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Biomedical subjects

A L Agnoli

Publications and source records attributed to A L Agnoli.

At least 19 recordsLinked to original sources
PubMed1992

Surgery, dopamine agonist therapy of combined treatment--results in prolactinoma patients after a 12 month follow-up.

In a non-randomized retrospective study n = 36 prolactinoma patients (n = 7 micro- and n = 29 macroadenomas) were evaluated before (E0), 4 (E1) and 52 weeks (E2) after applying 3 different treatment modalities: A dopamine agonist (DA) therapy (n = 14), B surgery as initial procedure (n = 12) and oral DA therapy, C DA preinjection, subsequent surgery (n = 10) and oral DA medication. T0 outline the effect of the 3 regimens upon serum prolactin (PRL) and tumour size reduction, clinical signs and symptoms, anterior/posterior pituitary lobe function and MRI/CT findings were evaluated in each patient at E0, E1 and E2. In group A, PRL normalization was achieved in n = 10 patients (71%), although the frequency of an empty sella was only one out of 12 macroprolactinoma patients (less than 10%). Patients of group C showed the lowest PRLE2 levels (32 +/- 11 ng/ml, normalization rate 60%), although not statistically significant when compared with the other groups (A: 41 +/- 28 ng/ml, B: 114 +/- 33 ng/ml, normalization rate 31%). According to MRI studies in groups B and C total removal was achieved in 33% and 50% of macroprolactinomas, respectively. The most favourable ratio of the leading pre/posttreatment signs and symptoms was observed in patients of group C. It was concluded that no superiority of either treatment regimen exists for prolactinoma patients. Each mode of therapy has its own benefits which may be applied to the different biological behaviour of a prolactinoma in the respective patient.

Adolescent↗
PubMed1990

[Contrast medium assisted nuclear magnetic resonance tomography. Signal intensity of gliomatous tumors].

In 124 patients with different types of gliomas signal intensity was studied with and without contrast material using T1-weighted sequences. The diagnostic possibilities equal those of computed tomography scans. Except grade II and III astrocytomas, the extent of the observed disorders of the blood-brain-barrier corresponds to the malignancy of the tumour. A distinction between glioblastomas, anaplastic astrocytomas and mixed gliomas is not possible. The differences on examination with and without contrast medium in grade I and II astrocytomas and grade I oligodendro-gliomas can be important for differential diagnosis. In addition the T1-weighted sequences require less time for investigation than other sequences which demonstrate disorders of the blood-brain-barrier without contrast material.

Astrocytoma↗
PubMed1988

[Giant cell tumors, aneurysmal bone cysts and osteoid osteomas of the spine].

Experience collected by us from treating 15 patients suffering from giant cell tumours, aneurysmatic bone cysts or an osteoid osteoma prompted us to investigate which progress has been made to date in the diagnosis and treatment of these lesions that contain giant cells, basing on recent diagnostic methods such as computed tomography and magnetic resonance, as well as neurosurgical methods. It was found that the course of these rare changes cannot be influenced either by extensive diagnostic or special neurosurgical measures and that the prognosis finally depends on the growth trends inherent in the lesion concerned. Now that both diagnostic and surgical techniques are more refined than previously, there is a tendency to an improved individual approach that is better suited to the needs of the patient. Radiotherapy of benign changes involving giant cells in the region of the vertebral column is no longer of any importance.

Adolescent↗
PubMed1988

[Magnetic resonance tomographic findings in spinal lipomas].

The diagnosis of spinal lipoma was confirmed by computed tomography (CT) or magnetic resonance imaging (MRI) in six patients. MRI was superior to CT and myelography in detection of a tethered cord in combination with a lipoma. Fatty tissue, especially in the extradural intraspinal compartment, is not necessarily a pathologic finding. The etiology of spinal lipomas remains obscure. The seemingly idiosyncratic genesis of fatty tissue is discussed with reference to one of the patients in this series.

Adult↗
PubMed1987

Atlanto-axial dislocation in rheumatoid arthritis--diagnostic and therapeutic aspects.

