PubMed Health⌕ Search

Biomedical subjects

R Delfini

Publications and source records attributed to R Delfini.

At least 37 records · Page 2Linked to original sources
PubMed1992

Primary tumors of the cervical spine: surgical experience with 38 cases.

Thirty-eight primary tumors of the cervical spine were operated on in the Section of Neurosurgery, Department of Neurological Sciences, "La Sapienza" University of Rome between 1954 and 1988. Of these, 23 were malignant and 15 benign. The aims of surgical treatment in every case were tumor removal, decompression of the spinal cord, and conservation or restoration of vertebral stability. In no case was surgery confined to biopsy. Surgical stabilization was performed in 12 patients. Bone fusion was obtained with autologous bone (iliac crest, fibula) in benign tumors, whereas synthetic material (acrylic and metal) was used in malignant tumors. Past experience and greater awareness of the concrete possibilities of treating these tumors have led us to evolve the following strategy: 1. For aggressive benign tumors (osteoblastoma, giant cell tumors) and for malignancies in patients with fair life expectancy (solitary myeloma, chordoma): radical removal. 2. For benign tumors with low neoplastic potential and for malignant tumors in patients with poor life expectancy: conservative removal. Long-term results were gratifying in all benign lesions and low-grade malignancies even though two patients with chordomas needed reoperations. Sarcomas had relatively poor results.

Adult↗
PubMed1992

Surgical strategies in the treatment of symptomatic osteomas of the orbital walls.

We present a series of 19 surgically treated osteomas involving the orbital walls. Eight were localized at the junction of the frontal sinus and orbital roof, three were frontoethmoidal, two were of the orbital roof, one of the lateral wall, one of the orbital floor, and four involved all the walls of the orbit and were termed panorbital. All tumors at the junction of the frontal sinus and the orbital roof as well as those originating from the orbital roof proper were removed by frontal craniotomy. In the three that were frontoethmoidal, osteotomies were performed. Lateral and inferior orbitotomies were done when the corresponding orbital walls were affected. The four panorbital osteomas required large frontotemporal craniotomies in association with superolateral orbitotomy and zygomatic and/or malar osteotomy, when necessary. Satisfactory cosmetic and functional results were obtained in all but two cases of panorbital osteomas, in which the neurological deficit worsened after surgery. We discuss the choice of the various approaches described, with reference to the relevant literature.

Adult↗
PubMed1992

A two-step supraorbital approach to lesions of the orbital apex. Technical note.

A two-step supraorbital approach to lesions of the orbital apex is described. This technique is easy and allows a satisfactory exposure of the region. In addition, the reconstruction resulting from the procedure is anatomically perfect. The authors report the operative results obtained in 20 patients and compare this two-step supraorbital procedure with similar surgical techniques described previously.

Humans↗
PubMed1992

[Primary Meckel's cave lymphoma. A case and review of the literature].

A rare case of Meckel's cavity lymphoma is presented. Only two other cases of identical localization have been presented in the literature. The symptoms consisted of sensorimotor impairment of the Vth nerve associated with slight exophthalmos. C.T. scan showed a hyperdense lesion in Meckel's cavity. After total surgical removal, histological analysis diagnosed a B-lymphocyte non-Hodgkin's lymphoma. The patient received both radiotherapy and chemotherapy and at one year follow up, the clinical course was good. The lesion had no clinical or radiological specificity. Its prognosis appears to be identical to that of other intracranial lymphomas.

Aged↗
PubMed1992

Meningiomas of Meckel's cave.

