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Biomedical subjects

L Palma

Publications and source records attributed to L Palma.

At least 73 records · Page 4Linked to original sources
PubMed1984

Cerebral arteriovenous malformations in children. Clinical features and outcome of treatment in children and in adults.

A study of 19 children with cerebral arteriovenous malformation (AVM) is reported; these children represent 12% of 161 patients with this disease at the Rome University Institute of Neurosurgery. The published data on intracranial arteriovenous malformations in children and in adults are reviewed and the clinical features and results of treatment in the two age groups compared. The results of surgical removal seem to be better in children while the follow-up mortality with conservative treatment is higher. The last point receives indirect confirmation from a study of the risk of bleeding in which the patients of our series were compared by age at clinical onset, viz. those under 15 years of age and those over 15 years. After an average follow-up of slightly over 10 years, the risk of bleeding is higher with onset before the age 15 years and significantly higher if the onset is nonhemorrhagic.

Adolescent↗
PubMed1984

Prognosis of the so-called "diffuse" cerebellar astrocytoma.

The term "diffuse cerebellar astrocytoma" was originally introduced by Russell and Rubinstein to describe that minority of cerebellar tumors microscopically similar to the cerebral hemispheric astrocytoma. The aim of this study was to verify some recent reports warning against the less favorable long term prognosis of the "diffuse" form of the cerebellar astrocytoma. We reviewed our series of cerebellar astrocytomas in children and collected 49 cases operated on before 1966 (i.e., with a follow-up ranging from a minimum of 15 years to 29 years). In addition, we reexamined all recurrent cerebellar astrocytomas observed during a 30-year period, looking for the eventual occurrence of the "diffuse" form. In the first group, 10 cases (20%) were classified as "diffuse" and 39 cases (80%) were classified as "classic". However, in 3 cases largely featuring a diffuse pattern, we also noted some areas of the classic type. These two subgroups showed no significant differences in patient sex and age, the incidence of macrocysts, the surgical technique used, the eventual x-ray therapy, and the long term functional results (P greater than 0.05). When we studied recurrent tumors that were reoperated on, we did not find any case showing histologically the "diffuse" pattern. To conclude, we cannot agree with the pessimism about the ominous long term prognosis of the diffuse cerebellar astrocytoma. In our opinion, the so-called diffuse cerebellar astrocytoma does not exist as a separate clinicopathological entity.

Adolescent↗
PubMed1983

Cystic cerebral astrocytomas in infancy and childhood: long-term results.

24 cases of cystic cerebral astrocytoma represent 11% of 217 supratentorial tumors of the pediatric age group operated. Both macro- and microscopically, such tumors resembled in most cases the well-known cerebellar astrocytoma, presenting as a large cyst with a mural nodule with the pattern of a pilocytic astrocytoma (i.e. spongioblastoma of the German school). The preferential site of incidence was the temporal lobe and the age peaks were of 7 and 16 years without sex prevalence. The surgical technique consisted in the extirpation of the mural nodule, preceded by emptying the cyst, followed by opening the contiguous ventricular wall. The extirpation was partial in one-third of the cases of whom the minority underwent radiotherapy. 1 patient died after the operation while 2 others died from tumor recurrence after 3 and 4 years, respectively, both being mixed tumors (oligoastrocytoma) that were irradiated postoperatively. The follow-up ranged from 10 to 29 years in 70% of the cases. The long-term functional results of the available 17 patients are as follows: good (perfectly well), 12 cases (70%); fair (minor troubles), 5 cases (30%). 3 of the 5 cases with a fair result all had a partial resection.

Adolescent↗
PubMed1983

Congenital extradural cyst of the orbital optic nerve: case report.

A rare congenital arachnoid cyst of the orbital optic nerve affecting a 5-year-old boy is described and the relevant literature is reviewed. On the basis of the macro- and microscopic features of the reported case, an analogy is suggested between the observed optic nerve cyst and the extradural arachnoid cyst of the spinal canal. Moreover, the hypotheses put forward to explain the pathogenesis of spinal extradural arachnoid cysts may also account for the exceptional appearance of a similar cyst in the orbital portion of the optic nerve.

Arachnoid↗
PubMed1983

Suprasellar epithelial cyst. Case report.

This case report describes an epithelial cyst lying above the diaphragma sellae and causing hypopituitarism and chiasmal compression in a 17-year-old girl. The epithelial lining of the cyst showed similarities with enteric epithelium rather than with "classic" Rathke's cleft. The problem of the true origin of Rathke's cleft, and of cysts so labeled, and the possible role played by neuroepithelium are discussed briefly.

Adolescent↗
PubMed1981

Hemispheric supratentorial astrocytomas in children. Long-term results in 29 cases.

In a series of 41 cases of hemispheric supratentorial astrocytoma (HSA) in children, 29 patients have been followed for periods ranging from 5 to 27 years. The follow-up data show that HSA's are relatively benign tumors. Twenty-two patients (76%) are still living: 12 in good, eight in fair, and two in poor neurological condition. Their mean survival is 13.3 years. Five patients died from tumor recurrence within 4 years of the operation. All five were operated on before the age of 8 years. The best results in terms of mean survival and quality of life were obtained in cases of cystic HSA, especially the pilocytic variety. In children, HSA tends to take the cystic form (often pilocytic), and its relatively benign course points up an analogy between this rare supratentorial tumor and the more common tumor of the cerebellum (the so-called "cerebellar astrocytoma").

