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Biomedical subjects

A Fortuna

Publications and source records attributed to A Fortuna.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Cervico-medullary junction hemangioblastomas. Report of two cases and review of the literature.

Reporting two cases of dorsally located cervico-medullary hemangioblastomas the Authors discuss clinico-biological features, diagnosis and therapy of this vascular neoplasms, analyzing the cases reported in detail in the available literature. In this site the tumor has often an exophitic development, adhering more or less extensively to the posterior surface of medulla oblungata, where progressively creates a niche. Transient neurogenic arterial blood hypertension, by possible involvement of the dorsal nucleus of vagal nerve, together with the lack of postoperative respiratory disturbances constitute the main clinical features of differentiation with intraaxial hemangioblastomas of the brainstem. Actually MRI represents the radiological investigation of choice, even if angiography still plays an important role in the correct preoperative diagnosis of hemangioblastomas. The therapy of dorsally located cervico-medullary hemangioblastomas is the total removal of the lesion also in asymptomatic patients, being the late surgical results generally successful.

Adolescent↗
PubMedDate not supplied

[Continuous intradural anesthesia in geriatric patients undergoing orthopedic and traumatologic surgery].

OBJECTIVES: The aim of the study was to prospectively evaluate the results of continuous intradural anesthesia with 18G Tuohy needle and 20G catheter in geriatric patients. MATERIAL AND METHODS: We studied 70 patients with a mean age of 75.9 +/- 10.8 years who were subjected to orthopedic or traumatologic surgery of the lower extremities with a duration of 104.6 +/- 53.6 min. RESULTS: Success index was 95.7%. The initial dose of 1% tetracaine was 10.36 +/- 3.96 mg, the second dose in 29 patients was 7.2 +/- 2.7 mg, the third in 7 cases was 7.40 +/- 2.47 mg, and the total dose was 14.56 +/- 5.6 mg. The metameric level was between T8 and T11 in 80.32% of patients. Peroperative complications were limited to paresthesia in 5 cases (7.14%) during insertion of the catheter, difficulties in catheter placement in one case (1.42%), and accidental catheter extraction during withdrawal of the needle in 2 cases (2.85%). Ten patients (14.28%) presented arterial hypotension (pressure decrease greater than 30% of baseline systolic arterial pressure). During the postoperative phase there were 3 cases of slight headache after dural puncture (4.28%) that recovered with conservative treatment, and one case of lumbalgia at the puncture zone (1.42%). CONCLUSIONS: Continuous intradural anesthesia with the material used in this study is technically easy. It allows to accurately reach the desired metameric level, avoiding massive sympathetic blockade, and providing a steady hemodynamic condition. All these effects are essential for anesthesia in geriatric patients.

Aged↗
PubMedDate not supplied

Medulloblastoma in adulthood.

Reporting 32 cases of medulloblastoma in patients aged 17 to 65 years and reviewing the major case-series in the literature, we analyze the clinicobiological and diagnostic features and treatment of this tumor in adulthood. We consider some factors that seem to have a favorable bearing on the prognosis: female sex, length of clinical history, tumor size, hemispheric site, and total removal followed by radiotherapy. We then discuss the differences in tumor behavior between adulthood and childhood that emerged from the comparative analysis.

Adolescent↗
PubMedDate not supplied

Occasionally-occurring familial brain tumours (OFBT). Reports of cases and review of the literature.

We use the term "occasionally-occurring familial brain tumours" (OFBT) to designate cases in which more than one member of a family presents a brain tumours outside the range of the clinical syndromes in which CNS cancer heredity is well established. We report our experience of OFBT and review the published work on such cases with special reference to some clinicobiological concordances among affected families. On the evidence we present and on that of several genetic and epidemiologico-statistical studies we are inclined to think that there are genetic factors predisposing to the onset of OFBT.

Adolescent↗
PubMedDate not supplied

Narrowing of thoraco-lumbar spinal canal in achondroplasia.

