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Biomedical subjects

A Aliprandi

Publications and source records attributed to A Aliprandi.

7 recordsLinked to original sources

Platelet glutamate uptake and release in migraine with and without aura.

Glutamate may play an important role in the pathogenesis of migraine: glutamate release in the brain may be involved in the development of spreading depression and increased concentrations of this amino acid have been reported in plasma and platelets from migraine patients. Here we assessed platelet glutamate uptake and release in 25 patients affected by migraine with aura (MA) and 25 patients affected by migraine without aura (MoA), comparing the results with a group of 20 healthy matched controls. Both glutamate release from stimulated platelets and plasma concentrations of the amino acid were assessed by high-performance liquid chromatography, and were increased in both types of migraine, although more markedly in MA. Platelet glutamate uptake, assessed as 3H-glutamate intake, was increased in MA, while it was reduced in MoA with respect to the control group. These results support the view that MA might involve different pathophysiological mechanisms from MoA and, specifically, up-regulation of the glutamatergic metabolism. Understanding these dysfunctional pathways could lead to new, possibly more successful therapeutic approaches to the management of migraine.

Adolescent↗

The complications of migraine with aura.

Migraine with aura is a common disorder in industrialised countries, affecting up to 5% of the adult population. Although migraine aura is usually a benign disorder, in rare instances it can be the cause of serious neurologic complications. The most common is migrainous stroke, defined as a persistent neurologic deficit following the aura with evidence of brain infarction at neuroimaging and lack of alternative explanations. The most likely pathogenic mechanism is brain ischaemia induced by cortical spreading depression, but other possibilities, such as intracranic arterial dissection or embolism through patent foramen ovale need to be considered. Other complications are migraine-related seizures, which are probably caused by neuronal hyperexcitability in migraineurs, and persistent auras without infarction. These disorders are of both clinical and scientific interest, as they throw light on the complex and not yet fully understood relationship between migraine with aura, stroke and epilepsy.

Epilepsy↗

One-shot CT and MR arthrography of the shoulder with a mixture of iodinated and paramagnetic contrast agents using arthroscopy as a gold standard.

PURPOSE: Our aim was to perform computed tomography arthrography (CTA) and magnetic resonance arthrography (MRA) of the shoulder as a one-shot examination and to evaluate its value on the basis of arthroscopy as a gold standard. MATERIALS AND METHODS: Fifteen men and 16 women with planned arthroscopy for chronic (n=17) or traumatic tear of the rotator cuff (n=8), congenital atraumatic (n=1) or traumatic glenohumeral instability (n=2), traumatic tear of the rotator cuff with glenohumeral instability (n=1), or "frozen shoulder" (n=2) underwent plain helical CT in neutral position and intra-articular CT-guided injection of a mixture of iodinated and paramagnetic contrast agents (gadodiamide at 1:250 and iobitridol 350 at 1:5 in 20 ml of saline solution). CT helical scans in intra- and extrarotation and T1-weighted MRA scans in the neutral position were obtained. CTA and MRA were evaluated separately and jointly (CTA-MRA) in different blinded sessions, giving a 0-3 score to the agreement of CTA, MRA, and CTA-MRA with arthroscopy. RESULTS: The injected volume of the solution ranged from 10 to 24 ml. No side effects were observed. CTA obtained a score of 2.33+/-0.62, MRA 2.47+/-0.52, and CTA-MRA 2.67+/-0.49. Significant differences were found for CTA-MRA versus CTA (p=0.0281) and MRA (p=0.0277). There was no significant difference for CTA versus MRA. CONCLUSIONS: CTA and MRA can be performed as a one-shot exam. CTA-MRA seems to give more information than CTA or MRA separately.

Adult↗

Neuroradiological investigations in secondary headaches.

In this work, we examine the neuroradiologic features of the main non vascular clinical conditions responsible for secondary headache; excluding CSF hypotension, which will be treated extensively in another work in this supplement. Headache is not a constant feature of intracranial mass lesions, even of large extension. Headache has a high diagnostic value in children, as it can be the only heralding symptom, sometimes even for a long time, of severe intracranial pathologies, which later give rise to seizure or focal neurological signs. Particular attention should be paid to children affected by leukaemia under pharmacological treatment, in which headache is almost always the presenting symptom of serious neurological syndromes, consequent to antiblastic drugs.

Adult↗

MIDAS questionnaire in the emergency setting.

Migraine is a common disorder and is a major cause of disability and loss of working performance in western countries. Therefore, many tools have been developed to assess migraine related disability. Among these, the Migraine Disability Assessment (MIDAS) questionnaire has been shown to be of particular interest, as it is valid, reliable and useful for therapeutic decisions. In this pilot study, we address the validity of the MIDAS questionnaire in an unselected population of migraine patients in the emergency setting. We found that the MIDAS scores in the emergency room were similar to those collected in a specialised headache centre. This result suggests that the MIDAS questionnaire could be reliably used in the emergency setting, hence avoiding unnecessary delays in the treatment of migraine patients.

Adult↗

Deep brain stimulation for the treatment of Parkinson's disease: the experience of the Neurosurgical Department in Monza.

deep brain stimulation is a widely accepted surgical therapy for the symptomatic treatment of advanced parkinson's disease; high frequency chronic stimulation of the subthalamic nucleus proved its efficacy to control the major motor symptoms. In the neurosurgical department of Monza we treated 72 parkinsonian patients (November 1998-January 2003). One year follow-up results are: decrease of tremor 90%, hypertonous 56%, bradykinesia 70%, voice impairment amelioration 30%, mean total daily L-dopa intake reduced 58%. Freezing and balance did not ameliorate, some voice impairment and psychic derangement have been observed. Major surgical complications were: haemorrage (1 case - transient hemiparesis), infections (2 cases), pulmonary embolisation (1 case). To optimise the surgical results, careful clinical and instrumental selection of the patients are mandatory before surgery.

Clinical Trials as Topic↗

Increased glutamate in CSF and plasma of patients with HIV dementia.

BACKGROUND: Experimental evidence suggests that excitotoxicity might play a major role in HIV-induced neurodegeneration. However, few studies have investigated the role of endogenous glutamate in patients with HIV dementia. OBJECTIVE: To analyze CSF and plasma glutamate levels in 30 patients with AIDS with different dementia severity compared with 10 patients with other neurologic disorders, 11 healthy control subjects, and 10 patients with Alzheimer-type dementia. METHODS: CSF and plasma glutamate levels were measured by reverse-phase high-performance liquid chromatography followed by fluorometric analysis. RESULTS: Glutamate CSF levels were increased fivefold in the patients with HIV vs normal control subjects (p = 0.001), patients with Alzheimer-type dementia (p < 0.0001), and patients with other neurologic disorders (p < 0.01). CSF glutamate levels were also related to the degree of dementia (p < 0.02) and brain atrophy (p < 0.002). Plasma levels were also higher in the patients with HIV (p < 0.0001) but did not correlate with either clinical or imaging features. CONCLUSION: Increased CSF glutamate may originate within the CNS and may play a pathogenetic role in HIV dementia, thus supporting the treatment of these patients with glutamate receptor antagonists.

AIDS Dementia Complex↗