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Biomedical subjects

D Rigamonti

Publications and source records attributed to D Rigamonti.

At least 91 records · Page 5Linked to original sources
PubMed1990

Delayed traumatic intracerebral hematomas: "Spät-Apoplexie". Report of two cases.

Two patients who suffered a head trauma experienced sudden clinical deterioration more than 1 week after their injury. The initial computerized tomography (CT) scan demonstrated a small hematoma underlying a depressed skull fracture in one patient and a small interhemispheric subdural hematoma in the other. Both patients had made a complete recovery and follow-up CT scans were normal when clinical deterioration suddenly occurred. Both patients developed a large intracerebral hematoma and underwent emergency evacuation of the mass. The first patient recovered with the exception of a moderate hemiparesis and dysphasia, but the second patient died. Delayed traumatic intracerebral hematomas have been described in the literature. Since the advent of CT scanning, the incidence of this phenomenon has been estimated as between 1.7% and 7.4% of closed head injuries. In 1891, Otto Bollinger described four patients who suffered head injury, followed days to weeks later by death from an apoplectic event. His criteria for diagnosis of "traumatische Spät-Apoplexie" included the absence of preexisting vascular disease, a definite history of trauma, an asymptomatic interval of at least several days, and an apoplectic episode. These two cases reemphasize the existence of Spät-Apoplexie as a rare clinical condition. In the presence of CT findings of even small traumatic intracerebral or extracerebral hematomas, the possibility of this late complication should be kept in mind.

Adolescent↗
PubMed1990

Cerebral venous malformations.

Although cerebral venous malformations have been reported to cause epilepsy, progressive neurological deficits, and hemorrhage, their clinical significance remains controversial. In an attempt to clarify the natural history of the lesion and suggest an appropriate management strategy, the authors review their experience with 30 patients. In four patients with cerebellar venous angioma, an acute episode of ataxia was documented. The coexistence of a cavernous malformation was pathologically confirmed in the two patients who underwent surgery for bleeding presumed caused by the venous angioma. Infarction was shown in two patients and a tumor in two others. Follow-up periods ranged between 18 and 104 months, with only five patients symptomatic at the time of this report. Rebleeding had not occurred, nor had acute episodes of neurological dysfunction been documented. This clinical experience suggests that a venous malformation is frequently associated with other, more symptomatic conditions and is often erroneously identified as the source of the symptoms. Because the nature of the relationship between the venous malformation and the allied conditions remains ambiguous, it is recommended that patients harboring a "symptomatic" venous malformation undergo high-field magnetic resonance imaging to rule out underlying pathology, and that any such pathology be treated independently of the venous malformation.

Adolescent↗
PubMed1989

Intramedullary and extramedullary schwannoma of the cervical spinal cord--case report.

Intramedullary schwannomas and neurofibromas are rare tumors. Only two cases have been reported as having both an intramedullary and extramedullary component. We have managed the case of a 15-year-old girl with a schwannoma that appeared to track along the sensory nerve root into the spinal cord. The clinical presentation in this case was that of motor weakness and atrophy, sensory abnormalities, and, late in the course, pain. Magnetic resonance imaging with gadolinium enhancement was better than myelography and computed tomography at delineating the intramedullary extent of the tumor. The tumor was removed microsurgically at two operative sittings. Reports of this unusual pathology are reviewed.

Adolescent↗
PubMed1989

The efficacy of intravenous nimodipine in the treatment of focal cerebral ischemia in a primate model.

The clinical and pathological effects of nimodipine on cerebral infarction were investigated in 12 male baboons. In randomized/blind trials, six animals given intravenous nimodipine (2 micrograms/kg/min load, 1 microgram/kg/min maintenance) for 96 hours starting 50 minutes before 6-hour double-clip occlusion of the middle cerebral artery were compared to 6 control animals. Standardized neurological examinations were performed by examiners blinded to the animals' therapy on Day 7 and Day 14 after stroke. On Day 14 the animals were killed. The brains were studied pathologically, and the relative areas of infarction were quantified. Intracranial pressure was lower in nimodipine-treated animals; however, the range of intracranial pressure values in each group was broad. Two control animals with high intracranial pressure died. There were no deaths among the nimodipine-treated animals. The neurological scores on Days 7 (P less than or equal to 0.01) and 14 (P less than or equal to 0.05) were significantly different between the two groups. The nimodipine-treated animals had less clinical evidence of infarction compared to controls. Nimodipine-treated animals tended to have smaller areas of infarction; however, the difference between the two groups was not statistically significant. The infusion of nimodipine in the treatment of focal cerebral ischemia is safe and does not appear to aggravate the extent of infarction or to exacerbate intracranial hypertension. The clinical neurological evaluations indicate that nimodipine may improve or preserve neurological outcome after stroke.

Animals↗
PubMed1988

Cerebral cavernous malformations. Incidence and familial occurrence.

We studied 24 patients with histologically verified cerebral cavernous malformations, reviewing the familial occurrence and presenting signs, symptoms, and radiographic features of the disorder. Eleven patients had no evidence of a heritable trait and had negative family histories. Thirteen patients were members of six unrelated Mexican-American families. Sixty-four first-degree and second-degree relatives were examined, and family pedigrees were established. Most relatives (83 percent) were asymptomatic; 11 percent had seizures. Magnetic resonance imaging was performed in 16 relatives (5 of whom were asymptomatic). Fourteen of the 16 studies revealed cavernous malformations; 11 studies identified multiple lesions. As compared with computerized tomography and angiography, magnetic resonance imaging was far more accurate in detecting cavernous malformations. We conclude that cavernous malformations are more prevalent than previously reported, and that a familial form of the disorder exists that is more common than expected, with a high incidence of multiple lesions and an increased frequency of occurrence among Mexican-American families. Magnetic resonance imaging is the radiographic technique of choice for the identification and follow-up of these lesions.

