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Biomedical subjects

G Broggi

Publications and source records attributed to G Broggi.

At least 109 records · Page 6Linked to original sources
PubMed1990

Guided microsurgery by computer-assisted three-dimensional analysis of neuroanatomical data stereotactically acquired.

Stereotactic acquisition of neuroradiological data, followed by identification of cerebral structures and three-dimensional rendering, has been successfully applied to guided microsurgical resection of deep-seated cerebral lesions. The method described utilizes data from magnetic resonance, computed tomography, and digital angiography and allows the surgeon to 'wire frame' the lesion volume and the position of cerebral vessels and structures of high functional relevance. Three-dimensional rendering of surgical instrumentation around the reconstructed anatomy allows for planning and simulation of the trajectory of approach.

Adolescent↗
PubMed1989

Epilepsy course in cerebral gangliogliomas: a study of 16 cases.

From November 1979 to March 1988, 16 patients with cerebral gangliogliomas were investigated and underwent surgery at the Institute Neurologico "C. Besta" of Milan. Their age varied from 11 to 48 years. 15 of these patients presented with a seizure as the first and often the only neurological symptom. This report deals with the epileptologic and neuroradiologic features of these patients before and after surgical treatment.

Adolescent↗
PubMed1989

Computer-assisted planning of stereotactic neurosurgical procedures.

To extend the advantages of stereotactic localization to open procedures, a computational device with a graphic output is introduced. It is designed to be used in the operating room, where it processes neuroradiological information (CT, MR, and angiography) acquired under stereotactic conditions. The surgeon can interact with neuroanatomical data, extracting borders of structures of surgical relevance. The resulting sets of outlines, shown tridimensionally within the reference of a stereotactic head holder, are presented with respect to the planned approaching trajectory. Color-coded high-resolution graphics show the relationship between lesions and normal brain structures and guide the surgeon's access to deep-seated lesions through small exposures.

Humans↗
PubMed1989

Surgical approach to pineal tumours.

During a period of 10 years (1977-1986) 40 cases of tumour of the pineal region have been treated at the Istituto Neurologico "C. Besta"-of Milan. Out of these 40 cases, 27 (67.5%) were in the paediatric (10-15 years) or juvenile (15-20 years) age at the time of operation. Since 1983 a specific diagnostic and therapeutic protocol has been adopted and thereafter direct surgical removal of the tumour was performed only when the neuroradiological investigations were highly suggestive of a benign extrinsic lesion. Sixteen cases in this series underwent direct surgical removal; in the remaining 24 cases stereotactic biopsy of the tumour was performed in the first instance. On the basis of the histological diagnosis obtained by this procedure surgical excision of the tumour (9 cases) or radiotherapy (15 cases) was then performed. 25 cases underwent surgical removal of the lesion. In all the cases the infratentorial supracerebellar approach as introduced by Krause and then modified by Stein was adopted. On analysis of the data of this series it was observed that in 25% of the cases completely benign resectable tumours were found; in 25% of the cases astrocytoma (grade I-II) which could be treated at least by partial removal were present; in 30% of the cases radiosensitive lesions were encountered. In the remaining 20% of the cases highly malignant tumours were found which should be treated only by radiotherapy and/or chemotherapy.

Adolescent↗
PubMed1989

Cell kinetic investigations in brain tumors studied by serial stereotactic biopsy.

Between July 1983 and July 1986, 109 consecutive patients affected by brain tumors and selected for stereotactic biopsy underwent in vitro investigation of cell kinetics. The potential proliferative activity of these different neoplasms, evaluated as in vitro 3H-thymidine labeling index (LI), has been determined in 46 mature astrocytomas, 19 anaplasic astrocytomas, 25 glioblastomas, 5 cystic craniopharyngiomas, 6 metastatic tumors, 4 primary C.N.S. lymphomas, 3 pineal germinomas and one choroid plexus papilloma. The relevance of LI on prognosis has been evaluated in 35 patients affected by glial tumors with adequate follow-up longer than 2 years. This retrospective study allowed us to demonstrate the prognostic value of LI in mature astrocytoma and anaplasic astrocytoma series. The feasibility of LI determination by in vitro procedure has been demonstrated also in non-neuroectodermal tumors. In craniopharyngioma the LI investigations allowed to demonstrate a peculiar topographic arrangement of cells in S phase.

