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Cesare Colosimo

Publications and source records attributed to Cesare Colosimo.

At least 19 recordsLinked to original sources
PubMed2006

Multidetector CT in abdominal aortic aneurysm treated with endovascular repair: are unenhanced and delayed phase enhanced images effective for endoleak detection?

PURPOSE: To retrospectively determine the sensitivity and specificity of unenhanced, delayed enhanced phase (DEP), and arterial enhanced phase (AEP) multi-detector row computed tomography (CT) for depicting endoleaks during follow-up of endovascular aneurysm repair. MATERIALS AND METHODS: Fifty patients (two women, 48 men; mean age, 72 years) underwent follow-up multi-detector row CT 1, 6, and 12 months after endovascular aneurysm repair. Unenhanced CT was performed with 2.5-mm collimation; 1-mm collimation was used with AEP and DEP examinations. Two independent readers assessed the presence of endoleak in three reading sessions: AEP (session A), unenhanced and AEP (session B), and AEP and DEP (session C). At 6- and 12-month follow-up, a fourth set was included: 1-month unenhanced and AEP (session D). Sensitivity, specificity, and positive predictive value of each session were calculated. Triple-phase multi-detector row CT was the reference standard. RESULTS: At 1 month, sensitivity, specificity, and positive predictive value, respectively, were 79%, 75%, and 55% for session A; 93%, 97%, and 93% for session B; and 93%, 78%, and 62% for session C. At 6 months, sensitivity, specificity, and positive predictive value, respectively, were 92%, 68%, and 48% for session A; 92%, 100%, and 100% for session B; and 100%, 84%, and 67% for session C. At 12 months, sensitivity, specificity, and positive predictive value, respectively, were 80%, 80%, and 50% for session A; 90%, 98%, and 90% for session B; and 100%, 80%, and 56% for session C. Sensitivity did not significantly differ (P > .05) among reading sessions A, B, and C, whereas specificity and positive predictive values in session B were significantly higher (P < .001). For 6- and 12-month follow-up, no significant differences (P > .05) were found between sessions D and B. CONCLUSION: The combination of AEP and unenhanced imaging performed at 1-month follow-up offers improved specificity and positive predictive values compared with AEP alone. DEP imaging does not significantly increase sensitivity for detection of endoleaks, but it does depict low-flow endoleaks not seen at AEP.

Aged↗
PubMed2006

Contrast-enhanced MR imaging of the spine: when, why and how? How to optimize contrast protocols in MR imaging of the spine.

The optimal protocols and the role of contrast agents in spinal MR imaging are controversial. Although the diagnosis of many common spinal diseases can be reliably achieved by means of unenhanced images, contrast use is often necessary to improve lesion detection and differential diagnosis. The heterogeneity of the different spinal compartments and the wide variety of spinal pathology require tailored imaging strategies. Thus, the rules to achieve optimization of contrast protocols for MR imaging of the spine are frequently very different to those for brain imaging, and depend on the location and site of origin of the lesions in a specific spinal compartment, on the findings of unenhanced imaging, and on the concomitant use of fat-suppression techniques. Furthermore, in most cases, the small size of the examined structures requires a meticulous technique, and the administration of a contrast agent with high relaxivity, such as MultiHance, is advisable to enable the detection of tiny areas of contrast enhancement. The applications and clinical utility of post-contrast MR imaging are discussed with regard to different spinal diseases.

Contrast Media↗
PubMed2006

Magnetic resonance imaging findings in sudden sensorineural hearing loss.

