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Biomedical subjects

G Cinalli

Publications and source records attributed to G Cinalli.

44 records · Page 3Linked to original sources

Chronic tonsillar herniation in Crouzon's and Apert's syndromes: the role of premature synostosis of the lambdoid suture.

The incidence of chronic tonsillar herniation (CTH) was evaluated with magnetic resonance imaging in 44 patients with Crouzon's syndrome and 51 with Apert's syndrome; the incidence was 72.7% in Crouzon's syndrome and 1.9% in Apert's syndrome. All the patients with Crouzon's syndrome and progressive hydrocephalus had CTH, but of 32 individuals with Crouzon's syndrome and CTH, only 15 had progressive hydrocephalus. Five patients with Apert's syndrome were treated for progressive hydrocephalus; none had CTH. The patterns of suture closure in these two groups of patients were studied, and significant differences in coronal, sagittal, and lambdoid sutures were found between patients with Crouzon's and Apert's syndromes. In Crouzon's syndrome, significant differences in the pattern of lambdoid suture closure were found between the groups with and without CTH; in the group with CTH, the lambdoid closure appeared earlier. The authors propose that the high incidence of individuals with CTH who have Crouzon's syndrome is related to the premature synostosis of the lambdoid suture in the first 24 months of age.

Acrocephalosyndactylia↗

Melanotic neuroectodermal tumor of the skull and meninges in infancy.

Three cases of melanotic neuroectodermal tumors of infancy are presented. Two were localized on the midline, involving the skull and extending subdurally. One was located on the inner aspect of the dura and developed intracranially. Two had a benign course following gross total removal. One had a malignant course, recurring locally and spreading within the brain. The difficulties of removing these tumors when they are implanted on the midline are stressed. Histological features of prognostic value are pointed out. Further support for neural crest origin of these tumors is given.

Child, Preschool↗

Transient visual symptoms and carotid artery disease. Exploration by real-time B-mode echotomography.

The real-time B-mode echotomographies of 100 patients with transient visual symptoms have been reviewed and their findings have been compared with those of other 100 patients with transient ischemic attacks, who never had visual disturbances in their clinical history. The rate of pathologic echotomographies was higher in the group of patients with transient visual symptoms (72%), who also had a higher percentage (50% of the positive cases) of small or mild plaques without significant hemodynamic effects. The amaurosis fugax, particularly when associated with hemispheric ischemic symptoms, should suggest a carotid disease. The non-invasive exploration by real-time B-mode echotomography and Doppler with spectral analysis is the method of choice for the diagnosis of patients with transient visual symptoms.

Adult↗

Megadolichobasilar artery and acute cerebrovascular pathology.

Sixteen patients with a megadolichobasilar artery and acute cerebrovascular symptoms are reported. All were explored by computerized tomography and vertebral angiography. Nine had transient ischaemic attacks or definitive ischaemic lesions, whereas 7 had subarachnoid or intracerebral haemorrhage. Among the patients with ischaemic troubles, vertebro-basilar insufficiency and pontine infarction were the most common clinico-radiological findings. Among the patients with intracranial haemorrhage, 4 had associated aneurysms or arteriovenous malformations, while 3 had subarachnoid or intracerebral haemorrhage with no vascular malformations on the angiograms. The possible relationships between the megadolichobasilar anomaly and the cerebral ischaemic or haemorrhagic pathologies are discussed also from a review of the pertinent literature.

Aged↗

Diagnosis of carotid artery occlusion by duplex scanning.

This paper reviews 70 patients, with complete occlusion of the internal carotid artery, investigated by duplex scanning. The correlation between the echogenicity of the occlusion (anechogenic, hypoechogenic or hyperechogenic) and the time interval between the ischaemic symptoms and the ultrasonic investigation showed that some occlusions are hypoanechogenic and others hyperechogenic, in spite of the time interval, and consequently the echogenicity of the occlusion cannot be correlated with the time of its formation. Duplex scanning allows a correct diagnosis in almost all cases of carotid artery occlusion by comparison of the morphological and flowmetric data. The 95% sensitivity in 20 cases was explored by digital angiography also. It was concluded that angiography was usually unnecessary to confirm a carotid occlusion and its use could be limited to rare, doubtful, cases and to patients with contralateral stenosis i.e. candidates for surgery.

Aged↗

Familial cerebral cavernous angiomas.

Three families with two or more members affected by cavernous angiomas of the brain are described and the other 17 reported in the literature are reviewed. The familial occurrence of cerebral cavernous angiomas has been considered a rare event; nevertheless, the experience of the authors (positive familiarity in three patients where two or more relatives have been explored radiologically) suggests that cavernous angiomas of the brain might be, at least in most cases, a familial disease. Therefore, when a patient with cerebral cavernous angioma is observed, a careful familial history and the exploration of the familial members by computerized tomography or better still by magnetic resonance must be performed. The high frequency of multiple lesions in familial cases, the surgical indications and the role of the ultrasonic prenatal diagnosis are also discussed.

Adolescent↗

Cerebral cavernous angiomas in the first year of life.

Two rare cases of cerebral cavernous angiomas in two infants, 9 and 6 months old, respectively, are reported and the other 11 cases in the literature concerning patients in the first year of life are reviewed. Cavernous angiomas of the brain occur rarely in the first year of life and present with seizures and head enlargement. On computed tomographic scan they typically appear as large, hyperdense, unenhanced masses, with large cysts and must be differentiated from tumors more common in infants, such as teratomas, ependymomas, and mixed tumors. Total removal is often possible, even with large lesions, because of the small amount of bleeding and the well-defined limits of the mass.

Brain Neoplasms↗

Nonobstructive symptomatic plaques of the carotid bifurcation: echotomographic-angiographic correlations.

This study reports a selected group of 45 patients with symptomatic low-grade stenoses of the carotid bifurcations, detected by real-time B-mode echotomography, and correlates the results of this technique with those of the Doppler flow study and carotid angiography. The Doppler study with spectral analysis was negative in all cases, whereas a correlation between the echotomographic and angiographic results was observed in 20 among 27 patients explored by angiography (74%). The causes of failure of angiography in some cases are briefly discussed. The almost absolute sensitivity of high resolution B-mode echotomography in detecting these early, sometimes symptomatic atherosclerotic changes of the carotid artery wall is emphasized.

Adult↗