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Biomedical subjects

E Pozzati

Publications and source records attributed to E Pozzati.

At least 19 recordsLinked to original sources
PubMed1992

Spinal cavernous angioma: a rare cause of subarachnoid hemorrhage.

A case of cervical intrathecal extramedullary cavernous angioma is presented. The rarity of this lesion in comparison with the more frequent vertebral cavernous angiomas with secondary extension to the epidural space is emphasized. The special features of this case are noted: the acute clinical onset due to recurrent subarachnoid hemorrhages, the visualization only by means of magnetic resonance imaging, and the unusual cervical level. The most debated characteristics of these lesions and the relevant literature are summarized.

Female↗
PubMed1991

Benign arterial dissections of the posterior circulation.

Four young adults with spontaneous dissection of the vertebrobasilar system are reported. Clinically, two patients presented with subarachnoid hemorrhage and two with brain-stem ischemia. In two cases of ruptured arterial dissection of the posterior cerebral artery, angiography demonstrated fusiform and "sausage-like" dilatation of the involved vessel. In two cases of occlusive dissection of the basilar artery, angiography revealed the typical "string sign." All four patients were treated conservatively: three survive in good clinical condition and one remains disabled. Follow-up angiograms showed spontaneous healing of the lesion with return to an almost normal arterial configuration in two cases; residual narrowing corresponding to the dissection was the most notable finding in the other two. It is recommended that, in a subset of neurologically stable patients, angiographic monitoring is undertaken to assess the tendency for spontaneous repair before surgical intervention is planned.

Adult↗
PubMed1990

Long-term follow-up of occlusive cervical carotid dissection.

We retrospectively studied 19 cases of occlusive cervical carotid dissection encountered at our hospital between 1974 and 1984 and followed for 5-13 (mean 8.2) years to assess the long-term prognosis of the disease. Five patients had transient ischemic attacks, seven had minor stroke, six had major stroke, and one had epileptic seizures. Angiography demonstrated the typical string sign in 17 cases, a double lumen with occlusion in one, and multiple scalloped narrowings with distal occlusion in the other. Three patients died within 1 month and three remain severely disabled (overall mortality and major morbidity 32%), five have permanent deficits, and seven are neurologically intact; the remaining patient was lost to follow-up. Five patients were treated surgically (two had extracranial-intracranial bypass and three had cervical carotid exploration), and the other 14 were treated medically. The overall rate of reopening was 47% with eight of 10 patients demonstrating recanalization on control angiography and another patient demonstrating recanalization at surgery. These nine patients remain clinically stable on follow-up evaluations. However, vascular abnormalities in the healed arteries were notable and include kinking, fibromuscular dysplasia, dissecting aneurysms, intracranial occlusion, and a residual mural defect.

Adolescent↗
PubMed1989

Extradural hematomas of the posterior cranial fossa. Observations on a series of 32 consecutive cases treated after the introduction of computed tomography scanning.

A series of 32 patients with posterior fossa epidural hematoma treated after the introduction of computed tomography scanning between 1975 and March 1988 is presented. Sixteen patients harbored "pure" epidural hematomas, whereas 16 had other infratentorial or supratentorial traumatic lesions. Glasgow Coma Scale on admission was 7 or less in 10 patients, 8-12 in 11, and 13-14 in 11. Only six patients had a lucid interval. Thirty patients were treated surgically; two patients with small hematomas were treated conservatively. Overall mortality was 15.6%, with 0% for "pure" and 31.2% for "complicated" posterior fossa epidural hematomas. The value of routine computed tomography scanning is emphasized in cases with occipital skull fracture or when such fracture is found in patients undergoing emergency evacuation of supratentorial hematomas. The pertinent literature is addressed with special regard to the delayed occurrence, associated lesions, and mortality of posterior fossa epidural hematomas and to the role of computed tomography scanning.

Adolescent↗
PubMed1989

Rapid spontaneous disappearance of an acute extradural hematoma: case report.

The authors report the case of a patient presenting with an acute extradural hematoma and diffuse axonal injury. Control CT scan performed 4 hours later showed the complete resolution of the extradural collection together with increased evidence of shearing injuries. The mechanism of the hematoma resolution may probably be related to the concomitant acute brain swelling.

Accidents, Traffic↗
PubMed1989

The growth of cerebral cavernous angiomas.

The natural history of cavernous angiomas is poorly understood, and their growth has rarely been documented. We report three cases of cavernous angiomas that grew to large size in 6 years, 2 years, and 2 months, respectively. An initial computed tomographic scan disclosed no abnormalities in one patient and demonstrated two "minimal" lesions in the other two. The mechanisms of growth of these lesions are discussed; subsequent hemorrhages and capsule formation played a major role in their enlargement.