OBJECTIVE: To investigate the role of magnetic resonance imaging (MRI) in the diagnosis of sudden sensorineural hearing loss (SSNHL). METHODS: Fifty-four consecutive patients affected by SSNHL were investigated using brain MRI. MRI was performed with an eight-channel phased-array head coil to study the entire audiovestibular pathway and the whole brain. The protocol study consisted of a high-resolution study of the temporal bone, internal auditory canal (IAC), cerebellopontine angle (CPA), and brainstem combining 2 mm thin-slice axial T(2)-weighted two-dimensional fast spin echo (FSE) and fluid-attenuated inversion recovery (FLAIR) sequences, pre- and postcontrast (gadolinium-diethylenetriamine pentaacetic acid) administration fat-suppressed axial T(1)-weighted two-dimensional FSE sequences, and a T(2)*-weighted three-dimensional Fourier transformation-constructive interference in steady state sequence (FT-CISS) , with 0.4 mm ultrathin partitions. The rest of the brain was studied with a 4 mm axial T(2)-weighted FLAIR sequence. RESULTS: Thirty-one of 54 (57%) cases of SSNHL presented with MRI abnormalities. In 6 of 54 cases, the detected abnormality was directly correlated to the clinical picture (2 labyrinthine hemorrhage, 1 cochlear inflammation, 1 acoustic neuroma, 1 arachnoid cyst of the CPA, and 1 case of white matter lesions in the pons, compatible with demyelinating plaques along the central audiovestibular nervous pathway, as the first expression of multiple sclerosis). CONCLUSIONS: An extensive MRI study of the audiovestibular nervous pathway and of the whole brain, pre- and postparamagnetic contrast administration, is recommended to rule out the wide spectrum of abnormalities that can cause SSNHL.

Adult↗
PubMed2006

Idiopathic spinal cord herniation: diagnostic, surgical, and follow-up data obtained in five cases.

Idiopathic spinal cord herniation (ISCH) is a rare, although increasingly recognized, cause of myelopathy. It is the result of an anterior dural defect in the thoracic spine through which the spinal cord herniates. Surgical restoration of the herniated cord to its normal position is usually followed by significant improvement in patients' clinical status. Differing surgical techniques have been used to manage the dural defect. In this report the authors discuss the cases of five patients (four women and one man) with ISCH treated during a 13-year period. Clinical and imaging findings in each patient are reported. Two different surgical techniques were used to treat this condition: dural defect enlargement in two cases and dural patch secured with stitches in three. The intra- and postoperative findings are discussed in relation to the two surgical techniques. Based on the results and complications in these five cases, the authors now believe that ISCH should be treated, when feasible, by using a dural patch to close the dural defect at the site of the herniation.

Adult↗
PubMed2005

Classical lissencephaly associated with dolichocephaly, hair and nail defect.

We report on an 1-day-old boy with classical lissencephaly (grade 1, according to Kato and Dobyns, 2003) associated with an extended phenotype, including dolichocephaly, and hair and nail defects. The diagnosis of lissencephaly was made in utero, allowing the rapid characterization of the phenotype at birth. Because previously reported cases were not associated with the features described in our proband, they might represent a newly identified condition.

Brain Diseases↗
PubMed2005

Comparison of gadobenate dimeglumine (Gd-BOPTA) with gadopentetate dimeglumine (Gd-DTPA) for enhanced MR imaging of brain and spine tumours in children.

BACKGROUND: Gadobenate dimeglumine (Gd-BOPTA) demonstrates superior enhancement of brain tumours in adult patients than Gd-DTPA. OBJECTIVE: To determine whether Gd-BOPTA has advantages over Gd-DTPA for enhanced MR imaging of paediatric brain and spine tumours. MATERIALS AND METHODS: Sixty-three subjects, aged 6 months to 16 years, who were enrolled in a prospective, fully blinded, randomized parallel-group phase III clinical trial, received 0.1 mmol/kg doses of either Gd-BOPTA (n=29) or Gd-DTPA (n=34). The MR images were acquired before and within 10 min of contrast agent injection. The primary objective was to compare the difference from pre-dose to post-dose lesion visualization between Gd-BOPTA and Gd-DTPA. Lesion visualization was determined as the sum of individual scores for three criteria of lesion morphological characteristics (lesion border delineation, internal morphology, and contrast enhancement), each assessed qualitatively using 4-point scales. Quantitative evaluation compared changes in lesion-to-background (LBR) and contrast-to-noise (CNR) ratios and per cent enhancement. Monitoring for adverse events and evaluation of vital signs and laboratory values was performed. RESULTS: Pre-dose to post-dose changes in lesion visualization were significantly better for Gd-BOPTA for both lesion level (2.68+/-2.17 vs. 1.05+/-1.90, P=0.0106) and patient level (2.55+/-2.18 vs. 1.14+/-1.68, P=0.0079) comparisons. The mean pre-dose to post-dose change in CNR was greater for Gd-BOPTA (9.13+/-15.36) than Gd-DTPA (2.18+/-9.90), but the difference was only marginally significant (P=0.0779; 95% CI: -0.553, 14.454) because of wide variations of signal intensity between lesions. Similar findings were obtained for LBR and per cent enhancement. No differences between the agents were noted in terms of safety parameters. CONCLUSIONS: At an equivalent dose Gd-BOPTA is significantly better than Gd-DTPA for visualization of enhancing CNS tumours in paediatric patients.

