Biomedical subjects

L Mastronardi

Publications and source records attributed to L Mastronardi.

At least 73 records · Page 4Linked to original sources

PubMed1988

RISA cisternography in the option of ventriculocisternal shunt for infantile non-tumoural aqueductal stenosis.

Twenty cases of infantile triventricular hydrocephalus from non-tumoural aqueductal stenosis were treated by ventriculocisternal shunt following RISA cisternography. In 11 cases RISA cisternography showed a normal pattern of CSF circulation. One patient was lost to follow-up. Two had their intrathecal shunt converted into an extrathecal one because of postoperative meningeal infection. Of the remaining 8 patients, 7 had good and 1 fair long term results. In 9 cases RISA cisternography presented an abnormal pattern without indicating a definite impairment of CSF absorption. Slow flow of the tracer leading to its complete disappearance from 36 to 48 hours and 48 to 72 hours was observed respectively in 7 and 2 patients. In both the latter as well in two of the other seven an extrathecal shunt had to be employed (44%). A retrospective analysis to assess the predictive value of CSF absorption test by RISA in the selection of this kind of intrathecal shunt is made.

Adolescent↗

PubMed1988

Cystic meningiomas.

Twenty-two cases of unusual intracranial meningioma associated with a cyst are reported and 144 published cases reviewed. The complex mechanisms leading to the formation of the cyst within the meningioma are analyzed on the basis of the surgical and histopathological evidence. The neuroradiological features (Computed Tomography and Angiography) which supply a correct preoperative diagnosis are discussed. It is clear from the literature how difficult preoperative diagnosis is, being possible only in 38% of cases with CT scanning and in 13% with angiography. It is necessary to remove not only the solid portion of the meningioma but also the cyst wall in order to prevent a recurrence. This is technically difficult for the type II intratumoural variety of Nauta's classification.

Adolescent↗

PubMed1988

Endaural extracranial repair for cerebrospinal otorrhoea with human fibrin glue: technical note.

A simple surgical procedure for the repair of cerebrospinal otorrhoea using human fibrin glue has proved safe and successful in two patients with post-surgical fistula. The procedure, which requires only mild sedation, is recommended for open or closed cerebrospinal otorrhoea accompanied by severe neurosensory hearing loss, as long as the fistula has not been caused by chronic inflammatory processes or given rise to intracranial infectious complications.

Aprotinin↗

PubMed1988

Tension pneumocephalus after CSF shunting procedures.

We report a case of tension pneumocephalus following the insertion of a ventriculoperitoneal shunt for hydrocephalus secondary to aqueduct stenosis and discuss the possible genesis of the complication, diagnosis and treatment.

Cerebrospinal Fluid Shunts↗

PubMed1988

Tuberculoma of the ulnar nerve: case report.

A peripheral nerve tuberculoma, the third on record, involved the ulnar nerve, as did the other two. This case report is followed by a discussion of the pathogenesis and diagnosis of this lesion. Its pathogenesis is unclear. Direct infection from a tuberculous sister was disproved, and infection via a local wound is highly unlikely. A previous, silent form of tuberculosis seems to have been the cause.

Adult↗

PubMed1988

Supratentorial hemangioblastoma. Report of a case and review of the literature.

Hemangioblastoma is a benign tumor of vascular origin that develops usually in the posterior cranial fossa and only very rarely in the supratentorial region. A case of supratentorial hemangioblastoma is reported and the 71 published cases are reviewed. The features that distinguish this tumor from angioblastic meningioma are discussed, the clinical and biological features of supratentorial and subtentorial hemangioblastoma are compared, the neuroradiological findings examined and the results of treatment assessed.

Adult↗

PubMed1987

Association between intracranial aneurysms and pituitary adenomas. AEtiopathogenetic hypotheses.

Of 144 cases of pituitary adenoma operated on in the period 1981-1985, 53 underwent angiography and two of these had an associated intracranial aneurysm. The aetiological hypotheses are viewed in the light of these two cases and of the 60 published cases of this association. The most convincing hypotheses involve mechanical, microcirculatory and hormonal factors. On the hormonal front, GH seems to have a predisposing influence on intracranial aneurysm formation.

Adenoma, Acidophil↗

PubMedDate not supplied

Coagulation study in patients who had undergone surgery for meningioma.

