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Biomedical subjects

M Zavanone

Publications and source records attributed to M Zavanone.

At least 19 recordsLinked to original sources
PubMed2003

Intracranial metastasis of testicular seminoma in an HIV-positive. Case report and review.

We present what appears to be the first case of an intracranial metastasis from testicular seminoma in an HIV-positive patient. The computed tomography and magnetic resonance imaging appearance of the lesion mimicked meningioma or lymphoma. A significant increase in the risk of testicular seminoma has been reported in AIDS patients. Whenever there is lymph-node involvement upon diagnosis of testicular seminoma, intracranial metastases may appear. After surgical removal of an intracranial metastasis from testicular seminoma, radiotherapy should be considered. Chemotherapy is to be included in the treatment of intracranial metastases from testicular seminoma with systemic involvement.

Brain Neoplasms↗
PubMed2002

Cerebellar mature teratoma in adulthood.

Mature teratoma of the posterior cranial fossa in adults is extremely rare. We report a particularly rare case of medio-lateral cerebellar mature teratoma that became symptomatic in a middle-aged man. The CT revealed the lesion of heterogeneous density with calcifications in the solid medial portion. Only the MRI could reliably define the borders of the cystic component extending into the left cerebellar lobe. Histologically the presence of fully matured representative tissues of the 3 germ layers ensured the diagnosis of mature teratoma. We suggest that the cyst formation from progressive latent hemorrhage and/or secretion from the gland cells of the tumor, may be responsible for the clinical decompensation even in adulthood.

Cerebellar Neoplasms↗
PubMed1999

Percutaneous treatment of gas-containing lumbar disc herniation. Report of two cases.

A limited number of cases have been reported in which gas-containing lumbar disc herniation caused compression of nerve roots. The authors describe two patients in whom computerized tomography scanning revealed a large intraspinal gas collection that appeared to be causing nerve root compression and that was successfully evacuated by percutaneous needle aspiration.

Aged↗
PubMed1998

Stereotactically guided endoscopy for the treatment of arachnoid cysts.

Arachnoid cysts are well known to the neurosurgeon, and the evolution of their surgical treatment has followed technological advances in neurosurgical procedures and techniques. With the recent mastering of neuroendoscopy by the neurosurgeons, it is becoming the modality of choice for the treatment of arachnoid cysts. A neonate harboring a middle parasagittal arachnoid cyst benefited from stereotactically guided endoscopy. We report this case because of its peculiarities and introduce technical details about the procedure which are not found in the literature.

Arachnoid Cysts↗
PubMed1998

Localization accuracy of AC-PC line and functional pallidal target using BRW stereotactic implementation system and axial CT scanning. An experimental study.

BACKGROUND: Ventriculography is still considered an unavoidable step for functional target localization, even though this method is invasive and requires stereotactic rooms, orthogonal frames, and parallax-free X-ray equipment. In this experimental study, the authors investigated the feasibility of performing stereotactic lesions using a conventional, widely employed frame, such as the Brown-Roberts-Wells (BRW) apparatus, and computerized axial tomography (CAT) imaging. METHODS: Five ex vivo models consisting of cadaveric brains enclose in a plastic shell were fixed in a BRW frame. A simple BRW implementation was used to ensure more symmetrical placement of the basal ring. Two-millimeter plastic balls were inserted at the level of the anterior (AC) and posterior commissures (PC) and at the target in the pallidus. Their final position was measured on the anatomical specimens and compared with Schaltenbrand Atlas maps. RESULTS: The error in estimating the length of the intercommissural line ranged from 0.5 mm to 2.0 mm, with a maximum backward angulation of four degrees in predicting the AC-PC plane. Upon dissection, in four out of five cases, the balls were found within the area of the pallidus defined by Laitinen for posteroventral pallidotomy. CONCLUSIONS: The authors conclude that anatomical identification of the AC-PC line and the pallidus target, using the BRW stereotactic system and CAT axial images alone offers sufficient accuracy. They suggest that functional neurosurgery for movement disorders could be safely and successfully carried out without ventriculography if neurophysiological monitoring is also employed.

Cadaver↗
PubMed1998

[Giant aneurysms].

