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Biomedical subjects

F Cusmano

Publications and source records attributed to F Cusmano.

At least 37 records · Page 2Linked to original sources
PubMed1995

Progression of cerebral atrophy in patients on regular hemodialysis treatment: long-term follow-up with cerebral computed tomography.

Fifteen patients (10 males, 5 females) on regular hemodialysis treatment (average age 43.6 +/- 4.0 years, average time on dialysis 100.7 +/- 62.8 months) underwent cerebral computed tomography between 1981 and 1984. Ten patients showed mild cerebral atrophy (CA) on the basis of cortical sulci exceeding 3 mm in breadth and an Evans ratio exceeding 0.31, for a total of 14 degrees of CA (mean 0.9 +/- 1). The same 15 patients underwent a second cerebral computed tomography during 1991/92 (101 +/- 23.7 months later). At that time, the patients exhibited a degree of CA of 2.6 +/- 1.4, for a total of 39 degrees with an overall increase of 25 degrees. Since CA is not detected before the age of 55 years in the normal population, we conclude that the CA in this patient group can only be attributed to uremia-related pathology and that it tends to worsen as regular hemodialysis treatment continues. Nevertheless, no evident cognitive, affective, or behavioural changes were verified in these patients. To our knowledge, this is the first presentation of radiologically documented progression of CA in the same patient population over time.

Adult↗
PubMed1994

Peripheral arteriography with a new nonionic agent: comparison of iomeprol with iopamidol.

Aim of this randomized, double-blind, parallel group study was to compare the safety, tolerance and diagnostic efficacy of iomeprol and iopamidol, both at iodine concentration of 150 mgI/ml, in 100 adult patients undergoing peripheral intra-arterial digital subtraction angiography (IA-DSA). All patients underwent extensive pre- and post-contrast clinical, instrumental and laboratory evaluation for safety assessments. The tolerance to the test compounds was evaluated in terms of discomfort associated with the injection of the test compounds. Image quality was prospectively graded by two independent readers according to a five-point scale as 1, insufficient; 2, sufficient; 3, good; 4, excellent; or E, excessive. At the end of the study, two experienced radiologists working at institutions other than the study centre and not aware of patients identity, clinical profile or results of other imaging procedures, jointly evaluated study images using the same ordinal scale. The procedure was always well tolerated. None of the studied patients experienced adverse events. All angiographic examinations were rated as diagnostic. The quality of the radiographs was judged as excellent or good in most individual patient studies, without significant differences between the two study groups. No significant differences between the results of prospective on-site assessment and retrospective external assessment were detected. The results of our study show that iomeprol and iopamidol are equally effective, well tolerated and safe contrast agents when used for peripheral IA-DSA.

Adult↗
PubMed1990

MR cisternography of the cerebello-pontine angle and internal auditory canal in diagnosis of intracanalicular acoustic neuroma.

One hundred and fifteen patients, suffering from sensorineural hearing loss were tested with a 1.5 T superconducting magnet. The authors describe utility of both T1-weighted multiple slice and T2-weighted multiple echo images for the evaluation of cerebello-pontine angle, internal auditory canal and their neurovascular content. In seventy-three cases MR cisternography was normal. The remaining forty-two cases were subdivided into twenty extracanalicular masses, eleven small intra-extracanalicular and nine purely intracanalicular lesions. All the lesions were histologically proven acoustic neuromas, except one intracanalicular mass which was a meningioma. Examination was inconclusive only in two cases and decision was then made to follow the clinical course. Advantages of MR cisternography over CT and air CT cisternography, such as absence of ionizing radiation and contrast material, easy multiplanar evaluation of the region of interest and the possibility to delineate both the cisternal and canalar extremities of the tumor mass are pointed out.

Adult↗
PubMed1989

[The optic pathways: a magnetic resonance study at 1.5 tesla. I. Anatomy].

