Biomedical subjects
Publications and source records attributed to E Bianco.
An 88-year-old man was found at laminectomy to have an encapsulated spinal epidural hematoma. The surgical result was gratifying and reinforced a recent statement that spinal surgical procedures in the very elderly should not be withheld on the basis of age alone. Moreover, the rarity of this pathology in this age group and the clear identification of the lesion on the computed tomography scan of this case are to be noted.
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A case of a acoustic neuroma with a two-stage removal due to severe bleeding is presented. The patient remained drowsy after the second operation and by the 8th day deteriorated quickly with progressive right hemiplegia and aphasia. The cerebrospinal fluid was bloody, vasospasm was shown in the angiograms, and an ischemic area was disclosed in the computed tomography scan. The outcome and the neuroradiologic examinations suggested that blood in the basal cisterns caused the vasospasm and the brain ischemia. A review of the literature disclosed only one similar case.
Cranial computed tomography in the evaluation of possible surgical separation in a case of craniopagus occipitalis twins demonstrated the relationship between certain intracranial structures. Computed tomography appears to be a simple, useful diagnostic procedure to such evaluation.
A group of 137 patients observed at the Emergency Surgery and First Aid Division of the Fatebenefratelli Hospital of Milan between 1971 and 1974 is examined. The patients all presented a clinical picture of occlusion and/or perforation of the colon and rectum due to carcinoma, requiring emergency surgery. The clinical material examined is analysed and the surgical treatment adopted and the results obtained reported. Post-operative mortality was 16.8% in cases of occlusion, 21.6% in cases of perforation, and 36.4% in mixed cases. 63 patients, i.e. 46%, were subjected to more or less extensive resection and the mortality in this group was 11.2%; in the remaining 74 patients, ax only palliative measures were possible and mortality was 28.3%. It is observed, finally, that among emergency colon operations, right colectomy carried out immediately offers encouraging results, while resection of the left colon, apart from certain special cases, should be preceded by decompressive colostomy.
Eleven cases of intracranial arterial aneurysms in patients under 15 years of age, treated from 1959 to 1976, are presented. The preponderance of aneurysms at the internal carotid artery bifurcation and the peculiarities of the defects in this location are remarkable.
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Carotid-ophthalmic aneurysms have intimate relationships with the ipsilateral optic nerve and other neighboring structures. Direct operation for treatment of these aneurysms has been considered particularly hazardous and difficult. Therefore, some authors have recommended an indirect operation (carotid artery ligation in the neck) as the procedure of choice. A Consecutive series of eight patients with carotid-ophthalmic aneurysms in presented; a direct operation was performed in seven instances. There was no operative mortality and the morbidity was very low. The direct attack seems to be reliable, and is recommended.
We have made a detailed neurolinguistic study of a patient with motor aphasia. The method used for his reeducation and the variants found in his language from a linguistic point of view through the course of several months are described. During this study we have found similarities with cases studied by Marcie reached by him in the errors common in patients with motor aphasia. But, contrary to Marcies, findings, we have found phonemes and allophones outside of the phonological and/or dilectal system of the language in this area. These phonemes and allophones are described together with the environment in which they appear.
The comparative performance in the repetition of a set of sentences was investigated in 8 children with developmental aphasia, average 5-7 years and 8 dyslalic ones, average 5-3 years. None presented any hard neurological signs. A battery of sentences was devised for repetition purpose and used as stimulus. Production proved to be less advanced in the group of children with developmental aphasia characterized as follows: highly systematic reduction of the models, lack of consistency in the substitutions both on the phonetic and the lexical levels ill-formed constructions in certain types of structures, high percentage of omission of function words. The dyslalic children's performance however proved to be more advanced and the subjects reproduced well-formed sentences in every single sentence regardless of the sentence length or type. The test devised might turn out to be helpful in practice for the correct diagnosis between patients with developmental aphasia and children with multiple and complex dyslalias.
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