ホーム　＞　診療科・部門　＞　脳神経外科

 

 

脳神経外科

2024年10月1日掲載

 

• 診療内容
• 診療実績
• 外来担当医表
• スタッフ紹介
• 研究実績

 

診療内容

脳・脊髄という中枢神経系の主な疾患として、血管障害（いわゆる脳卒中や脊髄血管病変）、腫瘍性病変（脳腫瘍や脊髄腫瘍）、外傷（急性および慢性の頭蓋内出血、頭蓋骨骨折など）、脊椎疾患（変形性脊椎症、椎間板ヘルニア、脊椎間狭窄症など）、機能的疾患（てんかん、不随意運動など）、その他（顔面けいれん、三叉神経痛、正常圧水頭症など）があります。現れる症状として、頭痛（突然の痛みや増悪する痛みなど）、手足の感覚障害（ビリビリする、触った感じがわかりにくい）や運動障害（動かしにくい）、言語障害（言葉が出にくい、人の話を理解しにくい）、複視（物が二重に見える）、難聴（聞こえにくい）、嚥下障害（飲み込みにくい、むせる）などがあります。高血圧、糖尿病、脂質異常症、不整脈、喫煙、大量飲酒などの危険因子をお持ちの方は脳卒中発症の危険性が高くなります。これらの疾患、症状、危険因子のある方に対して、2023年4月より再開させていただきました脳神経内科と相談しながら検査、診断、治療を行い、必要に応じて近隣の病院や滋賀医科大学などと連携しつつ高度な治療へ結びつけます。日常生活に支障をきたすような症状でお困りの方や危険因子のある方でご心配の方、検査を希望される方は受診してください。また、診断された疾患、治療中の疾患で専門医の意見を希望される方はセカンドオピニオンにも対応させていただきます。

 

脳動脈瘤の治療方法

開頭による脳動脈瘤頚部クリッピング術

 

血管内治療による脳動脈瘤コイル塞栓術

 

右巨大内頚動脈瘤の３D-CTA画像

クリッピング術前（左）と術後（右）

 

脳腫瘍のMR画像（造影）

 

認知機能低下をきたすが手術で改善できる疾患のCT画像

 

 

診療実績

＜外来患者数＞

2019年度　　622名

2020年度　　474名

2021年度　　571名

2022年度　　679名

2023年度　　692名

（入院を要する疾患については脳神経内科と連携して対応しておりますが、入院での脳神経外科手術は行っておりません）

 

 

外来担当医表

診療科	月	火	水	木	金
脳神経外科	後藤　幸大	－	野﨑　和彦	－	平井 久雄

備考

野﨑医師は水曜第2・4週のみの診察

 

 

スタッフ紹介

 

 

研究実績

著書

1. 野崎和彦：未破裂脳動脈瘤：脳神経疾患　最新の治療2024-2026、pp.98-100 南江堂　2023年11月刊行
2. 野崎和彦：未破裂脳動脈瘤の今後の展望：エビデンスとガイドラインに基づく脳動脈瘤とくも膜下出血　森田明夫監修pp.123-127 医学書院2023年3月刊行
3. 野崎和彦、九嶋亮治、辻篤司：脳血管奇形の発生機序：日本臨床80巻2022年1月増刊号：最新臨床脳卒中学（第2版）上　pp.181-188
4. 宮田悠、青木友浩、野崎和彦：くも膜下出血　病因と病態：日本臨床80巻2022年2月増刊号：最新臨床脳卒中学（第2版）下　pp.366-371
5. 辻篤司、野崎和彦：無症候性脳動静脈奇形：日本臨床80巻2022年2月増刊号：最新臨床脳卒中学（第2版）下　pp.499-507
6. 脳神経外科学　改訂13版：原著：太田富雄　編集：松谷雅生・野崎和彦、Kinpodo、2021年3月
7. 野崎和彦：臨床解剖：標準脳神経外科学　第15版　　pp.5-16　医学書院 2021
8. 野崎和彦：くも膜下出血：脳神経疾患最新の治療2021-2023　pp89-91、南江堂　2021
9. 宮田悠、青木友浩、野崎和彦：臨床医のための神経病理　再入門　くも膜下出血：Clinical Neuroscience　39巻5号：526-528、2021
10. 辻篤司、野崎和彦：脳動静脈奇形・硬膜動静脈ろう：脳神経外科　周術期管理のすべて　改訂第5版　pp.79-91, 2019　Medical View社：編集：松谷雅生、田村晃、藤巻高光、森田明夫）

