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Biomedical subjects

G Costabile

Publications and source records attributed to G Costabile.

6 recordsLinked to original sources
PubMed1988

Intrathecal infusion test and decrease in shunt revisions and infections.

The intrathecal infusion test leads to a more accurate diagnosis of communicating hydrocephalus, and is useful in identifying those patients with insufficient cerebrospinal fluid (CSF) absorption who are most likely to improve after a shunt operation. Furthermore, shunt function can be evaluated by assessing the CSF absorption of shunt-operated patients in the same way. Some patients do not improve after surgery because of irreversible or shunt-independent neurological and radiological signs, while the postoperative infusion test demonstrates a normal shunt function. The clinical condition and neuroradiological picture of such patients cannot be improved by shunt revision if the implanted shunt already allows a normal CSF outflow. By means of infusion tests the number of patients who need a further operation can be reduced, with a consequent drop in shunt infections, a very welcome aspect especially in pediatric neurosurgery. In our department 298 infusion tests were carried out over a seven-year period, and a decrease in shunt revisions and infections could be observed.

Adult↗
PubMed1977

[Classical low back pain and sciatica syndrome caused by a melanotic nerv sheath tumour of the first sacral root (author's transl)].

This is the description of the case of a 22 year old patient with low back pain and sciatica on the right side investigated by lumbar Dimer-X-Myelography. The result of the examination was an impression in the contrast column at the L5/S 1 level on the right. At operation an intradural tumour, plum-sized, well-defined, and blue-black in colour, was found and removed. Histologically the tumour was melanotic and of high cellular density, with spindle-shaped cells as well as giant cells, with round nuclei, considerable polymorphism, and atypical mitoses. On the basis of the operation finding, the clinical course, and the histology, the diagnosis is melanotic nerve sheath tumour of the first sacral root. For two years following operation the patient has experienced no discomfort.

Adult↗
PubMedDate not supplied

[Usefulness of somatosensory evoked potentials in the diagnosis of low-pressure hydrocephalus].

The study group comprised 35 patients in whom previous computed tomography had demonstrated significant dilatation of the ventricular system. On the basis of analysis of clinical manifestations and tomograms the patients were divided into two groups: 24 cases (group I) low-pressure hydrocephalus, 11 cases (group II) brain atrophy. For establishing of final diagnosis in both groups the resistance of cerebrospinal fluid outflow was determined (using continuous infusion at a rate of 2 ml/min) and somatosensory evoked potentials were produced by stimulation of median nerve. In patients with increased resistance to CSF resorption (low-pressure hydrocephalus) the conduction time in the N14-P15 segment involving brain stem structures was prolonged (in 17 out of 19 cases). In cases with not increased resistance no changes of evoked potentials were noted. It is thought that the so called posterior cranial fossa conduction time (N14-P15) may be a useful indicator for differential diagnosis of low-pressure hydrocephalus from brain atrophy.

Adult↗