The authors retrospectively examined one hundred and twenty-nine patients who had undergone MR examination of the sellar, parasellar and orbital regions, to evaluate MR capabilities in demonstrating the optic pathways and their relationship to the most important anatomical structures nearby. T1-weighted images allowed a very good evaluation not only of the optic pathways as a whole, but also of the intracanalicular and intracranial segments of the optic nerve; the optic tracts and geniculate bodies were also clearly demonstrated. Optic radiations were clearly visible on both T1- and T2-weighted images. The orbital portion of the optic nerve could be evaluated with T1-weighted images, which showed its external profile. However, only multi-echo T2-weighted images allowed the nerve to be differentiated from perineural spaces, filled with cerebrospinal fluid, thus giving a true cisternographic effect.

Geniculate Bodies↗
PubMed1988

[Presentation of a case of spinal osteoid osteoma causing dorsal scoliosis. Role of high resolution CT].

A case of vertebral osteoid osteoma in a 19 years old female is described. The tumor was located at D7 right peduncle and was responsible for a mild left convex curve dorso-lumbar scoliosis. The patient had been complaining for 3 years because of a stablike pain at medio-dorsal level. The symptomatology was exacerbated by erect position, during the night and was relieved by salicylic acid. Diagnosis was suspected on the basis of scintigraphic and computed tomographic features and confirmed at surgery. Limited value of plain films and the importance of bony scintigraphy and high resolution computed tomography to establish the localization and nature of the lesion are stressed.

Adult↗
PubMed1988

[Dissection of the internal carotid artery. Personal case reports and a review of the literature].

The clinical and angiographic features of 20 patients affected by internal carotid artery dissection are reported. In one patient the neurological signs were related to a traumatic event, in two cases the symptoms presented after hyperextension of the neck during athletic events, while their onset was apparently spontaneous in the remaining 17 patients. Plain CT was normal in 14 cases and positive for ischemic necrosis in 6 patients. Angiography demonstrated extensive/segmental stenosis of the internal carotid lumen in 12 cases (60%), pseudoaneurysmal dilatation in 3 cases (15%), and complete carotid occlusion in 5 patients (25%). The "double lumen" feature was seen in 3 cases at the origin of the dissection. One patient died, surgical ligature of the internal carotid artery was performed in two cases, while the other patients received medical treatment with platelet inhibitors, except for the young patient affected by post-traumatic artery dissection. Complete recovery was observed in 82% of the patients. Follow-up angiograms demonstrated normal recanalization of the internal carotid artery in 4 out of 6 patients; one of them had two false aneurysms which following angiograms demonstrated to be completely resolved. Regression of stenosis was observed in 6 of the remaining patients by Doppler US. On the whole, the recanalization of the internal carotid artery was observed in 59% of cases. Angiographic findings seemed not to play a decisive role in the prognosis of carotid dissections, which largely depends on the overall patient's condition and on the presence/absence of ischemic cerebral damages.

Adolescent↗
PubMed1988

[The role of computerized tomography in the diagnosis of osteoid osteoma].

Radiological diagnosis of osteoid-osteoma is based upon conventional radiographic techniques, i.e. plain film and tomography, scintigraphy and Computed Tomography (CT). The authors report on the use of CT in 13 patients affected by histologically verified osteoid-osteoma, in different locations, as related to their main clinical and epidemiological signs. A comparison is made of the diagnostic contribution of the different techniques, including scintigraphy and tomography, when available. CT results were evaluated referring to fundamental semiologic elements, such as the presence of the nidus--with or without calcifications--of perilesional sclerosis, hyperostosis and periosteosis. As a rule, we can affirm that CT allows a better spatial location in the metaphysodiaphyso-epiphyseal areas, the only exception being represented by location in the metacarpal and phalangeal bones, which are better evaluated in the axial plane due to their thinness. CT is otherwise indispensable for a correct evaluation of the posterior vertebral arch.

Adolescent↗
PubMed1988

[Preoperative embolization of angiomas of the face. Remote angiographic results].