Adolescent↗
PubMed1989

Blunt traumatic carotid dissection with delayed symptoms.

We describe five patients with blunt traumatic carotid dissection with delayed clinical presentation that varied from 2 weeks to 6 months. Four patients had severe head injury, and one patient had direct blunt trauma to the neck. Cerebrovascular symptoms developed in four patients. The fifth patient suffered loss of vision as a result of a concurrent giant intracranial dissecting aneurysm. Arteriography demonstrated a "string sign" in two cases and a cervical carotid aneurysm in three; two of the latter also had siphon occlusion, and one of these had a superimposed supraclinoid dissecting aneurysm. One patient was treated by thromboendarterectomy, one by aneurysmorraphy, another by carotid ligation, and the other two patients were treated medically. Mechanisms of injury, forensic problems, and therapeutic options are discussed.

Adolescent↗
PubMed1988

Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically.

Arachnoid cysts of the middle cranial fossa (Sylvian cysts), represent the most common type of intracranial leptomeningeal malformation. Among the 102 intracranial arachnoid cysts operated on at the authors' institution from January 1970 to August 1986, the 77 cases (75%) located in the middle cranial fossa are reviewed. The higher incidence in the first two decades of life (51 cases) as well as the marked predilection for the male sex (60 cases) and the left hemisphere (55 cases) are confirmed in the authors' experience. As for clinical presentation cranial deformities, symptoms of raised intracranial pressure and epilepsy constituted the most frequent features. In 13 patients a complicating lesion was associated: subdural or intracystic haematomas in 7 cases, subdural hygromas in 4 cases and, extradural haematomas in 2 cases. Based on the appearance at CT scan and the results at CT cisternography the authors proposed a classification into three basic types of increasing severity and different pathophysiologic conditions. All the patients underwent craniotomy, excision of the cyst walls and perforation into the basal cisterns. There was one postoperative death (mortality rate of 1.3%) due to meningitis. The remaining clinical results were gratifying in all three types of lesion; on follow-up CT scans the cysts of type I. and II. exhibited a steady tendency to reduction or obliteration while cerebral reexpansion seemed less evident in the third, most severe, type. The authors compare and discuss the options of radical open surgery versus shunting procedures.

Adolescent↗
PubMed1987

Late recurrence of bleeding in a chronic extradural hematoma.

Recurrence of bleeding from the inner capsule occurred in a chronic extradural haematoma in a 15-year-old boy 4 months after the original trauma. The case is presented to emphasize the potential hazards of nonsurgical treatment of chronic extradural hematomas.

Adolescent↗
PubMed1987

Pituitary apoplexy, bilateral carotid vasospasm, and cerebral infarction in a 15-year-old boy.

The authors report a case of pituitary apoplexy associated with oculomotor defects and focal cerebral signs; the visual pathways were intact. Computed tomography documented a mass of heterogeneous density within an enlarged sella turcica and a right parietal infarct. Angiograms revealed bilateral carotid spasm and occlusion of the right angular artery. Treatment was conservative. Control angiograms showed spontaneous resolution of the vasospasm and recanalization of the cortical artery. The patient made a complete neurological recovery; he needed only treatment with vasopressin due to transient diabetes insipidus. The risk of vasospasm and brain ischemia should be kept in mind when treating pituitary apoplexy. The early occurrence of vasospasm in our case suggests the participation of powerful vasoactive agents liberated from the tumor.

Adenoma↗
PubMed1986

Extradural hematoma complicating middle fossa arachnoid cyst.

Two cases of post-traumatic extradural hematoma complicating an arachnoid cyst of the middle cranial fossa in children are described. While subdural and intracystic hemorrhages are well-known complications from this malformation, the association with extradural hematoma has never been previously reported in the literature. The pathogenetic mechanisms are discussed and the particular vulnerability of intracranial arachnoid cysts is stressed.

Adolescent↗
PubMed1986

Benign cerebellar hematomas in children.

Cerebellar hematoma is generally regarded as a rapidly progressive condition which necessitates prompt evacuation in most cases. Unlike adults, where hypertension is the most common etiological factor, children generally have underlying structural lesions (angiomas, tumors) that per se demand surgical intervention. While several reports describe nonsurgical management of cerebellar hematomas in adults, the spontaneous resolution of juvenile cerebellar hematomas is almost unknown. This paper describes a 16-year-old boy with a cerebellar hematoma of obscure etiology that was managed conservatively. This report indicates that nonsurgical treatment of cerebellar hematomas, once structural lesions have been excluded, may be attempted in neurologically stable children.

Adolescent↗