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Biomedical subjects

C Uggetti

Publications and source records attributed to C Uggetti.

35 records · Page 2Linked to original sources

Transsynaptic degeneration of lateral geniculate bodies in blind children: in vivo MR demonstration.

PURPOSE: To investigate signal alterations in the thalamic lateral geniculate bodies of blind patients compatible with transsynaptic degeneration of these nuclei caused by pregeniculate or postgeniculate interruption of the visual pathway. METHODS: Six patients were selected from a group of blind children in our care. Four had cerebral palsy caused by periventricular leukomalacia, one had infantile neuroaxonal dystrophy, and one had Chiari I malformation and hydrocephalus, which was worsened by bilateral ischemic lesions of the occipital lobes. MR examinations (obtained at 0.5 T) were reviewed retrospectively by two neuroradiologists, with particular attention to the visual pathway. RESULTS: Symmetric, focal areas of T2 prolongation were found at the precise site of the lateral geniculate bodies. CONCLUSION: Anterograde (pregeniculate) and retrograde (postgeniculate) transsynaptic degeneration of the second neurons of the visual pathway produce alterations in MR signal.

Arnold-Chiari Malformation↗

[Dynamic study of the distal radioulnar joint with computerized tomography].

The authors describe a CT technique which allows the dynamic study of the inferior radioulnar joint. The examination consists of 4 CT slices, three of them acquired at the same level-i.e., the radioulnar joint- in the prone, intermediate and supine positions, respectively. The last slice is acquired, with the patient in the prone position, at the base of the styloid process where the triangular fibrocartilage is demonstrated. The distal radioulnar ligaments are not directly visible. Nineteen patients complaining of painfully impaired pronation and supination because of previous trauma (11 Colles fractures, 7 distortions and 1 Galeazzi lesion) were examined with this technique. In all patients, both wrists were studied to obtain normal parameters. The radioulnar joint was evaluated superimposing a draft on the dynamic images, which demonstrated that, in healthy limbs, during movement the ulnar epiphysis is always contained between two parallel lines drawn on the volar and dorsal surfaces of the radial epiphysis, respectively. It was also confirmed that supination is possible up to 110-135 degrees from the support plane. CT demonstrated different causes of impaired movements in the affected joints: in 12 cases some fibrous density tissue was seen at the ulnar epiphysis on the volar aspect and considered to be the evolution of a traumatic hematoma; 6 patients presented dorsal subluxation of the ulna during movement; finally, volar subluxation was detected only in one case. In 6 patients the triangular fibrocartilage was detached; in 1 patient an intraarticular fluid collection was demonstrated. In 3 patients CT detected no abnormalities. The fibrous tissue is responsible for impaired movements and causes the detached triangular fibrocartilage to shrink. The authors believe that this simple CT technique can yield useful pieces of information for accurate surgical planning.

Female↗

Cerebral visual impairment in periventricular leukomalacia: MR correlation.

PURPOSE: To evaluate the involvement of central visual pathways in cases of periventricular leukomalacia, and to correlate the neuroradiologic findings with the degree of visual acuity. METHODS: The MR brain examinations of 27 preterm children affected by cerebral palsy resulting from periventricular leukomalacia and without significant ophthalmologic lesions were reviewed retrospectively to search for possible involvement of the optic radiations and/or of the calcarine cortex. The data were compared with the degree of visual acuity estimated by means of the Teller Acuity Cards test. RESULTS: Seventeen (63%) of the 27 patients had cerebral visual impairment, which correlated strongly with MR lesions. Quantitative reduction and signal hyperintensity of the peritrigonal white matter and atrophy of the calcarine cortex were present in the more severe cases. In two blind patients, an altered MR signal was detected in the lateral geniculate bodies. CONCLUSION: This study clearly establishes a relationship between specific MR findings and visual impairment in children with periventricular leukomalacia. The finding of hyperintensity in the lateral geniculate bodies was interpreted as an axonal reaction. MR imaging is useful for detecting potential visual impairment and for improving clinical diagnosis.

Atrophy↗

[High-dose carboplatin superselective intraarterial chemotherapy in advanced head and neck cancer].

