研究者詳細 - 春間　純

論文 - 春間　純

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硬膜動静脈瘻の経静脈的塞栓術に対する内頸静脈直接穿刺の有用性

木村颯, 春間純, 菱川朋人, 胡谷侑貴, 佐藤悠, 西和彦, 村井智, 高橋悠, 平松匡文, 杉生憲志, 伊達勲

脳血管内治療 5 ( Suppl. ) 87 - 87 2020年11月

Cone-beam CT fusion画像を用いたflow diverter留置後の経時的変化の検討

胡谷侑貴, 春間純, 杉生憲志, 菱川朋人, 平松匡文, 高橋悠, 村井智, 西和彦, 山岡陽子, 佐藤悠

脳血管内治療 5 ( Suppl. ) 51 - 51 2020年11月

Left temporal hemorrhage caused by cerebral venous reflux of a brachio-brachial hemodialysis fistula. 国際誌

Jun Haruma, Simon Escalard, Stanislas Smajda, Michel Piotin

Neuroradiology 62 ( 10 ) 1341 - 1344 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Central vein disease (CVD) is a well-known complication of central venous cannulations, indwelling dialysis catheters, and arteriovenous grafts. Brachiocephalic vein (BCV) stenosis or thrombotic occlusion can occur in dialysis patients, and the presence of an ipsilateral arteriovenous fistula can cause cerebral venous hypertension due to retrograde flow in the ipsilateral jugular vein. A 53-year-old man receiving hemodialysis (left brachiocephalic hemodialysis fistula) presented with impaired consciousness and seizures related to status epilepticus due to left temporal multifocal hemorrhages. Brain computed tomography and angiogram showed left cortical vein congestion without intracranial arteriovenous shunt. Complementary left brachial angiogram showed a left BCV stenosis and jugular and cerebral high-flow venous reflux with cortical venous reflux from the hemodialysis fistula. The left arm shunt resulted in severe cerebral venous hypertension due to ipsilateral stenosis of the BCV. BCV angioplasty immediately resolved the cerebral reflux. Patients with hemodialysis fistulas are at a higher risk of developing these intracerebral hemorrhage complications.

DOI： 10.1007/s00234-020-02457-1

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Detection of the common origin of the radiculomedullary artery with the feeder of spinal dural arteriovenous fistula using slab maximum intensity projection image. 国際誌

Masafumi Hiramatsu, Kenji Sugiu, Takao Yasuhara, Tomohito Hishikawa, Jun Haruma, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

Neuroradiology 62 ( 10 ) 1285 - 1292 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Endovascular therapy to the spinal dural arteriovenous fistula (SDAVF) with a common origin of the radiculomedullary artery and the feeder of the shunt has the risk of spinal cord infarction. This study aimed to retrospectively assess the detection rate of normal spinal arteries from the feeder of SDAVF. METHODS: We retrospectively collected the angiographic and clinical data of SDAVFs. This study included 19 patients with 20 SDAVF lesions admitted to our department between January 2007 and December 2018. We assessed the detection rate of normal radiculomedullary artery branched from the feeder of SDAVF between the period using the image intensifier (II) and flat panel detector (FPD) and evaluated the treatment results. RESULTS: The detection rates of the radiculomedullary artery branched from the feeder of SDAVF were 10% (1/10 lesions) during the II period and 30% (3/10 lesions) during the FPD period. During the FPD period, all normal radiculomedullary arteries branched from the feeder were only detected on slab maximum intensity projection (MIP) images of rotational angiography, and we could not detect them in 2D or 3D digital subtraction angiography. All lesions that had a common origin of a normal radiculomedullary artery and the feeder were completely obliterated without complications. There was no recurrence during the follow-up period. CONCLUSIONS: The flat panel detector and slab MIP images seem to show the common origin of the normal radiculomedullary arteries from the feeder more accurately. With detailed analyses, SDAVF can be safety treated.