 

 

論文　邦文

1. 山田茂樹、伊藤広貴、石川正恒、山口真、山本一夫、野崎和彦：出血性脳卒中後の続発性正常圧水頭症における脳脊髄液の動態観察：脳卒中の外科51：99-106，2023
2. 野崎和彦：特集　脳神経外科日常診療　COVID-19と脳神経外科診療：脳神経外科ジャーナル32：4-10, 2023
3. 伊藤清佳、深尾繁治、野々山裕、藤田智昭、辻篤司、野崎和彦、木戸岡実：くも膜下出血急性期患者におけるstress indexの検討：脳卒中43：201-205，2021
4. 岩間亨、飯原弘二、小笠原邦昭、豊田一則、長谷川康弘、大畑建治、塩川芳昭、野崎和彦、山上宏、早川幹人、日本脳卒中学会・日本脳神経外科学会・日本脳神経血管内治療学会・三学会合同指針作成委員会：経皮経管的脳血栓回収用機器適正使用指針（第4版）2020年4月：脳卒中42：281-313、2020
5. 野崎和彦、宮田悠、青木友浩：脳動脈瘤治療の未来像：脳神経外科ジャーナル 29:101-108, 2020
6. 高嶋直敬、三浦克之、喜多義邦、野崎和彦：地域悉皆登録から見た我が国の脳卒中の現状-滋賀県脳卒中登録より-：Medical Science Digest 45(3):27-30,2019

 

 

