Biomedical subjects
Publications and source records attributed to E Pozzati.
The CT appearance of two cases of ganglionic cysts of the common peroneal nerve at the knee is reported. In both cases the ganglion appeared as a cystic unenhanced lesion of mucoid density. The radiological findings were confirmed by surgery. The differences in the appearance of intraneural and extraneural ganglia are discussed.
A case of spinal epidural hemangioma is presented. The rarity of this lesion in comparison with the more frequent vertebral hemangiomas with secondary extension to the epidural space is emphasized. The special features of this case are noted: the acute clinical onset, the visualization by means of the spinal angiography, and the unusual cervical level.
This report describes the evolution of techniques of spinal surgery developed for the treatment of spasticity of varied etiology and further describes application of a T-shaped dorsal longitudinal myelotomy to five patients. Additionally, a losenge-shaped griseotomy was performed on three patients. Both techniques led to the elimination of hypertonicity and painful spasms, without producing sensory deficits. Although all procedures are performed at lumbar levels, some patients showed reduced spasticity in the neck or upper extremities as well.
From January to June 1986, 158 patients with extradural haematoma were admitted to our neurosurgical unit. They were divided into four groups, reflecting their clinical features: A. 46 cases (GCS less than or equal to 12) in whom a condition of coma/stupor had occurred at the time of injury and persisted to the time of surgical decompression; B. 41 cases showing deterioration of consciousness (GCS less than or equal to 12) after a lucid interval; C. 46 cases of 'asymptomatic' patients (GCS consistently greater than or equal to 13, no neurological deficits, no signs of increased intracranial pressure); D. 25 cases arriving at our unit in a conscious state, but restless and/or with neurological deficits. The location of the haematoma (temporal in only 35%), the incidence of associated lesions such as cerebral lacerations and/or subdural effusion (30.3%), and the age of the patients (28.4 +/- 18.4 years were similar in the four groups. The size of the haematoma and the displacement of the midline structures were significantly greater in comatose/stuporose patients (groups A and B). The overall mortality was 12% (19 patients), with a morbidity of 14% (22 patients). Factors statistically significant in determining mortality and morbidity were: degree of coma as assessed by GCS; displacement of midline structures: age of the patient; size of the haematoma. There was no mortality or morbidity in those patients who remained conscious (groups C and D). A pronounced increase in the number of CT examinations performed in patients with head injury in our area of referral has caused profound changes in the population of patients admitted to our centre, resulting in a greater proportion of extradural haematomas detected in patients who are still conscious, and in whom operative mortality and morbidity are negligible. One further therapeutic implication of the increase in the number of patients with EDH admitted while asymptomatic may be the option of conservative management in those patients who remain in a good clinical condition, with haematomas of less than 1 cm in thickness and no displacement of midline structures.
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The authors report seven cases of vascular malformations of the spinal cord. The AVMs were completely excised in five cases; in one case the clipping of the feeding vessel alone was performed; one patient with a huge cervical AVM died of respiratory complications independent of a simple laminectomy.
The authors report a case of left superior cerebellar artery aneurysm successfully operated. A review of the literature produced only 7 other reported cases. Symptoms and operative procedures are briefly discussed.
A case of Carpal Tunnel Syndrome (S.T.S.) in a patient with Persistence of the Median Artery is reported. The Authors consider this rare-condition as a possible cause of C.T.S. The persisting vessel may cause a damage to the Median Nerve in two difeent ways: 1) Compression and 2) Ischemia. The latter pathogenesis is expecially advocated when anastomotic connection between the Median Artery and the Radial and Ulnar Arteries as well as the Superficial Palmar Arch are poor. Two different clinical pictures are possible: an acute onset, after a thrombosis, or a chronic impairment when the vessel is previous. As treatment, the Authors always recommend the decompression of the Carpal Tunnel and the dissection of the Persisting Artery; on the other side, they consider the excision of the vessel possible only when a sufficient anastomotic blood-supply is ensured.