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C Mottolese

Publications and source records attributed to C Mottolese.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Partial recovery of the oculomotor nerve after section and repair during the excision of a tumor].

The authors report the case of a patient having suffered a section of the oculomotor nerve during the excision of a tumor located in the tentorium incisura. The nerve was immediately sutured (end to end anastomosis). After 18 months, a partial recovery of the function of the nerve was seen clinically and on EMG. Ptosis had disappeared and adduction of the eye reappeared. An analysis of available data on the suture of oculomotor nerves is then given: reparation of the third nerve in animals and man give variable and partial results. Partial recovery and aberrant regeneration are explained by the fact that this nerve innervates many muscles and by the absence of ultrastructural systematisation. On the contrary, some still rare studies have indicated that the suture of the fourth and sixth cranial nerves give better results probably because these nerves have a simple ultrastructural organization, are purely motor and innervate only one ocular muscle.

Adult↗
PubMed1988

[Long-term results of the treatment of ruptured intracranial aneurysms. Study of a series of 328 patients hospitalized from 1972 to 1984].

Between 1972 to 1984, 328 patients were admitted in the department of neurosurgery, for the treatment of a ruptured intracranial aneurysm, and being clinically in grades I to IV. These patients were submitted to a deferred surgery protocol. 5.5% of the patients died before surgery, and 94.5% were actually operated on. The follow-up was at least over one year, and up to 14 years (mean 3 years and 8 months). The long term result was appreciated according to the physical status of the patients and the activity resumption (professional, familial and social as well). This long term result was compared to the immediate results, which had been appreciated either at the time of discharge or a few months later. 25.9% of the 328 patients were lost of view, and 74.1% were followed (including pre-operative and operative death). The immediate results were: death 17.7%, poor 7.3%, fair 9.1%, good 66.2%. The long term results were appreciated as follows: Poor 7.3%, Fair (independent but with emotional or psychological difficulties), 14.8%, Good (fully independent) 55.1%. The long term activity resumption (ability to work) was: normal 46.5%, lesser level of work 7.8%, unable to work 20.5%. Out of the patients with a good and fair immediate result, only 66.5% have resumed their previous occupation. 21.2% of these patients did not resume their previous occupation due to psycho.

Activities of Daily Living↗
PubMed1987

Spontaneous progressive thrombosis and surgical resection of a giant aneurysm of the posterior cerebral artery in an 18-year-old.

The rare case is reported of an 18-year-old boy with giant fusiform aneurysm of the P1 and P2 segments of the posterior cerebral artery. The symptoms were two episodes of sudden headache with transient third-nerve palsy. The aneurysm developed into almost complete thrombosis over five months. The posterior cerebral artery distal to the aneurysm was also thrombosed and reirrigated by collateral channels without visual field deficit. The aneurysm was treated by resection. The development of this giant aneurysm, the progressive thrombosis and the clinical characteristics are discussed.

Adolescent↗
PubMed1986

Cerebellar astrocytomas in childhood.

According to CT appearance and surgical observations, cerebellar astrocytomas can be separated into three types. On CT scan, cystic astrocytomas have a typical mural nodule; with contrast injection only the nodule becomes hyperdense; the wall of the cyst is not modified. In these cases, only the mural nodule is removed since the wall does not contain tumor cells. In contrast, false cystic astrocytomas present an irregular wall, diffusely enhanced and thick. Then the wall is invaded by tumor cells, it must be totally removed. Solid astrocytomas may invade the peduncle, the IV ventricle, and the subarachnoid spaces. Removal is sometimes questionably total. As recurrences are not frequently observed in these cases, radiotherapy is not always recommended. Rather, radiotherapy is only used in cases of undoubted partial removal or after partial removal of a recurrence. Of 63 cases, early postoperative mortality was 4.7% and late recurrence 6.3%.

Adolescent↗
PubMed1986

Outcome of ruptured intra-cranial aneurysm treated by a deferred operation. Review of 345 consecutive cases treated over a period of 12 years.

This paper reports experience with 345 patients admitted to a neurosurgical department after an aneurysm rupture. At the time of admission, patients were separated into two groups: the patients unsuitable for planned surgery and called 'unoperable'; the patients planned for surgery and called 'operable patients' (328 patients). The general management attitude consisted of deferred surgery according to the clinical status of the patients and the risk of vasospasm and ischaemia. Of these, 18 died before the day of surgery, and are called 'operable and non-operated' patients. The cause of death was vasospasm and ischaemia in 10 cases and recurrence of haemorrhage in 8 cases. 310 patients were actually operated upon. Their final outcome was: good 70%, fair 9.6%, poor 7.7%, death 12.5%. This paper discusses the risk of SAH recurrence and the risk of vasospasm and ischaemia during the waiting time before surgery, in the attitude of deferred surgery which was elected in most cases of this series and compares the outcome with other published series.

