Superficial temporal artery aneurysms.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D Locatelli.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Twenty-four high-risk newborns with a low birth weight developed progressive hydrocephalus and underwent ventriculoperitoneal shunting (at the time of shunting they weighed 1,100-1,900 g, mean 1,541 g). The changes in hydrocephalus after shunting were determined by ultrasound examinations; preoperative examination was by CT. Of the factors evaluated for their relationship to shunt complication, we considered in particular babies with a CSF protein level of over 1.5 g/l (7 cases). These cases were treated with external drainage and later with ventriculoperitoneal shunting. Shunt infections occurred in 20.9%, in contrast with a low incidence of shunt blockage (8.3%), probably owing to previous external shunting in children with high CSF protein. There were 2 deaths (8.3%). All children underwent careful follow-up during the 1st year and serial checkups subsequently for 5 years.
Twenty supratentorial and 10 infratentorial arachnoid cysts are reported. The patients were from 0 to 15 years of age. The commonest presenting symptoms in children were cranial enlargement, epileptic seizures, and psychomotor retardation. Neuroradiological evaluation included CT, metrizamide CT, cisternography, and angiography. Echography was performed in 5 newborns. Therapeutic criteria according to the clinical and neuroradiological findings are reviewed. Cystoperitoneal shunting in combination with ventriculoperitoneal shunting for associated hydrocephalus is considered the treatment of choice.
The authors report ten cases of multiple meningiomas in a series of 227 intracranial meningiomas from 1977 to 1984. The incidence of multiple meningiomas was 4.4% (according to Cushing and Eisenhardt's [1938] concept of "multiplicity" of such tumours). These results are comparable to those obtained by other authors. All patients were females and all underwent CT scan before operation. Clinical symptoms are presented along with location and size of the tumours. Pathogenetic theories and research prospects are discussed.
The authors report on twelve years experience with so-called normal pressure hydrocephalus. If care is taken to make a correct diagnosis and give adequate treatment with a shunt, hydrocephalic dementia has a good prognosis. Such cases should be distinguished from other syndromes, particularly senile dementia and Alzheimer's disease. The occurrence of a syndrome of dementia should compel every neurologist and neurosurgeon to carry out careful investigations in order to determine the favourable time for possible treatment.
Endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea is becoming a common procedure. The purpose of this study was to perform a literature analysis centering cases of treatment failure and to review our 31 cases with a 1-year minimum follow-up. An extensive search of the literature was conducted, which focused on success rate, follow-up, diagnostic techniques, graft material used, failure rate, and comments on failures. A retrospective analysis of our 31 patients was carried out, and all cases were treated with the endoscopic approach with a 1-year minimum follow-up. From the literature analysis, the median success rate at the first endoscopic attempt is 90%. Our success rate was 87.1%. Failures were analyzed. A unique protocol for CSF leak diagnosis does not exist; we suggest our diagnostic algorithm. Graft material used depends on the authors' experience, and based on this review of cases to date, did not significantly influence the success rate. The analysis of cases of failure shows that the majority of authors omit details. More research is needed to improve prevention of failures.
Intraoperative ultrasonography with real time sonographic imaging equipment is widely used and, in the neurosurgical operating room, has been really successful, initially in the brain and subsequently in the spinal cord as well. Its main applications i.e. accurate needle biopsies, localization of intracerebral masses, placement of ventricular and cyst shunts, can diminish the amount of potential damage to normal brain tissue. Moreover results of tumor resection may be intraoperatively confirmed and the end results are more accurate. No intraoperative complications and no postoperative infections result from use of ultrasound in the operating room. No evidence is given that the small amount of mechanical vibration emitted by the transducer damages the brain or the spinal cord. Surgical procedures, as a result, are faster, safer and better planned by virtue of informations obtained by ultrasonographic intraoperative examination, instead of simple preoperative imaging procedures.
Authors present 36 patients with recurrent sciatica or low-back pain after lumbar disk operation. All patients were submitted to clinical and instrumental devices. CT-scan was performed in 36 patients, 12 underwent myelography and 4 EMG. Authors verified reliability of clinical and instrumental devices on the basis of surgical results. We believe that myelo-CT is actually the first choice investigation in the neuroradiological ones. In the near future MRI will take its place in investigating spinal pathology.
The authors report their experience in the surgical treatment of intracranial dermoid and epidermoid tumors. These lesions are rare but may, in most of the occasions, be completely resected allowing a complete cure of the patient. The usefulness of the most recent diagnostic tools is discussed and the surgical indications, complications and results are reviewed in comparison to the most significant literature reports.
The authors report their experience with the cranial recontouring techniques in the treatment of craniosynostoses. The results obtained treating sixteen children suggest that these techniques can be tolerated well by patients, with very limited postoperative complications. It is underlined that the precocity of the surgical treatment is an indispensable prerequisite in order to obtain satisfactory clinical and cosmetic results.
The authors report two clinical trials concerning chemotherapy and immunotherapy combined in the treatment of primary and metastatic brain tumors. In the first study bacillus Calmette-Guerin (BCG) and in the second Levamisole (LMS) were utilized as immunostimulating agents. Chemotherapy was performed with BCNU or CCNU in association with surgery and/or radiotherapy. The immunological response was obtained but immunotherapy failed to demonstrate any significant effect on survival.
Eighty-six cases of spontaneous intracerebral haemorrhage, some treated by surgery, some by medical therapy, were studied retrospectively. The two groups, characterized on the basis of numerous parameters were compared: the findings are discussed and interpreted in the hopes of indicating a correct therapeutic strategy.
The authors present the outcome of 42 patients operated at birth for closure of the spinal malformation. The age of patients at first observation ranged from 3 months to 21 years (mean 8.3 years); 7 patients (16.7%) had a close spina bifida, 35 (83.3%) had an open spina bifida and 30 (85.7%) of them developed hydrocephalus. The protocol included neurological evaluation, determination of development quotient using the Griffith's scale and intelligence quotient using the Wise-R scale. Adolescents underwent also the Blacky pictures test and Offer's interview. Verticalization and tutorial deambulation were achieved in 95.2% of patients; 76% of patients had a I.Q. > 90. The emotional situation was unsatisfactory in the majority of patients due to reduced autonomy and limited self-consideration.