Preoperative embolization was performed on 27 patients with facial angiomas supplied by the external carotid branches. Sixteen were males and 11 females; 13 of these angiomas were high-flow arteriovenous (A-V), 14 were low-flow capillary malformations. Fourteen patients underwent surgical removal after preoperative embolization; in this group embolization was carried out with Spongel in 3 cases and with Lyodura in 11 cases. In 12 of these patients the last angiographic examination was performed 3-6 years later: angiography evidenced no recurrence in 8 cases (67%), while in 3 cases (25%) there was capillary residual angioma of negligible size. Treatment was unsuccessful in one patient only, due to the large recurrent A-V angioma. Thirteen patients underwent embolization only, which was carried out with Lyodura in 10 cases, and with Ivalon in 3 cases. On 12 of these patients the last angiographic study was performed 2-14 months later: there was recurrent A-V angioma in 5 patients (42%), who underwent a subsequent embolization; angiography evidenced no recurrence in the other 7 patients (58%). In both series, the best results were obtained in the patients with low-flow capillary angiomas. Embolization and subsequent surgical removal are the treatment of choice for facial angiomas; embolization alone is useful in the management of surgically inaccessible vascular malformations, and it can be the only treatment in patients with small low-flow angiomas when distal occlusion of the feeding vessels with Lyodura or Ivalon particles is performed.

Adolescent↗
PubMed1987

[Post-traumatic arteriovenous fistulae and pseudoaneurysms of the superficial temporal artery: presentation of 4 cases].

Three cases of traumatic arteriovenous fistula of the superficial temporal artery and one of pseudoaneurysm seen over a recent two-year period are presented and the literature is reviewed. Because of the course of the superficial temporal artery over the temporal bone, it is vulnerable to injury. The differential diagnosis includes hematoma, cysts, inflammatory lesions, vascular tumors and aneurysms of the middle meningeal artery. If there is doubt as to the diagnosis, angiography could confirm it, although it is seldom necessary. The treatment is simple and consists of proximal and sital ligation of the artery before aneurysmal sac or fistula removal.

Accidents↗
PubMed1986

Diastematomyelia in adults.

The authors report two cases of diastematomyelia in adults. One patient had a congenital kyphoscoliosis; the other had undergone surgery at birth for a myelomeningocele. The occurrence of diastematomyelia in patients with congenital scoliosis and myelomeningocele is discussed. Diastematomyelia is regarded as one of the causes of late deterioration of neurological function in such cases.

Adult↗
PubMed1985

High resolution O2 computed meatocisternography in the differential diagnosis of internal auditory canal pathology.

Recent introduction of O2 computed tomography cisternography and imaging with high resolution program have greatly improved the detection and preoperative evaluation of acoustic neuromas and other possible pathologies of the internal auditory canal. Sixty patients have been evaluated following the diagnostic protocol given in the text. Based on our results and on the experience as reported in literature HRO2CTC proved to be the most reliable method for detection and exclusion of intracanalicular and small extracanalicular acoustic neuromas and other pathologies at the internal auditory canal level.

Adolescent↗
PubMed1985

Cerebral atrophy in patients on long-term regular hemodialysis treatment.

The presence of Cerebral Atrophy in the form of cortical damage (Cortical Atrophy) or subcortical damage (enlargement of ventricular cavities) was explored by computed tomography (CT) scans in 30 patients maintained on regular hemodialysis treatment (RDT) for not less than 10 years, and less than 50 years of age. Whereas a group of 50 normal subjects of the same age, used as control, gave no evidence of cerebral atrophy, 46.6% of the patients maintained on RDT showed cortical atrophy, evenly diffuse in half the cases and predominantly frontal in the other half. In addition 16.6% of the patients showed subcortical atrophy, even in the absence of evident central neurologic or neuropsychic symptoms. In a search for the possible causes of this high incidence of cerebral atrophy in chronic hemodialysis patients we reviewed the last five years' profiles of clinical and blood biochemistry parameters known or suspected to produce brain damage when altered, as stored in a computer system available to our Hemodialysis Unit: these were mean blood pressure before and after hemodialysis, blood cholesterol and triglyceride assays, and mean daily oral intake of A1(OH)3. The status of arterial blood vessels in terms of vascular calcification in soft tissue roentgenograms was also defined; then we correlated these clinical and biochemical indices with the findings of cerebral CT scans by the Fisher test and Discriminant Analysis. The Fisher test revealed a decreasing correlation of cerebral atrophy with mean blood pressure, A1(OH)3 intake, blood cholesterol content, arterial calcifications and blood trygliceride assay in that order.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