論文　英文

1. Kitamura T, Terashima T, Katagi M, Ohashi N, Nozaki K, Tsuji A. Bone marrow-derived mononuclear cells improve neuronal function via recovery of cerebral blood flow in mice with chronic ischemic stroke. Cytotherapy in press
2. Hisamatsu T, Tabara Y, Kadota A, Torii S, Kondo K, Yano Y, Shiino A, Nozaki K, Okamura T, Ueshima H, Miura K. Alcohol consumption and cerebral small- and large-vessel disease: a Mendelian. randomization analysis. J Atherosclerosis and Thrombosis 31:135-147, 2024
3. Kunimura A, Yano Y, Torii S, Kondo K, Hisamatsu T, Kadota A, Fujiyoshi A, Okamura T, Watanabe Y, Shiino A, Nozaki K, Ueshima H, Miura K. Differential association of circulating proprotein convertase subtilisin/kexin type 9 with the subclinical cerebral small vessel disease and intracranial artery stenosis. J Hypertension 41, E327-328, 2023
4. Azahar NM, Yano Y, Kadota A, Shiino A, Syaifullah A, Miyagawa N, Kondo K, Moniruzzaman M, Torii S, Segawa H, Hisamatsu T, Fujiyoshi A, Nozaki K, Tooyama I, Ueshima H, and Miura K. Association of Arterial Stiffness and Atherosclerotic Burden with Brain Structural Changes among Japanese Men. J Am Heart Assoc 2023 Jun 6;12(11):e028586.
5. Kurogi R, Kada A, Ogasawara K, Nishimura K, Kitazono T, Iwama T, Matsumaru Y, Sakai N, Shiokawa Y, Miyachi S, Kuroda S, Shimizu H, Yoshimura S, Osato T, Horie N,Nagata I, Nozaki K, Date I, Hashimoto Y, Hoshino H, Nakase H, Kataoka H, Ohta T, Fukuda H, Tamiya N, Kurogi AI, Ren N, Nishimura A, Arimura K, Shimogawa T, Yoshimoto K,Onozuka D, Ogata S, Hagihara A, Saito N, Arai H, Miyamoto S, Tominaga T, Iihara K; J-ASPECT study collaborators. National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study. BMJ Open 2023;13(4):e068642
6. Higo Y, Sawayama Y, Takashima N, Harada A, Yano Y, Yamamoto T, Shioyama W, Fujii T, Tanaka-Mizuno S, Kita Y, Miura K, Nozaki K, Suzuki T, Nakagawa Y. Epidemiology of Acute Aortic Dissection in a General Population of 1.4 Million People in Japan: Shiga Stroke and Heart Attack Registry. Cir J 87:1155-1161, 2023
7. Yamada S, Otani T, Ii S, Kawano H, Nozaki K, Wada S, Oshima M, Watanabe Y. Aging-related volume changes in the brain and cerebrospinal fluid using artificial intelligence-automated segmentation. Eur Radiol 33:7099-7112, 2023
8. Kunimura A, Yano Y, Hisamatsu T, Torii S, Kondo K, Kadota A, Fujiyoshi A, Okamura T, Watanabe Y, Shiino A, Nozaki K, Ueshima H, Miura K; on behalf of the SESSA research group. Association between proprotein convertase subtilisin/kexin type 9 (PSCK9) and　subclinical cerebrovascular disease in the community. Eur J Neurology 30:1327-1334, 2023
9. Yamada S, Hiratsuka S, Otani T, Ii S, Wada S, Oshima M, Nozaki K, Watanabe Y. Usefulness of intravoxel incoherent motion MRI for visualizing slow cerebrospinal fluid motion. Fluids and Barriers of the CNS 20(1):16
10. Haemmerli J, Meling T, Morel S, Georges M, Morita A, Nozaki K, Tominaga T, Bervitskiy A, Rzaev J, Schaller K, Bijlenga P. Characteristics and distribution of intracranial aneurysms in ADPKD patients compared to the general population: a meta-analysis. Kidney 360 4(4):e466-e475, 2023
11. Sawayama Y, Higo Y, Takashima N, Harada A, Yano Y, Yamamoto T, Shioyama W, Fujii T, Tanaka-Mizuno S, Kita Y, Miura K, Nozaki K, Suzuki T, Nakagawa Y. Incidence and In-hospital Mortality of Acute Myocardial Infarction: A Report From a Population-based Registry in Japan. Journal of Atherosclerosis and Thrombosis 30:1407-1419, 2023
