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Gabriele Polonara

Publications and source records attributed to Gabriele Polonara.

9 recordsLinked to original sources

Contribution of posterior corpus callosum to the interhemispheric transfer of tactile information.

Three total and three partial callosotomy patients underwent neuropsychological testing to evaluate interhemispheric transfer of tactile information. Tactile transfer is required to name objects presented to the left hand, to compare objects held in either hand, and to transfer topological information between hands. Tactile Naming, Same-Different Recognition, and Tactile Finger Localization Tests (intra- and intermanual tasks) were administered as specific tools. Results were compared with previous fMRI data from the same subjects and with the performance of a control group (20 age-matched subjects). Total callosotomy patients performed modestly: mean correct responses were 93% and 30% (right and left hand, respectively) in Tactile Naming; 68% in Same-Different Recognition; 84% and 76% (right and left hand stimulation, respectively) in intermanual Tactile Finger Localization, and 100% in the intramanual task. Partial callosotomy patients achieved 93-100% accuracy: all have an intact splenium, and one, and possibly all, also an intact posterior callosal body. Controls scored 99% in Tactile Naming, both hands, and Same-Different Recognition; 100% in intramanual Tactile Finger Localization; and 96% and 95%, with right and left hand stimulation, respectively, in the intermanual task. Differences between the two callosotomy groups were significant, as were those between total callosotomy patients and controls. The partial callosotomy group scored like the control subjects. Neuropsychological data agree with previous functional findings, further demonstrating that interhemispheric tactile transfer requires posterior corpus callosum integrity.

Adult↗

Bilateral cortical representation of the trunk midline in human first somatic sensory area.

The cortical representation of the trunk zone in the human first somatosensory area was studied with functional magnetic resonance imaging (fMRI) to establish whether the cutaneous regions close to the midline are represented in this area of both hemispheres. Cortical activation foci evoked by unilateral tactile stimulation of ventral trunk regions were detected in the postcentral gyrus of the contralateral hemisphere slightly medial to or just behind the omega-shaped region of the central sulcus and in the anterior bank of the postcentral sulcus. These regions probably correspond to the trunk ventral midline representation zones of areas 3a-3b and 1-2, respectively. Stimulation of cutaneous regions adjacent to the midline evoked activation foci also in the ipsilateral postcentral gyrus in regions symmetrical to those activated in the contralateral hemisphere. These data demonstrate that in humans, as in nonhuman primates, the cutaneous regions adjacent to the trunk midline are represented bilaterally in the first somatic sensory cortex. Whether the ipsilateral activation depends on callosal or extracallosal inputs remains to be elucidated.

Abdomen↗

Predicting posttraumatic epilepsy with MRI: prospective longitudinal morphologic study in adults.

PURPOSE: Evaluation of morphologic risk factors for posttraumatic epilepsy (PTE) by using brain magnetic resonance imaging (MRI) in serial assessments <or=2 years after traumatic brain injury (TBI). METHODS: Brain MRI hyperintense (gliosis) or hypointense (hemosiderin) areas or both were assessed in the images of 135 adult TBI inpatients who completed a 2-year clinical, EEG, and MRI study protocol. Overall clinical follow-up for the development of PTE was 5-10 years (median, 102 months). Morphologic risk factors for PTE were evaluated by using Kaplan-Meier curves and Cox regression analysis. RESULTS: In 20 patients, PTE developed. Kaplan-Meier curves showed that gliomesenchymal sequelae of focal brain lesions (subdural hematomas/contusions) that required surgical treatment (sSDH-C) were a PTE risk factor (p<0.001), as were sequelae of nonsurgical hemorrhagic contusions with gliosis wall incompletely surrounding hemosiderin dregs (IW) (p=0.039) and mainly those with time-related changes from incomplete to complete gliosis wall around hemosiderin (I/CW) (p=0.005); those with early hemosiderin completely surrounded by gliosis (CW) were not (p=0.821). Cox regression analysis showed that for patients with sequelae of sSDH-C, the PTE risk was 4.38 (p=0.023) times higher than for those who did not require surgical treatment or underwent surgery because of purely extradural hematoma; for those with IW and I/CW lesions, considered pooled, it was 6.61 times higher (p=0.014) than for those with CW lesions. CONCLUSIONS: MRI follow-up examination in the early chronic stage can differentiate among low-, intermediate-, and high-risk sequelae of TBI. These findings yield new evidence for, but do not resolve, the debate on posttraumatic epileptogenesis.

Adult↗

Bobble head doll syndrome in a child with a third ventricular cyst and hydrocephalus.