Adolescent↗
PubMed2004

A fast visual evoked potential method for functional assessment and follow-up of childhood optic gliomas.

OBJECTIVE: To evaluate a fast technique of visual evoked potentials (VEPs) recording, in response to steady-state luminance stimuli (SS-LVEPs), for functional assessment and follow-up of childhood optic gliomas (OGs). METHODS: Eighteen OG patients (age range: 3.5-18 years), with different degrees of optic pathway damage severity, were examined. Sixteen age-matched normal subjects served as controls. Ten of the 18 OG patients were re-tested 1-3 months after the first examination. SS-LVEPs were elicited by a sinusoidally-modulated flickering (8 Hz) uniform field, generated by a light emitting diode (LED)-array and presented monocularly in a mini-ganzfeld. Amplitude and phase of the Fourier-analyzed response fundamental (1F) and second harmonic (2F) were measured. The full VEP protocol had a median duration of 6 min (range: 4-12). RESULTS: When compared to normal control values, median 1F and 2F SS-LVEP amplitudes of OG patients were reduced (P<0.01), with a borderline increase in 2F phase lag (P<0.05). In 11 OG patients with asymmetric optic pathway damage in between-eye comparisons, median 1F amplitude losses were greater (P<0.01) in fellow eyes with more severe damage. No significant interocular difference was observed in control subjects. Median test-retest changes of 1F and 2F component were <20% and 30 degrees for amplitude and phase, respectively. In individual OG patients, 1F and 2F amplitudes were positively correlated (P<0.01) with visual acuity. 1F amplitude losses were correlated (P=0.01) with the severity of optic disc atrophy. Considering both 1F and 2F abnormalities, diagnostic sensitivity of SS-LVEP in detecting OG-induced optic pathways damage was 83.3%. CONCLUSIONS: The present findings support the use of this technique, as an alternative to pattern VEPs, for functional assessment and follow-up of OG in uncooperative children.

Adolescent↗
PubMed2004

Cavernous hemangioma extending to extracranial, intracranial, and orbital regions. Case report.

Extraaxial cavernous hemangiomas are rare intracranial lesions that can be located in different cranial compartments. Extension across different tissue planes such as the subcutaneous tissue, skull, orbital cavity, intracranial dura mater, and extracranial trigeminal divisions within the same patient has not been previously reported. This 32-year-old woman suffered left exophthalmos, left sixth nerve palsy, and trigeminal neuropathy. Magnetic resonance imaging studies revealed an extensive multicompartmental lesion, with enhancement following Gd administration. A left orbitopterional approach allowed removal of several cavernomatous lesions located in the orbit, frontotemporal dura, and lateral wall of the cavernous sinus. A histologically based diagnosis of extraaxial cavernous hemangioma was made. In the postoperative period the patient experienced a regression of her symptoms. The authors report on a case of cavernous hemangioma with a unique extension to different intracranial/extracranial compartments. Although radical removal of the lesion was not feasible, partial excision allowed for satisfactory clinical control of the patient's symptoms.