DOI： 10.1007/s00234-020-02466-0

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【良性脳腫瘍】頭蓋内腫瘍塞栓術の役割と可能性招待

杉生憲志, 菱川朋人, 平松匡文, 春間純, 西廣真吾, 木谷尚哉, 高橋悠, 村井智, 西和彦, 山岡陽子, 胡谷侑貴, 佐藤悠, 藤井謙太郎, 伊達勲

脳神経外科ジャーナル 29 ( 8 ) 543 - 552 2020年8月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：(一社)日本脳神経外科コングレス

脳腫瘍塞栓術は多くの場合開頭術前の補助療法であり安全性が重要である。当科での過去12年間169塞栓術で、恒久的合併症は1例(0.6%)であった。外頸動脈を主栄養血管とする髄外腫瘍(髄膜腫)の塞栓術は安全だが、血管芽腫などの髄内腫瘍では合併症の危険性は高くなる。合併症として、術後腫瘍内出血、塞栓物質の神経栄養血管への迷入による脳神経麻痺や視障害、および脳梗塞などがあるが、十分な血管機能解剖の知識と技術をもってすればその多くは回避できる。術前塞栓術の有用性は知られているが、摘出術への貢献を科学的に証明することは困難である。当科では一貫して開頭術者が術前塞栓を依頼しており、有効性の表れと感じている。(著者抄録)

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破裂椎骨動脈解離性動脈瘤に対するステント併用コイル塞栓術

西和彦, 杉生憲志, 菱川朋人, 平松匡文, 春間純, 高橋悠, 村井智, 山岡陽子, 伊達勲

Neurosurgical Emergency 24 ( 3 ) 365 - 365 2020年2月

Metal artifact reduction algorithm for image quality improvement of cone-beam CT images of medium or large cerebral aneurysms treated with stent-assisted coil embolization. 国際誌

Satoshi Murai, Masafumi Hiramatsu, Yuji Takasugi, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Yukei Shinji, Jun Haruma, Tomohito Hishikawa, Kenji Sugiu, Isao Date

Neuroradiology 62 ( 1 ) 89 - 96 2020年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: The aim of the present study was to assess image quality improvement using a metal artifact reduction (MAR) algorithm in cases of medium or large cerebral aneurysms treated with stent-assisted coil embolization (SAC), and to analyze factors associated with the usefulness of the MAR algorithm. METHODS: We retrospectively evaluated the cone-beam computed tomography (CBCT) data sets of 18 patients with cerebral aneurysms treated with SAC. For subjective analysis, images of all cases with and without MAR processing were evaluated by five neurosurgeons based on four criteria using a five-point scale. For objective analysis, the CT values of all cases with and without MAR processing were calculated. In addition, we assessed factors associated with the usefulness of the MAR by analyzing the nine cases in which the median score for criterion 1 improved by more than two points. RESULTS: MAR processing improved the median scores for all four criteria in 17/18 cases (94.4%). Mean CT values of the region of interest at the site influenced by metal artifacts were significantly reduced after MAR processing. The maximum diameter of the coil mass (< 17 mm; odds ratio [OR], 4.0; 95% confidence interval [CI], 1.2-13.9; p = 0.02) and vessel length covered by metal artifacts (< 24 mm; OR, 2.3; 95% CI, 1.1-4.7; p = 0.03) was significantly associated with the usefulness of the MAR. CONCLUSIONS: This study suggests the feasibility of a MAR algorithm to improve the image quality of CBCT images in patients who have undergone SAC for medium or large aneurysms.

DOI： 10.1007/s00234-019-02297-8

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Stent-assisted Coil Embolization to Treat Extracranial Carotid Artery Aneurysm 13 Years after Endarterectomy: A Case Report.

Jun Haruma, Nobuyuki Hirotsune, Tetsuo Oka, Tadashi Arisawa

NMC case report journal 7 ( 1 ) 23 - 27 2020年1月

記述言語：英語

Development of extracranial carotid artery aneurysm (ECCA) after carotid endarterectomy (CEA) is a rare complication, occurring in connection with <1% of all CEAs. The main causes are infection, suture failure, and degeneration of arterial wall or patch. The traditional treatment has been operative repair, which can present a significant technical challenge owing to reoperative neck inflammation and potential cranial nerve injuries. Here, we report a case of successful stent-assisted coil embolization for right noninfectious ECCA. A 63-year-old female was admitted to our hospital for a 3-cm pulsating mass in her right midneck. Doppler examination and digital subtraction angiography revealed a large (15 mm) ECCA at the right common carotid artery (CCA). Thirteen years earlier, eversion CEA with patch angioplasty and abbreviation of the internal carotid artery (ICA) had been performed for a symptomatic 80% diameter stenosis with transient ischemic attack at another hospital. As the patient refused blood transfusion for religious reasons, we treated her with stent-assisted coil embolization, which achieved nearly complete obliteration of the aneurysm while preserving the parent artery patency. Three months after initial treatment, ultrasound revealed complete occlusion of the ECCA, but also showed stent shortening. Hence, we performed an additional stent placement so as to overlap the previous stent by 2.5 cm. Six months after initial treatment, carotid duplex ultrasound confirmed a good outcome. This procedure is an excellent choice for high-risk patients, and a larger case series is needed to establish this technique as the treatment of choice for ECCAs.

