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Biomedical subjects

G Corriero

Publications and source records attributed to G Corriero.

At least 19 recordsLinked to original sources

Endoscopic carpal tunnel release surgery: retrospective study of 390 consecutive cases.

Endoscopic carpal tunnel release (ECTR) surgery was developed by Okutsu and Chow in 1989. Many reports indicated that the endoscopic technique reduces postoperative morbidity with minimal incision, minimal pain and scarring, a shortened recovery period and high level of patient satisfaction. To evaluate these reports, a retrospective study was conducted with 390 procedures of two-portal Chow technique for idiopathic carpal tunnel syndrome. Follow-up was performed at 1, 3 and 6 months and overall results were backed up by telephone questionnaire (Health Outcomes Carpal Tunnel Questionnaire, Health Outcomes, Bloomington, MN, USA). Results were favourable in 98% and 2% unfavorable for persistent pain. Rate of satisfaction of the patients was 90%. Average time of patient's return to work was 20 days. Eleven procedures (2.8%) were converted to open release. There was one case (0.2%) of incompleted section of the perineurium due to failure of endoscopic visualization of the ligament. In this case the procedure was converted to open and was completed with perineurium sutura. In six cases (1.5%) there were injury to superficial palmar arch. During the follow-up period there were no recurrences and no re-exploration. The mean preoperatively obtainable distal motor latency (DML) and sensory conduction velocity (SCV) values were 6.7 m/s and 29.2 m/s, respectively. The mean DML and SVC values at final follow-up were 3.8 msec and 42.3 m/s, respectively. In conclusion, ECTR can be used in the carpal tunnel syndrome and is a reliable alternative to the open procedure with excellent self-report of patient satisfaction. Reduced recovery period with minimal tissue violation and incisional pain can be expected.

Adult↗

Paraspinal approach to the far lateral disc herniations: retrospective study on 42 cases.

Forty-two patients underwent surgery for far-lateral disc herniations. Average patient age was 45.1 years, 28 patients were male and 14 female. The level concerned most was L4-5 disc (55%). A paramedian muscle-splitting intertransverse approach is described for this type of disc herniation. This method allows direct visualization of the disc and root involved and does not provide bone resection and important surgical manipulation. Ninety-one percent of the patients reported excellent or good results according to Macnab outcome criteria with an average follow-up of 32.5 months (range 1-5 years). Twelve patients (28.6%) developed postoperative transient radicular pain that disappeared in 15-21 days after analgesic therapy. There were no recurrences or spinal instability. The paramedian muscle-splitting intertransverse approach is a rational technique. Its advantages are that the spine is not opened and spinal stability is maintained. It requires minimal soft-tissue and bone resection and the herniated disc is directly visualized. Moreover, it contains minimal manipulation of the neuro-vascular structures and avoids significant muscle retraction. However, it requires an adequate learning curve and good familiarity with microsurgical techniques.

Adult↗

Cervical neuroma presenting as a subarachnoid hemorrhage: case report.

OBJECTIVE AND IMPORTANCE: The association of subarachnoid hemorrhage (SAH) with spinal lesions is well known, but hemorrhage from a cervical schwannoma is exceedingly rare. The histopathology and the mechanism of bleeding are discussed. CLINICAL PRESENTATION: We report a healthy 37-year-old man presenting with SAH after intense physical stress caused by bleeding of a cervical neuroma. INTERVENTION: A C6-T1 laminectomy disclosed an ovoid lesion, 4 cm in diameter; extremely dilated veins originated from the tumor. Removal of the spinal lesion resulted in immediate decongestion of the related venous network. The histopathological examination confirmed that the lesion was a telangiectatic schwannoma. The mechanism of bleeding of the intraforaminal cervical schwannoma is discussed. CONCLUSION: Telangiectatic neuromas may be a cause of occult SAH. The importance of magnetic resonance imaging of the cervical spine is emphasized to explain SAH with negative findings on four-vessel angiography in patients whose SAH may have a surgically correctable cause distant from the intracranial compartment.

Adult↗

Giant aneurysm of the pericallosal artery.

A rare case of a giant aneurysm of the pericallosal artery, evaluated by computed tomography, magnetic resonance imaging, and angiography, is reported, and the other 7 cases in the literature are reviewed. Giant aneurysms are exceptional in the distal segments of the anterior cerebral arteries, and may simulate a callosal tumor or hematoma on computed tomographic scan. The clinical, radiological, surgical, and pathological findings of giant aneurysms of this location are discussed and the other reported cases are analyzed. The role of magnetic resonance imaging in diagnosing and characterizing giant aneurysms is stressed.

Adult↗

CT indications for surgery and evaluation of prognosis in patients with spontaneous intracerebral haematomas.

This study retrospectively analyzes the CT findings of 50 patients with spontaneous intracerebral haematomas and correlates them with the clinical condition at admission and the outcome. The volume of the haematoma was well correlated with the outcome and was a very useful indicator for surgery. In patients with haematoma volume lower than 25 ml and above 80 ml there was no indication for surgery; in patients with haematoma volume between 25 and 50 ml the operation does not significantly modify the survival rate, but favours a more rapid and complete recovery of the neurological deficits, whereas a haematoma volume between 50 and 80 ml favours the rate of survival.

