the reason for the selection of endovascular treatment, treatment technique, and treatment outcomes. RESULTS: There were 18 procedures in 16 patients. The average age was 65.7 years and 56% of patients were male. The average diameter of the dome was 5.5 mm, and the location of aneurysm was A3 in 83% and A4 in 17%. We mainly selected endovascular treatment for patients with a past history of craniotomy and head trauma, or with systemic comorbidities. The technical success rate was 94%, and adequate obliteration immediately after treatment was achieved in 72%. There were no symptomatic periprocedural complications. The retreatment rate was 11.1%. CONCLUSION: Coil embolization for DACA aneurysms yielded good treatment outcomes. Endovascular treatment for DACA aneurysms will become more common with advances in endovascular devices and the establishment of stable perioperative antiplatelet therapy.

DOI： 10.1016/j.jstrokecerebrovasdis.2022.106811

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くも膜下出血の病態ラットSAH single injection modelにおける脳波抑制時間がearly brain injuryに及ぼす影響

高杉祐二, 菱川朋人, 清水智久, 村井智, 春間純, 平松匡文, 徳永浩司, 杉生憲志, 武田吉正, 森松博史, 伊達勲

脳循環代謝 34 ( 1 ) 84 - 84 2022.10

脳血管内治療と感染症 Invited

平松匡文、春間純、菱川朋人、杉生憲志、伊達勲

脳神経外科 50 ( 5 ) 969 - 976 2022.9

A case of delayed foreshortening and disconnection of pipeline embolization device detected by chronological cone-beam computed tomography fusion image. Reviewed International journal

Yuki Ebisudani, Kenji Sugiu, Jun Haruma, Satoshi Murai, Tomohito Hishikawa, Masafumi Hiramatsu, Yu Takahashi, Kazuhiko Nishi, Yoko Yamaoka, Yu Sato, Ryu Kimura, Hisanori Edaki, Isao Date

Acta neurochirurgica 164 ( 8 ) 2203 - 2206 2022.8

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

OBJECTIVE: The morphological changes of the pipeline embolization device (PED; Medtronic, Minneapolis, MN, USA), such as delayed migration or foreshortening, can relate to the incomplete occlusion of aneurysms. CASE PRESENTATION: A 30-year-old man with a giant cavernous carotid artery aneurysm was treated with two PEDs using the overlapping technique. Six months after treatment, follow-up angiography showed morphological changes of the PEDs and residual flow into the aneurysm. Chronological cone-beam computed tomography fusion imaging clearly revealed the dynamic foreshortening of the first PED and the disconnection of both PEDs, so we decided to implant an additional PED. CONCLUSION: This case illustrates that a three-dimensional understanding can be useful for assessing the cause of treatment failure or recurrence.

DOI： 10.1007/s00701-022-05245-3

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Hemifacial spasm due to vertebral artery dissecting aneurysm treated with stent-in-stent placement; Pre- and post-treatment evaluation by 3D multifusion imaging using silent MR angiography. Reviewed International journal

Toru Satoh, Yu Sato, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Isao Date

Surgical neurology international 13 232 - 232 2022.6

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

BACKGROUND: Hemifacial spasm (HFS) due to vertebral artery (VA) dissecting aneurysm (VADA) is rare and endovascular treatment has been performed in selected cases. CASE DESCRIPTION: We encountered a case of HFS caused by VADA that was managed with endovascular stent placement and additional stent-in-stent placement. Therapeutic strategies and benefits based on pre- and post-treatment evaluation by 3D multifusion imaging using silent MRA were discussed. CONCLUSION: This is the first case report of stent-in-stent placement in successful treatment of HFS caused by VADA, in which relief of neurovascular contact was demonstrated by multifusion imaging.