DOI： 10.2176/nmccrj.cr.2019-0030

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Dural Arteriovenous Fistulas in the Parasellar Region Other Than the Cavernous Sinus 招待査読

Masafumi Hiramatsu, Kenji Sugiu, Jun Haruma, Tomohito Hishikawa, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

Journal of Neuroendovascular Therapy 14 ( 12 ) 593 - 604 2020年

Important role and future perspective of embolization for intra‒cranial tumors

Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Yuki Ebisudani, Yu Sato, Kentarou Fujii, Isao Date

Japanese Journal of Neurosurgery 29 ( 8 ) 543 - 552 2020年

掲載種別：研究論文（学術雑誌）

Purpose：Embolization for intracranial tumors currently plays a supporting role to open surgery. The reasons for embo-lization include：1）tumor necrosis resulting in a safer operation and more aggressive surgery, 2）reduction in intraoperative bleeding and avoidance of blood transfusion, and 3）decrease in operative time. Functional vascular anatomy and endovascular technique are the most important issues for safe embolization. Herein we report our standard techniques for tumor emboliza-tion and compare our results with those of the Japanese Registry of NeuroEndovascular Therapy（JR‒NET）. Methods：Our standard procedure is as follows：1）embolization is performed several days before open surgery, 2）in cases with strong peritumoral edema, steroid administration or embolization may be performed immediately before surgery, 3）patients undergo the procedure under local anesthesia, 4）insertion of the microcatheter is as close as possible to the tumor, 5）particulate emboli are the first line material, 6）embolization is occasionally performed with N‒butyl cyanoacrylate （NBCA）glue, and 7）if possible, additional proximal feeder occlusion with coils is performed. Results：During the past 12 years, 169 intra‒cranial tumor embolization procedures were performed in our department. Meningioma was the main target of embolization（154 of 169 patients, 91.1%）. Seven procedure‒related complications were observed, with one permanent complication（0.6%）of hearing loss after anterior inferior cerebellar artery embolization for hemangioblastoma with NBCA. Transient complications included three middle meningeal arterio‒venous fistulas, two cranial nerve paresis, and a pseudoaneurysm of the femoral artery（puncture site）. We conducted the JR‒NET 2（2007‒2009）and JR‒NET 3（2010‒2014）in Japan. Complications of tumor embolization occurred in 57 of 1,544 JR‒NET 3 patients（3.69%）, although the complication rate for JR‒NET 2 was only 1.48%（15 of 1,012 patients）. Tumors other than meningioma were a significant risk factor for the occurrence of JR‒NET 2 complications. Further, embolization of vessels other than the external carotid artery（ECA）and use of liquid embolic material were significantly associated with the development of JR‒NET 3 complications. We suggest that more aggressive embolization targeted to vessels other than the ECA and increased applica-tion of liquid embolic materials might worsen the risk of complications. Conclusions：Although embolization was safe for extra‒axial tumors such as meningiomas fed by the ECA, embolization of vessels other than the ECA as occurs in hemangioblastomas was a significant risk factor for complications. Use of liquid embolic material increased the risk for complications. Endovascular neurosurgeons should fully discuss the indications and strategies for preoperative embolization with tumor neurosurgeons to perform safe and effective procedures.

