Biomedical subjects
Publications and source records attributed to A Casotto.
One case of cystic lesion of the third ventricle is reported. The authors stress the importance of CT combined with ventriculography for the diagnosis of the intraventricular cystic lesions.
Neoplasms of the third ventricle are lesions arising within the ventricular cavity, often free but more often pedunculated. True third ventricle tumours are surgically removable. In a consecutive surgical series of 580 intracranial tumours the authors operated on 27 lesions of the third ventricle, 7 of which were benign gliomas. The histological diagnosis was polar spongioblastoma in 5 cases and fibrillar subependymal astrocytoma in 2 cases. The dominant clinical features were a slowly progressive or intermittently increased intracranial pressure syndrome, and mental and visual disturbances. CT and CSF contrastographic studies provided the essential diagnostic data for the therapeutic plan. CT scans at follow-up studies confirmed the successful removal of the lesions. A right trans-ventricular approach was employed in all cases. Depending on the size and position of the lesion, removal was performed through the foramen of Monro or through a sub-choroidal approach. In two patients a ventriculo-atrial shunt was necessary in spite of tumour removal. No surgical mortality occurred and patients are well at a follow-up time of from 2 to 6 years.
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A case of epilepsy is reported during ventriculography with hydrosoluble triiodate contrast (methylglutamine iotalamate). The cysternal interhemispheric cavities of the midline were flooded. This complication, which could have been lethal was treated with thiopental sodium salt, 6 methylprednisolone, mannitol, curare, trans-larynx intubation, ventilation with oxygen and nitrous oxide. The AA. conclude that the presence of an anaesthetist-resuscitator is essential during ventriculography with triiodate hydrosoluble contrast medium.
The authors present a new, advanced system for electrocoagulation. In order to solve the problems connected with standard and bipolar EC machines available to date (i.e.: uneven and incostant coagulation; adhesion of tissue to the tips of the forceps, etc.), the Authors realized bipolar screened forceps with a well balanced current flow to avoid any heat dissipation. This new type of forceps are fed by a peculiar, two-step heating pattern, time dependent, that coagulates only the core of the clamped tissue.
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