PubMed Health⌕ Search

Biomedical subjects

G Crisi

Publications and source records attributed to G Crisi.

At least 19 recordsLinked to original sources

Multifocal leukoencephalopathy associated with 5-fluorouracil and levamisole adjuvant therapy for colon cancer. A report of two cases and review of the literature. The INTACC. Intergruppo Nazionale Terpia Adiuvante Colon Carcinoma.

BACKGROUND: Since 1990 the combination of 5-fluorouracil plus levamisole has been considered the standard therapy for stage B2-C resected colon cancer in the adjuvant setting. Since 1992, 14 cases of multifocal leukoencefalopathy following 5-fluorouracil and levamisole therapy have been reported. PATIENTS AND METHODS: Two cases of this rare but severe neurological syndrome, observed at our Institution within the scope of the INTACC (Intergruppo Nazionale Terapia Adiuvante Colon Carcinoma, Italy) 01 study, are described. CONCLUSIONS: The clinical and radiological features of the syndrome and the relationships between therapy (with the possible pivotal role played by levamisole) and onset of the multifocal leukoencephalopathy are analyzed in light of the literature data.

Chemotherapy, Adjuvant↗

MRI of intracranial meningiomas: correlations with histology and physical consistency.

Magnetic resonance imaging (MRI) appearances of 43 intracranial meningiomas were reviewed and correlated with their histology and consistency at surgery and on pathological examination. There was a statistically significant prevalence of hard tumours within the fibroblastic subtypes. No statistically significant correlation between signal intensity and histology or consistency was found. A meningioma hyperintense on T2-weighted images is, however, unlikely to be fibroblastic or hard.

Adult↗

Globus pallidus alterations and brain atrophy in liver cirrhosis patients with encephalopathy: an MR imaging study.

Brain magnetic resonance (MR) was performed in 29 liver cirrhosis patients without (N = 10) and with hepatic encephalopathy (HE) of chronic recurrent (N = 10) and of chronic persistent (N = 9) type. Sixty percent of the patients with chronic recurrent HE and 100% of the patients with chronic persistent HE showed a bilateral and symmetrical hyperintensity of the globus pallidus in the T1-weighted images while the T2-weighted images were normal, suggesting the possibility of the accumulation of a paramagnetic compound in this brain area during HE. Other findings of the study were evidence of brain atrophy of mild or moderate degree in 70% of patients with chronic recurrent HE and in 77% with chronic persistent HE and patients with liver cirrhosis without HE appeared normal on MR examination.

Adult↗

Familial pseudotumor cerebri in male heterozygous twins.

Papilledema due to raised intracranial pressure in absence of intracranial mass arose roughly at the same time in 2 male heterozygous twins. The diagnosis of benign intracranial hypertension (BIH) was confirmed by the finding of normal cerebrospinal fluid and high opening pressure. Neurologic examination was normal. In both cases choroidal folds were evident. The relationship between BIH and genetic factors is discussed.

Diseases in Twins↗

Magnetic resonance imaging.

All of the data published in the literature show that MR is more sensitive than CT in diagnosing cerebral ischemic lesions. This greater sensitivity is due to its ability to detect even the minimal changes in tissue water content which occur in the early phases of the infarct. The literature concerning the use of MR in lacunar lesions is extremely limited but agrees with the general data regarding ischemia. However, there is some doubt that the thickness of the strata of CT and the interval between the strata of MR could have an influence on their ability to detect very small lesions. Modifications in the sensitivity of MR in detecting ischemic lesions are now well known: during the acute phase, the T2 images are more sensitive, while in the subacute and chronic phase both T1 and T2 have the same diagnostic capability.

Cerebral Infarction↗

Muscle CT, biopsy and EMG in diagnosis of neuromuscular diseases.

The diagnostic value of EMG and muscle biopsy has been compared with muscle CT in 53 patients with neuromuscular diseases. CT concordance with clinical diagnosis was found in 62% of myopathies and was highest in Duchenne PMD and scapulo-peroneal myopathy and very low in metabolic and inflammatory myopathies. In neurogenic diseases muscle CT agreed with clinical diagnosis in 63% of patients: the highest concordance was found in acquired polyneuropathies.

Biopsy↗

Prevalence of brain atrophy in liver cirrhosis patients with chronic persistent encephalopathy. Evaluation by computed tomography.