A series of 16 patients with meningiomas of Meckel's cave is reported. Trigeminal neuralgia, typical or atypical, was the initial symptom in 10 patients (62.5%). At admission, trigeminal signs and symptoms were present in 15 patients (93.7%); in 7 patients (43.7%), trigeminal dysfunction was combined with the impairment of other cranial nerves. On retrospective analysis, these patients fall into two clinical groups that differ also in prognosis. Group 1 comprises eight patients with trigeminal signs and symptoms only. These patients had small meningiomas strictly affecting Meckel's cave. Total removal of the tumor was achieved in seven of eight patients, without adjunctive postoperative neurological deficits. In this group, there were no tumor recurrences. Group 2 comprises the other eight patients in whom trigeminal dysfunction was combined with impairment of other cranial nerves. These patients had large tumors arising from Meckel's cave and secondarily invading the cavernous sinus (five patients) or extending into the posterior fossa (two patients) or largely growing into the middle fossa (one patient). Total removal was achieved in only one patient, and a worsening of the preoperative neurological status was observed in four patients; there were three cases of tumor progression. A subtemporal intradural approach (used in the past in every case) is still used for the small tumors of Group 1 with good results. Since 1985, for tumors involving the cavernous sinus, we have employed a frontotemporal craniotomy with extradural clinoidectomy and superior and lateral approach to the cavernous sinus. When the tumor extends toward the posterior fossa, we use a combined temporosuboccipital-transpetrosal approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Tumors of the lateral ventricles.

Tumors are only rarely found in the lateral ventricles. Although various oncotypes of these tumors differ in growth rate and invasiveness they present the same clinical pattern with the same diagnostic and surgical problems. Thus we can consider them as a group. This series comprises 51 primary tumors arising strictly from the structures of the lateral ventricles, the majority from the trigone, operated on between 1952 and 1988: 20 meningiomas, 19 ependymomas, 9 papillomas of the choroid plexuses, and 3 subependymomas. As most of these tumors were benign, the response to surgical treatment was, as other authors have found, good with permanent cure or long survival in the majority of cases. Advances in neuroradiological techniques have greatly facilitated the work-up and differential diagnosis of these tumors. Of the various surgical approaches, the parieto-occipital is preferred by our department, even for tumors of the dominant hemisphere. Our operative mortality of 10.6% tallies with that of other workers.

Adolescent↗
PubMed1991

A comparison of computerized tomography-guided stereotactic and ultrasound-guided techniques for brain biopsy.

Forty-one patients with brain lesions underwent brain biopsy using either a computerized tomography (CT)-guided stereotactic approach or an ultrasound-guided technique. The cases were selected according to location and size of the mass lesion. Lesions 15 mm or less in diameter and those in the posterior fossa were biopsied by a CT-guided stereotactic technique (18 patients). Supratentorial lesions with a diameter larger than 15 mm were approached using ultrasound guidance (23 patients). These criteria for procedure selection provided a diagnostic yield of 94% for the CT-guided procedures and 91% for those guided by ultrasound. Safety for the two procedures was similar. The ultrasound procedure was more rapid, simpler, and less costly to perform. It is concluded that, with the protocol described, CT-guided stereotactic procedures could be reserved for cases in which absolute accuracy is mandatory.

Biopsy↗
PubMed1990

Persistent primitive trigeminal artery-cavernous sinus fistulas: report of two cases.

Two cases of persistent primitive trigeminal artery-cavernous sinus fistulas are presented. In one case, the fistula was treated by using a two-balloon tandem technique. This method was accomplished by introducing, inflating, and detaching a silicone balloon into the trigeminal artery, thus preserving the carotid and basilar blood flow. An unusual case of a similar fistula with only contralateral exophthalmos is also reported. The relationship between this type of fistula and the presence of aneurysms on the persistent primitive trigeminal artery and the relationship with traumatic events are discussed.

Adult↗
PubMed1989

Altered restriction pattern of the putative DNA binding domain of estrogen receptor or related genes in primary human meningiomas.

We analyzed by restriction mapping the genomic organization of the estrogen receptor gene in several primary human brain tumors in order to investigate the possible relationships between the development of these tumors and gonadal steroid hormones. In 5 out of 23 meningiomas the Eco RI restriction of genomic DNAs revealed 6 invariant normal fragments of 6.5, 4.8, 3.8, 3.1, 2.7 and 1.7 kb, plus 2 additional variant fragments of either 8.6 or 2.5 kb. More detailed analysis showed that these variant bands hybridized with a probe specific for the middle region of the estrogen receptor cDNA, coding for the DNA-binding domain of the receptor. This abnormal restriction pattern was found only in these meningiomas and not in other brain tumors or DNAs obtained from peripheral blood lymphocytes.

Blotting, Southern↗
PubMed1989

Stenosis of one carotid artery with occlusion of the contralateral carotid.

