Twenty-six neurosurgery patients were given prophylactic treatment with Aztreonam at a dose of 1 g every 8 hours (30 mg/kg every 12 hours in children) for 8-12 days after the operation. In 18 cases 300 mg Clindamycin was also given every 8 hours for 8 days. No local or general infections arose in the postoperative period. Three patients with infections caused by susceptible bacteria were given 1 g Aztreonam every 6 hours (30 mg/kg every 8 hours in children) for 8 days. In all cases all clinical and microbiological signs of the infection had disappeared by the end of treatment. Apart from one episode of mild nausea no side effects were noted. Aztreonam is therefore considered a safe and effective drug for the treatment and prophylaxis of postoperative infections in neurosurgery.

Adult↗

PubMed1987

Cerebral edema associated with meningiomas.

Fifty patients with intracranial meningiomas have been retrospectively examined, and the cerebral edema on computed tomography scan has been correlated with the clinical evolution, size, location, and histological features of the tumor. The degree of brain edema was found to be related to the clinical evolution and the size of the tumor, whereas the histological features were less significant. These results are discussed after reviewing the data of five other series in the literature of this subject. A correlation between the tumor steroid receptors and edema is suggested.

Adult↗

PubMed1987

Craniopharyngioma of the cranial base and nasopharynx.

A rare case of craniopharyngioma extending to the cranial base and nasopharynx is reported and eight other cases in the literature are reviewed. The embryology and the clinical features of these tumors are discussed. Tomograms of the skull and computed tomography are the most useful radiological tools of investigation. A nasoseptal or transpalatal approach to surgery, which has been performed in reported cases of cystic nasopharyngeal craniopharyngiomas, was not performed on our patient because of the hard consistency and the diffusely infiltrating aspect of the tumor.

Adult↗

PubMed1987

Primary cerebral neuroblastomas.

Two children with primary cerebral neuroblastomas are reported and the other cases from the literature are reviewed. Cerebral neuroblastomas are a distinct pathological entity, which differs from other neuroectodermal tumours, although the clinical features are aspecific. The review of the CT findings shows that neuroblastomas appear as large solid tumours in half of the cases and as cystic lesions in the other half; massive contrast enhancement, calcification and cystic hypodensity are typical CT features. The importance of a radical operation and radiotherapy is stressed. The long-term prognosis is better for the cystic forms; also neuroblastomas seem to have a longer survival than other primitive neuroectodermal tumours.

Brain Neoplasms↗

PubMed1987

Echographic measurement of the optic nerve in patients with intracranial hypertension.

Measurement of the optic nerve diameter by echographic technique has been performed in 40 patients with intracranial hypertension syndromes of various origin. In all the cases examined the diameter was always increased. Postoperative checks revealed a decrease of the nerve thickness until it reached the normal values. The changes in the optic nerve diameter reflect the variations of the intracranial pressure and they appear earlier than any changes in the fundus oculi. This simple and non-invasive echographic technique is very useful in following patients with an intracranial hypertension syndrome.

Brain Neoplasms↗

PubMed1987

Primary cerebral lymphoma presenting as steroid-responsive chiasmal syndrome.

A case of multiple primary cerebral lymphoma presenting with bitemporal hemianopsia due to a large suprasellar lesion is described; the visual symptoms improved after corticosteroid treatment. Involvement of the optic pathways is very unusual in primary central nervous system lymphomas; the visual symptoms can be due to lymphomatous uveitis or to infiltration of the optic nerves by leptomeningeal lymphoma, whereas bitemporal hemianopsia due to chiasmal compression has not been reported as first symptom of a cerebral lymphoma. The CT finding of multiple hyperdense well-enhanced lesions and their symmetrical distribution in the basal ganglia and frontal horns suggest the diagnosis of lymphoma. Improvement of neurological deficits during corticosteroid treatment is another feature typical of cerebral lymphomas.

Adult↗

PubMed1987

Postoperative intracerebral haemorrhages remote from the site of the initial operation.

