Biomedical subjects
Publications and source records attributed to F Tognetti.
A case of spinal meningocele is reported in which erosion of adjacent vertebral bodies and stretching of some roots coexisted. The neurological picture cleared after neurolysis and repair of the anterior thecal continuity.
Two cases of intracranial saccular aneurysm related to an arteriovenous malformation (AVM) are illustrated, in which a remarkable growth of the sac over the years was demonstrated angiographically. According to the relevant literature, aneurysm enlargement is correlated to the flow toward the AVM, increasing the intrasaccular turbulence and stress on the wall to which "solitary" aneurysms are usually subjected. The presence of bilateral infundibular widening at the origin of the posterior communicating artery is noted in one of the cases. This finding possibly confirms further the effects of hemodynamic stress.
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.
A new approach for the treatment of metastatic brachial plexus neuropathy at the axillary level is described. This may be used in patients previously submitted to radical mastectomy followed by radiotherapy for breast cancer. The method consists of external neurolysis of the cords of the plexus, dissection and excision of the pathological axillary contents along with the overlying atrophic cutaneous and subcutaneous tissues, reconstruction of the axilla by the latissimus dorsi musculocutaneous flap, and finally early radiotherapy by high-dose radiation delivered to the entire area. The advantages of the procedure are briefly discussed.
A huge solitary neurofibroma of the radial nerve was resected in a 74-year-old woman. The nerve was cut across and repaired with epineural suture. The patient made an excellent recovery of nerve function. The ability for regeneration of a neurofibromatous nerve even in the elderly is outlined, and the relevant literature briefly reviewed.
The authors report a rare case of intramedullary teratoid cyst, in which an arteriovenous malformation of the spinal cord was first suspected. The controversial problem of the histogenesis of teratomas is reviewed. The authors stress the benign course of these lesions after operation, even when radical surgery cannot be performed.
A case of extrathecal cavernous hemangioma, a rare entity, is presented. Some clinical, radiological, and histological features of the lesion are discussed. The unusual dumbbell-like growth of the tumor through an intervertebral foramen is considered, as well as the potential effectiveness of radiation therapy. The literature dealing with spinal hemangiomas and hemangioblastomas is summarized.
Thirty-one cases of arachnoid cysts of the middle cranial fossa were investigated by CT scan, 7 of them undergoing additional metrizamide CT cisternography. In this paper we analyze and correlate the different findings from these two examinations and propose a classification of arachnoid cysts of the middle cranial fossa into three basic types. Pathophysiological and surgical implications are discussed.
The authors describe an unusual and unique case of a giant capillary telangiectasis of the right frontal lobe encountered in a 10-month-old child. The patient presented with progressive neurologic symptoms mimicking a brain tumor. The lesions was resected in toto with good clinical results.
Two cases of a rare entity, spinal extrathecal hemangiolipoma, are presented. The clinical and histological features of the tumor are discussed, with particular attention to the uncommonly sudden onset of symptoms in one patient. Complete neurological recovery was exhibited by one patient after excision of the lesion, whereas only a partial recovery was achieved in the other case. The pathogenetic aspects of hemangiolipomas and the literature dealing with the previously reported 12 cases are reviewed.
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Stereotaxic rostral mesencephalotomy was performed 19 times in 14 patients suffering from intractable pain syndromes due to malignant diseases. The satisfying results in terms of pain relief during a necessarily short follow-up period (mean 4.9 months) are outlined. Undesired side effects were mainly confined to oculomotor disorders, which partly subsided over the months following the operation. Some technical aspects of the procedure and the pertinent literature are briefly 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.
Arteriovenous malformations (AVMs) of the spinal cord are a rare occurrence in the pediatric age group. This report describes the successful, complete removal of such a lesion in a boy age 12. The clinico-radiological findings and different treatment modalities of these entities are reviewed.