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Biomedical subjects

E Pozzati

Publications and source records attributed to E Pozzati.

At least 37 records · Page 2Linked to original sources
PubMed1989

Blunt traumatic carotid dissection with delayed symptoms.

We describe five patients with blunt traumatic carotid dissection with delayed clinical presentation that varied from 2 weeks to 6 months. Four patients had severe head injury, and one patient had direct blunt trauma to the neck. Cerebrovascular symptoms developed in four patients. The fifth patient suffered loss of vision as a result of a concurrent giant intracranial dissecting aneurysm. Arteriography demonstrated a "string sign" in two cases and a cervical carotid aneurysm in three; two of the latter also had siphon occlusion, and one of these had a superimposed supraclinoid dissecting aneurysm. One patient was treated by thromboendarterectomy, one by aneurysmorraphy, another by carotid ligation, and the other two patients were treated medically. Mechanisms of injury, forensic problems, and therapeutic options are discussed.

Adolescent↗
PubMed1988

Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically.

Arachnoid cysts of the middle cranial fossa (Sylvian cysts), represent the most common type of intracranial leptomeningeal malformation. Among the 102 intracranial arachnoid cysts operated on at the authors' institution from January 1970 to August 1986, the 77 cases (75%) located in the middle cranial fossa are reviewed. The higher incidence in the first two decades of life (51 cases) as well as the marked predilection for the male sex (60 cases) and the left hemisphere (55 cases) are confirmed in the authors' experience. As for clinical presentation cranial deformities, symptoms of raised intracranial pressure and epilepsy constituted the most frequent features. In 13 patients a complicating lesion was associated: subdural or intracystic haematomas in 7 cases, subdural hygromas in 4 cases and, extradural haematomas in 2 cases. Based on the appearance at CT scan and the results at CT cisternography the authors proposed a classification into three basic types of increasing severity and different pathophysiologic conditions. All the patients underwent craniotomy, excision of the cyst walls and perforation into the basal cisterns. There was one postoperative death (mortality rate of 1.3%) due to meningitis. The remaining clinical results were gratifying in all three types of lesion; on follow-up CT scans the cysts of type I. and II. exhibited a steady tendency to reduction or obliteration while cerebral reexpansion seemed less evident in the third, most severe, type. The authors compare and discuss the options of radical open surgery versus shunting procedures.

Adolescent↗
PubMed1987

Late recurrence of bleeding in a chronic extradural hematoma.

Recurrence of bleeding from the inner capsule occurred in a chronic extradural haematoma in a 15-year-old boy 4 months after the original trauma. The case is presented to emphasize the potential hazards of nonsurgical treatment of chronic extradural hematomas.

Adolescent↗
PubMed1987

Pituitary apoplexy, bilateral carotid vasospasm, and cerebral infarction in a 15-year-old boy.

The authors report a case of pituitary apoplexy associated with oculomotor defects and focal cerebral signs; the visual pathways were intact. Computed tomography documented a mass of heterogeneous density within an enlarged sella turcica and a right parietal infarct. Angiograms revealed bilateral carotid spasm and occlusion of the right angular artery. Treatment was conservative. Control angiograms showed spontaneous resolution of the vasospasm and recanalization of the cortical artery. The patient made a complete neurological recovery; he needed only treatment with vasopressin due to transient diabetes insipidus. The risk of vasospasm and brain ischemia should be kept in mind when treating pituitary apoplexy. The early occurrence of vasospasm in our case suggests the participation of powerful vasoactive agents liberated from the tumor.

Adenoma↗
PubMed1986

Extradural hematoma complicating middle fossa arachnoid cyst.

Two cases of post-traumatic extradural hematoma complicating an arachnoid cyst of the middle cranial fossa in children are described. While subdural and intracystic hemorrhages are well-known complications from this malformation, the association with extradural hematoma has never been previously reported in the literature. The pathogenetic mechanisms are discussed and the particular vulnerability of intracranial arachnoid cysts is stressed.

Adolescent↗
PubMed1986

Benign cerebellar hematomas in children.

