Paraparesis due to bilateral subdural hematoma.
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Biomedical subjects
Publications and source records attributed to D Benvenuti.
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Three cases of meningiomas associated with large cysts are reported, and 58 other cases from the literature are reviewed. The etiology of these cysts is analyzed on the basis of surgical and pathological findings. The preoperative diagnosis of large computed tomographic hypodensities associated with meningiomas and the differential features from other cystic tumors are discussed. The surgical aspect of the solid tumor and particularly the absence of a capsule separating the tumor from the cyst are usually decisive in confirming the intratumoral nature of the cyst. In questionable cases a histologic evaluation of the cyst walls may be necessary.
A 30-year-old man with a giant fusiform aneurysm of the intracavernous segment of the right carotid artery, clinically revealed by right painful ophthalmoplegia with exophthalmos, was treated by closure of the carotid artery in the neck with two paediatric Gianturco coils. The aneurysm, which had already shown partial spontaneous intraluminal thrombosis on CT and angiography, was no longer filled and its volume progressively decreased, with almost complete recovery of the oculomotor deficits. Serial CT and angiography performed seven months after treatment demonstrated the reduction in size of the aneurysm, its exclusion from the circulation and a good supply of the intracranial vascular bed, without the necessity of an extracranial-intracranial by-pass.
A 52-year-old woman had a right temporal glioblastoma six months after an operation for a right internal carotid aneurysm. In the literature there are no reports of gliomas arising in the region of a preceding craniotomy for an aneurysm. The rare association of brain tumours with arterial aneurysms and the pathogenetic theories are discussed. The authors suppose that in their case there is a relationship between the vascular changes due to the aneurysm and the operation and the growth of the malignant glioma.
A case of a very extensive spinal ependymoma, treated by operation and irradiation with good outcome, is reported and the other cases in the literature are reviewed. In patients with giant spinal ependymomas, operation is always necessary, whatever the extent of the tumour, although the removal is often incomplete. Nevertheless, even partial removal sometimes brings about a neurological improvement, because of the favourable effect of the laminectomy. Postoperative irradiation is useful in cases with the histological appearance of malignancy.
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The use of lasers in medicine and surgery has increased slowly-its effectiveness based on trial-and-error clinical experience. Very little comprehensive data has been published that scientifically presents dosage, energy, absorption, and comparisons between types of lasers. Our laboratory has developed a method for taking the guesswork out of laser dosage using scientific data to optimize therapy and give reproducible responses. Experiments were conducted using an argon laser, a neodymium: YAG laser, and a broad-band infrared light source. This preliminary study uses a beam scan technique, which for the first time permits accurate measurement of the laser intensity incident on tissue. Therefore, this protocol allows the standardization of dosage measurements with good experimental reproducibility in biological models. By using this accurate method of measuring the intensity delivered to pigskin, we are able to reproduce for the first time similar histological damage with the different energy sources.
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