The incidence of neurological deficits in achondroplastic subject is by no means negligible. We considered the clinico-radiological and therapeutic data of 35 achondroplasic patients (5 personal cases and 30 published in the available literature) harbouring myelo-radicular deficits related to narrowing of thoraco-lumbar canal. There was no significant sex prevalence. The clinical symptoms appear most frequently in the III or IV decades of life. Actually morphological anomalies of the spinal canal are already present at birth in achondroplasic dwarfs, and signs of cervical cord involvement are not uncommon in achondroplasic children. The delayed occurrence of clinical symptoms related to narrow toracho-lumbar canal may be explained by the pathogenetic role of acquired cofactors as prolapse of intervertebral disks and for degenerative spondyloartrosis. The clinical history is usually of insidious onset. Most frequent symptoms are motor weakness of the lower limbs (82.8%) and low-back pain (77.1%). Sensory and/or sphincter disturbances appeared to be less frequent (about 40% of the examined subjects). Plain X-rays, myelography, CT, CT-myelography and MRI are the diagnostic examination of choice. Surgical treatment consists of anterior decompression with fusion, when thoraco-lumbar kyphosis is prevalent, and/or posterior decompression, when the symptoms are mainly caused by canal stenosis. From the prognostic point of view, two groups of patients are recognized, in relationship to the presence of marked dorsal kyphosis. Those with kyphosis showed almost invariably poor functional results. In the remaining ones the results were satisfactory, provided that the clinical history lasted less than 3 years and the symptomatology was not already too advanced.

Achondroplasia↗
PubMedDate not supplied

A review of papillomas of the third ventricle. One case report.

The Authors present one case of choroid plexus papilloma localized in the third ventricle. This is in fact the only case in a series of about 4,000 patients operated on for brain tumors at the Neurosurgical Institute of the University of Rome. They consider 56 cases reported in the literature. Out of these, 43 are described and summarized in a table according to the clinical, radiological and surgical features. Twentyfive were the patients operated on, the average mortality in the cases which underwent indirect or not specified operation was 80%; that of patients submitted to a direct approach or to subtotal excision was 50%; and finally 3 patients out 13 (about 23%) who had total resection, died after surgery.

Adolescent↗
PubMedDate not supplied

Postoperative arachnoidal diverticula of the lumbar spine.

Arachnoidal diverticula are a rare complication of spinal surgery and occur most often at lumbar level, especially after discectomy. We report a case of lumbar arachnoidal diverticulum that arose two years after an L4-L5 discectomy and presented clinically with low back pain and sciatic pain and neurological deficits. We analyze the etiopathogenesis, clinical and radiological features and treatment.

Arachnoid↗
PubMedDate not supplied

Recurrent cystic meningiomas. Report of two cases.

The Authors report 2 cases of recurrent cystic meningiomas among 22 cases operated on. After a review of the literature, the pathogenesis of the recurrences of these tumors is discussed, concluding that wrong interpretation of neuroradiological examination and/or incomplete extirpation of tumoral capsule are the main factors responsible of recurrences of cystic meningiomas.

Cysts↗
PubMedDate not supplied

[Primary intraorbital meningiomas].

The authors found in literature the description of 124 cases of intra-orbital primitive meningiomas; they illustrate their clinico-surgical aspects as well as the differential features on the ground of their point of origin: 90 meningiomas of the (dural) sheath of the optic nerve (23 intraforaminal ones and 67 extraforaminal ones), 34 extradural meningiomas; they present 4 original cases, 3 extradural ones and 1 of the sheath of the optic nerve. After describing the elements of differential diagnosis with the most common intra-orbital expansive lesions (gliomas, sarcomas, angiomas, psuedotumors or orbital granulomas) the authors end by stating that total extirpation must be always carried out including, if necessary, the optic nerve and the ocular globe when it is invaded.

Adult↗
PubMedDate not supplied

High cervical (C2-C3) spondylogenetic myelopathy treated by transoral approach. Case report.

It is reported a case that required transoral exposure of C2-C3 intervertebral space in order to remove a huge osteophyte spur projecting into the spinal canal and producing a severe myelopathy. This unusual surgical route was used because the relevant interspace was inaccessible via the standard anterior approach due to an extremely short neck. The case is reported both because of its rarity and to confirm that the transoral approach is simple, safe and resolvent and that its range of indication is steadily increasing to cover a broad spectrum of disease entities.

Aged↗