Adolescent↗
PubMed1981

[The significance of the lymphocytes and plasma cells infiltration in brain metastases (author's transl)].

The histological slides of 270 consecutive cases of brain metastases have been reviewed to investigate the incidence of lymphocytes and plasma cells infiltration. As shown in a previous study, the overall incidence of the infiltration was found to be significantly higher in metastases than in glioblastomas (respectively, 76 p. cent and 39 p. cent), and similar to, even though slightly less, than that observed in other malignancies elsewhere in the body. Moreover, the infiltration was generally more intense in brain metastases than in glioblastomas (respectively, 50 p. cent and 16 p. cent, of "definite" infiltration), and was characterised by the presence of more plasma cells. These figures once again support the view regarding the brain as a site only partially "privileged" from an immunological standpoint, due to the weakness of the afferent limb of the immunological response. On the other hand, the slight reduction of the infiltration in brain metastases as compared to primary tumors might well represent a host's immune depression during the process of metastasizing.

Brain↗
PubMed1980

Oligodendrogliomas of the spinal cord.

The clinical, surgical, and pathological data from 35 published cases of oligodendroglioma and of one personal case are analysed and compared with those from other tumours of the cord and from cerebral oligodendrogliomas. Oligodendroglioma of the cord has a slightly lower average age than other gliomas and is closer to that of glioblastoma. In oligodendroglioma of the cord, as of the brain, acute onset or aggravation of the symptoms and an oscillating course are frequent. Two correlated data are particularly worth noting: a) the mean CSF protein content in oligodendroglioma of the cord is higher than in any other glioma; b) intracranial hypertension, in the form of papilloedema or hydrocephalus, or both, was present in 31% of cases. This signifies cerebral oligodendrogliomatosis, which was found in 6 out of 10 necropsied cases. At operation most oligodendrogliomas of the cord appear as infiltrating "gelatinous" tumours, though a minority have a firm consistency and apparently clearcut contours, which seem to be associated with a better prognosis. Postoperative radiotherapy seems to be useful.

Adolescent↗
PubMed1980

31 primary orbital mass lesions in infancy and childhood.

A series of 31 primary orbital mass lesions in patients up to 15 years of age is presented (malignancies: 5 sarcomas, 1 retinoblastoma; benign lesions: 7 optic nerve gliomas, 4 pseudotumors, 4 angiomas, 3 fibrous dysplasias, 2 dermoids, 1 hemiangioblastoma, 1 osteoma, 1 neurofibroma, 1 eosinophilic granuloma, 1 echinococcus). All the patients were operated upon using the subfrontal-extradural approach. The pathological and roentgenological features, and the long-term follow-up are analyzed. In the author's experience, computerized tomography scan (CT scan) is useful in planning the surgical approach more than in the pathological differential diagnosis. In orbital pseudotumors, without visual function impairment, CT scan is also useful in checking the results of conservative steroid therapy. The author's stress the importance of performing radical surgery, either along with (in benign lesions, including optic nerve gliomas) or followed by radiotherapy (in malignancies).

Adolescent↗
PubMed1979

Extracranial CSF shunting for infantile non tumoral hydrocephalus--a retrospective analysis of 360 cases.

A series of 360 consecutive extracranial CSF shunts performed between June 1960 and June 1976 for infantile non tumoral hydrocephalus is reviewed. The surgical methods used, the reasons for re-operation, the time distribution of post-operative complications, the causes of death and the long term results are analysed and discussed for each of the four groups: tetraventricular communicating hydrocephalus, triventricular hydrocephalus, obstructive hydrocephalus with a ventriculo-cisternal block and post-meningocele or post-myelomeningocele hydrocephalus.

Bacterial Infections↗
PubMed1978

Lymphocytic infiltrates in primary glioblastomas and recidivous gliomas. Incidence, fate, and relevance to prognosis in 228 operated cases.

The correlation existing in several human malignancies between lymphocytic infiltration and prolonged survival prompted this study. Two hundred selected patients who were operated on for glioblastoma were reviewed to investigate the incidence of the lymphocytic infiltration in the histological slides and its possible relevance to a better clinical course. The group that exhibited a definite lymphocytic infiltration (Group A, 11.5%) had a significantly longer preoperative history and postoperative survival (p less than 0.01) than the other two groups that presented slight or no infiltration (Group B, 23%, and Group C, 65%, respectively). In addition, biopsies of 28 recidivous gliomas were reviewed to study the fate of this lymphocytic infiltration in relation to time and therapy, such as irradiation and steroids which are known to depress the immune response. The authors found that severe lymphocytic infiltration is a rare immunobiological reaction which significantly improves the prognosis of a malignant brain tumor and seems not to be influenced by time, local x-ray therapy, or steroids.

Adolescent↗