Biomedical subjects

M Domenicucci

Publications and source records attributed to M Domenicucci.

23 records · Page 2Linked to original sources

PubMed1988

Spinal meningiomas: prognosis and recovery factors in 22 cases with severe motor deficits.

The 22 cases of spinal meningioma with severe motor deficit operated on during a 34-year span are reviewed. The motor deficit is graded according to a modified version of the scale proposed by Levy et al. in 1982, their grade IV being split into grade IV (toe movements and muscular concentrations) and grade V (paraplegia). All 10 grade IV patients were able to walk normally within a year of surgical treatment while only 50% of the grade V patients (12 cases) recovered, and then not completely. The preoperative duration of the motor deficit and age under 60 influenced the speed of recovery in the grade IV patients and the possibility of recovery in the grade V cases. We consider that the dual mechanism of mechanical and ischemic trauma played an important part in the speed and possibility of recovery in the patients reviewed.

Adult↗

PubMed1988

Tentorial meningiomas: surgical experience with 61 cases and long-term results.

The authors report their experience and long-term results in the surgical treatment of 61 tentorial meningiomas. These cases were operated on between 1951 and 1985 and represented 4.8% of all intracranial meningiomas operated on in that period. The mean duration of clinical history was 29 months, except for cases of meningioma of the posteromedial border, for which it was 5 years. Plain x-ray films and cerebral angiograms were obtained in all cases. Computerized tomography, performed in the last 20 cases (32.7%), supplied much better lesion topography and early diagnosis. The tumor site was posterolateral in 26 cases (42.6%), anterolateral in 14 (22.9%), posteromedial in eight (13.1%), at the free border in seven (11.4%), and in the tentorium itself in six (9.8%). Lateral and medial tumors with solely or mainly supratentorial development were approached from above. The approach from below was reserved for meningiomas with subtentorial involvement only. In meningiomas with both supra- and subtentorial growth, a supratentorial bone flap was combined with a suboccipital craniectomy using a retromastoid incision. The mortality rate was 9.8%. Of the remaining 42 patients, who were followed for at least 5 years, long-term results were good in 26 cases (61.9%), fair in 11 (26.2%), and poor in five (11.9%). Postoperative complications arose in 34% of the patients, but cleared in 27%.

Adult↗

PubMedDate not supplied

Diagnosis and follow-up of minor cervical trauma.

In order to evaluate sensitivity, specificity and accuracy of radiographic findings, 1347 patients with minor cervical injury underwent clinical, orthopaedic, neurosurgical examination, and were classified as monosymptomatic (only cervical pain) or polysymptomatic (cervical pain plus additional symptoms). X-rays were taken in anteroposterior, lateral and open-mouth views; additional views if necessary. X-ray outcome was normal in 69.8% of monosymptomatic patients and there were no fractures. In 45.1% of polysymptomatic patients, outcome was normal, but there were seven fractures. Computed tomography/magnetic resonance (CT/MR) was performed in patients with documented injury and/or strong persistent symptoms. X-ray follow-up at 4-6 weeks included flexion-extension examination. Elevated statistical radiographic values were reached. All patients with minor cervical trauma should undergo clinical, neurosurgical and three-view radiographic follow-up. A simplified algorithm could lead to substantial savings and decrease patients' exposure to radiation.

Adolescent↗

PubMedDate not supplied

The results of the surgical and conservative treatment of non-neurologic comminuted thoracolumbar fractures.

A retrospective radiologic study of 40 non-neurologic thoracolumbar fractures allowed for the evaluation of the long-term results of surgical and conservative treatment in terms of correction of the post-traumatic deformity. The Magerl classification and the McCormack scale were used to select compressive type fractures (type A), and fractures characterized by comminution of the vertebral body without involvement of the posterior elements. Instability related to comminution and to considerable diastasis of the fragments is at the basis of failure of conservative (plaster brace) and surgical (short posterior fixation and posterolateral fusion) treatments. Severe type A fractures treated conservatively have, in fact, at follow-up shown significant residual deformity, while failure of the instrumentation or loss of correction in 40% of cases treated surgically has been revealed.

Adult↗

PubMedDate not supplied

Association of intracranial meningiomas and aneurysms. Report of three cases and review of the literature.

The Authors report three personal cases of association between meningioma and arterial aneurysm, both intracranial. Twenty-three similar cases are referred in the literature, bringing the total to 26. Of these 26, the overall average age at diagnosis was 48.3 years: 17 were females and 9 males. The predominant site for the meningioma was the cerebral convexity and for the aneurysm the anterior communicating artery. Meningiomas were multiple in 5 cases and the aneurysms were multiple in the same number of cases. In 21 cases the meningioma was removed: in 11 of these the aneurysm was treated simultaneously. In the majority of cases the aneurysm was an accidental finding during neuroradiological investigation to document the meningioma; panangiography is reported to have been performed only in a few cases. Greater use of the latter would probably have revealed a higher incidence of this rare association. The greater frequency found of the association of aneurysm and multiple meningiomas makes it advisable to perform panangiography in all such cases. The best long-term results were obtained in the cases where the meningioma and aneurysm were operated simultaneously.

Aged↗