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Biomedical subjects

M Zanusso

Publications and source records attributed to M Zanusso.

11 recordsLinked to original sources
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↗
PubMed1997

Gene stereotactic neurosurgery for recurrent malignant gliomas.

Four patients affected by glioblastoma recurrence were treated with a gene therapy-immunotherapy protocol consisting of intratumoral injections of culture cells producing a retroviral vector which expresses human interleukin-2 and the herpes simplex virus thymidine kinase genes. Seven to 14 days after implantation, the patients were treated with ganciclovir at standard doses. Anatomopathological and immunohistochemical data confirm the efficacy of transduction. From the clinical point of view, gene therapy combined with immunotherapy demonstrated safety and a short-range but clearcut oncolytic effect.

Brain Neoplasms↗
PubMed1991

Trigeminal evoked potentials in patients undergoing percutaneous microcompression of gasserian ganglion.

22 patients undergoing percutaneous microcompression of Gasserian ganglion for the treatment of trigeminal neuralgia were monitored intraoperatively by means of trigeminal evoked potentials (TEPs). The second trigeminal branch was stimulated at the maxillary foramen; evoked responses were recorded using subcutaneous electrodes placed over the scalp. TEPs presented several short-latency waves (called W1, W2, W3, P4, N5, P6, N10) which are generated before and after the ganglion (W1, W2, W3), in the brain stem (P4, N5, P6) and possibly in the cortex (N10); other waves occur within 150 ms after the stimulus (late waves). During compression, W1 did not change, while W2 and W3 as well as P4, N5, P6, N10 and late waves decreased in amplitude: this pattern was noted in the patients who presented with pain relief during the follow-up period. On the contrary, the patients who suffered from pain recurrence did not show similar intraoperative TEP changes. In conclusion, intraoperative TEP derangements may be related to the effectiveness of the compression on the Gasserian ganglion.

Aged↗
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↗
PubMed1988

Validity of stereotactic biopsy as a diagnostic tool.

254 patients affected by intracranial lesions underwent stereotactic biopsy in our department from 1978 to 1986. Target localization was achieved by CT. Multiple biopsy sampling was performed by cup microforceps or sliding cannula. Operative mortality was limited to 2 cases. Definitive tumour diagnosis including type and approximate grading was obtained in 211 (83%) patients. Diagnostic failures have been investigated from the neuroradiological point of view. Failure rate is low in solid tumours with CT homogeneous appearance and clear-cut borders, gradually increases in non homogeneous tumours, necrotic haemorrhagic or cystic, and is high in non classifiable lesions, generally hypodense at CT, with indefinite borders. In the authors opinion the variability of diagnostic retrieval in different types of lesions must be taken into account when proposing stereotactic biopsy.

Biopsy↗
PubMed1987

Linear accelerator radiosurgery of arteriovenous malformations.

Forty-five patients affected by cerebral arteriovenous malformations not suitable to open surgery have been treated by a radiosurgical technique employing a linear accelerator. One-year follow-up angiography is available for 10 cases. Therapeutic effect of focalized irradiation is presented.

Adolescent↗
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↗
PubMedDate not supplied

Isolated fracture of occipital condyle. Case report.

Fractures of the occipital condyle occur very rarely. Plain cervical spine films are not able to detect them. Tomography and CT scan of atlanto-occipital joint are, in these cases, very important. The Authors report a case of a young girl who had a head trauma associated to a fracture of the right occipital condyle. The value of CT and tomography are emphasized.

Adolescent↗