DOI： 10.25259/SNI_253_2022

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Incidence and clinical characteristics of spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan. International journal

Masafumi Hiramatsu, Ryota Ishibashi, Etsuji Suzuki, Yuko Miyazaki, Satoshi Murai, Hiroki Takai, Yuji Takasugi, Yoko Yamaoka, Kazuhiko Nishi, Yu Takahashi, Jun Haruma, Tomohito Hishikawa, Takao Yasuhara, Masaki Chin, Shunji Matsubara, Masaaki Uno, Koji Tokunaga, Kenji Sugiu, Isao Date

Journal of neurosurgery. Spine 36 ( 4 ) 670 - 677 2022.4

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

OBJECTIVE: There have been no accurate surveillance data regarding the incidence rate of spinal arteriovenous shunts (SAVSs). Here, the authors investigate the epidemiology and clinical characteristics of SAVSs. METHODS: The authors conducted multicenter hospital-based surveillance as an inventory survey at 8 core hospitals in Okayama Prefecture between April 1, 2009, and March 31, 2019. Consecutive patients who lived in Okayama and were diagnosed with SAVSs on angiographic studies were enrolled. The clinical characteristics and the incidence rates of each form of SAVS and the differences between SAVSs at different spinal levels were analyzed. RESULTS: The authors identified a total of 45 patients with SAVSs, including 2 cases of spinal arteriovenous malformation, 5 cases of perimedullary arteriovenous fistula (AVF), 31 cases of spinal dural AVF (SDAVF), and 7 cases of spinal epidural AVF (SEAVF). The crude incidence rate was 0.234 per 100,000 person-years for all SAVSs including those at the craniocervical junction (CCJ) level. The incidence rate of SDAVF and SEAVF combined increased with advancing age in men only. In a comparative analysis between upper and lower spinal SDAVF/SEAVF, hemorrhage occurred in 7/14 cases (50%) at the CCJ/cervical level and in 0/24 cases (0%) at the thoracolumbar level (p = 0.0003). Venous congestion appeared in 1/14 cases (7%) at the CCJ/cervical level and in 23/24 cases (96%) at the thoracolumbar level (p < 0.0001). CONCLUSIONS: The authors reported detailed incidence rates of SAVSs in Japan. There were some differences in clinical characteristics of SAVSs in the upper spinal levels and those in the lower spinal levels.

DOI： 10.3171/2021.7.SPINE21233

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A New Method of Intracranial Aneurysm Modeling for Stereolithography Apparatus 3D Printer: The "Wall-Carving Technique" Using Digital Imaging and Communications in Medicine Data. International journal

Jun Haruma, Kenji Sugiu, Minori Hoshika, Masafumi Hiramatsu, Tomohito Hishikawa, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Yu Sato, Yuki Ebisudani, Hisanori Edaki, Ryu Kimura, Isao Date

World neurosurgery 159 e113-e119 2022.3

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

PURPOSE: To assess the ability of the "wall-carving (WC) image technique," which uses vascular images from three-dimensional digital subtraction angiograms (3DDSAs). Also, to verify the accuracy of the resulting 3D-printed hollow models of intracranial aneurysms. METHODS: The 3DDSA data from nine aneurysms were processed to obtain volumetric models suitable for the stereolithography apparatus. The resulting models were filled with iodinated contrast media. 3D rotational angiography of the models was carried out, and the aneurysm geometry was compared with the original patient data. The accuracy of the 3D-printed hollow models' sizes and shapes was evaluated using the nonparametric Wilcoxon signed-rank test and the Dice coefficient index. RESULTS: The aneurysm volumes ranged from 34.1 to 4609.8 mm3 (maximum diameters 5.1-30.1 mm), and no statistically significant differences were noted between the patient data and the 3D-printed models (p = 0.4). Shape analysis of the aneurysms and related arteries indicated a high level of accuracy (Dice coefficient index value, 88.7-97.3%; mean [± standard deviation (SD)], 93.6% ± 2.5%). The vessel wall thickness of the 3D-printed hollow models was 0.4 mm for the parent and 0.2 mm for small branches and aneurysms, almost the same as the patient data. CONCLUSION: The WC technique, which involves volume rendering of 3DDSAs, can provide a detailed description of the contrast enhancement of intracranial vessels and aneurysms at arbitrary depths. These models can provide precise anatomic information and be used for simulations of endovascular treatment.