DOI： 10.7887/jcns.29.543

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Ex vivo release of pipeline embolization device polytetrafluoroethylene sleeves: a technical note 査読国際誌

Takahashi Y, Sugiu K, Haruma J, Murai S, Kidani N, Nishihiro S, Hiramatsu M, Hishikawa T, Date I

Journal of Neuroendovascular Therapy 12 ( 9 ) 463 - 468 2018年9月

NADH fluorescence imaging and the histological impact of cortical spreading depolarization during the acute phase of subarachnoid hemorrhage in rats. 国際誌

Tomohisa Shimizu, Tomohito Hishikawa, Shingo Nishihiro, Yukei Shinji, Yuji Takasugi, Jun Haruma, Masafumi Hiramatsu, Hirokazu Kawase, Sachiko Sato, Ryoichi Mizoue, Yoshimasa Takeda, Kenji Sugiu, Hiroshi Morimatsu, Isao Date

Journal of neurosurgery 128 ( 1 ) 137 - 143 2018年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE Although cortical spreading depolarization (CSD) has been observed during the early phase of subarachnoid hemorrhage (SAH) in clinical settings, the pathogenicity of CSD is unclear. The aim of this study is to elucidate the effects of loss of membrane potential on neuronal damage during the acute phase of SAH. METHODS Twenty-four rats were subjected to SAH by the perforation method. The propagation of depolarization in the brain cortex was examined by using electrodes to monitor 2 direct-current (DC) potentials and obtaining NADH (reduced nicotinamide adenine dinucleotide) fluorescence images while exposing the parietal-temporal cortex to ultraviolet light. Cerebral blood flow (CBF) was monitored in the vicinity of the lateral electrode. Twenty-four hours after onset of SAH, histological damage was evaluated at the DC potential recording sites. RESULTS Changes in DC potentials (n = 48 in total) were sorted into 3 types according to the appearance of ischemic depolarization in the entire hemisphere following induction of SAH. In Type 1 changes (n = 21), ischemic depolarization was not observed during a 1-hour observation period. In Type 2 changes (n = 13), the DC potential demonstrated ischemic depolarization on initiation of SAH and recovered 80% from the maximal DC deflection during a 1-hour observation period (33.3 ± 15.8 minutes). In Type 3 changes (n = 14), the DC potential displayed ischemic depolarization and did not recover during a 1-hour observation period. Histological evaluations at DC potential recording sites showed intact tissue at all sites in the Type 1 group, whereas in the Type 2 and Type 3 groups neuronal damage of varying severity was observed depending on the duration of ischemic depolarization. The duration of depolarization that causes injury to 50% of neurons (P50) was estimated to be 22.4 minutes (95% confidence intervals 17.0-30.3 minutes). CSD was observed in 3 rats at 6 sites in the Type 1 group 5.1 ± 2.2 minutes after initiation of SAH. On NADH fluorescence images CSD was initially observed in the anterior cortex; it propagated through the entire hemisphere in the direction of the occipital cortex at a rate of 3 mm/minute, with repolarization in 2.3 ± 1.2 minutes. DC potential recording sites that had undergone CSD were found to have intact tissue 24 hours later. Compared with depolarization that caused 50% neuronal damage, the duration of CSD was too short to cause histological damage. CONCLUSIONS CSD was successfully visualized using NADH fluorescence. It propagated from the anterior to the posterior cortex along with an increase in CBF. The duration of depolarization in CSD (2.3 ± 1.2 minutes) was far shorter than that causing 50% neuronal damage (22.4 minutes) and was not associated with histological damage in the current experimental setting.

DOI： 10.3171/2016.9.JNS161385

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Flow Diverter留置にて根治が得られた外傷性内頸動脈瘤の1例

春間純, 杉生憲志, 岡哲生, 有澤正, 高橋悠, 木谷尚哉, 西廣真吾, 平松匡文, 菱川朋人, 伊達勲

脳血管内治療 2 ( Suppl. ) S252 - S252 2017年11月

外傷性脳動脈瘤に対してステント併用コイル塞栓術を施行した一例

西廣真吾, 杉生憲志, 菱川朋人, 安原隆雄, 春間純, 久壽米木亮, 平松匡文, 木谷尚哉, 高橋悠, 村井智, 伊達勲

脳血管内治療 2 ( Suppl. ) S251 - S251 2017年11月

Combined gene therapy with vascular endothelial growth factor plus apelin in a chronic cerebral hypoperfusion model in rats. 国際誌