Adult↗
PubMed2003

Cryptic t(1;12)(q44;p13.3) translocation in a previously described syndrome with polymicrogyria, segregating as an apparently X-linked trait.

We report on the multistep progression to the correct genetic diagnosis in an apparently new syndrome of mental retardation and multiple congenital anomalies, including hypogenitalism and polymicrogyria. We had previously reported it as an X-linked condition affecting four members (three males and one female) of a family [Zollino et al., 1992: Am J Med Genet 43:452-457]. Two of the four patients, both males, presented with a brain abnormality that was initially described as pachygyria, while the remaining two (one male and one female) did not. Our present study includes a clinical follow-up on the patients, neuroradiological reexamination of one patient, X linkage studies and X inactivation analyses, and finally molecular cytogenetics, which allowed us to establish definitely the genetic causes of the condition. After the detection of a subtle t(1;12)(q44;p13.3) balanced translocation in healthy carriers, two unbalanced segregation products were observed in different patients, resulting in 1q44qter monosomy and 12p13.3pter trisomy in patients with polymicrogyria and severe psychomotor delay, 12p13.3pter monosomy and 1q44qter trisomy in the other two patients without polymicrogyria, with less severe mental retardation and less distinctive physical anomalies. Thus, this condition is no longer to be considered X-linked, but the result of cryptic autosomal imbalance. Furthermore, this study identified an approximately 14 Mb interval in 1q44qter pathogenetically related to polymicrogyria.

Abnormalities, Multiple↗
PubMed2003

Magnetic resonance imaging of intramedullary spinal cord schwannomas. Report of two cases and review of the literature.

Intramedullary spinal cord schwannomas are rare benign tumors for which resection is possible and safe. The purpose of this paper is to present the magnetic resonance (MR) imaging features in two cases of intramedullary spinal cord schwannoma to assist both neurosurgeons and pathologists in preventing misdiagnosis and resultant partial resection. The MR imaging evidence of a small- or medium-sized well-marginated intramedullary spinal cord tumor in a patient in whom no syringomyelia is present but in whom moderate edema with marked Gd enhancement can be seen shouldbe considered in the differential diagnosis of intramedullary spinal cord schwannoma. In cases in which an associated thickened Gd-enhancing spinal nerve root is seen the diagnosis of schwannoma should be assumed.

Female↗
PubMed2002

Long-term cognitive outcome, brain computed tomography scan, and magnetic resonance imaging in children cured for acute lymphoblastic leukemia.

BACKGROUND: Prevention of meningeal recurrence achieved by intrathecal methotrexate (MTX) and systemic chemotherapy is part of standard acute lymphoblastic leukemia (ALL) treatment. Cranial irradiation has been a routine part of past protocol treatment but is currently reserved only for select subsets of patients. Central nervous system (CNS) prophylaxis may cause brain abnormalities such as intracerebral calcifications, cerebral atrophy, and white matter alterations. In addition, long-term neuropsychologic sequelae following CNS prophylaxis have been investigated marginally in children cured for ALL. METHODS: To explore possible correlations between neuroimaging findings and neuropsychologic outcome, we used detailed cognitive tests to evaluate 21 children with ALL who received cranial irradiation (range, 18-24 Gy) plus intrathecal MTX as CNS prophylaxis. All children were followed prospectively once a year by cerebral computed tomographic scan and magnetic resonance imaging. All patients had continuous complete disease remission for at least 4 years and cognitive tests were performed after neuroradiologic examinations. RESULTS: White matter abnormalities were associated with poor performance only in a task exploring visual motor integration in about 50% of patients. Intracerebral calcifications correlate with the number of intrathecal MTX doses and with low scores in total intellectual quotient, performance intellectual quotient, and significant impairment in attention and visual motor integration tests. Girls are more vulnerable to the effects of CNS prophylaxis, whereas age at treatment and radiotherapy dose are not relevant to neuropsychologic outcome. CONCLUSIONS: Our results indicate the need for careful follow-up of children's cognitive abilities because global intellectual measures often fail to detect specific disorders that may cause learning difficulties. Moreover, as the clinical implications of neuroimaging findings are often limited, periodic extensive evaluation by specific neurocognitive tests of mental abilities is recommended to detect early signs of cognitive impairment.