Giant aneurysms (> 2.5 cm) represent only 5-7% of all aneurysms. Nevertheless, their management is rather difficult due to their atypical natural history and peculiar treatment. Clinical history of giant aneurysms does not differ from that of the smaller ones regarding the incidence of subarachnoid hemorrhage, but it is complicated by much more neurologic deficits and by the occurrence of chronic intracranial hypertension syndrome. Diagnosis is essentially based upon CT scan and MR imaging in order to detect the morphological mass features and anatomical relationships, and upon angiography to appreciate characteristics regarding arterial flow and vascular relationships. The goal of treatment lies in the exclusion of the aneurysmal sac from the blood-stream and in the reduction of the mass effect. The treatment may be either surgical, endovascular or both. The most common surgical techniques consist in the direct occlusion of the neck of the aneurysm by means of metallic clips, or by fastening or trapping the carrier vessel or by removing the aneurysmal sac with the reconstruction of the arterial aspect when severe mass effect is detectable. The use of endovascular techniques goes for occlusion of the carrier vessel with balloons or for dynamic study of the collateral vascular districts with temporary occlusions.

Cerebral Angiography↗
PubMed1992

Primary traumatic benign midbrain haematoma in hyperextension injuries of the head.

Primary traumatic brain stem injury occurring in isolation is not universally recognized as a distinct pathological entity which may follow a head injury. We describe two patients with clinical and radiological evidence of primary posttraumatic midbrain haemorrhage occurring in isolation associated with good recoveries. It is suggested that paramedian midbrain syndromes associated with midbrain haemorrhages should be recognized as a distinct, although unusual, complication of hyperextension injury to the head which may have a benign course.

Adult↗
PubMed1982

Pituitary function before and after transsphenoidal adenomectomy in patients with Cushing's disease.

Over the past 4 years 11 patients with Cushing's disease have been operated on by a transsphenoidal microsurgical technique. All patients had small intrahypophyseal adenomas found at operation. Eight of the 11 patients had a remission of the disease on the basis of clinical evaluation and hormonal studies. The endocrinological results revealed a transient state of hypocorticism in all successfully treated patients. Within 6-8 months after operation recovery of hypothalamic-pituitary-adrenal function and other tropin function took place. These findings, together with the absence of recurrence up to now, further confirm the efficacy of transsphenoidal surgery in the management of patients with Cushing's disease.

Adolescent↗
PubMed1977

Long-term results in 62 cases of post-traumatic complete apallic syndrome.

After the transition state of decerebrate coma, at least four different kinds of the so-called apallic status can be identified: 1. Complete apallic syndrome: coma vigil, alertness without any awareness, mass movements only, impairment of sleep rhythm, absence of any emotional responses, postural abnormalities, some primitive motor responses, tetraplegia, and alteration of muscle tone. 2. Incomplete apallic syndrome: some of the features of the complete apallic syndrome are lacking, and the patient shows emotional reactions with appropriate grimacing and some appropriate motor responses. 3. False apallic syndrome: most signs of complete apallic syndrome are present, but the patient is in touch with the environment. This condition is somewhat similar to the so-called locked-in syndrome. 4. Functional apallic syndrome: full clinical picture of the complete apallic syndrome but full recovery within a few days. Long-term results in 62 patients, aged between 4 and 62, affected by a post-traumatic complete apallic syndrome are reported. Thirty two patients were operated upon and 30 were not operated upon. Out of these cases, 38 died after weeks or months; 3 patients entered a chronic apallic status; 2 patients are improving; 10 recovered with severe neurological or psychic sequels or both; 4 recovered with minimal sequels, and 5 without sequels; no patients in these two last groups were aged more than 20.

Adolescent↗
PubMedDate not supplied

A cervico-dorsal intramedullary epidermoid cyst. Case report and review of the literature.

Intramedullary epidermoid cysts are rarely observed. Only a little more than 30 cases have been reported in the literature. The authors have treated a 51 year-old woman with a cervico-dorsal intramedullary epidermoid tumor associated with a syringomyelia. The frequency of this lesion, its CT and MRI appearance and the possibility of a preoperative diagnosis are discussed.

Epidermal Cyst↗
PubMedDate not supplied

Traumatic fractures of the craniovertebral junction. Management of 23 cases.