Masafumi Hiramatsu, Tomohito Hishikawa, Koji Tokunaga, Hiroyasu Kidoya, Shingo Nishihiro, Jun Haruma, Tomohisa Shimizu, Yuji Takasugi, Yukei Shinji, Kenji Sugiu, Nobuyuki Takakura, Isao Date

Journal of neurosurgery 127 ( 3 ) 679 - 686 2017年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE The aim of this study was to evaluate whether combined gene therapy with vascular endothelial growth factor (VEGF) plus apelin during indirect vasoreconstructive surgery enhances brain angiogenesis in a chronic cerebral hypoperfusion model in rats. METHODS A chronic cerebral hypoperfusion model induced by the permanent ligation of bilateral common carotid arteries (CCAs; a procedure herein referred to as "CCA occlusion" [CCAO]) in rats was employed in this study. Seven days after the CCAO procedure, the authors performed encephalo-myo-synangiosis (EMS) and injected plasmid(s) into each rat's temporal muscle. Rats were divided into 4 groups based on which plasmid was received (i.e., LacZ group, VEGF group, apelin group, and VEGF+apelin group). Protein levels in the cortex and attached muscle were assessed with enzyme-linked immunosorbent assay (ELISA) on Day 7 after EMS, while immunofluorescent analysis of cortical vessels was performed on Day 14 after EMS. RESULTS The total number of blood vessels in the cortex on Day 14 after EMS was significantly larger in the VEGF group and the VEGF+apelin group than in the LacZ group (p < 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p < 0.05, respectively). Apelin protein on Day 7 after EMS was not detected in the cortex for any of the groups. In the attached muscle, apelin protein was detected only in the apelin group and the VEGF+apelin group. Immunofluorescent analysis revealed that apelin and its receptor, APJ, were expressed on endothelial cells (ECs) 7 days after the CCAO. CONCLUSIONS Combined gene therapy (VEGF plus apelin) during EMS in a chronic cerebral hypoperfusion model can enhance angiogenesis in rats. This treatment has the potential to be a feasible option in a clinical setting for patients with moyamoya disease.

DOI： 10.3171/2016.8.JNS16366

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De novo vertebral artery dissecting aneurysm after internal trapping of the contralateral vertebral artery. 国際誌

Naoya Kidani, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Shingo Nishihiro, Yu Takahashi, Isao Date

Acta neurochirurgica 159 ( 7 ) 1329 - 1333 2017年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

We present the case of a de novo vertebral artery dissecting aneurysm (VADA) after endovascular trapping of a ruptured VADA on the contralateral side. The first ruptured VADA involved the posterior inferior cerebellar artery, which was successfully treated by endovascular internal trapping using a stent. A follow-up study at 3 months revealed a de novo VADA on the contralateral side. The second VADA was successfully embolized using coils while normal arterial flow in the vertebral artery was preserved using a stent. Increased hemodynamic stress may cause the development of a de novo VADA on the contralateral side.

DOI： 10.1007/s00701-017-3204-2

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[Preoperative Embolization for Solid Cerebellar Hemangioblastoma on the Day of Surgery:Two Case Reports].

Ken Kuwahara, Tomotsugu Ichikawa, Jun Haruma, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Isao Date

No shinkei geka. Neurological surgery 45 ( 7 ) 615 - 622 2017年7月

記述言語：日本語掲載種別：研究論文（学術雑誌）

Surgical resection of solid cerebellar hemangioblastomas can be challenging because of the profuse blood supply and tight space. We report two cases of solid cerebellar hemangioblastomas treated via surgical resection with the aid of preoperative endovascular embolization on the day of surgery. Case 1: A 36-year-old woman presented with a two-month history of headache and vomiting. Magnetic resonance imaging(MRI)revealed a right cerebellar solid mass, mild hydrocephalus, and apparent peritumoral edema. Angiogram showed a highly vascularized mass, three feeding arteries from the superior cerebellar artery(SCA), and a dilated vein draining into the confluence. We performed preoperative embolization of the three feeders with 15% n-butyl-2-cyanoacrylate(NBCA). Final angiogram showed an absence of tumor staining. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. Case 2: A 36-year-old man presented with a four-month history of headache and numbness in the left upper extremity. MRI revealed a right cerebellar solid mass with peritumoral edema. Angiogram showed a highly vascularized mass with two feeding arteries from the right SCA, one from the left posterior inferior cerebellar artery(PICA), and a dilated vein draining into the confluence. Preoperative embolization was performed with 15% NBCA, and complete devascularization was achieved. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. In conclusion, preoperative embolization with NBCA on the day of surgery is a safe and effective adjunctive treatment for solid cerebellar hemangioblastoma.