12. Nakasu S, Nakasu Y, Tsuji A, Fukami T, Nitta N, Kawano H, Notsu A, Nozaki K. Incidental diffuse low-grade gliomas: A systematic review and meta-analysis of treatment results with correction of lead-time and length-time biases. Neuro-Oncology Practice 10:113-125, 2022
13. Tram HTH, Tanaka MS, Takashima N, Khan K, Arima H, Kadota A, Fujii T, Shitara S, Kitamura A, Miyamatsu N, Kita Y, Urushitani M, Nakagawa Y, Miura K, Nozaki K. Control of diabetes mellitus and long-term prognosis in stroke patients: The Shiga Stroke and Heart Attack Registry. Cerebrovasc Dis 52:81-88, 2023
14. Moniruzzaman M, Kadota A, Hisamatsu T, Segawa H, Kondo K, Torii S, Miyagawa N, Fujiyoshi A, Yano Y, Watanabe Y, Shiino A, Nozaki K, Ueshima H, Miura K; SESSA.Research Group. Relationship Between Serum Irisin Levels and MRI-measured Cerebral Small Vessel Disease in Japanese Men. J Atherosclerosis Thrombosis 2022 Nov 15. doi: 10.5551/jat.63824. Online ahead of print.
15. Kawano H, Yamada S, Tsuji A, Tsuji K, Nozaki K. Four-dimentional flow magnetic resonance imaging analysis of cerebral aneurysm in the carotid rete mirabile. Stroke images 2022; 0:10.1161/STROKEAHA.122.040692
16. Tsuji K, Nakamura S, Aoki T, Nozaki K. The Cerebral Artery in Cynomolgus Monkeys (Macaca fascicularis). Experimental Animals 71:391-398, 2022. doi: 10.1538/expanim.22-0002
17. Shitara S, Tanaka-Mizuno S, Takashima N, Fujii T, Arima H, Kita Y, Tsuji A, Kitamura A. Urushitani M, Miura K, Nozaki K. Population-based incidence rates of subarachnoid hemorrhage in Japan: The Shiga Stroke and Heart Attack Registry. J Stroke 24:292-295, 2022, doi.org/10.5853/jos.2022.00087
18. Yamada S, Ishikawa M, Nakajima M, Nozaki K. Reconsidering ventriculoperitoneal shunt surgery and postoperative shunt valve pressure adjustment: our approaches learned from past challenges and failures. Frontier Neurology 12:798488, 2022, doi;10.3389/fneur.2021.798488
19. Zuurbier CMC, Molenberg R, Mensing L, Wermer M, Juvela S, Lindgren A, Jääskeläinen J, Koivisto T, Yamazaki T, Uyttenboogaart M, van Dijk JMC, Aalbers M, Morita A, Tominari S, Arai H, Nozaki K, Murayama Y, Ishibashi T, Takao H, Gondar R, Bijlenga P, Rinkel GJE, Greving J, and Ruigrok Y. Sex difference and rupture rate of intracranial aneurysms: an individual patient data meta-analysis. Stroke 53:362-369, 2022
20. Fujii T, Arima H, Takashima N, Kita Y, Miyamatsu N, Tanaka-Mizuno S, Shitara S, Urushitani M, Miura K, Nozaki K. Seasonal variation in incidence ofstroke in a general population of 1.4 million Japanese: the Shiga Stroke Registry. Cerebrovasc Dis 51:75-81, 2022.
21. Salman E, Kadota A, Hisamatsu T, Segawa H, Torii S, Fujiyoshi A, Kondo K, Watanabe Y, Arima H, Shiino A, Nozaki K, Ueshima H, Miura K. Relationship of four blood pressure indexes to subclinical cerebrovascular diseases assessed by brain MRI in general Japanese men. J Atheroscler and Thromb 29:174-187, 2022
22. Zuurbier CMC, Mensing LA, Wermer MJH, Juvela S, Lindgren AE, Koivisto T, Jääskeläinen JE, Yamazaki T, Molenberg R, van Dijk JMC, Uyttenboogaart M, Aalbers M, Morita A, Tominari S, Arai H, Nozaki K, Murayama Y, Ishibashi T, Takao H, Rinkel GJE, Greving JP, Ruigrok YM. Difference in rupture risk between familial and sporadic intracranial aneurysms: an individual patient data meta-analysis. Neurology 97: e2195-e2203, 2021
