Biomedical subjects

L Sigona

Publications and source records attributed to L Sigona.

7 recordsLinked to original sources

PubMed1998

Neuroendoscopy. Personal experience, indications and limits.

The authors report a series of 40 patients treated by endoscopic neurosurgery. It includes 31 cases of obstructive hydrocephalus, 4 paraventricular or intraventricular CSF cysts, 3 cases of multiloculated hydrocephalus, one suprasellar arachnoid cyst and one cystic astrocytoma with mural tumor nodule. Third ventriculostomy is the most frequent indication of the endoscopic neurosurgery, which is very useful also for performing fenestration of CSF cysts and multiloculated hydrocephalus. The surgical endoscopic techniques in the different above mentioned pathologies are exposed. The criteria for patient selection, the clinical results and the postoperative radiological findings, that confirm the patency of the fenestration, are discussed.

Adolescent↗

PubMed1997

Cyst of the velum interpositum treated by endoscopic fenestration.

BACKGROUND: The cavum veli interpositi is a not infrequent radiologic finding in both children and adults, as confirmed by computed tomography (CT) and magnetic resonance (MR). A moderate enlargement of the cavum may sometimes be observed; on the other hand, a true large cyst may be considered exceptional, with only one reported case. CASE HISTORY: This 9-year-old boy with psychomotor retardation and epileptic seizures had a large CSF cyst in the region of the cavum veli interpositi, diagnosed by CT and MR. The patient was treated by endoscopic surgery, with introduction of the endoscope into the occipital horn of the right lateral ventricle and multiple fenestrations from the right ventricle to the cyst, and then from the cyst to the left lateral ventricle. The surgery resulted in decrease in the size of the cyst and reduction of the frequency of seizures. DISCUSSION AND CONCLUSIONS: Children with dilated or cystic cavum veli interpositi present with a large head, mental retardation, seizures, and hydrocephalus. On CT and MR, the cyst shows a typical triangular configuration on the axial plane and lies on the roof of the third ventricle in the coronal plane. Endoscopic ventricular fenestration is the treatment of choice for these as well as all other intraventricular and intracerebral CSF cysts, because it ensures communication between the cyst and the ventricular system and avoids definitive shunting of the cyst.

Brain Diseases↗

PubMed1996

Endoscopic ventricular fenestration of intracranial fluid cysts.

The authors report 5 patients with paraventricular or intraventricular fluid cysts, successfully treated by fenestration into the ventricular system using a neuroendoscopic technique. The series includes three paraventricular malformative CSF cysts, a cyst of the velum interpositum and a cystic astrocytoma with small, deeply located and unresectable mural nodule. In all cases the endoscopic fenestration was the unique treatment and allowed to avoid the definitive ventriculoperitoneal shunt. The surgical endoscopic technique and the postoperative radiological findings which indirectly confirm the patency of the fenestration are discussed. The authors conclude that endoscopic ventricular fenestration represents the treatment of choice for most paraventricular and intraventricular CSF collections.

Adolescent↗

PubMed1996

Giant spinal cord ependymoma in a child. Case report.

Ependymomas of the spinal cord extending to more than ten vertebral segments are rare. A case of a 14-month-old child is described and the other 13 reported cases are reviewed. The finding of a very extensive tumor (from T5 to L5) after only 14 months of life suggests that in our case the tumor was present since birth. Magnetic resonance well shows the real extent of the tumor in height and its different components. Complete removal is often possible even in very extensive ependymomas and results in clinical improvement. Postoperative radiotherapy is necessary only for incompletely removed or malignant ependymomas.

Ependymoma↗

PubMed1993

Rapid growth of a brain-stem cavernous angioma.

A rare case of rapidly enlarging cavernous angiomas of the cerebral hemispheres and brain stem in a child is reported. Rapid growth of cavernous malformations of the brain is rarely observed; it may be due to different mechanisms, including enlargement of the vascular channels, hemorrhage and cysts formation. The possibility of progressive enlargement of cavernomas makes periodical MR studies necessary in all cases. When the growth is radiologically documented, surgical removal is imperative even in patients with trivial symptoms.

Brain Neoplasms↗

PubMed1990

Familial cerebral cavernous angiomas.

Three families with two or more members affected by cavernous angiomas of the brain are described and the other 17 reported in the literature are reviewed. The familial occurrence of cerebral cavernous angiomas has been considered a rare event; nevertheless, the experience of the authors (positive familiarity in three patients where two or more relatives have been explored radiologically) suggests that cavernous angiomas of the brain might be, at least in most cases, a familial disease. Therefore, when a patient with cerebral cavernous angioma is observed, a careful familial history and the exploration of the familial members by computerized tomography or better still by magnetic resonance must be performed. The high frequency of multiple lesions in familial cases, the surgical indications and the role of the ultrasonic prenatal diagnosis are also discussed.

Adolescent↗

PubMedDate not supplied

Cavernous angioma of the pineal region.

The pineal region is one of the most rare localizations of intracranial cavernous angiomas, with only 8 cases reported up today. The Authors report a case of cavernous angioma of such localization and review the pertinent literature. Magnetic resonance allows the correct diagnosis of cavernous malformations on the basis of their typical aspect, even in the absence of histological verification. We suggest that this imaging technique will allow to identify more frequently pineal cavernomas preoperatively, thus avoiding useless irradiation.

Brain Neoplasms↗