Humans↗
PubMed1986

[Stenosis of the posterior cerebral artery (P1) discovered at the time of a meningeal hemorrhage and simulating an arterial aneurysm].

A case is reported, in which a patient 54 years old, was admitted after a SAH. The CT Scan (D1) demonstrated blood in the peri-peduncular cisterns. A first angiogram through femoral route was performed at D1. There was no vascular malformation on both carotid territories. An arterial ectasia was demonstrated on the basilar artery, arising at the origin of the left superior cerebellar artery. The left posterior cerebral artery was supplied only by the left carotid artery through a dilated posterior communicating artery. A second left vertebral angiogram was performed at D8, to make sure whether this ectasia was an aneurysm or a non aneurysmal dysplasia, but failed to provide certainty. The patient was operated upon at D17, with the diagnosis of possible aneurysm at the origin of the left superior cerebellar artery. Through a pterional route the posterior communicating artery was approached, no blood was found in the area of the upper basilar artery; there was an abnormal posterior circle of Willis, the superior cerebellar artery arising with a common trunk from the upper basilar artery; distal to this common trunk, the P1 segment was normal on the first three fourths of its course; the last fourth of the P1 segment was highly narrowed, the outer diameter of the narrowed P1 segment was approximately one third of the normal P1 segment, and was located at the junction with the complex posterior communicating artery-P2 segment. This narrowed part of the P1 segment showed evidence of an atheromatous plaque on its wall. No aneurysm was found in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗
PubMed1984

Transient occlusion of intracranial blood vessels. Presentation of one clinical and preliminary considerations.

The authors suggest that some cerebral ischaemic lesions depend upon a transient obstruction of intracranial blood vessels (particularly the trunk and the branches of the middle cerebral artery). This explains (as in the patient described here) the cases in which an ischaemic lesion does not correspond with the vascular lesions found on arteriography and/or at autopsy. Furthermore the authors indicate the importance of blood flow in the spontaneous relief of obstruction which is favoured by an undamaged vascular bed. Consequently they recommend, if possible, early surgical treatment of the carotid lesions, in order to reduce the risk of emboli and to improve cerebral blood flow in general.

Adult↗
PubMed1984

[Outcome of ruptured intracranial aneurysms treated in accordance with the principle of deferred surgery. 308 consecutive cases over an 11 year period].

The diagnosis of the aneurysm rupture either was assessed at the time of admission, or was assessed after the admission into the surgical department. Most patients were admitted after the first 24 hours following the S.A.H. From the beginning the patients were separated in two groups: 1) The patients unsuitable for planned surgery (grade V--Botterrel, or general contra-indication, such as neoplasm), 2) The patients planned for surgery and called much less than operable patients much greater than (grade I to IV--Botterell, without extra neurological contra-indication). The general management attitude consisted of the delayed surgery according to the neurological status of the patients, and the risk of vaso spasm and ischemia. Thus, in most cases, the surgery was delayed after the 9th day, following S.A.H., and even after the 12th day for anterior communicating aneurysms. The following results were observed: 1) Unoperable patients: (15) The 12 patients in grade V at the time of admission died (with or without emergency surgery). The 3 patients with a general contra-indication have been lost of view. 2) 293 patients were considered for delayed surgery: 16 died before the day of surgery (5,5%). Out of these much less than operable and no operated patients much greater than, 10 died from cerebral ischemia (3,4% of operable patients) and 6 died from hemorrhage recurrence (2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1983

[Supratentorial arachnoidal cysts].

The AA., after having examined the various hypothesis reported in literature about the etiopathogenesis and the contrasting anatomical and pathological data concerning the arachnoid supratentorial cysts, point out the remarkable frequency of they malformative and above-all post-traumatic genesis. On the formation mechanism of this last type, they agree upon the supposition expressed by Taveras and Ransohoff in 1953. The AA., therefore, after having analysed the principal morphological and topographical aspects, pay attention to the present diagnostic possibilities, above all in radiological range, where the TAC represents, by this time, the examination of election compared with traditional assurances with means of contrast. It follows the analysis of the personal casuistry, consisting in 6 arachnoid supratentorial cysts, two of which clearly post-traumatic and two, very probably, of malformative genesis (for the coexistence of data in favour of both suppositions). The AA. draw these conclusions: the CT Scan is the only diagnostic means which permits an exact pre-operating diagnosis on the nature of the lesion; the surgical and, above all, anatomo-pathological reports assume an essential rule for an exact etiopathogenetic interpretation of the lesion examined.

Adolescent↗