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Biomedical subjects

D Riva

Publications and source records attributed to D Riva.

At least 37 records · Page 2Linked to original sources
PubMed1998

Language deficits in a child with omolateral (left) temporo-basal and cerebellar lesions.

We report the case of an 8-year-old boy with two distinct brain lesions, probably hamartomas or low grade gliomas: one in the left basal temporal region, with involvement of the fusiform gyrus, the other in the white matter of the left cerebellar hemisphere. Both lesions were diagnosed at seven, when NMR was performed because of partial complex seizure. A mild delay in the first language acquisition and a long-lasting difficulty in word retrieval were reported. On neuropsychological testing, language was impaired more in production tasks than in comprehension ones, with severe deficit in word finding. The etiological role of the two different lesions is discussed in relation to experimental evidence of the existence of a distinct language area in the basal temporal region (fusiform gyrus).

Brain Neoplasms↗
PubMed1997

Radiosurgery for cerebral AVMs in children and adolescents: the neurobehavioral outcome.

Eight patients, ranging in age from 9 to 18 years, were treated for arteriovenous malformations using gamma knife radiosurgery and were evaluated an average of 6 years after treatment to record potential effects of radiosurgery on cognitive and neuropsychological performance. Tests for general intelligence, nonverbal intelligence, memory and its components, and attention performance were administered to patients and compared with test results of age-matched siblings or first cousins. No statistically significant difference was found between the performance of patients and controls in any of the tests administered. Additionally, a specially designed questionnaire completed by the patients, their parents, and their teachers revealed that the patients' emotional and relational behavior was stable and unchanged after treatment. No correlation was found between the neurocognitive test performance and the lesion volumes irradiated, but the lesion site was found to contribute to the type of deficit recorded after treatment. The less invasive nature of the radiosurgical approach, combined with the brevity or absence of hospitalization, presumably contributed to the patients successful physical, mental, and emotional recovery.

Adolescent↗
PubMed1996

Discontinuation of phenobarbital in children: effects on neurocognitive behavior.

Neurocognitive performances were evaluated in 9 children with different types of epilepsy prior to and at least 6 months after discontinuation of phenobarbital. The patients treated with phenobarbital monotherapy were seizure free for at least 2 years, without electro-encephalographic anomalies for at least 1 year. Results indicated that phenobarbital at low therapeutic doses causes attentional and memory deficits, reversible after therapy discontinuation. Further research utilizing the same design is needed on larger samples in order to confirm our results.

Adolescent↗
PubMed1994

Intelligence outcome in children with shunted hydrocephalus of different etiology.

Children with shunted hydrocephalus of differing etiologies were assessed. There was a more selective loss of non-verbal than of verbal intelligence. The verbal and visuo-perceptual abilities were affected by different sets of variables. Variables related to the hydrocephalus had no effects, while associated supratentorial malformations significantly affected non-verbal functions.

Adolescent↗
PubMed1994

Homozygous hypertrophic hereditary motor and sensory neuropathies.

We compared 25 autosomal dominant hereditary motor and sensory neuropathy (HMSN) type I patients with 7 subjects affected by hypertrophic HMSN with non-dominant inheritance. All the autosomal dominant HMSN I cases carried the chromosome 17p11.2 duplication, providing evidence that it is widely represented in HMSN I families. The second group included: two siblings born to unrelated, unaffected parents and suffering from hypertrophic HMSN of strikingly different severity; two sisters with HMSN I phenotype, born to first-cousin unaffected parents; two brothers with HMSN III phenotype born to unrelated parents both showing HMSN II phenotype; a child with classic HMSN III phenotype, born to unrelated, unaffected parents. The 17p11.2 duplication was not found in any of the patients of the second series or in their parents. Our data provide further evidence that: HMSN III is heterogeneous and encompasses the homozygous expressions of different neuropathic genes; it is advisable to separate autosomal recessive hypertrophic HMSN from dominant HMSN Ia, because they appear to be due to different DNA mutations.

Adolescent↗
PubMed1994

Stereotactically guided transfrontal removal of intraventricular midline tumors in children. Neurosurgical and neuropsychological considerations.

