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Biomedical subjects

F Tomasello

Publications and source records attributed to F Tomasello.

At least 109 records · Page 6Linked to original sources
PubMed1982

Relation of cerebral vasospasm to operative findings of subarachnoid blood around ruptured aneurysms.

An investigation was carried out in 28 patients in order to evaluate the relationship between angiographically documented vasospasm, amount of subarachnoid blood found at surgery around ruptured intracranial aneurysms, and delayed ischaemic deficits. Angiography was performed at time intervals ranging between 5 and 17 days, and surgery not later than 21 days following subarachnoid haemorrhage. The absence of subarachnoid clots was associated in ten patients, with no or minor vasospasm and no or mild neurological deficits. Thin clots were found in eight patients; one of them had no vasospasm, six had minor vasospasm, and one showed severe vessel narrowing. Major clinical signs were absent in these cases. All ten patients with thick clots developed severe vasospasm, and eight of them severe neurological signs. The important aetiological role of local subarachnoid clots developed severe vasospasm, and eight of them severe neurological signs. The important aetiological role of local subarachnoid clots in determining vasospasm in emphasized in view of surgical timing.

Adult↗
PubMed1982

Neuroradiological findings in multiloculated hydrocephalus.

The characteristic neuroradiological features of multiloculated hydrocephalus following neonatal meningitis and ventriculitis in five infants are presented. The role of ventriculography and computerized tomography in detecting multiloculated and enlarged ventricles and paraventricular cavities, as well as complete and incomplete septa, is emphasized for early diagnosis and surgical management. CT scan also provides clues indicating the presence of thin but not visualized septa. It is suggested that post-meningitic hydrocephalus should be repeatedly followed-up for detection of multiloculated transformation. Probably this entity occurs less uncommonly than was thought in the past. The CT scan appears the most helpful and safe procedure for the serial evaluation, but ventriculography may be usefully combined with it in order to plan the most suitable operative approach for fenestration of membranes.

Cerebral Ventriculography↗
PubMed1982

Paramedian hourglass epidermoid extending above and below the tentorium.

The case of a 22-year-old woman with a large hourglass epidermoid tumor extending both below and above the tentorium is presented. The tumor was located in the suprasellar region, left middle cranial fossa, and posterior fossa on the left side. Conventional computerized tomographic (CT) scanning was inconclusive as to the actual extension of the tumor, whereas air encephalography was more helpful. The subtemporal transtentorial approach made it possible to achieve a seemingly radical excision of the tumor. Nevertheless, the CT scan one year later showed the presence of a small tumor mass. The diagnostic and surgical implications are discussed in light of few similar cases reported in the literature.

Adult↗
PubMed1981

Pontine hematomas.

Pontine hematomas are very rare lesions that in the past were found at postmortem examination rather than diagnosed from the clinical presentation. The advent of computed tomography allowed more frequent identification of those lesions which has shown a more favorable prognosis than formerly thought. Three patients suffering from intrapontine hematomas, revealed by computed tomography, are discussed. The etiopathogenesis, location, and clinical features of this lesion are discussed in an attempt to establish general criteria from adequate management. All 3 patients (2 treated conservatively and 1 by surgical evacuation) had a successful outcome. Repeat CT scans gave evidence of resolution of this lesion in all patients.

Adult↗
PubMed1981

Choroid plexus papilloma of the third ventricle.

Choroid plexus papillomas are rarely located in the third ventricle. The case of a 49-year-old man who had a total microsurgical excision of such a lesion is reported. The neuroradiological features and the surgical results are discussed, with a review of 25 other cases reported in the literature. Microsurgical technique made possible a good exposure and successful complete removal of the tumor.

Cerebral Ventricle Neoplasms↗
PubMed1981

Dynamics of endothelial repair in end-to-side microsurgical carotid anastomoses in rats: a scanning electron microscopic evaluation.