Abnormal fibrinolysis and thrombotic complications have been often observed in patients who had undergone surgery for meningioma. Fourteen patients, affected by meningioma, were studied before surgery, during surgery and 24 h after surgery in order to evaluate the modifications of the fibrinolysis system and the coagulation physiological inhibitors. Before surgery, no patient showed hyperfibrinolysis and/or modifications of coagulation physiological inhibitors. During surgery, an activation of fibrinolysis with pathological levels of tissue plasminogen activator activity (mean = 6.33 U/dl, SD = 7.9, p = 0.02) and increased levels of fibrin degradation products (mean = 0.21, SD = 0.18, p = 0.002) was noted. Modifications of the fibrinolysis parameters occurred only in 9/14 patients (64%). These patients presented a more vascularized tumour, revealed before surgery by computerized tomography scan and cerebral arteriography and directly confirmed during the resection. Twenty-four hours after surgery no patient presented fibrinolysis activation. There was no evidence of disseminated intravascular coagulation in our patients. None of them presented pathological decrease of the physiological coagulation inhibitors or thrombotic complications. In conclusion, during surgery, fibrinolysis parameters show important modifications in patients with vascularized meningioma suggesting an ongoing tumour-host interaction. These variations must be taken in account, in order to plan timely a correct therapeutic approach.

Adult↗

PubMedDate not supplied

Adrenocorticotropic hormone secreting pituitary adenomas: analysis of growth fraction using the MIB-1 antibody.

AIMS AND BACKGROUND: Pituitary adenomas are usually considered well differentiated tumors, even if in about one third of cases they invade surrounding tissues, with the possibility of postoperative relapse after complete surgical removal. Adrenocorticotropic hormone (ACTH) secreting adenomas seem to be the most infiltrating subtype, with a higher incidence of recurrence. Ki-67 is a nuclear antigen which is easily detectable by means of the MIB-1 monoclonal antibody, and the labeling index (LI) obtained can be considered a marker of tumor proliferation. METHODS: In order to identify the growth fraction of these tumors we used the MIB-1 antibody to evaluate the expression of Ki-67 antibody in 11 ACTH secreting pituitary adenomas and to compare it with the LI obtained in 98 other hormone secreting or non-functioning pituitary adenomas consecutively operated on during a 40-month period. RESULTS: In relation to surgically verified infiltration of the sellar floor dura and bone, we identified eight non-invasive and three invasive ACTH secreting pituitary adenomas. All invasive tumors infiltrated the wall of the cavernous sinus (CS). The mean Ki-67 LI was 5.88 +/- 9.13% versus 2.33 +/- 2.40% in non-ACTH secreting adenomas (P = 0.0025). It was 13.27 +/- 15.42% in invasive and 3.11 +/- 4.37% in non-invasive ACTH adenomas, and 18.40 +/- 17.82% in patients over 50 years versus 3.10 +/- 4.09% in younger subjects (P = 0.02). CONCLUSIONS: Ki-67 LI is a useful marker in the determination of proliferative activity and invasiveness of anterior pituitary adenomas. Our data seem to confirm that ACTH secreting adenomas have a higher growth fraction than other pituitary adenomas and this observation presumably explains the higher incidence of relapse of these tumors even after macroscopically total removal.

Adenoma↗

PubMedDate not supplied

Long-term survival in cerebral glioblastoma. Case report and critical review of the literature.

Glioblastoma multiforme is the most malignant tumor of the glial series. The average survival of patients with this tumor ranges from 6 to 12 months. The case of a patient who survived for more than 11 years after diagnosis of a temporal-occipital glioblastoma which was treated with surgery, radiotherapy and chemotherapy is described. The authors deduce that among patients with glioblastoma multiforme (GM), those with a long disease-free interval after initial diagnosis who undergo multimodal therapy, including aggressive tumor removal, are the most likely long-term survivors (LS). Other factors which appeared to be related to longer survival were younger age and high Karnofsky scores.

Brain Neoplasms↗

PubMedDate not supplied

Solitary eosinophilic granuloma of the calvaria.

AIMS AND BACKGROUND: Histiocytosis X is a condition characterized by an abnormal proliferation of histiocytes with a variable granulomatous and inflammatory component; bone involvement is almost always present. The aim of this study was to define the management of solitary eosinophilic granuloma (EG) of the calvaria in adult patients, in relation to the size and site of the lesion. METHODS: Fourteen patients, ranging in age from 7 to 45 years, with solitary eosinophilic granuloma of the calvaria were surgically treated by craniectomy or curettage and cranioplasty. We subgrouped the lesions into two types: A) lesions localized inside the diploë and/or compressing the cerebral parenchyma below but without dural infiltration; B) lesions with mainly intracranial growth, compressing the cerebral parenchyma and infiltrating the dura. The infiltrated dura mater in type B lesions was replaced with a dural patch. Cranioplasty was performed in lesions with a diameter of 4 cm or more and/or located in aesthetically exposed areas of the skull. RESULTS: None of the patients died during the study and no local or systemic recurrences were observed during follow-up (min. 3 yrs, max. 8 yrs). CONCLUSIONS: Surgical treatment of patients with isolated EG of the calvaria not only is simple and quick but also allows histological diagnosis of the osteolytic lesion. These patients do not require further adjuvant treatment. Cranioplasty should be performed when the lesion has a diameter of 4 cm or more, when it is located in aesthetically exposed areas of the skull such as the frontal or temporal bones, or when it produces alterations of the normal skull morphology.