Twenty-three consecutive cases of traumatic C1-C2 fractures treated at the Department of Neurosurgery, University of Milano, are reported. Of these there were 13 cases of odontoid fractures, 6 hangman fractures, 2 anterior inferior corner fractures, 2 atlas-axis combination fractures and 2 Jefferson fractures. Almost all the patients were young people involved in motor vehicle accidents. Nineteen patients were treated with external immobilization (halo vest, Minerva) for 3-6 months while 4 odontoid fractures underwent early surgical posterior stabilization. At follow-up, 20 patients had a good fusion while 3, aged over 75 years, died due to cardiopulmonary or septic complications. The appropriate management of this type of lesion is still a matter of discussion. In our opinion the Halo device allows good stabilization after correct fracture reduction.

Adolescent↗
PubMedDate not supplied

Treatment of non-neoplastic stenosis of the aqueduct of Sylvius with extrathecal CSF shunts.

A series of 185 patients operated on with extrathecal shunts for non-neoplastic aqueductal stenosis has been reviewed. The longterm results of 84 of them, followed-up for 2 to 20 years after primary surgery, are illustrated and critically analyzed. This study indicates that a normal mental development or normalization of mental and neurological conditions can be expected in a high percentage of patients after the CSF diversional procedure which nonetheless is still associated with a high percentage of even serious complications.

Adolescent↗
PubMedDate not supplied

Intraventricular hemorrhage: role of early ventricular drainage.

Intraventricular hemorrhage (IVH) is usually the result of life-threatening intracranial bleedings eventually leading to death. Early ventricular drainage is suggested as a possible means of reducing fatalities. The retrospective analysis of 80 patients with CT diagnosed IVHs has indeed shown that early drainage prolongs significantly survival before death but does not influence mortality. Clinical and CT grading still remain fundamental prognostic indexes accounting for the irreversible hemorrhagic lesion. Thus ICP monitoring and ventricular drainage may be useful only in selected patients with alterations of consciousness of intermediate severity and sluggish evolution.

Adolescent↗
PubMedDate not supplied

Intracranial bleeding in haemophilia. A study of eleven cases.

We have analysed eleven cases of intracranial haemorrhage occurring over the last 9 years in a population of 250 haemophiliacs. The purpose of this survey was to evaluate the prognostic possibilities available since the introduction of new diagnostic procedures and the progress in replacement therapy with anti-haemophilic factor. The sites of the haemorrhages and changes after treatment were visualized by CAT in 7 of the patients. Four patients died following dramatic evolution of their clinical conditions; two of them died before surgery, the others after having been operated on while in very deep coma. Two patients were successfully operated on for lesions occupying extracerebral spaces (one subdural and one extradural haematoma); replacement therapy avoided both recurrence and serious neurological defects. One patient with subarachnoid haemorrhage complicated by hydrocephalus was given an extrathecal shunt of cerebrospinal fluid. Four haemophiliacs had intracerebral haematomas: two of these needed surgery whilst the others recovered without serious neurological defects with replacement therapy only. These findings indicate that replacement therapy has considerably changed the prognosis of intracranial haemorrhage in haemophiliacs and that the CAT is a very helpful diagnostic procedure for evaluation of the acute stage and the follow-up.

Adolescent↗
PubMedDate not supplied

Optic nerve and chiasm gliomas in children.

In a 30 years period, 42 children were admitted for optic nerve and chiasm gliomas; 20 patients aged less than 5 years and 22 between 6 and 16 years. Duration of symptoms ranged from 13.15 months in children aged less than 5 years, to 10.18 months in patients aged more than 6. Onset of symptoms were characterized by visual impairment and/or proptosis in 73.8%, diencephalic disorders in 16.6% and intracranial hypertension in 9.5%. All patients underwent skull X-rays; 31 had a PEG taken and 12 a CT scan. Surgery was prompted in 27 patients, 2 of which died in postoperative course. Radiotherapy was the treatment of choice in the other 15 patients, 40 patients were followed up: the best results were obtained in the group of patients operated on and irradiated.

Adolescent↗
PubMedDate not supplied

Practical value of CSF cytological examination in the diagnosis of intracranial neoplasm. A preliminary report.

The authors examined 214 CSF samples, 187 of which had been obtained by lumbar and 27 by ventricular puncture. Within 10' from time of collection, each of the CSF samples were centrifuged in a Shandow cytocentrifuge for 15' at 1500 r.p.m. Slides were made and stained according to the May-Grunwald-Giemsa method. Of the 214 samples, 137 were from patients suffering various neurological disorders while 77 were from patients affected by primitive or metastatic verified CSN neoplasms.

Brain Neoplasms↗