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Biomedical subjects

G Schisano

Publications and source records attributed to G Schisano.

At least 19 recordsLinked to original sources
PubMed1997

Cervical myelopathy caused by median disc herniation: analysis of the complications following anterior discectomy with and without Fusion Report of 90 cases.

Between 1980 and 1992 about 400 patients underwent anterior cervical discectomy with or without intersomatic fusion at the Department of Neurosurgery of CTO Hospital (Rome) and Nuovo Pellegrini Hospital (Naples). Among them 90 patients were selected (50 from CTO and 40 from Nuovo Pellegrini Hospital). Clinical evaluation of postoperative results were assessed according to Odom's grading system and postoperative complications were discussed. No difference was observed in patients who underwent anterior cervical discectomy with and without fusion; however, postoperative complications were frequently observed in patients who underwent fusion. In conclusion, we consider the anterior microdiscectomy as the treatment of choice for the removal of soft disc herniations with or without osteophytosis even at two level disc. If cervical myelopathy is expression of one or more disc herniations, maybe calcified and associated with marked osteoarthrosic degenerative phenomena, we favour the evacuation of the herniated disc and the removal of osteophytes with Cloward's or Smith-Robinson's techniques.

Adult↗
PubMed1996

Familial coagulation-inhibiting and fibrinolytic protein deficiencies in juvenile transient ischaemic attacks.

The aim of this study was to investigate the role of natural cascade inhibitors in Juvenile Transient Ischemic Attacks. Fifty patients with anterior or posterior brain attacks were studied. One hundred healthy subjects matched for sex and age were randomly assigned to a control group. All had a physical examination and radiologic work-up. Computerized tomography showed no ischaemia either with or without contrast medium. Digital angiography of epiaortic and intracerebral vessels was unremarkable patients non controls ever had war-farin therapy. Antithrombin III, protein C and plasminogen were determined by functional methods. Protein S was assayed by a functional clotting method based on prolonged PT. The activated protein C resistance test was performed and a poor response to activated protein C was verified in patients. Our findings show protein S, protein C and antithrombin III type I deficiency with a functional activity < 70% compared to controls. Eight of fifty patients (16%) had low protein S levels, 5 (10%) had low protein C, 2 (4%) had low antithrombin III and 1 (2%) plasminogen deficiency. A significant (p < 0.01) difference in activated protein C ratio was seen for controls and patients. These results suggest that screening for natural anticoagulants in young people suffering from transient ischemic attacks could be beneficial and should be encouraged.

Adult↗
PubMed1995

Intraradicular and intradural lumbar disc herniation: experiences with nine cases.

BACKGROUND: Intraradicular or intradural disc herniation is a very rare complication of spinal degenerative processes. The aim of our study is to analyze the clinical spectrum, the mechanism, and the treatment of this acute spinal pathology. METHODS: Retrospective clinical examination was performed in nine personal cases of intradural disc herniation: among these, six were associated with lateral perforation, the remaining three with intradural herniation and ventral perforation. A review of the literature concerning mainly the frequency pathogenesis and diagnosis of intradural disc herniation has also been done. RESULTS: Nine cases of intradural herniations comprise 1.51% of the 593 cases of ruptured lumbar disc that underwent surgery from 1980 to 1992. The site most frequently involved is at level L4-L5, and 30% of patients have previously undergone surgery for lumbar disc herniation. Most patients reported in literature and in our present series have been complaining of a chronic history of sciatica, complicated later by bilateral neurologic signs. In the present series, diagnosis was obtained by means of myelography and computerized tomography; magnetic resonance imaging was performed in one case. All patients underwent surgery, reporting excellent results in five cases and good results in the other four. Surgery was performed either with an interlaminar approach or with a bilateral laminectomy in cases of ventral perforation. CONCLUSIONS: There is no typical neuroradiologic picture of intraradicular herniation, while a total or subtotal block is frequently observed in intradural ventral perforations. Dural perforation is often an unexpected intraoperative finding. Surgical treatment is always necessary. Favorable results are obtained if surgical treatment is carried out before the neurologic deficit becomes too pronounced.

Aged↗
PubMed1995

Cavernous angioma of the diencephalon.

A case of cavernous angioma of the diencephalon presenting with subarachnoid hemorrhage in a 19 years old woman is reported. Pertinent literature is reviewed. Clinical data, Computerized Tomography (CT) and pre and post operative Magnetic Resonance (MR) imaging are presented and discussed. The problems of diagnosis and treatment of cavernous angiomas localized in critical areas of the brain are also discussed.

Adult↗
PubMed1994

Congenital deficiency of factor VII in subarachnoid hemorrhage.

BACKGROUND: Factor VII is essential for coagulation activation by the extrinsic pathway. Hemorrhages of the central nervous system in patients with congenital factor VII deficiency seem to have a higher incidence compared with other congenital coagulopathies. The purpose of this paper is to report two rare cases of subarachnoid hemorrhage and factor VII deficiency. CASE DESCRIPTION: Two cases of women affected by a congenital deficiency of factor VII and subarachnoid hemorrhage are reported. Diagnosis was obtained by cerebral computer tomography; cerebral pan-angiography was normal. Complete coagulation studies were performed showing prothrombin time prolongation and factor VII deficiency. In one patient, family studies revealed the existence of a similar coagulation disorder. CONCLUSIONS: We suggest routine coagulation studies in all patients with subarachnoid hemorrhage. Determination of factor VII activity might be performed in patients with normal activated partial thromboplastin time and prolonged prothrombin time.

Adolescent↗
PubMed1994

Monitoring of fibrin and fibrinogen degradation products (FDP) in the cerebrospinal fluid of patients with subarachnoid haemorrhage due to ruptured aneurysm. Report of 55 cases.

Fibrin and fibrinogen degradation products in the cerebrospinal fluid (CSF-FDP) were first studied in a group of 29 patients observed during the first and the second week after subarachnoid hemorrhage (SAH), then in a second group of 26 patients for a total of 55 patients. In the latter group only the first FDP value obtained as soon as possible after SAH was taken in consideration. In the whole series of 55 patients several noteworthy factors were found: 1) FDP determination should be performed as soon as possible after SAH; 2) CSF-FDP at or above 40, 80 micrograms/ml was found both in the patients with severe neurological deficits and in those with cerebral ischemia (statistically significant); 3) the significance of CSF-FDP in patients who rebled was also evaluated. In conclusion CSF-FDP could be considered useful in predicting cerebral ischemia.

Aneurysm, Ruptured↗
PubMed1978

The use of antifibrinolytic drugs in aneurysmal subarachnoid hemorrhage.

Antifibrinolytic drugs have been investigated in a series of 58 patients with recent aneurysmal subarachnoid hemorrhage. It is concluded that tranexamic acid (AMCA) provides a rational method for reducing the frequency of recurrences, and that antifibrinolytic treatment is a preliminary to surgical intervention. In the present series, ischemic complications, which often follow aneurysmal hemmorrhage, seem to be of a more serious nature. There is evidence also that hydrocephalus due to adhesive arachnoiditis is a rare occurrence. The last 20 patients of the present series have been treated with very low doses of AMCA associated with parotid kallikrein inhibitor (Trasylol); this dosage has been effective in preventing recurrence and has appeared to be freer from severe side effects.

Adolescent↗