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Biomedical subjects

L Volpin

Publications and source records attributed to L Volpin.

17 recordsLinked to original sources
PubMed2000

Chemotherapy in patients with recurrent and progressive central neurocytoma.

BACKGROUND: Recurrent central neurocytoma is very rare and to the authors' knowledge data regarding its response to chemotherapy currently are not available. METHODS: Three patients with progressive neurocytoma received chemotherapy after their informed consent was obtained. Disease recurred in two patients after surgery and radiotherapy and in one patient after surgery. The treatment regimen was comprised of etoposide, 40 mg/m(2)/day, for 4 days; cisplatin, 25 mg/m(2)/day, for 4 days; and cyclophosphamide, 1,000 mg/m(2), on Day 4; this cycle was repeated every 4 weeks. RESULTS: Stabilization of disease was observed in 2 patients and complete remission was observed in 1 patient; at last follow-up, these responses had been maintained for 15 months, 18 months, and 36 months, respectively. CONCLUSIONS: In this small series, this therapeutic regimen led to long term disease reduction, and merits further study.

Adult↗
PubMed2000

The role of decompressive craniectomy in the treatment of uncontrollable post-traumatic intracranial hypertension.

The benefit of decompressive craniectomy for the treatment of uncontrolled post-traumatic intracranial hypertension seems to be encouraging if medical management fails. We present our experience in 22 cases of cerebral edema due to head trauma. The edema alone was rarely the direct consequence of head trauma. Frequently it was associated with an acute subdural or extradural hematoma and contusion (with or without mass effect). First of all we treated the mass effect of the hematoma and contusion when the diameter was more than 3 cm. Intracranial pressure was monitored in the majority of patients. Bone decompression was performed in the operating theatre depending on the values of intracranial pressure. In our series 41% of patients had a good recovery, 18% a severe disability, 23% a vegetative state and 18% died. The findings showed that the bony decompression must be performed early before the situation becomes irreversible. We suggest that if intracranial pressure values remain greater than 30 mmHg with cerebral perfusion pressure below 70 mmHg, despite vigorous anti-edema therapy, decompressive craniectomy should be considered.

Adolescent↗
PubMed1998

Spontaneous healing of cerebral aneurysm at the beginning of left posterior inferior cerebellar artery (PICA). Case report.

We present the clinical and neuroradiological features of a ruptured aneurysm at the beginning of the left PICA suffering from subarachnoid hemorrhage (SAH). The young patient refused surgery, endovascular treatment and also follow-up. After 4 and 5 years she repeated the left vertebral angiography that showed a spontaneous thrombosis of the aneurysm. After 8 years MR angiogram images confirmed the total obliteration of the aneurysm.

Adult↗
PubMed1991

Pressure monitoring inside Meckel's cave during percutaneous microcompression of gasserian ganglion.

During percutaneous microcompression of the gasserian ganglion for the relief of trigeminal neuralgia, a computerized technique for monitoring the pressure inside Meckel's cave was employed in 22 patients. A dedicated transducer connected to a computer records the balloon inflation pressure. Its variations are discernible within tenths of a bar and are plotted in relation to time. The intraoperative pressure inside Meckel's cave is from 0.9 to 2.4 bars. When pressure was low, there was recurrence of pain. The highest values of pressure (1.9-2.4 bars) were observed in most of the patients suffering from untoward side effects. The clinical results seem to be influenced by the level of the intraoperative intracavitary pressure.

Aged↗
PubMed1990

Intra-operative monitoring by means of somatosensory evoked potentials during cerebral aneurysms surgery.

During cerebral aneurysms surgery, brain tissue may suffer for global or local ischemia due to deliberate hypotension and surgical manoeuvres. Somatosensory evoked potentials (SEPs) can detect functional derangements consequent to hypoxia, before a permanent brain damage is produced. Forty two patients, undergoing cerebral aneurysms surgery for treatment of SAH, were evaluated intraoperatively with SEP recordings. It has been stressed that no permanent neurological damage is to be expected if the absolute value of Central Conduction Time (CCT) does not exceed 9.5 ms for 10 min at least and the cortical waves are visible throughout the whole procedure. SEP changes are strictly related with MAP decrease and surgical handlings.

Adult↗
PubMed1990

The transcranial Doppler ultrasonography in the evaluation of vasospasm and of intracranial hypertension after subarachnoid hemorrhage.

The transcranial doppler (T.C.D.) is a non-invasive technique useful for the evaluation of vasospasm and intracranial hypertension in patients with subarachnoid hemorrhage (S.A.H.). Eighteen patients with recent S.A.H. were studied by means of T.C.D. device: in 14 patients the source of bleeding was a ruptured aneurysm of the circle of Willis, while the remaining 4 presented a negative four-vessels angiography. All the patients were studied 5 and 10 days after the bleeding. Our data showed that the ultrasonographic demonstration of vasospasm and/or I.C.H. is clearly related to the clinical status of the patients. No significant T.C.D. difference was noticed between the "sine materia" S.A.H. patients and the ones with ruptured aneurysm.