23. Nitta N, Usui N, Nozaki K. Neuropsychological outcomes after frontal lobectomy to treat intractable. Epilepsy. Epilepsy Behav 123:108240, doi: 10.1016/j.yebeh.2021
24. Ota N, Morita A, Tominari S, Nakayama T, Nozaki K, Tominaga T, Noda K, Kamiyama H, Tanikawa R on behalf of the Japan Neurosurgical Society for UCAS Japan Investigators. Differences between subarachnoid hemorrhage seen in daily practice and aneurysms that rupture during follow-up. Stroke 52:e491-e493. 2021
25. Hisamatsu T, Ohkubo T, Hozawa A, Fujiyoshi A, Torii S, Segawa H, Kondo K, Kadota A, Takashima N, Shitara S, Arima H, Nakagawa Y, Watanabe Y, Shiino A, Nozaki K, Ueshima H, Miura K, for the SESSA Research Group. Association of self-measured home, ambulatory, and strictly measured office blood pressure and their variability with intracranial arterial stenosis. J Hypertension 39:2030-2039, 2021
26. Yamada S, Ito H, Ishikawa M, Yamamoto K, Yamaguchi M, Oshima M, Nozaki K. Quantification of oscillatory shear stress from reciprocating cerebrospinal fluid motion on four-dimensional flow imaging. AJNR Am J Neuroradiol 42:479-486, 2021
27. Moniruzzaman M, Kadota A, Segawa H, Kondo K, Torii S, Fujiyoshi A, Hisamatsu T, Watanabe Y, Shiino A, Nozaki K, Ueshima H, Miura K. Relationship between Step Counts and Cerebral Small Vessel Disease in Japanese Men. Stroke 51:3584-3591, 2020
28. Kushamae M, Miyata H, Shirai M, Shimizu K, Oka M, Koseki H, Abekura Y, Ono I, Nozaki K, Mizutani T, Aoki T. Involvement of neutrophils in machineries underlying the rupture of intracranial aneurysms.　Scientific Reports 10:20004, 2020. doi:10.1038/s41598-020-74594-9.
29. Takashima N, Arima H, Kita Y, Fujii T, Tanaka S, Shitara S, Kitamura A, Sugimoto Y, Urushitani M, Miura K, Nozaki K. Long-term survival after stroke in a general Japanese population of 1.4 million Japanese: Shiga Stroke and Heart Attack Registry. J Stroke 22:336-344, 2020
30. Oka M, Shimo S, Ohno N, Imai H, Abekura Y, Koseki H, Miyata H, Shimizu K, Kushamae M, Ono I, Nozaki K, Kawashima A, Kawamata T, Aoki T. Dedifferentiation of smooth muscle cells in intracranial aneurysms and its potential contribution to the pathogenesis. Scientific Reports 10:8330. doi:10.1038/s41598-020-65361-x
31. Takashima N, Arima H, Kita Y, Fujii T, Tanaka S, Shitara S, Kitamura A, Miura K, Nozaki K. Two-year recurrence after first-ever stroke in a general population of 1.4 million Japanese patients: The Shiga Stroke and Heart Attack Registry study. Cir J 84:943-948, 2020
32. Yamada S, Ishikawa M, Ito H, Yamamoto K, Yamaguchi M, Oshima M, Nozaki K. Cerebrospinal fluid dynamics in idiopathic normal pressure hydrocephalus on four-dimensional flow imaging. Eur Radiol 30:4454-4465, 2020
33. Koseki H, Miyata H, Shimo S, Ohno N, Mifune K, Shimano K, Yamamoto K, Nozaki K, Kasuya H, Narumiya S, Aoki T. Two diverse hemodynamic forces, a mechanical stretch and a high wall shear stress, determine intracranial aneurysm formation. Transl Stroke Res 11:80-92, 2020
34. Khan MMH; Fujiyoshi A, Shiino A, Hisamatsu T, Torii S, Suzuki S, Kunimura A, Segawa H, Kadota A, Ohkubo T, Nozaki K, Miura K, Ueshima H, for the SESSA Research Group. The association between coronary artery calcification and subclinical cerebrovascular diseases in men: An observational study. J Atheroscler Thromb 27:995-1009, 2020