Adult↗

Cerebellar metastasis from prostatic carcinoma simulating, on CT-scan, a cerebellopontine angle tumor. Case report.

The authors report a rare case of cerebellar metastasis from prostatic carcinoma simulating on computerized tomography a cerebellopontine angle tumor. Solitary intracerebral metastases from prostatic cancer are infrequent, and their location in the posterior fossa with extension in the cerebellopontine angle is quite unusual. The differential CT findings from more common benign cerebellopontine angle tumors are briefly outlined.

Aged↗

Tumors of the neuron series presenting as cysts with mural nodules.

Two cases of tumors of the neuron series presenting as cysts with mural tumor nodules are described. This radiographic and surgical aspect may be observed in astrocytomas, meningiomas or ependymomas, whereas it is more rare for neuroblastomas and ganglioneuromas. There are not CT features which allow to differentiate cystic tumors of the neuron series from the other cystic tumors. The finding of cyst with enhancing mural tumor nodule and unenhanced wall is more favorable from a surgical point of view; the complete removal of the nodule with preservation of the reactive cyst wall results in the cure of patients with ganglioneuroma and ganglioglioma and in good long-term survival in those with cerebral neuroblastomas.

Adolescent↗

Fibromuscular dysplasia of the carotid arteries. Clinical and radiological considerations.

Seven patients with fibromuscular dysplasia of the carotid arteries are described. Three were asymptomatic and four had ischemic troubles. Angiographically, 3 had a fibromuscular dysplasia of type 1 and 4 of type 2; one patient also had an associated aneurysm of the cervical internal carotid artery. The neurological troubles and their pathogenesis, the angiographic findings and the differential diagnosis of this angiopathy are briefly discussed; the surgical procedures and their risks are also analyzed.

Adolescent↗

Postoperative cervical pseudomeningocele.

A case of postoperative cervical pseudomeningocele in a woman submitted to laminectomy for protruded disc is reported. The patient was investigated by myelography and metrizamide computed tomography and surgically treated with a good neurological result. The other eight reported cases of postoperative cervical pseudomeningocele are reviewed and the role of metrizamide CT scan in diagnosing this unusual complication of cervical laminectomies is emphasized.

Adult↗

Myxoma of the skull and orbit.

An unusual case of myxoma of the skull extending into the orbital cavity is reported. Myxoma is a benign tumour of the soft tissues and maxillary bones, which often presents infiltrating growth and recurrences. Histologically it is characterized by abundant myxoid stroma and is often confused with other tumours which can present mucoid degeneration. Although diagnosis is impossible before histological examination, the possibility of a myxoma must be considered in the presence of extradural osteolytic poorly vascularized lesions.

Female↗

Craniopharyngioma of the cranial base and nasopharynx.

A rare case of craniopharyngioma extending to the cranial base and nasopharynx is reported and eight other cases in the literature are reviewed. The embryology and the clinical features of these tumors are discussed. Tomograms of the skull and computed tomography are the most useful radiological tools of investigation. A nasoseptal or transpalatal approach to surgery, which has been performed in reported cases of cystic nasopharyngeal craniopharyngiomas, was not performed on our patient because of the hard consistency and the diffusely infiltrating aspect of the tumor.

Adult↗

Lateral thoracic meningocele.

A case of intrathoracic meningocele is reported, and 95 cases from the literature are reviewed. Thoracic meningoceles are usually associated with neurofibromatosis; nevertheless their etiology remains controversial. The authors postulate the role of spinal trauma in some patients and the origin of the meningocele from an abnormal prolongation of a nerve sleeve in nontraumatic cases. Thoracic meningoceles often are asymptomatic or produce radicular intercostal pain. Spinal computed tomography is the most useful investigation, particularly in the exploration of large meningoceles. Surgery is required in symptomatic cases and usually results in remission of the pain.

Accidents, Traffic↗

Anterior communicating artery aneurysm presenting with sudden paraplegia.

A case of sudden paraplegia as the first symptom of a ruptured anterior communicating artery aneurysm is reported. The sudden appearance of paraparesis or paraplegia is an exceptional event in patients with intracranial aneurysms. The various pathogenetic mechanisms are briefly discussed. The insufficient blood perfusion of both paracentral areas was the cause of paraplegia in the reported case.

Humans↗

Cystic lesions associated with meningiomas.

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.

Adult↗

Postoperative lumbar arachnoidal diverticula.

Five patients with arachnoidal diverticula after lumbar operations are reported. Myelography was performed in all cases, spinal computed tomography scanning in three; three patients underwent surgical treatment with good clinical results. Arachnoidal diverticula are a rare complication of operations on the lumbar spine. Spinal computed tomography scanning is very useful, especially in the investigation of large diverticula and in the radiologic visualization of the arachnoidal stalk. Surgical treatment, which is required in symptomatic cases, results in remission of pain and prevents neurological complications.

Adult↗