A scanning electron microscopic (SEM) investigation of endothelial behavior, following carotid end-to-side microsurgical anastomoses, was carried out in twenty-four Sprague-Dawley rats. From the hemodynamic point of view, the experimental model used in this study involved a bidirectional flow in the recipient vessel. Following surgery, specimens were collected at intervals varying from 15 minutes to 14 days. The thrombus formation was particularly evident in the first 45 minutes, and then gradually disappeared. Evidence showed that the new endothelial cells, covering the defect at the site of the suture, originate from the normal endothelium. Regenerated endothelial cells showed particular morphological features which are expressions of high metabolic rate and of active cell movement. Endothelial repair on the suture line began 3 days after the operation, and was completed there earlier than it was on the stitches. An accurate microsurgical technique is needed to avoid an increased thrombus formation and delayed re-endothelialization.

Animals↗
PubMed1981

Multiloculated hydrocephalus in infants.

The clinical features and the neuroradiological appearance of multiloculated hydrocephalus that followed meningitis and ventriculitis in five newborn infants are presented. Several factors probably involved in the pathogenesis are discussed. Computed tomography is particularly helpful in the recognition of this entity and in the evaluation of its course. However, ventriculograms are advised to document the communication of the septated cavities. Of four infants treated by ventriculoatrial shunting, two died and two are mentally and neurologically disabled. Another infant, who underwent craniotomy and fenestration of the ventricular membranes, died accidentally 3 months after operation. In light of similar cases reported in the literature, the prognosis seems very poor. Craniotomy with fenestration of the ventricular septa seems a promising procedure, although further supportive evidence is needed.

Cerebral Ventriculography↗
PubMed1981

SEM evaluation of endothelial changes following end-to-side microvascular anastomoses in rats.

A scanning electron microscopic (SEM) study was carried out to evaluate the endothelial changes in carotid end-to-side microsurgical anastomoses. This procedure, associated with occlusion of the brachiocephalic trunk, was performed in 24 Sprague-Dawley rats. The animals were sacrificed at time intervals ranging between 15 minutes and 14 days after surgery. The specimens were collected after perfusion-fixation in vivo and treated for SEM observations. The findings show that the first 45 minutes are the most critical time for thrombus formation. Reendothelialization could be detected at 3 days after the microsurgical procedure. Endothelial regeneration occurred earlier on the suture line than on the stitches, documented by the migration and morphological changes of the endothelial cells advancing from the normal endothelium to cover the defect and the suture material. The repair was usually completed within 14 days. Damage of the inner vascular wall, related to minor failures of the microsurgical technique, appears to be a cause of delayed reendothelialization.

Animals↗
PubMed1980

Giant intracavernous carotid aneurysm treated by combined trapping and extra- intra-cranial bypass.

A case of a giant intracavernous carotid aneurysm, surgically treated by combined procedure of trapping and extra- intra-cranial arterial bypass, is reported. The authors reviewed the literature concerning the risks of immediate, early and late ischaemic complications related to carotid surgical occlusion. In agreement with other authors, the usefulness of extra- intra-cranial anastomosis in preventing cerebral ischaemia, in patients requiring surgical occlusion of main cerebral arteries, is suggested.

Aneurysm↗
PubMed1980

Supratentorial hemangioblastoma in a child. Case report.

Hemangioblastomas are rarely seen in the supratentorial region, especially in childhood. The case of a 10-year-old boy with left parieto-occipital cystic hemangioblastoma is reported. The neoplasm was not attached to the dura, nor was it associated with von Hippel-Lindau syndrome or with erythrocythemia. Cerebral angiography showed no evidence of a vascularized tumor, whereas computerized tomography gave more accurate information. The gross and microscopic appearance of the lesion is described, and a review of similar cases previously reported in the literature is presented.

Brain Neoplasms↗
PubMed1980

Cerebral revascularization by transverse cervical-common carotid artery anastomosis.

A surgical procedure to bypass occlusive lesions of the proximal common carotid or vertebral artery is described. The case of a patient with recurrent cerebral ischemic episodes associated with proximal left common carotid stenosis is reported. A left transverse cervical-common carotid artery anastomosis was performed. It is suggested that this simple procedure may be useful in selected cases.

Arterial Occlusive Diseases↗