INTRODUCTION: The bobble head doll syndrome, mainly affecting children under 10 years of age, is a rare and surgically treatable movement disorder characterized by head bobbing occurring at a rate of 2-3 times/s. Its pathophysiological mechanism is not well known but two main factors are commonly associated with the condition: a dilatation of the third ventricle and, more frequently, a cystic lesion rather than a solid mass in the region of the third ventricle. ILLUSTRATIVE CASE: The illustrative case concerns a child with a third ventricular cystic lesion and hydrocephalus who had experienced abnormal head movements since the age of 1 year as well as ataxia and tremor of the arms. Contrast cranial MRI, at the age of 3, demonstrated enlargement of the third and lateral ventricles, a ballooned cyst inside the third ventricle with compression of all the diencephalic structures, a funnel dilation of the cranial part of the aqueduct, and a cyst in the septum pellucidum. A ventriculoperitoneal shunt (Hakim-Cordis) was placed and the head bobbing, tremor of the arms, and ataxia disappeared immediately. CONCLUSION: The good and immediate clinical result in our case emphasizes the opinion that the reduction of CSF pressure is the best therapeutical option in the bobble head doll syndrome.

Child, Preschool↗

Correlation between cerebral MRI abnormalities and mental retardation in patients with mucopolysaccharidoses.

Mucopolysaccharidoses (MPSs) are a group of inherited disorders due to lysosomal enzyme deficiencies which lead to multi-organ accumulation of glycosaminoglycans. Some forms of MPS disorders are characterized by various degrees of mental retardation. Magnetic Resonance Imaging (MRI) is the primary imaging technique to detect CNS alterations. The aim of this study is to evaluate the correlation between white matter (WM) alterations and the presence of mental retardation. We analyzed 20 patients with different forms of MPSs, 11 with mental retardation and 9 with a normal cognitive function; all of them underwent brain MRI and received a score on the basis of the alterations (WM alterations; perivascular, subarachnoid, and ventricular space enlargement; abnormalities of the basal ganglia, of the corpus callosum and of the atlanto-axial joint). All patients with mental retardation presented severe WM alterations, while only five out of the nine subjects without mental retardation showed certainly WM abnormalities. As far as the other cerebral abnormalities are concerned, no difference between the two groups has been found. These data seem to show that there is a significant correlation between the presence of WM alterations and mental retardation.

Adolescent↗

Expanding experience with spontaneous dermoid rupture in the MRI era: diagnosis and follow-up.

With widespread use of CT and MR imaging, experience with spontaneous dermoid rupture has significantly increased. What was previously believed to be a generally severe or even fatal accident, being the diagnosis made either at surgery or autopsy, or in patients with such consequent conditions as chemical meningitis or obstructive hydrocephalus, now appears to be more frequent than previously thought, and there is some evidence that it may also cause only a slight symptomatology or even be quite asymptomatic. We reviewed the clinical and imaging data of our series of five patients with spontaneously ruptured dermoids, spinal in one case, and intracranial supratentorial in four. These had their diagnosis following mild symptoms (number two cases) or incidentally (number two cases); the spinal tumor caused acute bladder dysfunction, possibly while undergoing rupture, and was associated with indolent intracranial fat spread. Three of the patients also had MR demonstration of asymptomatic persistence of fat spread in the subarachnoid spaces, respectively, 3, 4, and 5 years after rupture. One of the five cases, concerning a parasellar dermoid followed up over 6 years, provides the first demonstration of MR signal intensity change of the tumor prior to rupture.

Adult↗

MRI assessment of post-traumatic spinal instability.

The imaging evaluation of patients with spinal trauma has evolved over the past decades, and there has been particular interest in the concept of instability, to predict which a series of criteria have been proposed. We retrospectively evaluated the magnetic resonance imaging (MRI) findings in 50 patients with post-traumatic spinal instability according to Denis's three-column method, Daffner et al.'s radiographic criteria, and Oner et al.'s categorization of MRI findings; additionally, we evaluated the cord, the prevertebral tissue, and the epidural space. We suggest that an integrated panel of MRI information might be standardized in order to provide a more complete evaluation of spinal injury in an individual case and help planning surgical treatment.

Adolescent↗

White-matter alterations and callosal abnormalities in syndromic patients with mental retardation.

The aim of this study was to evaluate the frequency of callosal abnormalities and white matter alterations in syndromic patients. The authors report on the cerebral magnetic resonance imaging (MRI) morphologic analysis of the corpus callosum and white matter in 73 normal subjects and 61 syndromic patients. The study of the corpus callosum was carried out by MRI using different morphometric methods: measurement of the dimensions of length and thickness of genu, body, and splenium; measurement of angles obtained using the sagittal plane; and application of the proportional grid of Talairach. The evaluation of the white matter was carried out by applying a subjective grading scale. Abnormalities of the corpus callosum were found in about 50% of the syndromic subjects; in half of these cases, the abnormalities were associated with white matter alterations. In five syndromic patients (8.2%), the white matter alterations were not associated with corpus callosum abnormalities. This study shows that corpus callosum abnormalities are frequent in syndromology regardless of the syndrome type.

Adolescent↗