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Biomedical subjects

A Dario

Publications and source records attributed to A Dario.

32 records · Page 2Linked to original sources

Occlusion of the carotid artery as presenting symptom of acute promyelocytic leukemia.

In a 44-year-old female acute promyelocytic leukemia (APL) presented with abrupt onset of right hemiplegia and aphasia due to occlusion of the left carotid artery at bifurcatio. There was laboratory evidence of disseminated intravascular coagulation (DIC). Thrombotic complications are unusual in APL, even in cases with evidence of DIC. This report aims at underlying the important implication of a correct timely diagnosis in young patients presenting with stroke.

Adult↗

Panic disorder: the role of the balance system.

Experimental evidences suggest that Panic Disorder (PD) is characterized by abnormalities in respiratory and vestibular functions. We studied balance system function in patients with PD and its relationships with CO(2) reactivity and clinical characteristics. Nineteen patients with PD with/without agoraphobia underwent static posturography and the 35% CO(2) challenge. The severity of clinical symptomatology was measured by standardized psychometric scales. Patients were free of psychotropic medications during the 2 weeks before the study. Different investigators blind to each other carried out the CO(2) challenge, static posturography and clinical assessment. Nineteen age and sex-matched healthy controls underwent static posturography. Body sway velocity and length were significantly higher in panic patients than in controls and patients showed high percentages of abnormal scores. Patients with two or more abnormal scores on static posturography were significantly more agoraphobic than those with less than two. Abnormal posturography scores under the eyes-opened was related to high anticipatory anxiety, whereas those under eyes-closed was related to phobic avoidance. Symptomatological reactivity to CO(2) was significantly correlated to abnormal functions of the balance system in the eyes-closed condition. Our findings suggest that (1) many patients with PD (5-42%) have abnormalities in their balance system function compared with healthy controls (0-5%), (2) symptomatological reactivity to CO(2) and balance system function in patients with PD are correlated only in the eyes-closed condition and (3) there is a significant link between agoraphobic avoidance and subclinical abnormal function of the balance system network.

Administration, Inhalation↗

Associated olfactory groove meningioma and acoustic neurinoma.

The authors describe the case of a 71-year-old man without signs of phacomatosis with a history of progressive psychomotory lowering and two simultaneous tumors of the olfactory groove and of the cerebellopontine angle, as demonstrated by CT scans. Histologic examinations showed the lesions to be a meningioma and a neurinoma. The rarity and the possible pathogenesis of this association are discussed.

Aged↗

Unilateral headaches and their relationship with cervicogenic headache.

The concept of headache originating/starting in the neck is revised and considered in the light of previous descriptions of syndromes and entities and with reference to the current diagnostic systems for the classification of headache and other head pain. Cervicogenic headache (CEH), a clinical picture recently described by Sjaastad and coworkers and listed in the International Association for the Study of Pain (IASP) Classification, is analyzed, also taking into consideration its diagnostic criteria in terms of sensitivity and specificity. The problem of a differential diagnosis with migraine, tension headache and other well defined forms of unilateral headaches is discussed with reference to a case series of 114 patients who were selected based on their adherence to two fundamental criteria: (i) side-locked unilaterality of pain; and (ii) pain starting in the neck and spreading to the fronto-orbital area. Based on the results, these simple criteria can contribute to a preliminary identification of possible CEH cases that may then undergo a sequence of clinical and instrumental procedures in order to confirm the diagnosis and, possibly, to localize the level(s) of dysfunction in the cervical spine which may be the target for therapeutic investigations, whether invasive or non-invasive.

Diagnosis, Differential↗

Functional improvement in patients with severe spinal spasticity treated with chronic intrathecal baclofen infusion.