Advances in vascular radiology techniques for superselective transfemoral arterial infusion prompted us to evaluate the effects of high-dose rapid regional carboplatin infusion for patients with advanced head and neck squamous cell carcinomas. Twenty untreated patients received three infusions of carboplatin (300-350 mg/m2) every 2 weeks with this method. All the infusions were performed without any complication. Treatment was well tolerated, with moderate (Grade 1-3 WHO) local toxicity (stomatitis, dermatitis and alopecia) and minimal (Grade 1-2 WHO) myelosuppression. The total response index (complete response plus partial response) was 94% for primary tumors and 50% for neck metastases. Neoadjuvant chemotherapy employing superselective rapid infusion of high-dose carboplatin is a feasible, relatively nontoxic, effective technique and may have important applications in multimodality therapy of untreated patients with advanced head and neck cancer.

Adult↗

[Encephalitis lethargica].

We report the case of a 34-year old patient who first complained of fever, confusion and transient ophthalmoplegia and then developed akinetic mutism, frontal lobe, pyramidal tract and extrapyramidal signs. Clinical and electrophysiological data support a diagnosis of encephalitis lethargica. Magnetic resonance imaging showed hyperintensive lesions in various brain regions. The patient responded to corticosteroid treatment. Two years after the onset of the first clinical signs he had recovered completely and today, after 5 years, he shows no sign of disease.

Adult↗

Ganglioneuroblastoma of the spinal cord.

We report a case of ganglioneuroblastoma of the spinal cord in a 42-year-old man. MR examination was nonspecific, and the diagnosis was made from histologic findings. The MR picture was that of an intramedullary, mainly solid tumor with a central necrotic or cystic portion. The clinical picture and course were also nonspecific.

Adult↗

A case of parietal atrophy: etiopathogenetic evaluation.

We report on the case of a patient presenting a muscle atrophy of the right hand and a left parietal neoplastic lesion rapidly progressing. EMG findings showed no signs of denervation nor sensory-motor conduction impairments. Parietal lesions might interrupt sensory control mechanisms of motor activity.

Brain Neoplasms↗

[Indications for x-rays of the skull and cervical spine: an open question].

During the first six months of 1990, a study was carried out on a group of patients examined at the Neuroradiology Department of a Neurological Institute for skull and cervical spine X-rays. Kind of disturbances, the examination prescribed and patients' places of origin were taken into consideration. We studied 174 patients: 108 suffering from headache, 28 from cervical arthrosis, and the others from miscellaneous diseases. Male/Female ratio (M/F) was lower in the group affected by headache; the age was more advanced in the group affected by cervical arthrosis. Skull X-rays were usually normal in headache patients; cervical X-rays were not informative in cervical arthrosis patients. We can conclude that only through a different relationship between the prescribing physician and the Radiologist it will be possible to approach the justification and optimization criteria of medical radiological exposure.

Cervical Vertebrae↗

[CT study of the carpal tunnel. The carpal tunnel syndrome].

The authors describe the CT aspects of carpal tunnel syndrome. Seventy-seven patients with signs and symptoms of carpal tunnel syndrome were studied, together with 28 postoperative controls (8 with and 20 without recurrence of symptoms) and 10 normal subjects. CT studies were carried out according to the conventional technique employing 3 high-definition axial slices respectively at the proximal end, in the middle and at the distal end of carpal tunnel. The patients affected with carpal tunnel syndrome presented changes in median nerve volume, in synovial sheet thickness, and in shape and density of the flexor tendons. Postoperative CT patterns of asymptomatic patients were similar to those of normal subjects. In the group of patients presenting postoperative recurrence of symptoms, 3 main findings were observed: incomplete surgery, newly formed cysts on the volar surface of the tunnel, and abnormal soft tissue interposed between the tendons. All the above findings were histologically confirmed during a second surgery. The authors believe CT to be a very useful tool in the evaluation of carpal tunnel syndrome, for both the first diagnosis and the demonstration of the causes of postoperative recurrences.

Adolescent↗

Spontaneous cerebellar hemorrhage.

