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Biomedical subjects

A Bazzan

Publications and source records attributed to A Bazzan.

At least 19 recordsLinked to original sources

[A systematic approach to the prediction of psychosomatic disease].

This paper is an introduction to the "philosophy" adopted in research on the influence of mental factors in the onset of psychosomatic diseases. The research is oriented to the construction and implementation on a computer of a model that makes it possible to formulate predictions regarding the onset and possibly the classification of the "type" of psychosomatic disease so as to be able to activate an appropriate prophylaxis.

Humans

Spontaneous spinal haematomas.

A series of 10 surgically treated "spontaneous" spinal haematomas (7 cases with epidural, 3 with intramedullary location), is presented. Symptomatology was rarely acute. Clinical onset was mostly dominated by spinal or radicular pain, followed by severe motor deficit. Surgical outcome was satisfactory in the majority of cases. Age, duration of symptoms, haematoma site and size appeared to have no influence on final outcome. This was significantly correlated only with the preoperative neurological condition.

Adult

Intracranial hematomas following aneurysmal rupture: experience with 309 cases.

Three hundred and nine consecutive cases of intracranial hematomas due to aneurysmal rupture--representing 34% of the total number of patients with aneurysms observed in a 12-year period--were evaluated; of these, 211 were submitted to computed tomography scan. Hematomas were present on admission in 71% of patients and occurred at rebleeding in 29%. Ruptured middle cerebral artery aneurysms caused an intracranial hematoma more frequently than aneurysms in other locations. Ventricular hematomas were frequently observed--especially at rebleeding--in cases with anterior communicating artery aneurysms. Basal ganglia hematomas were detected in eight cases with internal carotid bifurcation aneurysms and in three with middle cerebral artery aneurysms. Subdural hematomas were observed in 32 cases, mainly due to ruptured middle-cerebral-artery and internal-carotid-artery aneurysms. As for clinical evolution, a rapid deterioration was observed in 39% of cases and a chronic course in 46%; a subacute deterioration was far less frequent. Delayed deterioration from vasospasm was observed in 8% of cases, and appeared to be related to the amount of subarachnoid bleeding associated with the hematoma. One hundred and forty-two patients were submitted to surgical treatment (evacuation of hematoma together with exclusion of aneurysm); deep coma, poor medical condition, stabilized neurological disability, or combinations of these factors accounted for the high number of patients not operated upon. Regardless of treatment, 24% of patients showed good results and 58% died. Presence of a large hematoma, ventricular hemorrhage, and shift of the ventricles represented significant risk factors, associated with a poor prognosis. A comparison between two groups of patients admitted within 3 days of hemorrhage--47 operated on early, and 149 with delayed treatment--showed that better results were achieved by early operations, especially for cases in Hunt's grades IV and V.

Adolescent

Surgical versus medical treatment of spontaneous posterior fossa haematomas: a cooperative study on 205 cases.

22 Italian centres have joined together in a cooperative study aiming to define the ideal management of spontaneous posterior fossa haematomas. 205 cases have been evaluated: 155 cerebellar haematomas and 50 brainstem haematomas. Out of these, 190 cases, all studied by CT scan, are the subject of the present study. Cerebellar haematomas have been divided, according to a tomographic classification, into 3 groups: group 1 (4th ventricle not shifted), group 2 (4th ventricle shifted or obliterated) and group 3 (intraventricular blood). Each group has been subdivided into: A (no hydrocephalus), and B (hydrocephalus). Regardless of therapeutical modalities, mortality rate was 38% for cerebellar haematomas; level of consciousness a few hours after haemorrhage and size of the lesion appeared to be significant prognostic factors. As a whole, medical treatment gave better results than surgical treatment. Considering each tomographical group in detail, surgery should be limited to patients in group 2B and 3B, especially when exhibiting neurological deterioration. For brainstem haematomas, overall mortality was 57%. The possibility of survival was linked to the presence or absence of initial loss of consciousness and to the size of the lesion; while hydrocephalus did not influence the final outcome, ventricular blood was a risk factor. Surgical evacuation showed some value in chronic cases. However, medical treatment appears to be the best policy for brainstem haematomas of limited size; for larger lesions, the outcome appears to be uniformly fatal, regardless of the treatment employed.

Adolescent

Intracranial arteriovenous malformations in the pediatric age: experience with 24 cases.

24 patients below 16 years of age with intracranial arteriovenous malformations are considered. Presenting history has been constituted mainly by intracranial hemorrhage, followed by epilepsy and hydrocephalus. The utility of angiography and CT scan is stressed, especially for preoperative evaluation. The arteriovenous malformation was located in noncritical cortical areas in 7 cases, in critical cortical areas in 6 cases, in the midline structures or in the basal ganglia in 8 cases, in the posterior fossa in 2 cases, and was only dural in 1 case. Complete surgical resection of the lesion has been carried out in 18 cases, and embolization in 1 case. The operative microscope, induced hypotension, and the 'backward technique' have been very useful during surgery. Following the operation, good results have been achieved in 83% of cases; mortality has been 11%. In most cases epilepsy has shown improvement after surgery. It is concluded that direct surgical extirpation of the angioma is the treatment of choice for pediatric patients, even in the presence of epilepsy alone.

Adolescent