DOI： 10.11477/mf.1436203560

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血管内治療シミュレーターを用いたシミュレーション教育

新治有径, 杉生憲志, 村井智, 春間純, 菱川朋人, 平松匡文, 高橋悠, 木谷尚哉, 西廣真吾, 伊野英男, 伊達勲

脳神経外科速報 27 ( 7 ) 751 - 754 2017年7月

記述言語：日本語出版者・発行元：(株)メディカ出版

当科では医学生やメディカルスタッフに対して、血管内治療シミュレーターVascular Intervention Simulator Trainer(VIST)を用いたシミュレーション教育を行っており、その有効性について検討した。実習は3名1組となり、VISTを用いてデバイスの選択、血管造影、カテーテル操作、コイル塞栓術の手技を行った。実習終了後に行った筆記試験やアンケートでは血管内治療への理解度向上の効果が得られた。VISTを用いた血管内治療シミュレーション教育は血管内治療や血管解剖の理解度向上に効果があり、医学生に対して脳神経外科や脳血管内治療への興味喚起につながり、メディカルスタッフに対してより良いチーム医療の形成に役立つと考えられた。(著者抄録)

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3DDSA-MRI fusion画像を用いた脳血管障害に対する開頭手術術前シミュレーション

平松匡文, 杉生憲志, 菱川朋人, 春間純, 高杉祐二, 西廣真吾, 新治有径, 伊達勲

脳卒中の外科 45 ( 4 ) 270 - 275 2017年7月

記述言語：日本語出版者・発行元：(一社)日本脳卒中の外科学会

2013年9月〜2015年10月に脳血管障害に対する開頭手術術前に3DDSA-MRI fusion画像を作成した3例を対象に、画像作成法を紹介し、脳血管障害に対する手術の術前シミュレーションとして有用か検討した。fusion画像は10〜15分程度で、全例問題なく作成できた。全例、fusion画像の有用性が認められ、手術戦略や手術アプローチに影響を与えていた。血管位置の最大誤差は平均2.5±0.1mmであったが、実際の術野での脳表上の血管構造物の同定には全例支障がなかった。頭蓋内血管病変に対する3DDSA-MRI fusionを活用することで、脳血管障害に対する術前シミュレーションとして有効と思われた。

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手術当日術前塞栓術が有用であった充実性小脳血管芽腫の2例

桑原研, 市川智継, 春間純, 菱川朋人, 平松匡文, 杉生憲志, 伊達勲

Neurological Surgery 45 ( 7 ) 615 - 622 2017年7月

記述言語：日本語出版者・発行元：(株)医学書院

症例1は36歳女性で、2ヵ月前から頭痛と嘔吐があり、右小脳半球腫瘍を指摘された。MRIでは右小脳半球にT1強調画像で等信号、FLAIR画像で高信号、拡散強調画像で低信号を呈し、ガドリニウム造影ではほぼ均一に造影される最大径30mmの境界明瞭な腫瘍を認めた。嚢胞を伴わない充実性腫瘍で、また強い浮腫を伴っていることから、手術リスク軽減のために術前塞栓術を施行し、その後開頭腫瘍摘出術の方針とした。術後も神経学的脱落所見なく経過し、MRIで腫瘍の全摘出を確認し、術後8日に独歩退院した。症例2は36歳男性で、4ヵ月前より頭痛があり、しばらくして左上肢の異常感覚を自覚した。MRIで右小脳半球にT1強調画像でやや高信号、T2強調画像でやや高信号、拡散強調画像では低信号を呈する最大径35mmの境界明瞭な腫瘍を認め、ガドリニウム造影によりほぼ均一に造影された。嚢胞を伴わない充実性腫瘍で、また強い浮腫を伴っていることから、摘出術リスク軽減のために術前塞栓術を施行し、同日に開頭腫瘍摘出術の方針とした。術後も神経学的脱落所見なく経過した。MRIでは腫瘍は全摘出されていた。術後15日目に独歩退院した。

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