Cerebellar hematoma is generally regarded as a rapidly progressive condition which necessitates prompt evacuation in most cases. Unlike adults, where hypertension is the most common etiological factor, children generally have underlying structural lesions (angiomas, tumors) that per se demand surgical intervention. While several reports describe nonsurgical management of cerebellar hematomas in adults, the spontaneous resolution of juvenile cerebellar hematomas is almost unknown. This paper describes a 16-year-old boy with a cerebellar hematoma of obscure etiology that was managed conservatively. This report indicates that nonsurgical treatment of cerebellar hematomas, once structural lesions have been excluded, may be attempted in neurologically stable children.

Adolescent↗
PubMed1986

Chronic subdural haematoma from cerebral arteriovenous malformation.

In a review of 122 intracranial arteriovenous malformations (AVMs) observed between 1970 and 1983, we have found the extremely rare occurrence of a chronic subdural haematoma overlying a frontal AVM. In this case the picture of a presumed primary epilepsy was complicated by symptoms of raised intracranial pressure, which warranted admission and neuroradiological examination. The pathogenesis of the haematoma is briefly discussed.

Adult↗
PubMed1986

Spontaneous healing of acute extradural hematomas: study of twenty-two cases.

A series of 22 patients with acute extradural hematomas that were not evacuated surgically is presented. Patients were asymptomatic or had only minimal neurological disturbances on admission. In all cases, serial computed tomographic scanning documented the progressive resolution of these clots, the great majority within 1 month of injury. The decision of conservative vs. surgical treatment may be guided by the thickness, configuration, location, and possible association with intradural parenchymal lesion.

Accidents, Traffic↗
PubMed1986

Chronic expanding intracerebral hematoma.

The cases of 10 normotensive patients with chronic intracerebral hematomas are reported. The patients' median age at diagnosis was 42 years. The median duration of symptoms was 22 days. Seizures were the presenting symptom in 50% of the cases. Computerized tomography almost consistently demonstrated ring-shaped lesions with mass effect and perifocal edema. Arteriography revealed that all but one of the lesions were avascular. All patients had superficial white matter lesions, mostly in the frontoparietal region. All patients were treated surgically. Most of the hematomas were encapsulated and contained blood in various stages of organization. The thick capsule consisted of an outer layer of collagenous tissue and an inner layer of granulation tissue. Occult cerebrovascular malformations were detected in two instances. There were two deaths, both related to recurrent postoperative hemorrhage. This entity can present much like a brain malignancy and should be considered in the differential diagnosis of ring-shaped lesions whatever the clinical presentation. Strategies of treatment are discussed.

Adolescent↗
PubMed1985

Polycystic and ring-shaped intracranial meningiomas.

Intracranial meningiomas may be associated with peritumoral, unilocular cysts. In two middle-aged women we have recently treated, CT scan revealed ring-shaped and polycystic tumors which proved to be meningiomas. This unusual aspect has previously received scant attention. In the first patient the cysts were intratumoral and the walls consisted entirely of meningiomatous tissue; in the second case the cysts were peritumoral and their connective walls contained scattered nests of tumor cells.

Female↗
PubMed1984

Spontaneous healing of extradural hematomas: report of four cases.

Our recent experience with four cases of acute extradural hematoma found in neurologically intact or mildly symptomatic patients is reported. These patients did not require operation; complete resolution of the hematoma was demonstrated within 1 month in three cases and within 4 months in the last case. Although far from being codified, nonsurgical treatment of extradural hematomas in some selected patients seems to be feasible. The computed tomographic findings (size and location of the hematoma, midline shift) in these cases are discussed.

Adolescent↗
PubMed1983

Association of cerebral mycotic aneurysm and brain abscess.

The authors report a case of brain abscess which occurred as a possible complication of a mycotic aneurysm. Inadequate antibiotic treatment given at the time of a febrile illness in a patient with rheumatic heart disease seems to be the most likely cause of this unusual complication. The effects of inadequate antibiotic treatment on the pathogenesis are briefly discussed.

Adult↗
PubMed1983

Acute bilateral extradural hematomas in a case of osteogenesis imperfecta congenita.

Acute bilateral extradural hematomas occurred after apparently trivial trauma in a patient suffering from osteogenesis imperfecta congenita. Factors influencing the development of this dramatic complication are peculiar to this rare disorder of bone and connective tissue development and include bony weakness, increased vascular fragility, and possible coagulopathies.

Adolescent↗