Search PubMed⌕ Search

Biomedical subjects

L Ferrante

Publications and source records attributed to L Ferrante.

At least 73 records · Page 4Linked to original sources

Intramedullary spinal cord ependymomas--a study of 45 cases with long-term follow-up.

Of the 62 patients with intramedullary spinal cord ependymoma treated surgically at our Neurosurgery Division between January 1951 and December 1990 45 had a follow-up of at least 3 years and the longest 30 years. The 28 conus-cauda equina-filum ependymomas operated during the same period are not considered in this study. An analysis of our cases and of the larger published series shows that favourable prognostic factors, apart of course from total tumour removal, which is now usually possible, are a site below the high cervical segments and a mild pre-operative symptom pattern. Patient age at diagnosis, tumour size and "low dose" (< 40 Gy) radiotherapy seem to have no influence on the prognosis. Aggressive surgical removal is the treatment of choice and also for long-term recurrence.

Adolescent↗

Neurinoma of the third, fourth, and sixth cranial nerves: a survey and report of a new fourth nerve case.

A rare case of trochlear nerve neurinoma is described. Including this case, the number of reported intracranial tumors arising from the sheaths of the third, fourth, and sixth cranial nerves is 38. By site and relationship to the nerve segment, they fall into three groups: cisternal, cisternocavernous, and cavernous. In cisternal tumors of the third and sixth nerves, paresis of the nerve hosting the tumor is the unique nerve deficit; by contrast, in those of the fourth nerve, paresis of the trochlear nerve can be absent and that of the third nerve present. In the latter tumors, a peculiar ataxic hemiparesis syndrome is produced by midbrain compression. Cisternocavernous neurinomas often cause symptoms of intracranial hypertension, while cavernous neurinomas bring about two clinical features: paresis of one or more nerves of the cavernous sinus and a clinicoradiological orbital apex syndrome. At surgery, generally cisternal neurinomas are totally removed and the nerve source of the tumor identified; in cisternocavernous and cavernous neurinomas, total removal of tumor and identification of the parent nerve have been reported in only half of the cases. In the majority of parasellar neurinomas, clinical differences can be found between those arising from the nerves governing eye movement and those arising from the gasserian ganglion.

Abducens Nerve↗

Posterior inferior cerebellar artery (PICA) aneurysm presenting with SAH and contralateral crural monoparesis: a case report.

A patient with contralateral monoparesis of the leg due to subarachnoid hemorrhage (SAH) from an aneurysm of the first posterior inferior cerebellar artery (PICA) segment is reported. The monoparesis may well be associated with the close anatomical relationships between the site of the aneurysm and the PICA blood supply of the corticospinal fibers to the contralateral leg.

Adult↗

Tumors of the lateral ventricles.

Tumors are only rarely found in the lateral ventricles. Although various oncotypes of these tumors differ in growth rate and invasiveness they present the same clinical pattern with the same diagnostic and surgical problems. Thus we can consider them as a group. This series comprises 51 primary tumors arising strictly from the structures of the lateral ventricles, the majority from the trigone, operated on between 1952 and 1988: 20 meningiomas, 19 ependymomas, 9 papillomas of the choroid plexuses, and 3 subependymomas. As most of these tumors were benign, the response to surgical treatment was, as other authors have found, good with permanent cure or long survival in the majority of cases. Advances in neuroradiological techniques have greatly facilitated the work-up and differential diagnosis of these tumors. Of the various surgical approaches, the parieto-occipital is preferred by our department, even for tumors of the dominant hemisphere. Our operative mortality of 10.6% tallies with that of other workers.

Adolescent↗

Association between neuroepithelial tumor and multiple intestinal polyposis (Turcot's syndrome): report of a case and critical analysis of the literature.

We report a case of association of a brain tumor with multiple intestinal polyposis (Turcot's syndrome) and offer a critical analysis of the relevant literature with a view to revising the classification of the syndrome in relation to familial multiple polyposis and Gardner's syndrome. For this purpose, we considered only cases of intestinal polyposis associated with a primary neuroepithelial tumor (medulloblastoma, glioma, or glioblastoma) as originally described by Turcot. Differences emerged, depending on the central nervous system tumor type, which suggests that this neoplastic association may be classified as two distinct syndromes.

Adenomatous Polyposis Coli↗

Intradural extramedullary cavernous angioma: case report.

Cavernous angiomas represent 5 to 12% of spinal vascular malformations and usually are located at the vertebral body level with possible extension into the extradural space. The intradural intramedullary cavernoma occurs in about 3% of cases, whereas extramedullary localization is extremely rare. A new case of an intradural extramedullary cavernous angioma is reported, and the clinical, diagnostic, and therapeutic aspects of this rare malformation are analyzed.

Female↗

Stenosis of the spinal canal in achondroplasia.

Stenosis of the spinal canal is a very frequent finding in achondroplastic patients. It is secondary to abnormalities of endochondrial ossification, which is responsible for formation of the vertebral bone structures, and, subsequently, to bone degeneration. Cervical stenosis (most frequently involving the first metameres and the craniospinal junction) is more common in children while thoraco-lumbar stenosis favors adults. The surgical indications for cervical stenosis depend mainly on the clinical evolution but also on neurophysiological data. In thoraco lumbar stenosis too, clinical data determine the surgical indications and the route of attack depends on the type of anatomical alteration affecting the spine.

Achondroplasia↗

Aphasia in polyglots: report of two cases and analysis of the literature.