In this retrospective study we evaluated the efficacy and functional benefits of chronic intrathecal baclofen infusion in severe spinal spasticity. Twenty patients with a diagnosis of severe intractable spinal spasticity were evaluated prior to implantation of a programmable pump for chronic intrathecal baclofen therapy and at follow up, which ranged from 12 to 36 months (mean 22.4 months). The mean age of the patients was 39.1 years. The prevailing pathology was multiple sclerosis. All were unable to walk. Patient assessment was based on the Ashworth Scale, the Spasms Frequency Scale, self-reported pain and Functional Independence Measure (FIM) scores. The Wilcoxon test was used for statistical analysis. A statistically significant decrease in muscle tone, spasms and pain was observed in all the patients. The Ashworth score decreased from 4.4 to 1.8, the spasms frequency score from 2.5 to 0.5 and the self-reported pain score from 5.5 to 2.3. The FIM score also showed a statistically significant change (increasing from a mean of 33.8 to 58.7). Two patients in employment were able to return to work. No severe side effects were observed. Chronic intrathecal baclofen infusion was seen to produce a functional improvement in patients with severe spinal spasticity, particularly as regards bathing, comfortable wheelchair sitting and mobility.

Adult↗

Isolated aspergillosis of the sphenoid sinus. Case report.

The Authors report a rare case of isolated sphenoid sinus aspergillosis in a 69-year-old man. The patient had a complete recovery. The preoperative CT-scans and the preoperative and postoperative MRI are shown. The incidence, the pathology, the various clinical presentations, the prognosis and the management of this disease are debated.

Aged↗

Solid supratentorial haemangioblastoma. Case report.

A rare case of solid supratentorial haemangioblastoma presenting in a 67-year-old female with psyco-motory lowering, dysphasia and mild haemiparesis is reported and the pertinent literature is reviewed. The distinction between angioblastic meningioma and haemangioblastoma with the non specific radiological findings of this supratentorial uncommon tumour in are also debated.

Aged↗

Associated cervical schwannoma and dorsal meningioma. Case report and review of the literature.

The association between spinal meningiomas and neurinomas without clinical signs of neurofibromatosis is very rare with only four cases reported in literature. A case of 70-year-old woman with a history of progressive paraparesis is presented. A cervico-dorsal magnetic resonance with contrast showed two tumors with different enhancement. The patient had examination negative for neurofibromatosis. At histological examination cervical schwannoma and a dorsal meningioma were found. The Authors debate the rarity of this association, the possible pathogenesis and the MR findings.

Aged↗

Intramedullary cervical cavernoma. Case report.

A rare case of intramedullary cervical cavernoma with complete neuroradiological examination is described. The Authors debate about clinical course, radiological examination and surgical indications.

Adult↗

Surgical approaches to the clivus and upper cervical spine.

The surgical approach to the lesions of the craniocervical junction raises important problems about the choice of the access. The authors debate the advantages and the disadvantages of the principal approaches, presenting their clinical experience of 8 operated patients and discerning between intradural approaches and extradural submucosal or transmucosal approaches.

Adult↗

Intraventricular subependymoma presenting as subarachnoid hemorrhage. Case report.

The Authors describe the case of an intraventricular subependymoma presenting as subarachnoid hemorrhage in a 42-year-old woman. The preoperative and postoperative CT-scans and Magnetic Resonance Images of this rare benign neoplasm are presented. The pathology, the clinical findings and the prognosis of this tumour are discussed.

Adult↗

Dysphagia due to anterior cervical osteophyte. Case report.

A case of 61-year-old man with a 2-year history of progressive difficulty in swallowing solid foods is presented. CT-scan and barium swallow test demonstrated an anterior osteophyte at C6. Resection of the osteophyte resolved the dysphagia. The rarity in the neurosurgical literature, the pathogenesis and the management of this condition are discussed.

Deglutition Disorders↗

Drainage of Aspergillus "primitive" brain abscess with long-term survival. Case report.

Aspergillus species are second only to Candidosis as the most common cause of fungal infections of the central nervous system in immunocompromised patients. Very rare is the sole abscessual cerebral localization in nonimmunocompromised patients. Successful treatment of Aspergillus brain abscess has been reported only few times. A case of Aspergillus "primitive" brain abscess treated by surgical therapy associated with local and general mirated antifungal therapy is described. The long-term survival with complete clinical and radiological recovery is reported.

Adult↗