Biomedical subjects
Publications and source records attributed to M Baldini.
Eighteen patients with chronic hydrocephalic dementia who had a ventriculo-atrial or ventriculo-peritoneal shunt are reported. The indications for operating on this type of dementia are discussed on the basis of the clinical and instrumental protocol and the postoperative results.
A case of Empty Sella secondary to Rathke's cleft cyst, successfully operated on, is reported. Asymptomatic cysts of Rathke's pouch are fairly frequent autopsy observations. They can cause optic-chiasmatic and endocrine symptomatology or, very rarely, an Empty Sella syndrome if the cyst is very large.
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The article reports on 8 cases of subdural hematoma consequent on 94 extrathecal CSF shunts inserted in 1977. Neuroradiolgical postoperative monitoning was carried out by CAT Scan and, where the neurological symptomatology required, cerebral angiography. The percentage of diagnosed subdural hematomas in relation to opening valve pressure, CSF opening ventricular pressure during surgery, and the hydrocephalus etiology, are discussed.
The Authors report on nine cases of thoracic disc hernia operated on through Carson's posterolateral approach. Several steps were taken to protect the spinal cord, and to remove completely disc fragments and any calcifications. The importance of the combined use of the operating microscope and the posterolateral approach are emphasized, and the longterm results are evaluated.
Btween 1971 and 1978 140 cases of spinal metastasis treated by decompression or possible removal of secondary neoplasm, were studied. Patients were divided according to their preoperative neurological conditions and then evaluated on the ground of regression of spinal cord and root symptom. The possibility of treating this type of compressive spinal pathology surgically is discussed.
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This retrospective study of nine patients in whom infection developed following operation for placement of an extrathecal drainage shunt, although it is not a complete biometric evaluation, shows an incidence of infection (10.5%) that corresponds with averages reported from other centers [7, 15--17]. Furthermore, it points out the limitations of antibiotic treatment when three significant aspects of therapy are not considered fully: 1) sensitivity of the identified organism, 2) CSF level of drug that can be achieved, and 3) pharmacokinetic action of drug in CSF.
A few hours after an ascending myelography with Pantopaque, a woman aged 52 presented light coma with signs of meningeal reaction, left hemiparesis and a central deficit of the left facial nerve. 24 hours later, a computer axial tomography revealed the presence of the contrast media (Pantopaque) in the basal cysterns. Three days after, the right carotid angiography indicated the presence of a diffuse spasm of the intracranial branches of the internal carotid artery, particularly a spasm of the cortical ascending parietal and descending temporal ones, without deplacements. A second CT investigation revealed a slow, but complete recovery of the neurologic functions in the following 10 days. According to the Authors, this clinical observation reproduces the experimental pattern of the cerebral spasm caused by the administration of a spasmogenic chemical factor in the basal cysterns, because of the following clinical aspects: blood absence in the liquor; T wave inversion (the electrocardiographic symptom considered as a predisposing factor); meningeal reaction owing to the irritation of the myelographic contrast and persistent vasospastic answer of the right carotid circle, as it may be seen in the angiographic control.
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