Spontaneous cerebellar hemorrhage was rarely diagnosed in the past and therefore thought to be infrequent but after the introduction of CT scanning has been more commonly diagnosed. A series of 28 cases of spontaneous cerebellar hemorrhage is analyzed concluding that the radiological and clinical aspects should be considered, instead of adopting the diameter as surgical indicator. An accurate monitoring of the patient's clinical status is very important since its worsening is an absolute indication for surgery independently of the size of hematoma.

Adult↗

Multiple meningiomas evaluated by computed tomography.

The authors report ten cases of multiple meningiomas in a series of 227 intracranial meningiomas from 1977 to 1984. The incidence of multiple meningiomas was 4.4% (according to Cushing and Eisenhardt's [1938] concept of "multiplicity" of such tumours). These results are comparable to those obtained by other authors. All patients were females and all underwent CT scan before operation. Clinical symptoms are presented along with location and size of the tumours. Pathogenetic theories and research prospects are discussed.

Adult↗

[CT study of the carpal tunnel. Normal anatomy].

The standard technique for CT investigation of the carpal tunnel and its normal anatomy were studied. Ten healthy asymptomatic volunteers, age 25-45, underwent wrist CT. The hand is placed in prone position with the third metacarpus in line with the radius. Digital radiograph and four axial CT scans are performed respectively: at the distal end of the radius, at the scaphoid tubercle level, at the hamate hook level and at the carpal-metacarpal joint. Standard carpal tunnel diameters are thus available with good reliability and repeatability when correct technique is adopted. The results permit a morphological description of the osseous walls, transverse ligament, flexor tendons with synovial sheets and median nerve. Gujon's canal and its content can also be investigated.

Adult↗

[Neuroradiology of spontaneous cerebral hematomas].

Computed Tomography plays a fundamental role in the diagnosis of spontaneous intracerebral haemorrhage, providing important informations relevant to prognosis and therapy. Therefore angiography should be planned on the basis of the CT finding and of some clinical data such as age, presence of risk factors, etc. Also the neurosurgical approach, besides clinical status, will depend on the neuroradiological evaluation.

Adult↗

[Updating the diagnosis of neonatal cerebral pathology. Comparison of ultrasonic diagnosis and CT x-ray in hemorrhage-ischemia-anoxia].

The authors compare the accuracy of Ultrasound and Computed Tomography in the diagnosis of hypoxic-ischemic brain damage and intracranial haemorrhage in 25 newborns with respiratory distress syndrome. Both examinations are performed at a maximum interval of 48 hours, within the first 8 days of life, and lately, after the third week. The results allow the introduction of a diagnostic protocol.

Age Factors↗

Cognitive and neuroradiological findings in myotonic dystrophy.

Cognitive functions were investigated in 37 patients with myotonic dystrophy (MD) and correlated with clinical and neuroradiological variables. The whole cognitive performance was at a low-average level; in about 1/3 of the subjects, in fact, the scores at the neuropsychological tests were below the normal range. There was a consistent trend for patients with inheritance on maternal side to perform worse on Wechsler verbal score and to present cerebral atrophy. In 7 out of 12 subjects focal white matter lesions were found at nuclear magnetic resonance. The significance of these findings and its relation to cognitive performance are discussed.

Adult↗

Ataxia-telangiectasia: MR and CT findings.

OBJECTIVE: The aim of our study was to describe the neuroradiologic features of 12 patients with ataxia-telangiectasia (A-T), a degenerative multisystemic autosomal recessive hereditary disorder with onset in childhood. Clinical features include cerebellar ataxia, oculocutaneous telangiectasias, and recurrent bronchopulmonary infections. Patients present varying states of immunodeficiency and a high incidence of neoplasms. Chromosomal instability with a rearrangement of chromosomes 7 and 14 is always present. MATERIALS AND METHODS: We describe the neuroradiological findings (10 MR and 2 CT) in 12 subjects: 11 with A-T and 1 heterozygote parent. RESULTS: The images revealed a diffuse cerebellar atrophy, with marked involvement of the vermis and unusual decreased thickness of the superior cortex of the cerebellar hemispheres. Hypoplasia of the inferior vermis and a large cisterna magna were also frequent signs. CONCLUSION: Magnetic resonance is the technique of choice in this type of disorder since it permits better visualization of the posterior fossa structures.

Adolescent↗