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Biomedical subjects

G Mariniello

Publications and source records attributed to G Mariniello.

17 recordsLinked to original sources

Objective pulsatile tinnitus: case report.

Anomalies in the vascular structures of the neck, cranial base, temporal bone, and intracranial circulation may give rise to pulsatile tinnitus. If the anomalous sound is perceived also by others, then it is defined as objective tinnitus. Herein, the case is reported of right pulsatile tinnitus of one year's duration, which appeared after cranial trauma. Magnetic resonance angiography showed that the jugular bulb was dominant on the same side as the tinnitus. The tinnitus was recorded with a high-sensitivity microphone, while otoacoustic emissions were measured by distortion products during follow-up.

Adult↗

Easy sellar reconstruction in endoscopic endonasal transsphenoidal surgery with polyester-silicone dural substitute and fibrin glue: technical note.

OBJECTIVE: To describe a simple method of sellar reconstruction after endoscopic endonasal transsphenoidal surgery that will allow rapid watertight closure of the sellar floor. METHODS: A bent sheet of a polyester-silicone dural substitute, fashioned for this purpose with scissors, is introduced into the sella after removal of the lesion. Because of the consistency of the sheet, it opens spontaneously and becomes stuck. Autologous fat tissue or gelatin foam is positioned thereafter, followed by another layer of the dural substitute; a film of fibrin glue completes the sealing. RESULTS: Fifteen patients underwent this method and no postoperative cerebrospinal leak or other complication was experienced. CONCLUSION: This easy method of sellar reconstruction represents an effective and fast possibility to perform the final step of the endoscopic transsphenoidal procedure, which otherwise may cause maneuverability problems in the limited space of one nostril.

Dura Mater↗

Connections of sympathetic fibres inside the cavernous sinus: a microanatomical study.

A microanatomical study has been designed to investigate the pattern of arrangement of the sympathetic fibres inside the cavernous sinus. The course of these fibres has been examined in 60 fresh specimens of parasellar region from autopsy cadavers. Apart from the thin branches arising at different intervals along its course, the sympathetic plexus of the carotid artery gives rise to a large division that usually joins the abducens nerve and leaves it to combine with the ophthalmic branch of the fifth. In 10% of specimens we have found a direct connection between sympathetic fibres and the ophthalmic branch of the trigeminal nerve. We did not recognise similar connections with oculomotor and trochlear nerves.

Abducens Nerve↗

Pituitary macroadenoma and diaphragma sellae meningioma: differential diagnosis on MRI.

Diaphragma sellae meningiomas are unusual tumours often not distinguished from pituitary macroadenomas. Preoperative differentiation is essential, because the trans-sphenoidal approach is used for surgical removal of adenomas, while meningiomas are approached via a craniotomy. We reviewed five patients in whom a diaphragma sellae meningioma was initially diagnosed as a nonsecreting pituitary macroadenoma. MRI criteria for differential diagnosis are discussed. The main findings considered are visibility of the pituitary gland, contrast enhancement, the centre of the lesion and sellar enlargement. These criteria, applied to a blind review, allow correct identification of the tumours.

Adenoma↗

En bloc resection of an intracavernous oculomotor nerve schwannoma and grafting of the oculomotor nerve with sural nerve. Case report and review of the literature.

A case in which a left oculomotor nerve schwannoma treated by en bloc resection of the lesion and grafting of the oculomotor nerve with sural nerve is presented. Recovery of nerve function was partial, but useful and cosmetically good. The last follow-up examination performed 2 years after surgery revealed recovery of function in the elevator muscle of the upper eyelid, together with slight vertical movement of the eye.

Cavernous Sinus↗

Microsurgical nervous reconstruction using autografts: a two-year follow-up.