Two cases of postoperative intracerebral haemorrhages remote from the site of the initial craniotomy for saccular aneurysms are reported and the other cases from the literature are reviewed. Lack of a good postoperative recovery and the appearance of neurological signs not related to the site of the operation may suggest this complication, which is associated with high mortality and disability rate. The possible pathogeness of those postoperative haemorrhages is discussed.

Cerebral Hemorrhage↗

PubMed1987

Paraparesis due to bilateral subdural hematoma.

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Aged↗

PubMed1986

Lateral thoracic meningocele.

A case of intrathoracic meningocele is reported, and 95 cases from the literature are reviewed. Thoracic meningoceles are usually associated with neurofibromatosis; nevertheless their etiology remains controversial. The authors postulate the role of spinal trauma in some patients and the origin of the meningocele from an abnormal prolongation of a nerve sleeve in nontraumatic cases. Thoracic meningoceles often are asymptomatic or produce radicular intercostal pain. Spinal computed tomography is the most useful investigation, particularly in the exploration of large meningoceles. Surgery is required in symptomatic cases and usually results in remission of the pain.

Accidents, Traffic↗

PubMed1986

Osteoid osteomas of the spine.

Seven patients with spinal osteoid osteomas are reported and another 110 cases from the literature are reviewed. Among the patients spinal pain is the constant clinical complaint, while radicular pain and scoliosis are present in half of the patients. Whereas radiograms and tomograms of the spine are sometimes inadequate for diagnosis, bone scanning is positive in 100% of patients and is useful for directing spinal computed tomography at the exact level of the lesion. Complete removal of the tumoral nidus produces remission of pain in more than 95% of cases. The possibility of an erroneous diagnosis of a lumbar protruded disk and the necessity of a bone scan in young patients with spinal or radicular pain are emphasized.

Adolescent↗

PubMed1986

Anterior communicating artery aneurysm presenting with sudden paraplegia.

A case of sudden paraplegia as the first symptom of a ruptured anterior communicating artery aneurysm is reported. The sudden appearance of paraparesis or paraplegia is an exceptional event in patients with intracranial aneurysms. The various pathogenetic mechanisms are briefly discussed. The insufficient blood perfusion of both paracentral areas was the cause of paraplegia in the reported case.

Humans↗

PubMed1986

Posterior fossa hemangioblastomas.

The authors report 40 personal cases of infratentorial hemangioblastomas and review 36 series from the literature for a total number of 1023 patients. The clinical, pathological, and surgical features of these tumors are discussed, with particular consideration of localizations outside the nervous system, multicentric tumors, recurrences, and long-term results. Although hemangioblastomas are benign tumors, their high growth potential makes their long-term development unpredictable in some cases.

Adolescent↗

PubMed1986

Estrogen and progesterone receptors in meningiomas.

Estradiol and progesterone receptors were studied in 14 patients with meningiomas. Estrogen receptors were detected by specific monoclonal antibodies, whereas progesterone receptors were assayed by the dextran-coated charcoal method. In 9 cases the estrogen receptors were also investigated in cultured tumor cells. Positive estrogen and progesterone receptors were found in 86% of patients. The results have been compared with 11 published series of sex steroid assays in meningiomas. The different rate of positive results in most series can be explained by preoperative glucocorticoid therapy. There is no correlation between the estrogen and progesterone receptor activity, the sex and age of the patients, and the location and histological features of the meningioma. The authors suggest that assays of antiestrogen and antiprogestin drugs in cultured cells can indicate whether this estrogen and progesterone receptor activity may be of therapeutic use.

Adult↗

PubMed1986

Cystic lesions associated with meningiomas.

Three cases of meningiomas associated with large cysts are reported, and 58 other cases from the literature are reviewed. The etiology of these cysts is analyzed on the basis of surgical and pathological findings. The preoperative diagnosis of large computed tomographic hypodensities associated with meningiomas and the differential features from other cystic tumors are discussed. The surgical aspect of the solid tumor and particularly the absence of a capsule separating the tumor from the cyst are usually decisive in confirming the intratumoral nature of the cyst. In questionable cases a histologic evaluation of the cyst walls may be necessary.

Adult↗