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Volume 26, Number 6—June 2020

Characterization of Sporadic Creutzfeldt-Jakob Disease and History of Neurosurgery to Identify Potential Iatrogenic Cases

Tsuyoshi Hamaguchi, Kenji Sakai, Atsushi Kobayashi, Tetsuyuki Kitamoto, Ryusuke Ae, Yosikazu Nakamura, Nobuo Sanjo, Kimihito Arai, Mizuho Koide, Fumiaki Katada, Masafumi Harada, Hiroyuki Murai, Shigeo Murayama, Tadashi Tsukamoto, Hidehiro Mizusawa, and Masahito YamadaComments to Author 
Author affiliations: Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan (T. Hamaguchi, K. Sakai, M. Yamada); Hokkaido University, Sapporo, Japan (A. Kobayashi); Tohoku University Graduate School of Medicine, Sendai, Japan (T. Kitamoto); Jichi Medical University, Shimotsuke, Japan (R. Ae, Y. Nakamura); Tokyo Medical and Dental University, Tokyo, Japan (N. Sanjo); National Hospital Organization Chiba-East Hospital, Chiba, Japan (K. Arai, M. Koide); Kameda Medical Center, Chiba (F. Katada); The University of Tokushima, Tokushima, Japan (M. Harada); International University of Health and Welfare, Narita, Japan (H. Murai); Tokyo Metropolitan Institute of Gerontology, Tokyo (S. Murayama); National Center of Neurology and Psychiatry, Kodaira, Japan (T. Tsukamoto, H. Mizusawa)

Main Article

Table 2

Patients with history of neurosurgery who had no periodic sharp-wave complexes on electroencephalogram during course of Creutzfeldt-Jakob disease*

Patient no. Age at CJD onset, y/sex Year of neurosurgery; reason Time from neurosurgery to onset of CJD, y Initial symptoms Disease duration, mo† Codon 129 of PRNP Lesions on DW-MRI Pathology findings
1 75/M 1977; head trauma 30 Dementia 11 MM CC, BG ND
2 49/F 1985; subarachnoid hemorrhage 9 Insomnia 28 MM ND MM2-T
3 75/F 1985; tumor 14 Drowsiness, gait disturbance 6 MM BG, Th CJD-MMiK
4 63/F 1985; tumor 27 Gait disturbance 19 MM BG, Th ND
5 64/F 1993; subdural hematoma 10 Visual impairment 21 MM CC MM2-C

*Among the patients with history of neurosurgery, average time (+ SD) from neurosurgery to onset of CJD was 18.0 (+ 9.8) years and average age at neurosurgery was 47.2 (+ 10.2) years. However, among 22 patients with PSWCs on EEG, average time (+ SD) from neurosurgery to onset of CJD was 14.3 (± 9.1) years and average age at neurosurgery was 58.0 (± 12.2) years. We noted no statistically significant differences between patients with and without PSWCs on EEG in relation to time between neurosurgery and onset of CJD or in age at neurosurgery. BG, basal ganglia; CC, cerebral cortex; CJD, Creutzfeldt-Jakob disease; DW-MRI, diffusion weighted images on magnetic resonance imaging; MM, methionine homozygous; MM2-C, MM2-cortical type sporadic CJD; MM2-T, MM2-thalamic type sporadic CJD; ND, not done; PRNP, prion protein gene; Th, thalamus.
†Disease duration is the time between onset of CJD and the appearance of akinetic mutism or death.

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Page created: May 18, 2020
Page updated: May 18, 2020
Page reviewed: May 18, 2020
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