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P Selviaridis

Publications and source records attributed to P Selviaridis.

8 recordsLinked to original sources

Intracranial aneurysms: evaluation using CTA and MRA. Correlation with DSA and intraoperative findings.

Computed tomographic angiography (CTA) and magnetic resonance angiography (MSA) have been used recently for evaluation of intracranial aneurysms. If they are to replace conventional digital subtraction angiography (DSA), their sensitivity and specificity should be equal to the latter. In order to determine whether computed tomographic angiography and magnetic resonance angiography can provide the necessary information for presurgical evaluation we compared blindly the results of helical CT angiography and MR angiography with the results of digital subtraction angiography and the intraoperative findings. We evaluated 35 patients with the possible clinical diagnosis of intracranial aneurysm. Our data suggest that both CTA and MRA can provide valuable preoperative information concerning the location, the characteristics and the relationships of most intracranial aneurysms. Both original and reconstructed images should be evaluated together for higher accuracy. In addition helical CT, being a fast, inexpensive and noninvasive method, can be used as a reliable alternative to DSA in emergency situations demanding immediate operation.

Adult↗

Fusiform aneurysm of the posterior cerebral artery: report of two cases.

Two cases with fusiform aneurysm in the posterior cerebral artery are presented: The first one is a large fusiform aneurysm of the P(2) segment of posterior cerebral artery (PCA) in a 58 years old patient and the second a fusiform aneurysm of the P(3) segment of PCA in a 43 years old patient. The aneurysms were successfully treated the first by proximal ligation and the second by trapping of the aneurysm. The patients had no additional neurological deficits postoperatively and they are in an good condition, in four years and one year follow up respectively. The operative approaches and the radiological investigation in relation to the micro-anatomy of the posterior cerebral artery, as well as the outcome in these cases are discussed.

Adult↗

Radiation and concomitant weekly administration of paclitaxel in patients with glioblastoma multiforme. A phase II study.

The present study was conducted to evaluate the activity and toxicity profile of radiation (RT) and concomitant chemotherapy in patients with glioblastoma multiforme (GBM). Thirty-nine patients were treated postoperatively with RT and concomitant administration of paclitaxel. Cranial irradiation was initiated 2-3 weeks postoperatively and was administered in 2.0 fractions, one fraction per day, for 5 consecutive days per week, to a total of 60 Gy. Paclitaxel was delivered at a dose of 100 mg/m2 over 3-h once weekly for 6 weeks. Thirty-three patients received all 6 cycles of paclitaxel according to the protocol. Totally, 217 cycles were delivered all of them at full dose. The median relative dose intensity of paclitaxel was 1 (range 0.88-1.1). Three (7.5%) patients achieved complete and 9 (23%) partial response, while 12 (30.5%) patients demonstrated stabilization of the disease. Side effects from combined chemoradiotherapy were mainly mild. Grade III toxicity included infection (7.5%) and alopecia (5%). Median time to progression was 6 (range 0.9-27) months and median survival 10.7 (range 0.9-39.5+) months. The present study has clearly shown that 100 mg/m2 of paclitaxel in 1-h infusion weekly can be safely given concomitantly with RT in patients with GBM with manageable toxicity. However, the efficacy of this combined modality treatment does not appear to be superior to that of RT alone.

Adult↗

Concurrent radiation and intracarotid cisplatin infusion in malignant gliomas: a feasibility study.

Twenty-two patients with supratentorial malignant gliomas were treated postoperatively with concurrent intracarotid chemotherapy and radiation therapy. There were seven women and 15 men with a median age of 56 years (range, 22-69) and median performance status (Karnofsky score) of 70 (range, 40-90). In all except two cases, histologic studies confirmed malignant glioma. All patients were irradiated with a cobalt 60 equipment. They should have received 45 Gy to the whole brain plus a 15-Gy coned-down boost to the tumor area. Chemotherapy consisted of cisplatin infusion at a dose of 60 mg/m2 on days 2, 22, and 42. Treatment was interrupted in two patients because of progressive disease and voluntary withdrawal in one patient each. In all, 63 courses of cisplatin infusion were administered, all at full dose. Two patients achieved a partial response, and nine had stable disease. Toxicities included nausea/vomiting in nine patients (41%) and transient hemiparesis, confusion, diarrhea, and thrombophlebitis in one patient each. Median time to progression was 26 weeks (range, 4-226+), and median survival was 58 weeks (range, 14-226+). In conclusion, the present study suggests that intracarotid cisplatin administered concurrently with radiation does not improve the therapeutic index in malignant gliomas.

Adult↗

Primary angiosarcoma of the brain: case report.

A 41-year-old patient with a primary angiosarcoma of the brain is reported. The tumor was located in the left parietal lobe and was radically removed. The diagnosis of angiosarcoma was established by immunohistochemistry. The patient was postoperatively treated with adjuvant chemotherapy and then radiation therapy. After 41 months, she was in excellent clinical and neurological condition without any sign of recurrence.

Adult↗

Intraventricular administration of morphine for control of intractable cancer pain in 90 patients.

OBJECTIVE: To quantitate the relief of intractable cancer pain by the use of intraventricular morphine administration. METHODS: Intraventricular morphine administration was performed through an Ommaya reservoir. An initial dose of 0.25 mg of morphine sulfate per 24 hours was administered to all of the patients. This dose was progressively increased in 0.25-mg increments until optimal analgesia was attained. RESULTS: Sixty men and 30 women with a median age of 58 years (range, 23-80 yr) entered the study. The median duration of pain was 6 months (range, 0.5-120 mo). A daily morphine dose of up to 1 mg was adequate to achieve an analgesic effect in 77% of the patients. Only nine patients (10%) achieved < 50% pain relief. Using a multiple regression analysis, only the morphine dosage was found to be an independent prognostic factor. The most frequent side effect (22%) was nausea/vomiting. Also, there were two patients with opioid intolerance and two with intracerebral hematomas. Three reservoirs failed. CONCLUSION: Intraventricular morphine administration is a useful method for palliation of intractable cancer pain.

Adult↗

Symptomatic trigeminal neuralgia.

In four cases with trigeminal neuralgia an intracranial neoplasm was detected. In the first two cases a meningioma of the cerebellopontine angle was producing symptomatic trigeminal neuralgia almost identical to the essential one. In the other two cases with a tumor in the gasserian ganglion area the facial pain was of a more atypical nature. In all four cases associated sensory trigeminal deficits were present. The causative factors which may produce symptomatic trigeminal neuralgia are especially discussed in this paper.

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