Blood Flow Velocity↗
PubMed1988

Computed tomography after lumbar disc surgery: a comparison between symptomatic and asymptomatic patients.

The evaluation of patients with recurrent symptoms after lumbar disc surgery, is a difficult diagnostic problem. The causes of failure may include recurrent disc herniation, postoperative scarring, arachnoiditis, spinal stenosis, infection and mechanical instability. The most common causes are recurrent herniation and postoperative scarring; the routine x-ray and myelographic differentiation between them is difficult or impossible. High resolution CT has shown some results in the evaluation of the postoperative patients. It requires some knowledge of CT findings of "normal" pictures of the physiologic healing and scarring after disc surgery. We scanned 30 asymptomatic operated patients and 30 patients with recurrent sciatic nerve pain after disc surgery. From our observations result that it is quite impossible to distinguish "normal" scar from asymptomatic fibrosis. The degree and type of fibrosis are not related to recurrent symptoms.

Adult↗
PubMed1988

Computed tomography of epidural fibrosis after discectomy: a comparison between symptomatic and asymptomatic patients.

The evaluation of patients with symptoms recurrent after disc surgery is a difficult diagnostic problem. The most common causes are recurrent herniation and postoperative scarring; routine x-ray and myelographic differentiation between herniation and scarring is difficult or impossible. High resolution computed tomography (CT) has shown some results in the evaluation of postoperative patients, but the role of epidural fibrosis in failed back surgery syndrome (FBSS) is not clear. Some knowledge of the "normal" CT physiological healing and scarring after disc surgery is necessary. We scanned 20 asymptomatic operated patients and 20 patients with recurrent sciatic nerve pain after disc surgery who did not have bony stenosis, recurrent disc herniation, or other causes of FBSS. Our observations showed no important differences in the fibrosis demonstrated by CT between symptomatic and asymptomatic patients. The degree and type of fibrosis are not related to recurrent symptoms.

Adult↗
PubMed1986

Our experiences in early aneurysm operations: a preliminary report.

Twenty-seven patients affected by ruptured aneurysms and operated on within three days of the first haemorrhage, are presented. At operation 22 patients were graded I-II; a six months follow-up showed a 22% mortality rate. Five patients were graded III-IV at operation and none survived. The results of early operation in our series are examined and discussed. In our opinion it is necessary to know the results of other larger series in order to obtain a final evaluation of early operations on aneurysms.

Adult↗
PubMed1986

Sclerosing orbital pseudotumor.

Sclerosing orbital pseudotumor is a particular type of idiopathic inflammatory process, frequently located at the orbital apex. Both from clinical and from instrumental examination the diagnosis of these forms is difficult. The ineffectiveness of steroid treatment and the progressive visual loss in these patients favors surgical exploration. We report on 5 patients who underwent exploration yielding the diagnosis of sclerosing orbital pseudotumor. Surgery allowed correct histological diagnosis and improvement of ocular symptoms.

Adult↗
PubMed1984

Spontaneous intracerebral hematomas: a new proposal about the usefulness and limits of surgical treatment.

We analyzed the volume of 132 spontaneous supratentorial intracerebral hematomas calculated with computed tomographic (CT) scans and related it to the clinical condition of the patients on admission and to the outcome at their discharge from the hospital (1 to 3 months after the ictus). Fifty patients were operated on, and 82 received only medical treatment. In evaluating outcome, we were more interested in survival than its quality. The main problem is the evaluation and treatment of the many patients who are comatose upon admission (about half of the patients). We concluded that surgical treatment by evacuation of the hematoma increases the percentage of survival of comatose patients with a hematoma volume between 26 and 85 ml.

Cerebral Hemorrhage↗
PubMed1978

Effects of disuse and nerve stump length on the development of fibrillation in denervated soleus muscle.

Both in normal (control) and in cordotomized (disused) rats, the soleus muscle was denervated either by cutting the sciatic nerve near the trochanter (proximal denervation) or by cutting the soleus nerve near the insertion into the muscle (distal denervation). In the control muscles, the development of fibrillation was not dependent on the level of nerve section. In disused muscles, the development of fibrillation was greater following distal denervation that following the proximal one.

Animals↗
PubMedDate not supplied

Breathing alterations in head injured patients.

Breathing abnormalities in patients affected by acute cerebral damage are herein studied as neurological signs of localizing value for the neurological diagnosis of the level of the lesion. Incidence and types of abnormal breathing pattern correlate with neurological syndromes, and in a given neurological syndrome the presence of these alterations entails a more severe outcome. Tachypnea shows the most significant correlations from a diagnostic and prognostic point of view.

Ataxia↗