Two cases of aphasia in polyglot patients who experienced different symptoms in each of the languages they knew are reported. The authors discuss the problem and analyze the available literature in an attempt to formulate a pathogenetic hypothesis of the different involvement of the known idioms sometimes observed in aphasic polyglots. In particular, when time has elapsed between the learning of the mother tongue and other languages, and all the known languages are, consequently, functionally independent, it is possible that the two or more known idioms have distinct anatomical representations, probably localized separately in the two hemispheres. This could explain why, in some polyglots, aphasia affects one of the known languages preferentially. In subjects in whom the different known idioms were learned during early childhood, the anatomical representation of the languages is similar, which explains why, in this kind of polyglot, all the known languages can be equally affected by cerebral damage that causes aphasia.

Adult↗

[Therapy of the lower respiratory tract infections in aged patients. Clinical experience with ceftriaxone using a single daily dose].

Sixty-seven elderly patients affected by acute or chronic pulmonary pathologies were treated parenterally with ceftriaxone in a single dose of 2 g/day. A deterioration of the bacterial analysis of expectorate during or at the end of therapy was observed in 92.5% of patients; a reduced bacteria count was found in one case; and no clinical or bacterial effects were observed in 3 cases. No adverse effects or changes in the main hematochemical parameters were reported.

Age Factors↗

Long-term results of surgical treatment of spinal lipomas. Report of 18 cases.

We report the long-term results of surgery on spinal lipomas in a series of 18 patients. Four patients had congenital lipomas with spina bifida and/or myelomeningocele and the other fourteen had tumoural (true) lipomas. Simple decompression or subtotal removal afforded a very good prognosis in all patients with intradural lipomas whose preoperative neurological deficits were slight. In the light of the long follow-up, the lack of difference in biological behaviour between congenital and tumoural (true) lipomas leads us to regard the two types as a single maldevelopment entity of dysembryogenetic origin.

Adult↗

The long-term postoperative trinitroglycerin hypotension in normal perfusion pressure breakthrough syndrome.

The authors describe a case of normal perfusion pressure breakthrough syndrome, a catastrophic hemorrhage complicating surgery for cerebral arteriovenous malformations, due to chronic loss of autoregulation. Successful treatment was achieved with prolonged postoperative trinitroglycerin hypotension, associated with barbiturate-induced coma and artificial ventilation.

Journal Article↗

Pharmacokinetics of sulbactam/ampicillin in humans after intravenous and intramuscular injection.

We investigated the pharmacokinetic properties of sulbactam/ampicillin (S/A), after intravenous (0.5/1.0 and 1.0/2.0 g) and intramuscular (0.5/1.0 g) coadministration in 10 male subjects. After 1.0/2.0 g intravenous doses of S/A the half-lives (t1/2 beta) were 1.14 +/- 0.14/1.09 +/- 0.16 h. The values for plasma clearance (CLp) were 198.83 +/- 26.27/250.33 +/- 39.28 ml/min and the renal clearance (Clr) 173.50 +/- 19.66/208.80 +/- 26.43 ml/min. The post distributive volumes (V beta) were 19.67 +/- 3.24/23.56 +/- 5.76 liters. Similar values were obtained after 0.5/1.0 g of S/A intravenous coinjection. After 0.5/1.0 g intramuscular coadministration the t1/2 beta values were 1.26 +/- 0.18/1.20 +/- 0.15 h. The values for Clp were 208.00 +/- 28.73/243.17 +/- 33.24 ml/min, for Clr 179.50 +/- 20.26/202.67 +/- 27.61 ml/min and for V beta 22.27 +/- 4.12/25.30 +/- 4.87 liters. The renal clearance of sulbactam is comparable to that of ampicillin and both clearances are greater than the glomerular filtration rate, suggesting active renal tubular secretion of the two drugs. The large volumes of distribution, and the ratio K12/K21 = 0.5 show the extensive distribution of the two drugs into extracellular fluids. The very similar values of the pharmacokinetic parameters of sulbactam and ampicillin confirm that the kinetics of the two drugs closely resemble one another.

Adult↗

Mutism after posterior fossa surgery in children. Report of three cases.

Three patients aged 5 1/2 to 9 years old with mutism after posterior fossa surgery are presented. The entity is discussed with a review of 15 additional previously reported cases in children aged 2 to 11 years. In all 18 patients, a large midline tumor of the posterior fossa (medulloblastoma in nine cases, astrocytoma in five, and ependymoma in four), often attached to one or both lateral recesses of the fourth ventricle, was removed. Mutism developed 18 to 72 hours after the operation (mean 41.5 hours) in patients with no disturbance of consciousness and no deficits of the lower cranial nerves or of the organs of phonation. All of these children had spoken in the first hours after surgery. The disorder lasted from 3 to 16 weeks (mean 7.9 weeks). Speech was regained after a period of dysarthria in six of the 10 cases for whom this information was available. The various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.

Astrocytoma↗

On a case of early-onset post-traumatic facial hemispasm.

In a 49 year old woman an injury to the right frontotemporal region was quickly followed first by paresis and then by spasm of the right side of the face. The early onset of the spasm prompts a critical review of current views on the pathogenesis of facial spasm.

Brain Concussion↗

Cerebral cavernous angioma in children.

Cerebral cavernous angioma is a rare vascular malformation at any age and is very rare in childhood. In the literature available to us, we have been able to trace only 50 cases, to which we have added the 6 cases from our own series. The incidence in pediatric group is higher at 0-2 years (26.8%) and at 13-16 years (35.7%). The clinical onset shows epilepsy in 45.4% of cases, hemorrhagic syndrome in 27.3%, intracranial hypertension in 16.4%, and focal neurological deficits in 10.9%. Furthermore, we discuss the neuroradiological features (CT, angiography, and MRI) and the therapy of pediatric cavernous angioma.

Adolescent↗