Antibiotic Prophylaxis↗
PubMed2002

High response rate to cisplatin/etoposide regimen in childhood low-grade glioma.

PURPOSE: The aim of this study was to avoid radiotherapy and to induce an objective response in children with low-grade glioma (LGG) using a simple chemotherapy regimen based on cisplatin and etoposide. PATIENTS AND METHODS: Thirty-four children (median age, 45 months) with unresectable LGG were treated with 10 monthly cycles of cisplatin (30 mg/m(2)/d on days 1 to 3) and etoposide (150 mg/m(2)/d on days 1 to 3). Tumor originated in the visual pathway in 29 patients, in the temporal lobe in two, in the frontal lobe in two, and in the spine in one. Eight children were affected by neurofibromatosis type 1. Objective tumor response and toxicity were evaluated by magnetic resonance imaging and neurologic and functional tests at 3-month intervals. RESULTS: An objective response was obtained in 24 (70%) of 34 patients, whereas the others had stable disease. None of the children were electively irradiated. In 31 previously untreated children, overall survival was 100% and progression-free survival was 78% at 3 years, with a median follow-up of 44 months. Acute toxicity was unremarkable; 28% patients evaluated for acoustic neurotoxicity revealed a loss of perception of high frequencies. CONCLUSION: Cisplatin and etoposide combined treatment is one of the most active regimens for LGG in children and allows avoidance of radiotherapy in the vast majority of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Ectopic recurrences of craniopharyngioma.

BACKGROUND: Ectopic recurrences of craniopharyngioma after total surgical removal are a rare event. Two possible mechanisms of seeding have been proposed: the dissemination of tumoral cells during the surgical procedure would account for tumor recurrence along the surgical path, whereas the migration of tumoral cells through the subarachnoid or Virchow-Robin spaces would explain ectopic recurrences far from the surgical bed or within the brain parenchyma. CASE REPORT: We report a unique case of metastatic craniopharyngioma recurring in a child after different intervals in which both the mechanisms could have taken place. The first ectopic seeding arose along the operative track of the primary surgical procedure in the frontal region while the second involved the deep cerebral nuclei and the brain stem. OUTCOME: The first recurrence was successfully operated upon. The following recurrences were not operated upon but remained stable for the last 4 years, thus showing dissociation between the capacity of seeding and invasivity.

Brain Neoplasms↗
PubMed2002

Neuroimaging of thalamic tumors in children.

INTRODUCTION: Thalamic tumors are typical deep brain tumors; their incidence is not precisely known because of the different definition criteria. However, taking only lesions arising in the thalami into consideration (and excluding those secondarily involving the thalami from adjacent structures) approximately 40% of thalamic tumors affect patients under 18 years of age and thalamic neoplasms account for 2-5% of all intracranial tumors in children. MATERIALS AND METHODS: In the present paper we have focused attention on the neuroimaging features of thalamic tumors in a pediatric population; based upon personal experience, we suggest a rational neuroradiological approach to the diagnostic evaluation, describe CT and MRI findings of the most common tumors, and attempt to define basic patterns in order to provide the most reliable "pathological" diagnosis.

Adolescent↗
PubMed2002

Hypersensitivity reactions to carboplatin in children.

Hypersensitivity reactions to carboplatin are rare but sometimes life-threatening events may occur requiring discontinuation of treatment. In our study, we describe clinical features and diagnostic procedures of carboplatin-associated reactions in children affected by low-grade astrocytoma and treated with multiple courses of carboplatin. In 6 out of 29 children, we reported allergic events. We also report a desensitization protocol for carboplatin administration, which allowed the patients to receive effective treatment without adverse reactions.

Anti-Allergic Agents↗