Symptoms, signs and neuroradiological findings of 15 cases with atlanto-axial dislocation (AAD) due to rheumatoid arthritis are presented. CT of the craniocervical region revealed the exact anatomical relationships between the dens, the subarachnoid space and the brain stem, especially after intrathecal contrast medium injection and different positions of the head. From the results of operative procedures to reduce AAD it was concluded that early diagnosis and treatment of AAD leads to prompt relief of painful symptoms within 3 months and protects from neurological deterioration.

Arthritis, Rheumatoid↗
PubMed1987

Magnetic resonance imaging of brain tumors: application of gadolinium-DTPA and comparison to computed tomography.

In general, CT examinations still seem to be necessary for preoperative classification of brain masses. With increasing experience it should become clear whether sensitivity and specifity of MRI in the diagnosis of brain tumors can be further improved. Although much more work will be necessary in order to establish the optimal dose, timing, and pulse sequences when using Gd-DTPA, this study demonstrates that contrast changes due to Gd-DTPA can have clinical value.

Astrocytoma↗
PubMed1986

Congenital intracranial neoplasms.

The clinical and histological findings are described in 12 infants (5 boys, 7 girls) suffering from congenital intracranial tumors. An enlarged head or signs of increased intracranial pressure were present at birth or within the first 12 months of life (average 5.1 months). The histological picture of the tumors (6 supratentorial, 6 infratentorial) varied. In 6 children a ventriculoperitoneal shunt was necessary; partial or total removal of the tumor was attempted in 5 infants; 4 patients received irradiation. Prognosis was poor, and survival time averaged 13 months. A short review of the literature is given; new diagnostic techniques (computed tomography, magnetic resonance imaging) allow earlier diagnosis. However, because of the size and location, successful treatment is rarely possible.

Brain Neoplasms↗
PubMed1986

[Neuroradiologic study using modern imaging procedures (CT:NMR) in venous, cerebral vascular malformations].

Clinical, neuroradiological and surgical findings were analysed in nine patients with venous cerebral malformations. Special emphasis has been placed on MR findings. Venous angiomas are characterised in MR tomography as low-signal areas whereas cavernous angiomas are characterised by a high incidence of signals due to the blood coagulates. In this manner MR tomography confirmed pathologico-anatomical findings to the effect that malformations are often made up of a venous and a cavernous component. Today it is also occasionally possible to clarify the aetiology of so-called "cryptogenic" epilepsies. Modern microsurgery enables the removal of a venous vascular malformation even in the parietal area without the risk of impairment or loss of nerve function.

Adult↗
PubMed1985

Digital subtraction angiography (DSA) in neuroradiology.

DSA ranks among the modern imaging procedures which owe their development to the advances made in computer technology. Thanks to i.v. contrast injection, it has become possible to evaluate a lesion in the cervical vessels in at least 80% of cases and in 60% of cases when intracranial vessels are concerned. Intra-arterial contrast injection renders the diagnostic yield of DSA equal to that of conventional angiography with the benefit that the required contrast volumes are low and that the catheter need not always be placed selectively. Intravenous contrast injection is required with patients advanced in age, when critical cardiovascular conditions prevail, when the arterial access routes are completely occluded or in the case of postoperative checks of the cervical vessels. Although its field of application remains restricted, particularly in the case of intravenous contrast injection, the clinical application of DSA appears well established and its advantages are undisputed. Examples are given to demonstrate the clinical boundaries set to this new imaging procedure based on i.v. and intra-arterial contrast injection.

Adult↗
PubMed1985

Cerebral venous angiomas.

Clinical symptoms and radiological signs in 15 patients with cerebral venous malformations are presented and the diagnostic problems discussed. The circulation time in combination with cerebral malformations and angiomas of the scalp are described. CT findings in cases of venous malformations of the brain stem are evaluated. Spot-like enhancement, as well as sharply demarcated rounded shaped enhancement are characteristic for venous angiomas. Cavernous angiomas usually present as homogenous or inhomogenous round shaped enhanced areas.

Adult↗
PubMed1984

Decerebrate rigidity and vegetative signs in the acute midbrain syndrome with special regard to motor activity and intracranial pressure.