DOI： 10.1016/j.wneu.2021.12.018

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高脂血症ラットにおけるくも膜下出血後脳血管攣縮の検討

西和彦, 菱川朋人, 高橋悠, 劉克約, 胡谷侑貴, 佐藤悠, 山岡陽子, 村井智, 春間純, 平松匡文, 杉生憲志, 西堀正洋, 伊達勲

脳血管攣縮 37 79 - 79 2022.2

Cone-beam CTを用いたlateral spinal arteryの正常解剖と頭蓋頸椎移行部動静脈瘻の血管解剖の解析

平松匡文, 杉生憲志, 安原隆雄, 菱川朋人, 春間純, 村井智, 西和彦, 山岡陽子, 佐藤悠, 胡谷侑貴, 伊達勲

脳血管内治療 6 ( Suppl. ) S40 - S40 2021.11

当院におけるCASのprotection deviceによる治療成績の検討

枝木久典, 春間純, 杉生憲志, 菱川朋人, 平松匡文, 村井智, 西和彦, 山岡陽子, 佐藤悠, 胡谷侑貴, 木村颯, 伊達勲

脳血管内治療 6 ( Suppl. ) S124 - S124 2021.11

脳脊髄動静脈シャント疾患の罹患率に対して地域性が与える影響

村井智, 高杉祐二, 平松匡文, 鈴木越治, 石橋良太, 宮崎裕子, 春間純, 菱川朋人, 安原隆雄, 杉生憲志, 伊達勲

脳血管内治療 6 ( Suppl. ) S308 - S308 2021.11

視神経管部硬膜動静脈瘻の2例報告

佐藤悠, 平松匡文, 杉生憲志, 中嶋裕之, 菱川朋人, 春間純, 村井智, 西和彦, 山岡陽子, 胡谷侑貴, 枝木久典, 伊達勲

脳血管内治療 6 ( Suppl. ) S305 - S305 2021.11

経時的CBCT fusion画像を用いたPipeline embolization device留置術後の脳動脈瘤閉塞率の検討

胡谷侑貴, 春間純, 杉生憲志, 菱川則人, 平松匡文, 村井智, 西和彦, 山岡陽子, 佐藤悠, 木村颯, 枝木久典, 伊達勲

脳血管内治療 6 ( Suppl. ) S274 - S274 2021.11

当院での高精度テーラーメード脳動脈瘤モデルを利用した脳血管内治療トレーニング

春間純, 杉生憲志, 木村颯, 胡谷侑貴, 佐藤悠, 枝木久典, 山岡陽子, 西和彦, 村井智, 平松匡文, 菱川朋人, 伊藤勲

脳血管内治療 6 ( Suppl. ) S36 - S36 2021.11

国内研修施設を対象とした脳血管治療のシミュレーショントレーニングに関するアンケート調査の報告

胡谷侑貴, 杉生憲志, 菱川朋人, 平松匡文, 春間純, 村井智, 西和彦, 山岡陽子, 佐藤悠, 木村颯, 枝木久典, 伊達勲

脳血管内治療 6 ( Suppl. ) S34 - S34 2021.11

高脂血症ラットにおけるくも膜下出血後脳血管攣縮

西和彦, 菱川朋人, 高橋悠, 劉克約, 枝木久典, 木村颯, 胡谷侑貴, 佐藤悠, 山岡陽子, 村井智, 春間純, 平松匡文, 杉生憲志, 西堀正洋, 伊達勲

脳循環代謝 33 ( 1 ) 87 - 87 2021.11

動脈瘤破裂による内頸動脈海綿静脈洞瘻に対してpterygoid plexus経由で経静脈的塞栓術を行った一例

松田勇輝, 平松匡文, 杉生憲志, 木村颯, 山岡陽子, 胡谷侑貴, 佐藤悠, 西和彦, 村井智, 春間純, 菱川朋人, 伊達勲

脳血管内治療 6 ( Suppl. ) S250 - S250 2021.11

中型動脈瘤にはflow diverterよりもstent-assisted coilingが薦められる

春間純, 杉生憲志, 菱川朋人, 平松匡文, 村井智, 西和彦, 山岡陽子, 佐藤悠, 胡谷侑貴, 木村颯, 枝木久典, 伊達勲

脳血管内治療 6 ( Suppl. ) S173 - S173 2021.11

光造形3Dプリンターによる脳動脈瘤モデル作成法の確立とその応用

木村颯, 春間純, 杉生憲志, 菱川朋人, 平松匡文, 村井智, 西和彦, 佐藤悠, 山岡陽子, 胡谷侑貴, 枝木久典, 伊達勲

脳血管内治療 6 ( Suppl. ) S172 - S172 2021.11

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