23 patients with unilateral internal carotid artery stenosis (greater than 70%) and contralateral internal carotid artery occlusion in the neck are reported. The symptoms are referable to the side of the occlusion in 13 cases (57%), to the side of stenosis in 7 cases (30%) and non-localizing in 3 cases (13%). All 23 patients had a carotid endarterectomy performed on the side of the stenotic lesion. There was no operative mortality. Late neurological symptomatology after surgery was referable to the side of stenosis in 13% and to the side of occlusion in 9%. The authors consider that, in cases of significant stenosis (greater than 70%) of an internal carotid artery with a contralateral occlusion, preference should always be given to end-arterectomy of the stenotic side, reserving extra-intracranial by-pass of the occluded side for patients who remain symptomatic after endarterectomy of the stenotic side.

Adult↗
PubMed1989

Primary chiasmatic lymphoma.

We report a case of primary cerebral lymphoma in an unusual site, the chiasma, and with a unique combination of symptoms. We review the salient published data on lymphomas in this site.

Aged↗
PubMed1989

Intra-extracranial thrombosis of the internal carotid artery associated with meningioma.

Cases of internal carotid artery occlusion associated with an intracranial tumor are rare. The authors report two cases of complete occlusion of the internal carotid artery. In one case the thrombosis was probably caused by direct compression of the carotid siphon by a large meningioma arising from the inner third of the sphenoid wing. In the other it was associated with multiple meningiomatosis although there was no contiguity between the intracranial tumors and the occluded carotid artery. After a review of literature we think they are of some interest, and we have found an interesting incidence of association between thrombosis and meningioma.

Adult↗
PubMed1989

Multiple intracranial meningiomas.

The authors report 14 cases of multiple intracranial meningiomas representing 1.1% of all meningiomas operated on at their hospital in the past 35 years. Differentiation of multiple meningiomas, especially from meningiomatosis, must be strict. Since the introduction of computerized tomography scanning, the frequency of these cases has risen from 0.58% to 4.5% in the authors' meningioma series. Despite the multiplicity of sites, multiple meningiomas do not differ in prognosis from benign solitary meningiomas.

Adult↗
PubMed1989

[Miction disorders symptomatic of neurologic disease].

Urodynamic test has a main role in: 1) making a precise diagnosis in presence of urinary symptoms not clearly interpretable by other means; 2) assessing the characteristics of neurogenic bladder for a correct treatment; 3) detecting an underlying, previously not diagnosed neurologic disease in patients with voiding abnormalities. This report concerns 10 patients with urinary symptoms in whom the urodynamic tests allowed to suspect a neurogenic problem. Seven pts. showed an areflexic bladder with positive betanechol supersensitive test, 3 pts. had detrusor hyperreflexia, while in 2 cases there was a low compliant bladder. All the patients with detrusor hyperreflexia had also detrusor sphincter dyssynergia, while 5 out of 7 pts. with detrusor areflexia showed a denervated perineal floor. The final neurologic diagnoses were 4 protruded discs, 2 multiple scleroses, 1 cerebral tumor, 2 spinal tumors, 1 cervical spondylosis.

Adult↗
PubMed1987

Prognostic value of early somatosensory evoked potentials during carotid surgery: relationship with electroencephalogram, stump pressure and clinical outcome.

The authors have reported on the prognostic value of continuous monitoring of somatosensory evoked potentials (SEP) in a survey of 25 patients who underwent carotid surgery. SEP recordings were correlated with the EEG, stump pressure (SP) values and clinical outcome. A non-cephalic reference was used for SEP recordings to allow the analysis of both subcortical and cortical components. During surgery the conduction time between SEP peaks relating to the subcortical components remained stable or showed minimum variations in all patients. During carotid clamping, SEP variations were observed in 9 out of 25 cases (36%). The application of an intraluminal shunt was accompanied by the return to normal values in 7 out of 9 patients. In the remaining two cases SEP abnormalities continued post-operatively and were accompanied by new neurological deficits. EEG changes during carotid clamping were associated with SEP modifications in 6 out of 7 cases, although they were not always correlated. Results confirm that SEP recordings provide useful data concerning the function of the CNS in anaesthetized patients and that, being sensitive to CBF changes, SEP monitoring acts as an indicator of cerebral ischaemia.

Adult↗