Adolescent↗

PubMedDate not supplied

Cervico-medullary junction hemangioblastomas. Report of two cases and review of the literature.

Reporting two cases of dorsally located cervico-medullary hemangioblastomas the Authors discuss clinico-biological features, diagnosis and therapy of this vascular neoplasms, analyzing the cases reported in detail in the available literature. In this site the tumor has often an exophitic development, adhering more or less extensively to the posterior surface of medulla oblungata, where progressively creates a niche. Transient neurogenic arterial blood hypertension, by possible involvement of the dorsal nucleus of vagal nerve, together with the lack of postoperative respiratory disturbances constitute the main clinical features of differentiation with intraaxial hemangioblastomas of the brainstem. Actually MRI represents the radiological investigation of choice, even if angiography still plays an important role in the correct preoperative diagnosis of hemangioblastomas. The therapy of dorsally located cervico-medullary hemangioblastomas is the total removal of the lesion also in asymptomatic patients, being the late surgical results generally successful.

Adolescent↗

PubMedDate not supplied

Medulloblastoma in adulthood.

Reporting 32 cases of medulloblastoma in patients aged 17 to 65 years and reviewing the major case-series in the literature, we analyze the clinicobiological and diagnostic features and treatment of this tumor in adulthood. We consider some factors that seem to have a favorable bearing on the prognosis: female sex, length of clinical history, tumor size, hemispheric site, and total removal followed by radiotherapy. We then discuss the differences in tumor behavior between adulthood and childhood that emerged from the comparative analysis.

Adolescent↗

PubMedDate not supplied

Occasionally-occurring familial brain tumours (OFBT). Reports of cases and review of the literature.

We use the term "occasionally-occurring familial brain tumours" (OFBT) to designate cases in which more than one member of a family presents a brain tumours outside the range of the clinical syndromes in which CNS cancer heredity is well established. We report our experience of OFBT and review the published work on such cases with special reference to some clinicobiological concordances among affected families. On the evidence we present and on that of several genetic and epidemiologico-statistical studies we are inclined to think that there are genetic factors predisposing to the onset of OFBT.

Adolescent↗

PubMedDate not supplied

Narrowing of thoraco-lumbar spinal canal in achondroplasia.

The incidence of neurological deficits in achondroplastic subject is by no means negligible. We considered the clinico-radiological and therapeutic data of 35 achondroplasic patients (5 personal cases and 30 published in the available literature) harbouring myelo-radicular deficits related to narrowing of thoraco-lumbar canal. There was no significant sex prevalence. The clinical symptoms appear most frequently in the III or IV decades of life. Actually morphological anomalies of the spinal canal are already present at birth in achondroplasic dwarfs, and signs of cervical cord involvement are not uncommon in achondroplasic children. The delayed occurrence of clinical symptoms related to narrow toracho-lumbar canal may be explained by the pathogenetic role of acquired cofactors as prolapse of intervertebral disks and for degenerative spondyloartrosis. The clinical history is usually of insidious onset. Most frequent symptoms are motor weakness of the lower limbs (82.8%) and low-back pain (77.1%). Sensory and/or sphincter disturbances appeared to be less frequent (about 40% of the examined subjects). Plain X-rays, myelography, CT, CT-myelography and MRI are the diagnostic examination of choice. Surgical treatment consists of anterior decompression with fusion, when thoraco-lumbar kyphosis is prevalent, and/or posterior decompression, when the symptoms are mainly caused by canal stenosis. From the prognostic point of view, two groups of patients are recognized, in relationship to the presence of marked dorsal kyphosis. Those with kyphosis showed almost invariably poor functional results. In the remaining ones the results were satisfactory, provided that the clinical history lasted less than 3 years and the symptomatology was not already too advanced.

Achondroplasia↗

PubMedDate not supplied

Postoperative arachnoidal diverticula of the lumbar spine.

Arachnoidal diverticula are a rare complication of spinal surgery and occur most often at lumbar level, especially after discectomy. We report a case of lumbar arachnoidal diverticulum that arose two years after an L4-L5 discectomy and presented clinically with low back pain and sciatic pain and neurological deficits. We analyze the etiopathogenesis, clinical and radiological features and treatment.

Arachnoid↗

PubMedDate not supplied

Familial meningiomas. Report of two cases.

The Authors report a case of intracranial meningioma in two sisters, with no evidence of neurofibromatosis. A study of the karyotype has been performed; in one patient we have found a pericentric inversion of one chromosome 9. The possible role of the genetical factors in the develop of familial meningiomas is discussed.

Adult↗

PubMedDate not supplied

Recurrent cystic meningiomas. Report of two cases.

The Authors report 2 cases of recurrent cystic meningiomas among 22 cases operated on. After a review of the literature, the pathogenesis of the recurrences of these tumors is discussed, concluding that wrong interpretation of neuroradiological examination and/or incomplete extirpation of tumoral capsule are the main factors responsible of recurrences of cystic meningiomas.

Cysts↗