PubMed Health⌕ Search

Biomedical subjects

R Canapicchi

Publications and source records attributed to R Canapicchi.

33 records · Page 2Linked to original sources
PubMed1995

Radiological findings in a case of Menkes' disease.

Menkes' disease, a neurodegenerative progressive X-linked disorder, was diagnosed in a 4-month-old child. The diagnosis was made on the combination of clinical features with laboratory and radiological findings. The pathogenesis of the skeletal findings in Menkes' disease is as yet unclear. Because of the severity of the prognosis and in order to plan treatment, the correct diagnosis has to be reached quickly. Typical manifestations of the syndrome are likely to develop after 3 months of age, with a pleiotropic appearance. In the present case, on the basis of the clinical investigation the patient underwent retrograde cystourethrography, roentgenographic examination of the skeleton, and magnetic resonance imaging of the brain. On analysis of the magnetic resonance imaging, we detected one-sided involvement of both subcortical and cortical parenchyma resembling a unilateral ischemic lesion such as, to our knowledge, has not yet been reported.

Brain↗
PubMed1995

[111In-DTPA-D-Phe]-octreotide scintigraphy in functioning and non-functioning pituitary adenomas.

Scintigraphy with [111In-DTPA-D-Phe]-octreotide is a recently developed technique for imaging somatostatin receptors in many neuroendocrine tumors. A good correlation between high [111In-DTPA-D-Phe]-octreotide uptake and the response to octreotide therapy has been proved in TSH- and GH-secreting pituitary adenomas, while few and conflicting scintigraphic data on somatostatin receptors in non-functioning tumors have been reported in the literature. The present study presents the results obtained with [111In-DTPA-D-Phe]-octreotide scintigraphy in thirteen patients with GH-secreting pituitary adenoma, four patients with inappropriate TSH-secretion and twelve patients with non-functioning pituitary adenoma. Twelve out of the 13 patients with GH-secreting pituitary adenomas had a positive scan; moreover, in 5/6 patients with a GH-secreting microadenoma (tumor size range 5-8 mm) a positive scan was found. Two TSH-secreting macroadenomas had a positive scan while a negative scan was obtained for a TSH-secreting pituitary microadenoma and in a patient with non-neoplastic, inappropriate secretion of TSH. Finally, only 2/12 patients with non-functioning pituitary adenoma showed a positive scan. In conclusion, [111In-DTPA-D-Phe]-octreotide scintigraphy is a useful tool to confirm the presence of somatostatin receptors in selected patients with GH- and TSH-secreting pituitary adenoma. The role of [111In-DTPA-D-Phe]-octreotide scintigraphy in non-functioning pituitary tumors remains to be established, but it could be useful for octreotide treatment in patients who refuse surgery or who are poor surgical candidates.

Adenoma↗
PubMed1994

White matter MRI hyperintensities in a hundred and twenty-nine consecutive migraine patients.

The most frequently reported abnormal MRI finding in migraine is the presence of high signal white matter foci (WMF) on long TR images. Recently, WMF have been distinguished in periventricular WMF (PVF), when contiguous to ventricles, and deep WMF (DF), when far from these. DF, but not PVF, appear positively correlated with cerebrovascular risk factors and are called leukoaraiosis. In this study the MRI examination was performed in 129 consecutive migraine patients (83 of them had migraine without aura and 46 migraine with aura). In 19.3% of the migraineurs studied we observed WMF on T2 weighted images strictly localized in the deep white matter (DF). No PVF were observed. These findings were independent of the type of migraine and did not correlate with age, sex, disease duration, or frequency of attacks. The presence in a subgroup of migraineurs of leukoaraiosis (DF), for which a vascular genesis has been hypothesized, suggests that migraine could represent, a cerebrovascular risk factor in these patients.

Adult↗
PubMed1992

Neuroimaging and functional outcome of neonatal leukomalacia.

Leukomalacia is a major cause of neurological impairment in the high-risk newborn. It can be identified during the early postnatal period by means of ultrasound (US) imaging of the brain, through the anterior fontanel. Magnetic resonance imaging (MRI) permits an optimal differentiation of brain tissue and of its abnormalities, without resorting to ionizing radiation or intravenous contrast. It is particularly appropriate for following the evolution of leukomalacia, after fontanel closure. Ninety-five fullterm and preterm infants with cystic and non-cystic leukomalacia, documented by US, were clinically followed-up until at least 12 months of corrected age. Thirty-two had a severe neurological outcome (mainly cerebral palsy, sometimes associated with mental retardation and/or cerebral visual impairment). The prognosis was worse in cystic leukomalacia than in prolonged flare. Electroencephalogram (EEG) carried out in the first 2 weeks of life provided valuable indexes of further outcome, especially for US findings of more uncertain prognosis. MRI was carried out at around 12 months of corrected age, by means of an apparatus operating at 0.5 Tesla. The main categories of abnormalities observed were the following: cystic lesions, enlarged ventricles with irregular outlines, delayed myelination, high intensity areas in the long TR (repetition time) images within the white matter, cortical atrophy. MRI findings correlated well with the results of US imaging and often with motor, cognitive and visual impairments. Nevertheless, clinical features cannot be predicted by neuroimaging alone and a comprehensive approach, including longitudinal functional and electrophysiological testing, is highly recommended.

Cognition↗
PubMed1992

High-dose intravenous immunoglobulin treatment in Graves' ophthalmopathy.

