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Biomedical subjects

A Fortuna

Publications and source records attributed to A Fortuna.

At least 109 records · Page 6Linked to original sources
PubMed1988

Intracranial arterial aneurysms in early childhood.

Cerebral saccular aneurysms are rare in early childhood. Seventy-one cases in children under 5 years of age found in the literature, plus one case of our own, are analyzed. In early childhood these aneurysms seem to have features that distinguish them from the same variety in adults. In children a congenital pathogenesis appears more convincing because of the higher frequency in the first 2 years of life, the often peripheral site (41.6%), the high frequency of large (50%) or giant (26.8%) aneurysms, and the association with other cerebral and vascular congenital abnormalities. Onset was nonhemorrhagic in 18.1% of cases compared with 2.5% in adults. The surgical outcome seems better in children than in adult patients in terms of both morbidity and mortality.

Cerebral Angiography↗
PubMed1988

Anterior cervical arthrodesis with heterologous bone graft and human fibrin glue in the surgical treatment of myelopathy due to spondylosis. Preliminary note.

The use of fibrin glue to fix heterologous bone dowels in the recipient site in Cloward's procedure for cervical spondylotic myelopathy is described. The procedure ensures immediate and satisfactory spinal stability without need for any postoperative contention device. It has been successful in 18 patients with 26 intervertebral spaces operated upon, as demonstrated by early and late dynamic X-rays study.

Aprotinin↗
PubMed1988

Supratentorial hemangioblastoma. Report of a case and review of the literature.

Hemangioblastoma is a benign tumor of vascular origin that develops usually in the posterior cranial fossa and only very rarely in the supratentorial region. A case of supratentorial hemangioblastoma is reported and the 71 published cases are reviewed. The features that distinguish this tumor from angioblastic meningioma are discussed, the clinical and biological features of supratentorial and subtentorial hemangioblastoma are compared, the neuroradiological findings examined and the results of treatment assessed.

Adult↗
PubMed1987

Association between intracranial aneurysms and pituitary adenomas. AEtiopathogenetic hypotheses.

Of 144 cases of pituitary adenoma operated on in the period 1981-1985, 53 underwent angiography and two of these had an associated intracranial aneurysm. The aetiological hypotheses are viewed in the light of these two cases and of the 60 published cases of this association. The most convincing hypotheses involve mechanical, microcirculatory and hormonal factors. On the hormonal front, GH seems to have a predisposing influence on intracranial aneurysm formation.

Adenoma, Acidophil↗
PubMed1986

Pneumocephalus and tension pneumocephalus after posterior fossa surgery in the sitting position: a prospective study.

Thirty patients subjected to posterior fossa surgery in the sitting position were evaluated postoperatively by CT scans in order to assess the true incidence of pneumocephalus and subsequent development, if any, of tension pneumocephalus. This prospective survey shows that the postoperative incidence of intracranial air was 100%, while no progression towards tension pneumocephalus producing severe neurological deterioration was observed. It can thus be claimed that, although the sitting position may favour the development of tension pneumocephalus also other factors contribute to its pathogenesis. Finally, neither nitrous oxide nor temperature play any significant role in the development of this complication.

Adolescent↗
PubMed1986

Benign tumors and tumorlike conditions of the spine. Radiological features, treatment, and results.

A series of 44 benign tumors and tumorlike conditions of the spine treated surgically between 1952 and 1982 is reported. We have focused on their radiodiagnosis, treatment, and long-term results. The radiologic features considered pathognomonic of skeletal tumors, and frequently found in tumors outside the spine, are less common in the spinal variety. In fact, the radiologic findings in spinal tumors are, as a rule, nonspecific. The long-term results in this series are considered satisfactory, despite two recurrences of a giant cell tumor and late malignant degeneration of an osteochondroma. The prognosis was good, and recurrence rare even after conservative excision of the lesion. More aggressive treatment is nonetheless recommended nowadays for giant cell tumors and osteoblastomas, even if vertebral stability has to be sacrificed and fusion performed, as this affords the best chance of permanent cure. Conservative excision without radiotherapy remains the treatment of choice for other benign tumors. Spinal instability is a serious risk especially in younger patients who have undergone radiotherapy and have residual neurological deficits. Provision should be made against this risk by planning a fixation procedure either in the same operation as ablative surgery or at a later stage.

Adolescent↗
PubMed1984

Granulomolecular hypertrophy of the cerebellum (Lhermitte-Duclos disease). Case report.

The clinical features and pathology of granule cell hypertrophy of the cerebellum (Lhermitte-Duclos disease) are described in a 30-year-old man. The patient, who underwent successful surgery, is the eighth reported survivor of this disease. Whether the disease is neoplastic or dysplastic is still unknown, but the lesion has growth potential, and consequently the proper treatment is surgical resection. A cerebrospinal fluid shunt was only temporarily effective in this case.

Adult↗
PubMed1983

Intradural spinal cysts.