Five children with supratentorial intraventricular midline cerebral tumors were operated on using a stereotactically guided transfrontal approach. Assisted by a three-dimensional graphic reconstruction of cerebral anatomy, the surgeon was able to reach and remove the lesion with minimal damage to healthy parenchyma. Neurosurgical and neuropsychological evaluation of the results suggests that this surgical approach is a valid alternative to the transcallosal route. This image-based intraoperative guidance is as effective as landmark-oriented surgery, which requires section of the corpus callosum, possibly leading to neuropsychological deficits, particularly in the pediatric age group.

Adolescent↗
PubMed1993

Neurophysiological evaluation in detrusor instability.

Different and complex neuronal systems are involved in the control of continence. Detrusor overactivity has been divided by the International Continence Society into two functional subgroups: a) detrusor instability and b) detrusor hypereflexia. Only in the latter group has neurological damage been shown, but pathophysiological mechanisms are still unknown. In order to complete a full investigation of sensory and motor pathways 12 female patients affected by idiopathic detrusor instability (mean age 60.2 years; range 49-73) and 13 age-matched healthy women were studied. All patients were submitted to a subtracted cistometrogram (CMG), anal sphincter electromyography (EMG) with a bipolar coaxial needle, sacral reflex analysis after stimulation of the dorsal nerve of the clitoris, tibial and pudendal somatosensory evoked potentials, motor evoked potentials after magnetic cortical coil stimulation, and recording from anal sphincter and abductor brevis hallucis muscles. All patients had normal neurophysiological tests, and no significant differences between patients and controls could be seen. Our data confirms the absence of both clinical and subclinical damage of central sensory or motor pathways in detrusor instability; an alteration of suprasegmental mechanisms cannot be excluded.

Adult↗
PubMed1993

Visuospatial judgment: a cross-national comparison.

Two samples of American and Italian 8 to 12 year-old children were compared for their performance on the Judgment of Spatial Orientation Test. No group difference emerged and, consequently, the same normative standards for performance can be applied in both countries. In both groups males performed better than females.

Child↗
PubMed1991

Combined treatment modality for medulloblastoma in childhood: effects on neuropsychological functioning.

8 long-surviving children, treated for medulloblastoma with combination radiotherapy and chemotherapy after surgery were examined in order to assess general intelligence, immediate attention and prolonged attention. Their siblings or first cousins were selected as controls. The children with medulloblastoma performed significantly worse than their peers, both in intelligence tests and attention tests. A trend towards a positive correlation between age at the start of treatment and IQs was confirmed in our study, while there was no evidence of a correlation between IQs and time elapsed from therapy. The role of chemotherapy, radiotherapy and their combination effect in producing neuropsychological sequelae is discussed.

Adolescent↗
PubMed1989

Impairment of neuropsychological functions in children with medulloblastomas and astrocytomas in the posterior fossa.

Neuropsychological impairment after removal of posterior fossa tumors is a recurrent issue in child neuropsychology and neurosurgery. The aim of this study was to assess verbal and performance intelligence, as well as immediate and sustained attention, in children with medulloblastoma or astrocytoma operated on for total removal of the lesion. Surgical treatment of medulloblastoma was always followed by chemoradiotherapy. Siblings of both tumor groups (without a history of neurological disease, even suspected) were examined as controls. The results were as follows: the cognitive performances were significantly poorer than the controls in both groups; the children with medulloblastoma scored below normal. Attention deficits were present in both groups as well when the usual clinical tests were used. When assessed by means of computerized methodology, the same function was normal. Considering that both groups of children underwent the same surgical treatment and all had hydrocephalus, the severe intellectual impairment reported only in patients with medulloblastoma can be ascribed to chemoradiotherapy. In contrast, the attention deficits present in both groups could be ascribed to the proximity of lesions to the ascending activating system. Malfunctioning of the activating system seems to be bypassed by the computerized administration of stimuli, which supplies motivation and kindles attention.

Adolescent↗
PubMed1986

Late effects of unilateral brain lesions sustained before and after age one.

Forty-eight children with unilateral cerebral lesions, incurred before or after the first year of life, were given the Wechsler Intelligence Scale for Children, with an average delays of 4 and 8 1/2 yr for the late and early injuries, respectively. Thirty-one of their siblings were chosen as controls. Results are as follows: early and late right-hemisphere lesions significantly lower only Performance IQ. Early left lesions impair equally Verbal and Performance IQ, while late left-hemisphere lesions do not significantly affect Verbal or Performance IQ relative to controls.

