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Biomedical subjects

X Morandi

Publications and source records attributed to X Morandi.

At least 19 recordsLinked to original sources
PubMed2001

Primary isolated lymphoma of the fourth ventricle: case report.

The authors present the case of a 33-year-old woman presenting with a 4-week history of vertigo and headaches. Physical examination revealed an isolated static cerebellar syndrome. Magnetic resonance imaging showed a homogeneously enhancing tumor located in the fourth ventricle. Complete surgical removal was performed and microscopic examination revealed a high-grade B-cell lymphoma. Postoperative investigations confirmed it to be primary. Only one case of primary isolated lymphoma of the fourth ventricle has been briefly reported in the medical literature. The authors suggest that primary lymphoma must be considered in the list of fourth ventricle tumors.

Adult↗
PubMed2001

Intracerebral hemorrhage complicating cervical "hourglass" schwannoma removal. Case report.

The authors report a case of infra- and supratentorial intracerebral hemorrhage complicating the postoperative course of a patient who had undergone surgical removal of a cervical schwannoma with an hourglass configuration. To their knowledge, this is the first case in which this neurosurgical procedure was followed by such a complication. Possible mechanisms are discussed; however, pathological events leading to this complication are unclear. The development of new neurological deficits not attributable to the surgical procedure should suggest this possibility.

Adult↗
PubMed2001

Anterior sacral meningocele in pregnancy. Case report.

Anterior sacral meningocele was first described in 1837. Most reported cases were associated with complications, including meningitis and death, because of misdiagnosis or inappropriate surgical approach. The authors present a case of anterior sacral meningocele accidentally discovered during pregnancy and provide unique magnetic resonance imaging documentation. The pathogenesis, management, and surgical technique are discussed.

Adult↗
PubMed2001

[Extraosseous Ewing's sarcoma of the spinal epidural space].

Ewing's sarcoma is found exceptionally as a primary epidural tumor of the spine. Four cases of extraosseous Ewing's sarcoma of the spinal epidural space are presented. Another 17 cases were found in the pertinent literature and are discussed. There were 15 males and 6 females with mean age of 16 years (range, 4 to 30). Symptoms included back pain and/or radicular pain, paresis of one or more limbs, sensory disturbances, and bladder and bowel dysfunction. The mean diagnostic delay was 4,7 months. Each patient underwent surgery but complete resection of the tumor was obtained in only half of the cases. Most patients received radiation therapy and chemotherapy. Twelve patients died, 1 to 54 months (mean, 18) after diagnosis. Even though the number of patients was too small in this series for statistical analysis, partially resected tumors do appear to be associated with a higher mortality.

Adolescent↗
PubMed2000

A data fusion environment for multimodal and multi-informational neuronavigation.

OBJECTIVE: Part of the planning and performance of neurosurgery consists of determining target areas, areas to be avoided, landmark areas, and trajectories, all of which are components of the surgical script. Nowadays, neurosurgeons have access to multimodal medical imaging to support the definition of the surgical script. The purpose of this paper is to present a software environment developed by the authors that allows full multimodal and multi-informational planning as well as neuronavigation for epilepsy and tumor surgery. MATERIALS AND METHODS: We have developed a data fusion environment dedicated to neuronavigation around the Surgical Microscope Neuronavigator system (Carl Zeiss, Oberkochen, Germany). This environment includes registration, segmentation, 3D visualization, and interaction-applied tools. It provides the neuronavigation system with the multimodal information involved in the definition of the surgical script: lesional areas, sulci, ventricles segmented from magnetic resonance imaging (MRI), vessels segmented from magnetic resonance angiography (MRA), functional areas from magneto-encephalography (MEG), and functional magnetic resonance imaging (fMRI) for somatosensory, motor, or language activation. These data are considered to be relevant for the performance of the surgical procedure. The definition of each entity results from the same procedure: registration to the anatomical MRI data set (defined as the reference data set), segmentation, fused 3D display, selection of the relevant entities for the surgical step, encoding in 3D surface-based representation, and storage of the 3D surfaces in a file recognized by the neuronavigation software (STP 3.4, Leibinger; Freiburg, Germany). RESULTS: Multimodal neuronavigation is illustrated with two clinical cases for which multimodal information was introduced into the neuronavigation system. Lesional areas were used to define and follow the surgical path, sulci and vessels helped identify the anatomical environment of the surgical field, and, finally, MEG and fMRI functional information helped determine the position of functional high-risk areas. CONCLUSION: In this short evaluation, the ability to access preoperative multi-functional and anatomical data within the neuronavigation system was a valuable support for the surgical procedure.