Cerebral Angiography↗
PubMed1988

The association of venous and cavernous malformations. Report of four cases and discussion of the pathophysiological, diagnostic, and therapeutic implications.

Four cases of venous malformation associated with a cavernous malformation are reported. Because cavernous malformations are often angiographically occult and do not have a characteristic appearance on computed tomography (CT), they are seldom recognized preoperatively and may be missed if the surgical specimen is not carefully reviewed. This association, however, may not be rare and may explain the presence of symptomatic venous malformations. Magnetic resonance (MR) imaging is particularly sensitive in detecting cavernous malformations and is highly specific. It is recommended that every symptomatic venous malformation be worked-up with a high field strength MR Unit.

Adult↗
PubMed1988

Aneurysms of the basilar artery treated with circulatory arrest, hypothermia, and barbiturate cerebral protection.

Complete circulatory arrest, deep hypothermia, and barbiturate cerebral protection are efficacious adjuncts in the surgical treatment of selected giant intracranial aneurysms. These techniques were utilized in seven patients, one with a large and six with giant basilar artery aneurysms; four had excellent results, one had a good result, one had a fair outcome, and one died. The rationale for the use of complete cardiac arrest with extracorporeal circulation, hypothermia, and barbiturate cerebral protection is outlined. The surgical and anesthetic considerations are reviewed. The perioperative morbidity and long-term results support the use of these techniques in selected patients with complex intracranial vascular lesions.

Aged↗
PubMed1988

Appearance of venous malformations on magnetic resonance imaging.

The magnetic resonance (MR) imaging appearance of venous malformations, all angiographically verified, was evaluated in 11 patients. A venous malformation is characteristically depicted as a tubular area of decreased signal intensity in the white matter of the brain. In one patient, a histologically verified cavernous malformation was also present with a characteristic mixed signal-intensity core on the T2-weighted MR images. Care should be used when evaluating venous angiomas to exclude the presence of a lesion with associated prominent venous drainage, such as a glioma.

Brain Neoplasms↗
PubMed1987

Magnetic resonance imaging and trigeminal schwannoma.

A case of trigeminal schwannoma, extending from the posterior fossa into Meckel's cave, is reported. The information provided by computed tomography, angiography, and magnetic resonance imaging allowed a correct preoperative diagnosis to be obtained. Due to the excellent sensitivity, the absence of bone artifacts, and the ease of imaging in any plane, magnetic resonance imaging best defined the "dumbbell" nature of the tumor, the atrophy of the masticatory muscles, and the infiltration of the third division of the trigeminal nerve.

Adult↗
PubMed1987

The MRI appearance of cavernous malformations (angiomas).

The angiographic, computerized tomography (CT), and magnetic resonance imaging (MRI) findings were compared in 10 patients with a total of 16 pathologically verified cavernous angiomas. Only three lesions had abnormal vasculature in the form of venous pooling or a capillary blush. The CT scans were positive in seven patients and detected 14 lesions, while high-field strength (1.5 Tesla) MRI was positive in each case and demonstrated 27 distinct lesions. On T2-weighted MRI, the combination of a reticulated core of mixed signal intensity (SI) with a surrounding rim of decreased SI strongly suggests the diagnosis of a cavernous malformation. Smaller lesions appear as areas of decreased SI (black dots). The sensitivity of MRI is based on magnetic susceptibility and possibly diffusion effects related to field heterogeneity that is more conspicuous on high-field imaging and caused by the presence of excessive iron (hemosiderin).

Adolescent↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part III. Craniofacial resection.

Of 400 patients with ethmoid sinus disease, 18 had undergone craniofacial resection. This operation is an aggressive surgical procedure directed at total en bloc extirpation of tumors that extend through the floor of the anterior cranial fossa. Recent advances in surgical technique have made it the procedure of choice for sinonasal tumors that extend through the cribriform plate, fovea ethmoidalis, and orbital roof. Specifically, this operation has had excellent results in patients with esthesioneuroblastomas. Radiologists must be aware of the possible pitfalls in interpreting the postoperative computed tomographic scans and the findings that suggest tumor recurrence.

Carcinoma↗
PubMed1981

[Cerebral lesions in attacks of transient ischemia. Results of clinical studies of microcirculation with perfusion brain scintigraphy (PBS)].

35 patients with supratentorial ischemic lesions were studied with the Perfusion Brain Scanning; 20 of them suffered for TIAs while 15 had Completed Strokes. In all cases a damage of the arteriolar-capillar bed were demonstrated. These findings favour the thesis that the focal supratentorial ischemic attacks are related to an irreversible lesion of the brain microcircle. The very high sensitivity in the detection of the small cerebral lesions and the diagnostic value of the PBS are underlined.

Adult↗
PubMed1980

[Physiopathological and therapeutic implications of somatostatin in internal medicine. Recent aquisitions in some disease conditions].

In previous paper, the role of somatostatin in diabetes was examined. Here, the inhibitive action of somatostatin on growth hormone and its physiopathological and therapeutic implications in acromegaly and diabetes mellitus are reanalysed. The effect of the polypeptide on the C.N.S. is looked at from the viewpoint of its role as neurotransmitter at encephalic level and of its therapeutic use.

Acromegaly↗