Cerebral amyloid angiopathy (CAA) is observed in most cases of nonhypertensive subcortical hemorrhage involving elderly patients. We herein describe the case of a female in whom a convexal subarachnoid hemorrhage was observed at 55 years of age. The cerebral hemorrhage occurred repeatedly; however, no obvious vascular lesions were observed on a cerebral angiography, and no signs of microbleeding or lesions in the deep white matter were identified on magnetic resonance imaging (MRI). Partial excision of the right frontal cortex and hematoma evacuation were performed, and histopathological examination showed deposition of an acidophilic substance with positive staining for Direct Fast Scarlet (DFS) in the cerebral vascular wall. Finally, brain hemorrhage due to CAA was diagnosed. This case suggests that CAA is an important differential diagnosis in patients with localized non-aneurysmal subarachnoid hemorrhage in the convexity sulcus.

There have been several reports on surgical interventions in patients with adult cervical spondylotic myelopathy associated with cerebral palsy. We performed posterior fusion with pedicle and/or lateral mass screws combined with preoperative intramuscular injections of botulinum toxin in two patients. Two weeks before the surgery, we injected the patients with the botulinum toxin to alleviate cervical pain and to reduce the involuntary movement associated with cerebral palsy. Surgical results were good in both patients without rigid external fixation. Both patients were able to undergo rehabilitation after the surgery as soon as possible without any complication. We think that our pre surgical treatment with botulinum toxin is a useful optional treatment for cervical spondylotic myelopathy associated with cerebral palsy.

To determine the physical symptoms and ki, ketsu and sui (qi, blood and fluid) factors associated with the presence of hie-sho (chill syndrome). Total 118 healthy university students (66 males and 52 females, median age 22 years, range 21­-29) were enrolled. A cross-­sectional study about the presence of chill syndrome in par­ticipants was performed. Terasawa's ki, ketsu and sui diagnostic score was used to identify the presence of physical symptoms. Number rating scale (NRS) was used to classify the chill and NRS more than 5 was de­fined as chill syndrome based on Furuya's report. Eighteen students (4 males and 14 females) were docu­mented as chill syndrome. The multivariate analysis of physical symptoms identified female (OR 4.65, p = 0.0427), heavy sensation of head (OR 2.98, p = 0.0190) and chill of extremities (OR 1.94, p = 0.0480) as sig­nificantly associated factors with chill syndrome. The score of ki-kyo (qi deficiency), ketsu-kyo (blood defi­ciency) and suitai (fluid retention) showed higher score in students with chill syndrome compared to students without chill syndrome in univariate analysis. Being female and two indicators of qi abnormalities including heavy sensation of head and chill of extremities were associated with the presence of chill syndrome in univer­sity students.