[A case of benign postpartum anterior spinal artery syndrome with thrombocytosis and high fibrolytic activity].

A 35-year-old woman was admitted to our hospital with acute onset paraparesis, sensory disturbance in her lower body, and urinary disturbance. She had given birth by normal vaginal delivery 6 days before the onset of these symptoms. On admission, paresis of her left leg was more severe than that of her right leg. Deep tendon reflexes of her lower limbs were hyperactive, and bilateral Babinski reflexes were observed. The patient's thermal and pain sensations below the lumbus were impaired. She lost bladder-filling sensation and bladder control. She showed an anterior spinal artery syndrome. Blood analysis revealed thrombocytosis and high fibrolytic activity. MRI of the brain and spinal cord did not show any lesions. Cerebrospinal fluid measurements showed that parameters were within the normal range and that the protein levels were not increased. We considered that a spinal cord infarction had occurred. After administration of antithrombotic agents and methylpredonisolone, her symptoms gradually improved. The coagulation disorders during the peripartum period were assumed to be a cause of anterior spinal artery syndrome in this case. It is very rare for perinatal women to have a spinal cord infarction. Only 3 cases of spinal cord infarction during the perinatal period have been reported thus far.

Use of 5-aminolevulinic acid for the confirmation of deep-seated brain tumors during stereotactic biopsy. Report of 2 cases.

5-Aminolevulinic acid (ALA) has been successfully used to confirm the target tumor tissues obtained during stereotactic biopsy. The authors report their experience with 2 patients who underwent stereotactic biopsies of thalamic malignant lymphoma and pontine glioma utilizing 5-ALA. Intraoperatively, the tumor specimens fluoresced, allowing for confirmation that the obtained target specimen contained tumor tissues. No serious side effects or complications occurred.

Surgical technique for a cystic-type metastatic brain tumor: transformation to a solid-type tumor using hydrofiber dressing.

BACKGROUND: Many metastatic brain tumors have a distinct border with normal brain tissue, which facilitates tumor removal. However, residual tumor tissue may be present after surgery when metastatic brain tumors are of cystic type. We have developed a method using hydrofiber dressing to transform cystic-type into solid-type tumors. METHODS: Hydrofiber dressing is a sodium carboxymethylcellulose hydrocolloid polymer with high fluid-absorptive capacity. This material was originally used as a dressing for exudative wounds. Hydrofiber dressing was used for 8 patients with cystic-type metastatic brain tumor. Tumor removal was performed after hydrofiber dressing was inserted into the cyst cavity to transform the tumor into a solid-type tumor. RESULTS: Transformation of cystic-type metastatic brain tumors into smaller solid-type tumors using hydrofiber dressing facilitated en bloc resection of tumor. The dressing also absorbed residual cyst fluid and was thus also effective in preventing intraoperative dissemination of tumor cells. This approach enabled ideal en bloc resection in all patients. There were no adverse events. CONCLUSIONS: These findings suggest hydrofiber dressing may be useful in surgery for cystic-type metastatic brain tumors.