Biomedical subjects
Publications and source records attributed to V Cassinari.
We describe a case of tarsal tunnel syndrome treated surgically. We analyze the principal etiopathogenetic and clinical features of the syndrome together with the surgical anatomy and go on to discuss the main steps in the surgical operation, the results and possible postoperative complications.
Since the sixties at our Department of Neurosurgery, we use an original method for external ventricular shunts. To verify the effectiveness for reduction of infections risks the Authors have retrospectively analyzed 95 patients: only 4 cases of meningitis have been observed. The Authors consider the utility of the proper method and the importance of the duration of ventriculostomy placement.
A rare example of ventriculo-peritoneal shunt malfunction is presented. Radiological and operative findings demonstrated a self-duplication with upward migration of the peritoneal catheter.
The use of a new prosthetic material (110 DTEX F 33 Propylene and Medical Polyester Torlen 165 DTEX) in the reconstruction of bone defects of the skull, even of large dimension, is described by the authors. The material has good biologic tolerance, is already pre-moulded, can be easily adapted to the exact size of the defect and offers remarkable aesthetic and functional results. EEG, X-ray, MRI and CT can be performed without artefact and interferences.
One hundred patients affected by S.A.H. have been studied, evaluating the possible correlations between clinical findings and hyponatremia. For a better understanding of hyponatremia during S.A.H., the hematic concentration of A.D.H. and A.N.P. have been determined and correlated with hyponatremia.
Forty five patients suffering by S.A.H., with I-III degree according to Hunt-Hess classification, have been studied with SPECT, performed within 72 hours from the hemorrhage, in order to evaluate early alterations of cerebral blood flow and their prognostic value. The patients with a clinical worsening showed an important diminution of C.B.F. detected by SPECT and a great amount of blood in the sub-arachnoidal spaces at the CT scan (III degree, according to Fischer). If these results will be confirmed with further studies, it could be possible to early identify a group of patients with a high risk of developing a cerebral vasospasm.
The Authors report a case of primary cerebral lymphoma occurred in a 62 years old lady, who came to observation for headache and mood alterations. An enhanced CT showed a lesion recalling a meningeal sarcoma. Points of interest in this case are the unusual radiological appearance and the infrequent localization. Main anatomical and clinical characteristics of primary CNS non-Hodgkin lymphomas are recalled, even with regard to modern immunohistochemical techniques.
The contemporary occurrence of a presumed suprasellar and pineal germinoma and its late association with an extranervous germinoma in the sacral region is reported. Metastatic dissemination versus multifocality of the tumour are discussed with respect to prognosis.
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.
Surgical operations on vessels and other methods of treatment are considered as non-medical therapies for ischemic cerebrovascular diseases. Some of these methods are accepted (improvement in lifestyle, rehabilitative measures) and some are not (acupuncture, homeopathic therapy). Considering the surgical operations, the results of microsurgical anastomoses between extra- and intracranial vessels, in particular, are discussed on the basis of experiences with 40 operated patients. The principles of some therapeutic methods like acupuncture and homeopathic therapy are then presented.
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