Biomedical subjects
Publications and source records attributed to P Angiari.
A case of spinal epidural haematoma diagnosed by means of Gadolinium-DTPA-enhanced MR imaging is described. The sensitivity of this recent technique is underlined.
A very small fiberoptic catheter initially developed as an intravascular pressure sensor was incorporated into a system to be used as an intracranial pressure (ICP) monitor. 13 patients with intracranial hypertension have been studied with this probe. The clinical experience confirmed the safety, accuracy and reliability of the device. The monitor has functioned very well, and there have been no complications except for two breakages of optic fiber as a result of nursing manoeuvres. This new device can be placed into the ventricular, subdural and epidural space. Camino System appears to offer advantages over other monitors presently in use.
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We report a case of aphasia and right hemiplegia, developing after myelography with metrizamide and lasting for an unusually long time. The neurological disorders, manifested 1 h after the examination was completed, were due to accidental passage of contrast medium into the basal cisterns. In the light of analogous case reports in the literature, as well as experimental data concerning the biochemical activity of metrizamide, possible aetiopathogenetic mechanisms responsible for such disturbances are indicated. The authors underline the lack of effective therapeutic measures after the onset of the disorders, and thus the importance of preventing such complications that behave functionally as true ictuses although with no anatomic substratum.
Between July 1981 and August 1983 the authors studied 21 patients with intracranial arachnoid cysts using metrizamide-enhanced CT. With this method we are able to determine the degree of communication between the cysts and the surrounding subarachnoid space as well as to assess the evolving character of some of these lesions. This information will allow a more rational choice of surgical treatment.
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A case of meningeal melanocytoma of the left Meckel's cave associated with ipsilateral Ota's nevus in a 43-year-old woman, was studied by light and electron microscopy. The cells of the tumor were characterized by the presence of dendritic cytoplasmic processes, melanosomes and premelanosomes; hence, they were deemed as neoplastic melanocytes. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic Schwannoma and primary meningeal melanoma. The prolonged clinical course was different from primary and metastatic malignant melanomas of the meninges. The best treatment appears to be radical excision, when possible; otherwise, the local or partial enucleation followed by radiation therapy has been found to be the best curative to date. On the whole, meningeal melanocytoma cannot be considered as entirely benign, given its morphologic patterns that resemble those of uveal melanoma, and its potential for recurrence. The association of this tumor with Ota's nevus is referred to as having a common origin from an arrested migration of melanoblasts at different stages.
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Several investigative procedures are currently used to diagnose communicating syringomyelia. The combination of isotope ventriculography and lumbar myelocisternography has never proposed nor carried out to verify this condition. We feel that this is a safe and valuable procedure to identify a patent central canal communicating with the fourth ventricle and is worth considering when diagnosing communicating syringomyelia.
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The Authors report three cases of pseudotumor cerebri with noteworthy visual defect. Lumboperitoneal shunt enables good recovery where there was no atrophy of the optic nerve and demonstrated its usefulness also in serious situations.
The Authors report a case of low back pain with sciatica due to a synovial cyst of the interapophyseal joint of the lumbar spine. The diagnosis was made by CT and MRI. A review of the literature confirms the relative rarity of their lesion at the lumbar level and the necessity of radical surgery, best achieved with microsurgical technique. The Authors emphasize the importance of accurate diagnosis before surgery.
The Authors report a case of cartilaginous tumor of the parasellar region, diagnosed as ossifying chondroma by virtue of the intense calcification it presented. Preoperative diagnosis was suggested by CT, which showed a characteristic honeycomb conformation, with alternate areas of greater or lesser density, without contrast enhancement. Angiography is, however, essential in planning the operation, which must on occasion be confined to partial resection only. This limitation may be acceptable where functionally important areas are concerned, since these neoplasms show an apparent tendency to only modest growth.
The authors report of a patients operated for a double encephalic mass in the left posterior parietal region. This lesion resulted a tubercoloma at a later investigation. This pathology is relatively common in underdeveloped countries, declining in western countries. The authors emphasize the need of a careful evaluation in searching tuberculous infection in presence of encephalic granulomatous masses.