18 cases of benign intradural spinal cyst (9 arachnoidal, 2 neuroepithelial, 7 endodermal) are reported and compared with 94 cases (67 arachnoidal, 7 neuroepithelial, 20 endodermal) obtained from the literature. Arachnoidal intradural cysts (AIC) have no sex preference, occur at around the fourth-fifth decades of life and have characteristic intermittent root symptoms. They prefer the thoracic level and the posterior position. (Myelography images the cystic cavity (diverticular form). Surgical removal is usually easy. Neuroepithelial intradural cysts (NIC) are rare, have a 2:1 predilection for females and occur after the fourth decade. They have a serious clinical course similar to intramedullary or extramedullary tumours. They prefer the conus-cauda and the anterolateral positions. They often give rise to manometric block and to albuminocytological dissociation. There may be substantial adhesions to the cord and roots and the intramedullary variety presents no clear plane of cleavage. Endodermal intradural cysts (EIC) have a 2:1 predilection for males and prefer the second and third decades. They may have an intermittent or serious course with signs of root and cord impairment. They prefer the cervical segment (in the anterior position) and the conus-cauda (in the posterior position). As a rule they present manometric block and albuminocytological dissociation. Their frequent tough adhesions to the roots and cord demand special care during their removal.

Adolescent↗
PubMed1983

[Solitary chondromas and osteochondromas of the spine with myeloradicular compressive manifestations. Apropos of 6 surgically-treated cases].

3 spinal chondromas and 3 spinal osteochondromas are described and the relevant literature is reviewed. These oncotypes may remain symptomless or may present as a hard paravertebral swelling or with pain or, more rarely, with a slowly-developing neurological syndrome. Chondromas may appear at any age whereas osteochondromas are more likely to occur during the age of skeletal growth. Both have a predilection for males. Standard Xrays may be diagnostic in osteochondromas but do not always visualise chondromas, which may simulate malignant osteolytic lesions or giant cell tumors and their variants. Computed tomography is indispensable for defining the size of the lesion and its relationships with surrounding structures, for planning surgical treatment, and for following-up its evolution. For both oncotypes treatment is surgical. Recurrence is very rare even after subtotal removal. Malignant degeneration is likewise rare. Operative mortality is nil and neurological recovery is the rule.

Adult↗
PubMed1983

[Solitary chondromas and osteochondromas of the spine provoking myeloradicular compression. Apropos of 6 cases treated surgically].

3 spinal chondromas and 3 spinal osteochondromas are described and the relevant literature is reviewed. These oncotypes may remain symptomless or may present as a hard paravertebral swelling or with pain or, more rarely, with a slowly-developing neurological syndrome. Chondromas may appear et any age whereas osteochondromas are more likely to occur during the age of skeletal growth. Both have a predilection for males. Standard Xrays may be diagnostic in osteochondromas but do not always visualise chondromas, which may simulate malignant osteolytic lesions or giant cell tumors and their variants. Computed tomography is indispensable for defining the size of the lesion and its relationships with surrounding structures, for planning surgical treatment, and for following-up its evolution. For both oncotypes treatment is surgical. Recurrence is very rare even after subtotal removal. Malignant degeneration is likewise rare. Operative mortality is nil and neurological recovery is the rule.

Adult↗
PubMed1982

Craniovertebral junction malformations. Clinicoradiological findings, long-term results, and surgical indications in 63 cases.

The fate of a series of 63 patients operated on between 1953 and 1979 was studied retrospectively to assess the efficacy of neurosurgical treatment in relieving symptoms associated with craniovertebral junction (CVJ) malformations. Fifty-eight patients underwent posterior cervicomedullary decompression, and the other five underwent transoral clivus-atlanto-odontoidectomy. Long-term results with the posterior approach showed that 50% of the patients benefited from surgery, 25% remained unchanged, and 25% continued to deteriorate or died. Patients with dorsal nervous tissue and/or meningeal anomalies, such as Arnold-Chiari malformation, hydrosyringomyelia, dural fibrous ring, or obstruction of the cisterna magna, did better than patients with ventral cervicomedullary indentation caused by a clivus-atlanto-odontoid bone complex. Anterior decompression is preferable to a posterior approach only if the CVJ malformation involves a ventral deformity in the absence of dorsal compression by soft tissue.

Adolescent↗
PubMed1981

Spinal neurinomas and meningiomas in children.

The literature on spinal neurinomas (N) and meningiomas (M) in children is reviewed, and five personal cases of N are added (one in the context of Recklinghausen's disease). The cases of N totalled 151, and of M 69, accounting respectively for 10.9% and 4.3% of childhood spinal tumours and 2.6% and 1.3% of spinal N and M of all ages. Sixty-one cases of N (16 in the context of Recklinghausen's disease) and 26 cases of M (5 in the context of Recklinghausen's disease) are analyzed in detail. N occurs chiefly between ages 9 and 15 years, the sex ratio is 3 : 2, all levels of the spinal canal are equally affected, and extradural N or conditions with an extradural component (48%) are more frequent than in adults (26.9%). M occurs chiefly between 12 and 15 years, the sex ratio is 3 : 2, the prevalence of the thoracic segment (47.8%) is less marked than in adults (81%), and the frequency of the extradural site (10.6%) is close to the sum of the extradural and dumb-bell lesions in adults (11.1%). In children vertebral signs, i.e., spinal rigidity and tenderness, and spasm of paravertebral muscles, are more intense, earlier, and more frequent than in adults, and the clinical history is shorter. The chances of recovery from neurological deficits are greater, as are those of malignant degeneration.

Adolescent↗
PubMed1981

Arnold-Chiari malformation detected by unenhanced multiplanar CT scan.

Multiplanar computed tomographic (CT) scanning done without injection of contrast agent detected the nervous tissue abnormalities in 4 patients with Arnold-Chiari Malformation. Comparisons were made between traditional radiological studies and CT scanning. Three cases were confirmed surgically; the fourth case was diagnosed purely by CT scanning. This preliminary study suggests that this new technique should be sufficient to make a positive diagnosis in most cases of Arnold-Chiari malformation.

Adult↗