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Biomedical subjects

R Donzelli

Publications and source records attributed to R Donzelli.

At least 19 recordsLinked to original sources
PubMed1992

[Complications of trans-sphenoidal surgery of the sellar lesions].

Trans-sphenoidal surgery has a very low rate of complications despite a series of apparently negative anatomo-topographical factors. Complications may be either mechanical or functional, transitory or permanent. The most important complications are: hematoma of the focus, sub-arachnoid hemorrhage, empty sella, liquoral fistula, opto-chiasmatic lesions, arterial lesions, lesions of the cavernous sinus, parenchymal damage, nasal and paranasal mechanical lesions, insipid diabetes, hypopituitarism. The overall mortality rate is 0.4-1% and is always associated with predisposing factors, such as previous treatment, voluminous extrasellar growth, concomitant causes of disease; the most frequent causes of death are: hemorrhagic phenomena in the extrasellar portion of large size adenomas; vascular lesions involving the intracavernous carotid artery; and hypothalamic lesions. The frequency of major complications is in the region of 2.3%. Predisposing factors are: volume, consistency, invasiveness, previous treatment, intratumoral necrotic-hemorrhagic phenomena, age. Surgery is only indicated for some of the above complications, including hematoma of the focus, acute postoperative empty sella, rhinoliquorrhea resistent to conservative treatment, excessive filling of the sellar cavity. All the other possible complications are results or functional alterations which must be treated medically, even if a specific therapy only exists for some (such as early hypotonic polyuria). The series of patients reported here refers to the period 1978-1989 and accounts for a total of 259 trans-sphenoidal operations performed in 245 patients. Of the secondary operations, 6 were due to postoperative complications (hematoma of the focus in 2 cases, rhinoliquorrhea in 2 cases; empty sella and hemorrhagic infarction of a large suprasellar site in the 2 remaining cases). There were 2 deaths related to direct mechanical complications (both caused by hemorrhagic infarction of large tumoural residues and the surrounding cerebral parenchyma). Complications which did not require re-operating were observed in 11 further cases: 6 cases of persistent rhinoliquorrhea which required protracted spinal drainage; 2 cases of deterioration of previous visual deficits unrelated to either hematoma of the focus or empty sella but caused by trauma to optic structures, either directly or on a vascular basis; 3 cases of dyplopia due to oculomotory deficiency. In terms of hypophyseal function, the ex-novo onset of postoperative pan-hypopituitarism and insipid diabetes was only observed in one case.(ABSTRACT TRUNCATED AT 400 WORDS)

Causality↗
PubMed1991

Hemodilution and revascularization for early treatment of stroke: an experimental trial.

A new experimental trial to investigate the usefulness of early therapeutic measures in case of acute I.V.D. has been performed, on the basis of a previous already reported experience. A combined treatment consisting of hemodilution and revascularization starting 16 hours after the onset of cerebral ischemia was tested. The study was performed in a population of 20 New Zealand male rabbits in which an acute cerebral ischemia was achieved by means of extracranial ligation of both common carotid artery and of one vertebral artery. The animals were divided into two groups. 1st group: no treatment; 2nd group: revascularization + hemodilution. Better results were observed in treated group considering either CBF rates or histological changes.

Acute Disease↗
PubMed1987

Antithrombotic effect of indobufen in an experimental model of arterio-arterial microanastomosis in the rat.

Using an end-to-side microanastomosis of the left common carotid into the right common carotid of rats, implementing a potentially thrombogenic situation, we have investigated the possible antithrombotic effect of indobufen, a new antiplatelet drug. In eight of 15 untreated rats the anastomosis was totally obstructed by a single thrombus growing from the anastomotic wall. Indobufen treatment prevented thrombus formation completely in 14 of 15 rats (p less than 0.02). In treated animals indobufen also produced a statistically significant reduction of ADP-induced platelet aggregation relative to basal values. Platelet count were not influenced by drug treatment. Our experimental results suggest the potential usefulness of indobufen as an antithrombotic agent.

Anastomosis, Surgical↗
PubMed1987

[Experimental giant arterial aneurysm. Resection and reconstruction of the arterial wall].