BACKGROUND: To analyze factors influencing surgical results after microsurgical reconstruction of injured nerves. METHODS: We report a series of 32 cases of microsurgical nerve reconstruction after traumatizing lesions using nervous autografts. The series comprises 8 reconstructions of radial nerve, 8 of median nerve, 6 of ulnar, and 10 of sciatic nerve. Motor and sensitive deficits have been evaluated preoperatively using a standard grading. RESULTS: A useful sensory recovery has been obtained in radial nerve, as well as in median and ulnar nerve reconstruction. Good results regarding the motor recovery have been obtained in superior limb nerve reconstruction. Sciatic nerve reconstruction showed the worse results. CONCLUSIONS: There is a big discrepance between superior limb vs inferior limb results. A more than 10 cm gap has a negative influence on the progression of regenerating axons, especially in median and ulnar nerves.

Adult↗

Supratentorial cavernous malformations and epilepsy: seizure outcome after lesionectomy on a series of 35 patients.

Epilepsy is the most frequent presenting sign in patients with cavernous angiomas and is the major cause of morbility. Persistence of seizures after surgical treatment prompted many authors to examine the possibility of removing the cavernoma and the surrounding tissue. In our series of 53 cavernous angiomas, all the 35 patients with preoperative seizures underwent surgery by means of lesionectomy alone. One hundred percent of patients with less than five preoperative seizures and/or an history under 12 months was seizure free, while only 62.5% of patients with more than five seizures and/or an history longer than 12 months was seizure free. Number and duration of seizures before surgery seems to be the most important factor in the seizure outcome after surgical treatment.

Adolescent↗

Multicentrical growth of meningiomas: "spatial" or "temporal" phenomenon.

Small nodules of neoplastic cells protruding from the arachnoidal layer surrounding an intracranial meningioma, completely independent from the tumor mass, have been observed in three patients who underwent primary surgery. The high rate of recurrence for meningiomas after a seemingly total excision has been many times reported, and related to histological subtypes, tumor site, and hormonal influence. In the past meningotheliomatous cell aggregates protruding from the inner surface of the dura mater at a distance of 3 cm from the insertion of globoid meningiomas have been described, and the concept of "localized dural multifocality" emphasized. Probably this concept has to be enlarged to consider meningioma as a "neoplastic disease" with different grade of expression. The presence of unidentified macroscopic or microscopic clusters of neoplastic cells, lying around, more or less close to, the line of insertion of lesion, could render any attempt to gain a "radical" excision useless.

Female↗

Microsurgical anatomy of sympathetic fibres running inside the cavernous sinus.

A microanatomical study has been designed to obtain data concerning the pattern of organization of the sympathetic fibres running within the cavernous sinus. The course of the sympathetic fibres has been examined in 60 fresh specimens of parasellar region from autopsy cadavers. The sympathetic nerve or nerves running with the carotid artery provide a multitude of thin branches at irregular intervals along its course, but the largest residual usually joins the 6th cranial nerve and leaves it to join the first division of the 5th. Despite other anatomical descriptions, we have found a direct connection with the ophthalmic branch of the trigeminal nerve in 10% of specimens. We report also an unrecognized parasellar syndrome characterized by Horner's syndrome and ipsilateral sensory disturbances over the distribution of the ophthalmic branch of trigeminal nerve, due to a traumatic carotid-cavernous fistula. We think that the anatomical data, together with the clinical findings of this syndrome, could explain the role of the sympathetic fibres within the cavernous sinus.

Cadaver↗

Hemodilution and revascularization for early treatment of stroke: an experimental trial.

A new experimental trial to investigate the usefulness of early therapeutic measures in case of acute I.V.D. has been performed, on the basis of a previous already reported experience. A combined treatment consisting of hemodilution and revascularization starting 16 hours after the onset of cerebral ischemia was tested. The study was performed in a population of 20 New Zealand male rabbits in which an acute cerebral ischemia was achieved by means of extracranial ligation of both common carotid artery and of one vertebral artery. The animals were divided into two groups. 1st group: no treatment; 2nd group: revascularization + hemodilution. Better results were observed in treated group considering either CBF rates or histological changes.

Acute Disease↗