Age Factors↗
PubMed1986

Development of hemisphere specialization for spatial skills in children from six to twelve years of age.

208 children, male and female, aged 6 to 12 years, grouped in 6-month steps, were tested for three spatial skills: two basic abilities, recognition of two lines of differing slope and of one line of differing slope in a frame and with no frame, and one more complex skill, route-finding by means of maps. The results support the hypotheses of neuropsychological development according to which the hemisphere strategies used in the course of cognitive development for the handling of spatial tasks differ by sex and may change before and after the age of ten.

Child↗
PubMed1984

Oxybutynin chloride in the treatment of female idiopathic bladder instability. Results from double blind treatment.

The Authors carried out a random double-blind trial on 30 patients affected by idiopathic urge incontinence with oxybutynin chloride (15 mg/die) and placebo for two 20 day therapeutical cycles. The 24 patients who completed the trial oxybutynin chloride induced statistically significant effects--compared to placebo too--both on the subjective symptoms (reduction or disappearance of the urgency in 14 cases - 60.8% - and of urge incontinence in 16 cases - 76.1%) and on the objective symptoms showed by cystomanometry (increased bladder capacity at the FD and VSD in 14 and 15 cases, respectively; absence of involuntary contraction in 9 cases and normal or reduced detrusor pressure at the VSD in 13 out of 16 cases). Improvements, though less significant, were also obtained with the placebo.

Adult↗
PubMed1982

Reliability and limitations of radiologic markers in women SUI.

The Authors review their series of pre- and post-operatory urethrocystographies in SUI and discuss their data according to the interpretative criteria proposed by the leading authors. None of the suggested criteria seems satisfactory at all; however, cystography seems undoubtedly useful in the overall comprehension of SUI pathogenesis; moreover, when it is supported with a complete urodynamic evaluation, it can lead to the most exact diagnosis and permit the most proper therapeutical approach.

Adult↗
PubMed1980

Anterior callosotomy in epileptics with multiform seizures and bilateral synchronous spike and wave EEG pattern.

Cerebral commissurotomy is a well established procedure in the treatment of epileptics refractory to drug therapy. Breeching of the ventricles in complete commissurotomy carries a certain morbidity. This has led others to perform operations in which the entire corpus callosum or only its anterior portion with or without the anterior commissure were sectioned. Sectioning of the anterior corpus callosum alone is justified by: a) frequent appearance in patients of seizures attributable to a frontal focus, b) clinical and experimental evidence that frontal discharges spread across the corpus callosum leading to subsequent generalized its, c) the attempt to understand the mechanisms involved in generalized seizures, d) even further reduced surgical morbidity and neuropsychological disability. Five epileptics were submitted to anterior callosotomy. The seizures in all of them suggested a frontal focus and consisted of absences, adversive, tonic, atonic, and tonic-clonic attacks. All patients were incapacitated by the frequency of seizures. Their EEGs showed paroxysms of bilateral synchronous slow spike and wave with uni-, or multiple (including bilateral symmetrical) focal accentuation. In two patients there were additional independent temporal lobe discharges. Neuropsychological evaluation showed cognitive deficits caused by inattention paroxysms and absences. After anterior callosotomy there was marked reduction in frequency of all types of seizures, the greatest improvement being in the reduction of frequency of absences. There was a marked decrease in physical, social and neuropsychological disabilities.

Adult↗
PubMed1980

Anterior callosotomy as a substitute for hemispherectomy.

Two patients with epilepsy and large hemispheric lesions underwent section of the frontal fibres of the corpus callosum for the treatment of seizures refractory to medical treatment. A severely retarded girl of 18 had encephalotrigeminal angiomatosis (Sturge-Weber syndrome) with multiple daily absences, tonic-clonic, myoclonic, atonic and adversive seizures since infancy. All types of fits--with the exception of adversive seizures and rare tonic-clonic fits--disappeared after anterior callosotomy. Another moderately retarded girl of 18 had an old cystic lesion over the entire territory of the left middle cerebral artery. She had had right hemiplegia since infancy and frequent brief absences and massive myoclonus triggered by unexpected sensory stimuli since the age of six years. Following anterior callosotomy there was an almost complete disappearance of the absences and a marked reduction of her startle myoclonus. Frontal callosotomy is a useful procedure in epileptics with large hemispheric lesions and carries less risk than hemispherectomy or total commissurotomy.

Adolescent↗