The authors describe 3 experimental techniques for the treatment of giant arterial aneurysm, based on removal of the aneurysmal pouch and reconstruction of the arterial wall. The aneurysm is realized with a venous graft implanted with end-to-side anastomosis on the common carotid artery on the rabbit. In the first experimental model it is resected along its basis; the arterial wall is reconstructed by means of a patch of dural substitute (dacron coated with silicone rubber) fixed with biological glue (human fibrine). In the second model, the experimental aneurysm is hooded with a venous graft sutured to the adventitia of the artery with four angular stitches and biological glue. The artery is then clamped, the aneurysm is resected along its basis. The median incision in the venous graft is sutured, restoring the continuity of the arterial wall. In the third model, a small artery is implanted at the bottom of the aneurysmal sac, realizing a condition similar to a collateral vessel arising from an aneurysm. In this case, too, the aneurysm is hooded by a venous graft fixed only to the adventitia of the arterial wall with the above mentioned technique. The main and the collateral vessels are clamped, and this latter is severed; the aneurysm is resected along its basis; the median incision in the venous graft is sutured, restoring the continuity of the arterial wall; the collateral vessel is re-implanted along the suture line. These techniques aim to realize the reconstruction of the arterial wall without stenosis and shortening the clamping time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Posterior fossa hemangioblastomas.

The authors report 40 personal cases of infratentorial hemangioblastomas and review 36 series from the literature for a total number of 1023 patients. The clinical, pathological, and surgical features of these tumors are discussed, with particular consideration of localizations outside the nervous system, multicentric tumors, recurrences, and long-term results. Although hemangioblastomas are benign tumors, their high growth potential makes their long-term development unpredictable in some cases.

Adolescent↗
PubMed1986

Arachnoid cyst of the quadrigeminal cistern.

Arachnoid cysts of the quadrigeminal region are rare. We report two new cases. The first is a 29-year-old woman, who had a recurrence five years after sub-total removal of the cyst wall. Initially it was communicating and was treated by a ventriculo-atrial shunt; later it became noncommunicating and direct drainage of the cyst cavity was required. The second was a 25-year-old female, successfully treated by wide removal of the cyst wall thus creating a large communication with the subarachnoid space. Diagnosis of these lesions, as regards either morphological or functional features, nowadays rests largely on CT. Choices about treatment are extremely difficult. The most radical one, namely, complete removal of the capsule, is not without risks and disadvantages. More prudent methods, such as partial removal of the capsule and/or drainage of the cyst and the ventricles, seem on the whole to be preferable, but careful pre- and post-operative evaluation of CSF dynamics are essential for a satisfactory and long-lasting outcome.

Adult↗
PubMed1986

[Experiences in experimental microneurosurgery].

The authors present their experiences in experimental micro-neuro-surgery referring to the last 2 years. In the field of vascular microsurgery, they explored: the possibility of performing end-to-side anastomoses reducing to few minutes the blood flow interruption in the receiving vessel; experimental reconstructive techniques of the arterial wall in case of giant aneurysm; micro-anastomoses between vessels with calibre smaller than 1 mm. The possibility of carrying out nervous anastomoses between intercostal and lumbar nerves to re-innervate these latter has been also examined on the basis of experimental trials.

Animals↗
PubMed1985

Subarachnoid hemorrhage due to a spinal neurinoma.

A rare observation of spinal neurinoma associated with subarachnoid hemorrhage is reported and the other 12 cases in the literature are reviewed. The extramedullary location of the tumor and the feeble arachnoidal attachments to the spinal cord favor subarachnoidal bleeding in these cases. When the meningeal signs are evident and signs of spinal cord impairment are still unclear, an intracranial origin of the bleeding must be excluded. In doubtful cases, selective spinal angiography is useful in the differential diagnosis between a bleeding spinal tumor and an arteriovenous malformation of the spinal cord.

Aged↗
PubMed1985

Giant intradiploic epidermoid cysts of the skull. Report of two cases.

The authors describe two cases of giant intradiploic epidermoid cysts of the cranial vault in which there was massive intracranial extension causing signs of neurological involvement. The very slow growth and the benign histological nature of these tumors explain their long preoperative evolution and the mild neurological signs in some cases. Roentgenographic and computerized tomography findings permit a correct diagnosis. Complete removal of these cysts and their capsules can be easily accomplished, despite their large size. Total removal of these cysts is associated with a very good long-term prognosis.

Epidermal Cyst↗
PubMed1985

[End-to-side anastomosis made with a short circulatory interruption in the receiving vessel. Experimental model in the rat].

End to side microsurgical anastomoses between vessels of small calibre require interruption of blood flow of about 25-40 min. In terminal vascular beds this time may be incompatible with the cellular survival. The authors refer their experience in rats with a partly original experimental technique requiring less time of clamping the receiving vessel (about 3-4 min), as the main part of the anastomosis is performed between the wall of the donor vessel and the adventitia of the receiving vessel, without interruption of blood flow in this latter. Histological examinations, performed 21 days later, reveal a patency rate of 60%.

Angiography↗