35. Ikawa F, Morita A, Nakayama T, Sakai N, Iihara K, Shiokawa Y, Date I, Nozaki K, Kinouchi H, Hokin K, Saito N, Tominaga T, Suzuki M, Miyamoto S, Kurisu K, Arai H, The Japan Neurosurgical Society. A register-based SAH study in Japan: high incidence rate and recent decline trend based on lifestyle. J Neurosurg 27:1-9, 2020
36. Ikawa F, Morita A, Tominari S, Nakayama T, Shiokawa Y, Date I, Nozaki K, Miyamoto S, Kayama T, Arai H and The Japan Neurosurgical Society for UCAS Japan Investigators. Rupture risk of small unruptured cerebral aneurysms. J Neurosurg 25:1-10, 2019
37. Hiramatsu T, Miura K, Fujiyoshi A, Kunimura A, Ito T, Miyazawa I, Torii S, Shiino A, Nozaki K, Kanda H, Arima H, Ohkubo T, Ueshima H; for the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA) Research Group. Association between excessive supraventricular ectopy and subclinical cerebrovascular disease: A population-based study. Eur J Neurol 26:1219-1225, 2019
38. Miyata H, Imai H, Koseki H, Shimizu K, Abekura Y, Oka M, Kawamata T, Matsuda T, Nozaki K, Narumiya S, Aoki T. Vasa vasorum formation is associated with rupture of intracranial aneurysms. J Neurosurg 16:1-11, 2019
39. Shitara S, Fujiyoshi A, Hisamatsu T, Torii S, Suzuki S, Ito T, Arima H, Shiino A, Nozaki K, Miura K, Ueshima H; SESSA Research group. Intracranial artery stenosis and its association with conventional risk factors in a general population of Japanese men. Stroke 50:2967-2969, 2019
40. Aoki T, Koseki H, Miyata H, Itoh M, Kawaji H, Takizawa K, Kawashima A, Ujiie H, Higa T, Minamimura K, Kimura T, Kasuya H, Nozaki K, Morita A, Sano H, Narumiya S. RNA sequencing analysis revealed the induction of CCL3 expression in human intracranial aneurysms. Scientific Reports Jul 17;9(1):10387, 2019 doi: 10.1038/s41598-019-46886-2.
41. Ikawa F, Ikawa F, Hidaka T, Yoshiyama M, Ohba H, Matsuda S, Ozono I, Iihara K, Kinouchi H, Nozaki K, Kato Y, Morita A, Michihata N, Yasunaga H, Kurisu K. Characteristics of Cerebral Aneurysms in Japan. Neurol Med Chir (Tokyo) 59:399-406, 2019
42. Shimizu K, Miyata H, Abekura Y, Oka M, Kushamae M, Kawamata T, Mizutani T, Kataoka H, Nozaki K, Miyamoto S, Aoki T. High fat diet intake exacerbates the progression of intracranial aneurysms in rats. J Neuropathol Exp Neurol 78:798-807, 2019
43. Nishimura A, Nishimura K, Onozuka D, Matsuo R, Kada A, Kamitani S, Higashi T, Ogasawara K, Shimodozono M, Harada M, Hashimoto Y, Hirano T, Hoshino H, Itabashi R, Itoh Y, Iwama T, Kohriyama T, Matsumaru Y, Osato T, Sasaki M, Shiokawa Y, Shimizu H, Takekawa H, Nishi T, Uno M, Yagita Y, Ido K, Kurogi A, Kurogi R, Arimura K, Ren N, Hagihara A, Takizawa S, Arai H, Kitazono T, Miyamoto S, Minematsu K, Iihara K; J-ASPECT study collaborators. Development of Quality Indicators of Stroke Centers and Feasibility of Their Measurement Using a Nationwide Insurance Claims Database in Japan.　-J-ASPECT Study - Circ J 83:2292-2302, 2019
44. Nitta N, Usui N, Kondo A, Tottori T, Terada K, Araki Y, Nakaoka K, Kawaguchi N, Idebushi G, Nozaki K, Inoue Y. Semiology of hyperkinetic seizures of temporal versus frontal lobe origin. Epileptic Disord 21:154-165, 2019
45. Toi H, Fujii Y, Iwama T, Kinouchi H, Nakase H, Nozaki K, Ohkuma H, Ohta H, Takeshima H, Tokumasu H, Yoshimoto Y, Uno M. Determining if cerebrospinal fluid prevents recurrence of chronic subdural hematoma: A multi-center prospective randomized clinical trial. J Neurotrauma 36:559-564, 2019