Adolescent↗
PubMed1988

Surgical approach to giant aneurysms of the anterior circulation.

The surgical approach to cerebral giant aneurysms is still a source of great concern. We describe our experience with giant aneurysms of the anterior circulation and discuss the different surgical techniques adopted. During the period January 1972-December 1985, a total of 33 patients were operated upon at the Istituto Neurologico "C. Besta" of Milan for a giant aneurysm of the anterior circulation. Nineteen cases had suffered subarachnoid haemorrhage before admission; in 14 cases the hospitalization was due to evidence of mass effect on the surrounding neurovascular structures. All aneurysms were directly approached: in 24 cases the neck was occluded by a suitable clip, in 4 cases intramural thrombosis was attempted, in 3 cases the aneurysms were definitively trapped and in one case aneurysmorrhaphy was performed after resection of the sac. Operative mortality was 12%. Long-term follow-up shows good results whenever exclusion of the aneurysm from cerebral circulation had been achieved, either after removal of the sac or not; on the contrary, only fair or poor results were evident when other surgical techniques were adopted, either electively or out of necessity. The importance of intraoperative protection and monitoring of brain function is stressed.

Adult↗
PubMed1988

Serial stereotactic biopsy of brain stem expanding lesions. Considerations on 45 consecutive cases.

Fourty-five patients affected by brain stem expanding lesions underwent serial stereotactic biopsy between 1978 and 1986. The definitive histological diagnosis allowed the definitive treatment of extrinsic tumours and non-neoplastic lesions. In patients affected from glial tumours the serial stereotactic biopsy allowed the histological grading and the definition of the growth modalities at the superior boundaries of the tumours. These data have been utilized to guide the choice of treatment. The future perspectives of stereotactic biopsies are discussed in view of the therapeutic results obtained in this series and in other series reported in the literature.

Adolescent↗
PubMed1988

Cell kinetics and multimodal prognostic evaluation in glial tumours investigated by serial stereotactic biopsy.

A retrospective evaluation of the prognostic value of different parameters available in patients affected by glial tumours and submitted to serial stereotactic biopsy is presented. The series investigated includes thirty-three untreated patients with proven brain gliomas submitted to stereotactic biopsy. All patients have been clinically and neuroradiologically monitored for three years. The factors investigated belong either to the preoperative data (clinical history and symptomatology, CT pattern and volume of the lesion) or to histological and biological data obtained after the stereotactic biopsy. The results suggest the need of a multimodal prognostic evaluation in glial tumours and particularly stressed is the accuracy of prognostic indications derived from cell kinetic studies.

Adult↗
PubMed1988

Intraoperative electrical stimulation for functional posterior rhizotomy.

Intraoperative electrical stimulation of dorsal spinal roots from L1 to S1 bilaterally was performed in 80 patients affected by cerebral palsy, in whom spasticity was the main symptom. Clinical examination and EMG recordings showed three main features of reflex responses. We know that they indicate respectively a normal presence, a defect or an excess of inhibitory activity within the spinal circuits examined. Only those roots or rootlets involved in circuits where normal inhibitory processes are reduced or absent are surgically sectioned. Therefore these circuits are interrupted. The theoretical bases and long-term results indicate that this method is a useful and correct approach to the neurosurgical therapy of spasticity. It allows us to utilize a new important criterion to identify the roots or rootlets to be sectioned, based not on the anatomic, but on the functional selection.

Cerebral Palsy↗
PubMed1987

Stereotactic neurosurgery in the treatment of tremor.

The results of stereotactical thalamotomy in 40 adult patients suffering from tremor of different etiology are presented. A combination of lesions of VOA-VOP-ZI seems to be optimal. Early results have been excellent in 63%, good in 23%, fair in 6% and poor in 8%. Long-term follow-up showed a negative shift with 40% excellent, 6% good and 54% poor results. In Parkinson disease with predominant tremor relief of this invalidating symptom can be achieved. But L-dopa therapy must be continued and surgical treatment does not stop the general disease progression.

Adult↗