Decerebrate rigidity, intracranial pressure and vegetative signs were studied in 25 patients. Advanced statistical techniques were used to analyse the interrelationships between muscle activity (IEMG), blood pressure (ABP), intracranial pressure (ICP), pulse rate (HR), respiratory rate (RR), and central venous pressure (CVP) occurring during paroxysms of decerebration. The pattern of reaction is influenced by compression or stress imposed on the brain stem at the tentorial incisure and is related to the degree of cisternal obstruction. Significant differences in reaction were disclosed between provoked and spontaneous decerebration posturing.

Adolescent↗
PubMed1984

[Obstructive hydrocephalus in cerebellar infarcts].

Large cerebellar ischaemic infarction may act as a space-occupying lesion and cause acute ventricular dilatation secondary to brain stem compression. 8 cases are regarded and the clinical course and therapy are discussed. After acute onset with vestibular and cerebellar symptoms, signs of progressive clouding of consciousness, accompanied often by signs of brain stem compression develop leading finally to decerebration syndrome. CT reveals an extensive hypodense area, usually in the lower part of the cerebellar hemisphere, compression and shift of the IVth ventricle and dilatation of 3rd and lateral ventricles. Drainage of ventricular fluid alone is not sufficient and the therapy of choice is the resection of infarcted tissue. Even in patients, who were operated in the early phase of decerebration excellent recovery was noted.

Adult↗
PubMed1984

[Arachnoidal cysts. A clinical, neuroradiologic and computed tomographic study].

The clinical features and neuroradiological and computertomographic findings in 125 patients with cystic intracranial processes, which were neither due to tumour nor of vascular origin, have been analysed. The intrathecal injection of iodinated contrast media is absolutely essential for the differential diagnosis of congenital cysts. CT demonstration using 2 mm. slices and coronal and sagittal reconstruction makes it possible to relate the lesions to surrounding brain structures. Additional anomalies of the brain can be diagnosed and considered when planning treatment. Air studies are no longer necessary, but plain films remain the first diagnostic step. In view of modern micro-surgical techniques, angiography remains of value in order to diagnose vascular anomalies at a pre-operative stage.

Adolescent↗
PubMed1984

Enterogenous intraspinal cysts.

The authors have reviewed the literature and recorded the distinguishing features of intraspinal enterogenous cysts. There are no characteristic clinical findings or history associated with this disease. These congenital space-occupying lesions frequently go undiagnosed, and the patient may be treated for many years as a case of multiple sclerosis. The teratogenic "determination period" is decisive for the development of anomalies affecting one, two, or all three of the germinal layers. All of these cysts belong to the same group, and their structure is an expression of the differing determination periods. The various theories about their etiology are discussed. True intraspinal enterogenous cysts are usually found in the cervical region. After careful operative removal, the prognosis is favorable.

Adult↗
PubMed1984

[Spontaneous hygroma in intracranial arachnoid cysts].

Anamnesis and treatment of two cases of arachnoid cysts extending into the subarachnoid space are described. No traumatic incident was discovered in the previous history of these two patients. The causal genesis of neurological signs of deficiency in patients with arachnoid and acquired cysts is discussed. However, the cause of the development of a subdural hygroma in arachnoid cysts remains unclarified. CT findings of arachnoid cysts with a hypodense zone between brain surface and the vault of the cranium always require an investigation into the possibility of a spontaneous emptying of the cyst or of a congenital and not only localised extension of the cyst itself

Brain Diseases↗
PubMed1984

[Computer tomographic detection of an intraspinal arachnoid cyst].

Clarification of the subjective complaints caused by meningeal malformations represented by an arachnoidal cyst in the sacral region was achieved for the first time by analysing an arachnoidal cyst which had been determined by myelography, computed tomography, biopsy and histological examination. Principles of mechanics and dynamics play an important part. The pattern of complaints is mainly due to the communication between the cyst and the CSF space, as well as a valve mechanism with filling of the cyst. Surgical reduction or removal of the cyst, and elimination of the connection with the CSF, produced freedom from complaints.

Adult↗