Brain computerized axial tomography scans were performed in 18 consecutive liver cirrhosis patients with chronic persistent encephalopathy (8 alcoholic and 10 nonalcoholic) in order to evaluate the incidence of brain atrophy in this pathological condition. Fifteen patients of similar age with liver cirrhosis of Child's class B but with acute episodic hepatic encephalopathy were studied in parallel. Brain atrophy was detected in 87.5% of alcoholic and in 50% of nonalcoholic liver cirrhosis patients with chronic persistent encephalopathy, whereas the patients with acute episodic encephalopathy were normal. The high frequency of brain atrophy in alcoholic patients with chronic encephalopathy can be attributed at least in part to the toxic effect of alcohol. The presence of brain atrophy in nonalcoholic liver cirrhosis patients with chronic persistent encephalopathy seems to indicate that the chronic exposure to toxins which are involved in the pathogenesis of hepatic encephalopathy leads to neuronal alterations which develop mainly in the cortex and which can be demonstrated by in vivo imaging only in a long-lasting state of coma. Moreover, alcohol and toxins causing hepatic encephalopathy seem to potentiate each other in inducing brain atrophy.

Adult↗

The pattern of neuropsychological impairment associated with left posterior cerebral artery infarcts.

We investigated the neuropsychological correlates of left posterior cerebral artery (LPCA) infarcts with a quantitative systematic approach and found a pattern of impairment extending well beyond the classical syndrome of alexia without agraphia. Sixteen consecutive patients with CT scan evidence of an infarct confined to the territory of LPCA were given a battery of tests assessing the following abilities. (1) Reading and writing; (2) naming and pointing to colours; (3) naming the same 30 objects on visual (objects and coloured photographs), tactile and verbal presentation; and (4) verbal memory. These tests were administered to large control samples and the performance of LPCA patients was considered pathological if it fell below the score of the last or second to last control patient. Seventy five per cent of PCA patients had alexia without agraphia. Although a lesion of the CT scan slice where the pineal is represented appeared to be crucially associated with alexia, the severity of the disorder increased when contiguous upper or lower slices were also involved. Not only colour anomia, but also object and especially photograph anomia could almost always be shown in alexics and were highly correlated with the degree of the reading impairment. The naming deficit was also present when items were presented in the tactile and verbal modality, in spite of the integrity of the oral language areas. Every right-handed patient, alexic as well as nonalexic, was impaired on at least two of the three verbal memory tests and most on all of them. The findings are discussed in terms of the anatomofunctional mechanisms subserving verbal memory and the transmission of visual information to the speech areas.

Cerebral Arteries↗

Bilateral paramedian thalamic artery infarcts: report of eight cases.

Eight consecutive patients with CT scan evidence of a bilateral infarct in the territory of the paramedian thalamic artery are reported. In seven cases the infarct also extended to the territory of the polar artery. The main symptoms were: disorder of vigilance which cleared in a few days, and hypersomnolence which lasted longer and in two patients was still present a year later; amnesia, detectable clinically in four patients and only with tests in two patients, which persisted in one patient for three years; changes of mood and bulimia present in five and four patients respectively; and vertical gaze paresis in five patients. Only one patient died, and in the remainder the symptoms tended to subside, but none of the patients who could be followed-up for a year returned to normal behaviour. Clinical and CT scan correlations pointed to the mammillo-thalamic tract as the structure whose damage was responsible for the memory disorders.

Adult↗

CT and the diagnosis of myopathies. Preliminary findings in 42 cases.

A total of 42 patients with myopathies underwent CT scans in order to study the relationship between CT images and clinical findings. CT is a valuable diagnostic aid to distinguish primary from neurogenic myopathies, to facilitate directed biopsy and finally to classify the disease according to the degree and extent of the muscular lesion.

Adolescent↗

Vascular ataxic hemiparesis: a prospective clinical and CT study.

Ataxic hemiparesis is a relatively frequent clinical syndrome in which motor and cerebellar deficits on the same side are associated. A prospective study conducted on 27 patients who displayed these vascular symptoms confirms that the areas crucial to the onset of this syndrome are the capsular region (posterior limb-corona radiata) and the upper basis pontis.

Adult↗

Limb apraxia in patients with damage confined to the left basal ganglia and thalamus.

Limb apraxia was investigated with standardised tests in 14 patients whose CT scan provided evidence of a vascular lesion confined to the left basal ganglia, or the thalamus, or both, and not involving the cortex or adjacent white matter. Five patients were severely impaired in imitating movements and pantomiming object use. Four of them also performed poorly when tested with real objects. In two patients the lesion was primarily thalamic and in three the lesion was primarily in the lenticular nucleus and the posterior limb of the internal capsule. Patients without apraxia generally had smaller injuries, but there were exceptions. Apraxia is currently conceived of as due to damage of cortical areas and their cortico-cortical connections, but the present data suggest that the model should be enlarged to include the deep nuclei and the pathways running through them.

Aged↗