Adult↗
PubMed2000

[Syringomyelia discovered in the course of peridural anesthesia].

Neurological symptoms after epidural anaesthesia suggest complications due to anaesthetic procedure. We report the case of a child who underwent perineal surgery in a gynaecological position under general and epidural anaesthesia, who experienced the day after surgery hypoesthesia of the whole left lower limb without any motor deficit. Magnetic resonance imaging excluded spinal compression, but revealed syringomyelic cavity extending from T9 to T11. Electromyogram evaluation was normal. Clinical signs completely vanished within 24 hours. This case emphasizes that the apparition of neurological signs after central nerve blocks is not only a complication of regional anaesthesia, but may reveal unknown neuropathy or result from surgical position or surgical procedure. Meticulous neurological examination, magnetic resonance imaging and electromyogram are immediately required.

Anesthesia, Epidural↗
PubMed2000

[Sulcal identification and neuronavigation in supratentorial cavernoma surgery].

We present the use of cortical sulci, segmented from magnetic resonance imaging, in image guided neurosurgery. Sulcal information was transferred to a surgical microscope with enhanced reality features. This assistance was used for the resection of supratentorial cavernomas (7 patients). Sulci were semi-automatically segmented from 3D MRI data sets. Sulci close to the cavernoma were selected and transferred to the neuronavigation system which allows the superimposition of graphics into the right ocular of the microscope. Selected sulci were displayed on the workstation and superimposed into the ocular of the microscope. Cortical sulci proved to be useful for the recognition of the anatomical environment. The superimposed sulci helped to optimize location and size of the skin incision as well as to guide the access to the cavernoma by using the course of a sulcus as indirect trajectory.

Adult↗
PubMed1999

Beware of dogs licking ears.

A patient with right-sided chronic purulent otorrhoea developed meningitis due to Pasteurella multocida transmitted by a dog that frequently licked his ear. We suggest that patients with a perforated tympanic membrane should avoid being licked on their ears by animals.

Aged↗
PubMed1999

Anatomic bases for the compression and neurolysis of the deep branch of the radial nerve in the radial tunnel.

The anatomy of the radial tunnel was studied on twenty-five elbow preparations. We noted five different elements that could affect the deep branch of the radial nerve in the radial tunnel and cause an entrapment syndrome: a capsule-tendon-aponeurotic complex on the anterior aspect of both the humeroradial joint and the radial head, the vascular arcade formed by the radial recurrent a, and its branches, the arcade formed by the medial edge of extensor carpi radialis brevis muscle, and the superior and inferior arcades of the superficial layer of the supinator muscle. These results are compared with recent anatomical and clinical data, and the relevance of a surgical approach between the extensor carpi radialis brevis and longus muscles is discussed.

Cadaver↗
PubMed1999

Dermal sinus and intramedullary spinal cord abscess. Report of two cases and review of the literature.

Intramedullary abscesses of the spinal cord are uncommon. Most of them occur in association with heart, pulmonary or urogenital infections. We report two cases of intramedullary spinal cord abscesses secondary to congenital dermal sinus. Only 14 cases of such an association have previously been reported. In our cases, dermal sinus was associated with an epidermoid tumour. The clinical presentation, pathogenesis, magnetic resonance imaging findings, surgical management and outcome are discussed.

Abscess↗
PubMed1999

Anterior screw fixation of odontoid fractures.

BACKGROUND: Anterior screw fixation is the best treatment for odontoid fractures when the fracture line is horizontal or oblique downward and backward, as it preserves atlantoaxial mobility, especially axial rotation. Some details regarding patient positioning and operative technique need to be stressed to obtain the best results and avoid complications. METHODS: Between 1989 and 1997, we treated 17 cases of odontoid fracture by anterior screw fixation. Only two patients presented with motor neurologic deficit. Fracture line was horizontal in 3 cases and oblique downward and backward in 14 cases. RESULTS: Adequate reduction and fixation was obtained in all cases except one, where posterior displacement of the screw occurred without neurologic complications. Functional result was satisfactory in all cases except two, where we noted significant limitation of cervical rotation. CONCLUSION: Successful anterior screw fixation gives the best anatomical and functional results for odontoid fractures. Correct installation is very important for operative success.

Adolescent↗
PubMed1999

Pituitary adenomas with infra-sellar extension into the nasopharynx.

Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.

Adenoma↗