We have evaluated the efficacy of high-dose intravenous immunoglobulin treatment in Graves' ophthalmopathy, and have carried out a prospective randomized clinical trial, including a single-blind evaluation, whereby 14 patients were assigned to two different treatment groups: 7 patients were treated with intravenous immunoglobulin and orbital radiotherapy (Group 1) and 7 patients were given intravenous immunoglobulin alone (Group 2). The results of the intravenous immunoglobulin treatment were also compared with those obtained in a Historical Control Group (12 patients) treated with systemic methylprednisolone and orbital irradiation. Degree of ocular involvement and response to treatment were assessed by ophthalmopathy index. The mean initial and final ophthalmopathy index showed no significant difference among the three groups. Comparison between the mean initial and final ophthalmopathy index showed a statistically significant reduction (p less than 0.005) in all three groups, the observed changes being confirmed by orbital computerized tomography in Groups 1 and 2. Corticosteroid treatment was associated with major and minor side effects, while no important adverse reactions were observed during intravenous immunoglobulin treatment. Even considering our results as preliminary, we conclude that intravenous immunoglobulin treatment is effective and safe in improving Graves' ophthalmopathy.

Adrenal Cortex Hormones↗
PubMed1990

Heterotopic gray matter. Neuroradiological aspects and clinical correlations.

Anomalies of cell migration manifest themselves in many ways with various clinical and morphological aspects. Among these, heterotopic gray matter, especially when isolated, is characterized by slighter symptoms and later onset. In this paper eight cases of gray matter heterotopia are presented which have been studied over a two-year period. Magnetic Resonance imaging is emphasised for a correct diagnosis.

Adolescent↗
PubMed1989

Spontaneous recanalization of carotid artery occlusion following non traumatic dissection.

We studied 7 patients with internal carotid occlusion following spontaneous arterial dissection. All presented strokes, in one associated with Horner's syndrome. The doppler examination showed carotid occlusion, but only angiography established the diagnosis of vascular disease. Spontaneous recanalization was observed in 6 cases, treated only by antiplatelet drugs.

Adult↗
PubMedDate not supplied

Acuity card testing in children with cerebral palsy related to magnetic resonance images, mental levels and motor abilities.

Visual acuity testing using Teller Acuity Cards was carried out on 78 infants and children affected by cerebral palsy (CP). Age of testing was between 3 and 109 months. The aim of the study was to investigate the usefulness of acuity cards in patients with CP, and to relate visual outcome with the type of CP, MRI findings, mental levels and motor disabilities. Visual acuity estimates were obtained for 60 children: acuity values were within normal values for age for 17 and below the 5th percentile for 43. Cerebral blindness was diagnosed in 10 patients. Eight infants were not testable, mainly because of behavioural problems. The overall success rate was 88%. Visual impairment in most infants with low acuity and in all blind children was not due to ophthalmological abnormalities. Visual outcome was significantly related to the type of CP, with hemiplegic children showing the best results and tetraplegics the worst. Cerebral blindness was significantly correlated with tetraplegia, the severity of lesions in the optic radiations, and visual cortex areas, as indicated by MRI, and the degree of mental, motor and oculomotor deficit. These correlations were mainly due to the blind subjects, who consistently showed major MRI abnormalities and severe motor, mental and oculomotor impairment. Longitudinal results obtained for 45 children showed visual outcome stable over time in 64.4% of cases, improvement in 6.6% and deterioration in 28.9%.

Blindness↗
PubMedDate not supplied

Late whiplash syndrome: a clinical and magnetic resonance imaging study.

Cervical hyperextension injuries are common and are associated with significant morbidity. Clinically two syndromes are described: "acute" whiplash syndrome and "late" whiplash syndrome (in which the patients are still symptomatic after six months despite normal physical and radiological examination). In order to clarify the pathology of the persistent pain in late whiplash syndrome we performed a cervical spine magnetic resonance imaging (MRI) in 33 consecutive patients suffering from this condition. Twenty-six patients (78.8%) showed MRI abnormalities, the most common MRI finding (57.6%) was pre-existent spondylosis. Indeed, the group of patients with spondylosis and other MRI changes had higher clinical scores than those without MRI abnormalities as measured by a three-point grading system based upon the symptoms and signs shown. Several MRI changes, most of them already demonstrable by standard X-ray were seen among 33 patients suffering from late whiplash syndrome. Although no one of these findings appears to be specific and certainly related to the previous neck injury, they could represent a risk factor for a longer pain duration.

Adult↗
PubMedDate not supplied

[Somatosensory evoked potentials after stimulation of the posterior tibial nerve in multiple sclerosis: comparative analysis with other modalities of evoked response and magnetic resonance].

Electrophysiological tests have proved to be a valuable method in assessing multiple sclerosis (MS) patients. In the last few years, scalp recorded short latency somatosensory evoked potentials to stimulation of nerves in the "lower extremity" have been more and more extensively employed. Some studies have aimed at comparing the sensitivity of MR imaging and multimodality evoked potentials, with somewhat conflicting results. In the present study posterior tibial nerve somatosensory evoked potentials (ptnSEPs) were performed in 29 MS patients with the aim to investigate the ability in revealing spinal cord conduction abnormalities and the sensitivity towards other evoked potentials and MR in MS. ptnSEPs showed a high percentage of abnormalities which did not significantly differ from that of visual evoked potentials; moreover in conjunction with median nerve SEPs can be used to localize thoracic or lumbar cord demielinating lesions, not evidenced on MR imaging. These results confirm that ptnSEPs, although non specific and crude in terms of precise localization, are a sensitive tool in detecting lesions, even subclinical, in MS patients. Moreover in anatomic regions like spinal cord where MR imaging is not very sensitive because the lower signal-to-noise ratio, they represent the only method available for demonstrating lesions.

Adult↗