Biomedical subjects
Publications and source records attributed to S Ferraresi.
Between January 1983 and December 1987, 121 patients who sustained a cervical spine injury were treated at the Neurosurgical Department of Ospedali Riuniti Bergamo. In 55 patients the segment between C3 and C7 was involved. Different techniques and results in the management of these lesions are discussed.
Hyponatremia is a state of relatively common observation among neurosurgical patients and it may determine or precipitate a condition of brain swelling in the head-injured. The quick reversal to normal values of serum sodium concentration may cause relevant neurological disturbances: they are related to peculiar neuropathological changes, the most representative of which is central pontine myelonilysis. Two cases (one in pediatric age) of head injured patients with brain damage resulting from rapid correction of a SIADH related hyponatremia are presented.
The surgical approach to cerebral giant aneurysms is still a source of great concern. We describe our experience with giant aneurysms of the anterior circulation and discuss the different surgical techniques adopted. During the period January 1972-December 1985, a total of 33 patients were operated upon at the Istituto Neurologico "C. Besta" of Milan for a giant aneurysm of the anterior circulation. Nineteen cases had suffered subarachnoid haemorrhage before admission; in 14 cases the hospitalization was due to evidence of mass effect on the surrounding neurovascular structures. All aneurysms were directly approached: in 24 cases the neck was occluded by a suitable clip, in 4 cases intramural thrombosis was attempted, in 3 cases the aneurysms were definitively trapped and in one case aneurysmorrhaphy was performed after resection of the sac. Operative mortality was 12%. Long-term follow-up shows good results whenever exclusion of the aneurysm from cerebral circulation had been achieved, either after removal of the sac or not; on the contrary, only fair or poor results were evident when other surgical techniques were adopted, either electively or out of necessity. The importance of intraoperative protection and monitoring of brain function is stressed.
Fourty-five patients affected by brain stem expanding lesions underwent serial stereotactic biopsy between 1978 and 1986. The definitive histological diagnosis allowed the definitive treatment of extrinsic tumours and non-neoplastic lesions. In patients affected from glial tumours the serial stereotactic biopsy allowed the histological grading and the definition of the growth modalities at the superior boundaries of the tumours. These data have been utilized to guide the choice of treatment. The future perspectives of stereotactic biopsies are discussed in view of the therapeutic results obtained in this series and in other series reported in the literature.
A retrospective evaluation of the prognostic value of different parameters available in patients affected by glial tumours and submitted to serial stereotactic biopsy is presented. The series investigated includes thirty-three untreated patients with proven brain gliomas submitted to stereotactic biopsy. All patients have been clinically and neuroradiologically monitored for three years. The factors investigated belong either to the preoperative data (clinical history and symptomatology, CT pattern and volume of the lesion) or to histological and biological data obtained after the stereotactic biopsy. The results suggest the need of a multimodal prognostic evaluation in glial tumours and particularly stressed is the accuracy of prognostic indications derived from cell kinetic studies.
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An endodermal sinus tumor of the pineal region is reported in a 5-year-old patient who complained of backache projecting to the legs.
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Two cases of frontal bilateral oligodendroglioma invading the corpus callosum occurred in a 56-year old man and his 32-year old son. CT images of both patients are presented.