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Biomedical subjects

M Gangemi

Publications and source records attributed to M Gangemi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Neuroendoscopy. Personal experience, indications and limits.

The authors report a series of 40 patients treated by endoscopic neurosurgery. It includes 31 cases of obstructive hydrocephalus, 4 paraventricular or intraventricular CSF cysts, 3 cases of multiloculated hydrocephalus, one suprasellar arachnoid cyst and one cystic astrocytoma with mural tumor nodule. Third ventriculostomy is the most frequent indication of the endoscopic neurosurgery, which is very useful also for performing fenestration of CSF cysts and multiloculated hydrocephalus. The surgical endoscopic techniques in the different above mentioned pathologies are exposed. The criteria for patient selection, the clinical results and the postoperative radiological findings, that confirm the patency of the fenestration, are discussed.

Adolescent↗
PubMed1997

Cyst of the velum interpositum treated by endoscopic fenestration.

BACKGROUND: The cavum veli interpositi is a not infrequent radiologic finding in both children and adults, as confirmed by computed tomography (CT) and magnetic resonance (MR). A moderate enlargement of the cavum may sometimes be observed; on the other hand, a true large cyst may be considered exceptional, with only one reported case. CASE HISTORY: This 9-year-old boy with psychomotor retardation and epileptic seizures had a large CSF cyst in the region of the cavum veli interpositi, diagnosed by CT and MR. The patient was treated by endoscopic surgery, with introduction of the endoscope into the occipital horn of the right lateral ventricle and multiple fenestrations from the right ventricle to the cyst, and then from the cyst to the left lateral ventricle. The surgery resulted in decrease in the size of the cyst and reduction of the frequency of seizures. DISCUSSION AND CONCLUSIONS: Children with dilated or cystic cavum veli interpositi present with a large head, mental retardation, seizures, and hydrocephalus. On CT and MR, the cyst shows a typical triangular configuration on the axial plane and lies on the roof of the third ventricle in the coronal plane. Endoscopic ventricular fenestration is the treatment of choice for these as well as all other intraventricular and intracerebral CSF cysts, because it ensures communication between the cyst and the ventricular system and avoids definitive shunting of the cyst.

Brain Diseases↗
PubMed1997

Arachnoid cyst of the lateral ventricle.

BACKGROUND: Arachnoid cysts rarely occur within the lateral ventricles, with only 10 reported cases in the literature. They may arise from the arachnoid layer that is present in the choroidal fissure. CASE DESCRIPTION: This 25-year-old man with headache and a left jacksonian seizure had an intraventricular arachnoid cyst of the right occipital horn and trigone found on radiologic examination by computed tomography (CT) and magnetic resonance imaging (MRI). He was successfully treated by evacuation of the cyst and removal of its wall through a right parietooccipital craniotomy. Histologic studies of the cyst wall confirmed the presence of arachnoid cells and connective tissue. CONCLUSIONS: Arachnoid cysts of the lateral ventricles occur in the occipital horns and trigone (all but 1 of 10 cases) in young patients with symptoms of intracranial hypertension. MRI well defines the relationship of the cyst with the ventricular wall. Surgical removal of the cyst wall or cystoperitoneal shunt have been successfully performed in the reported cases; however, endoscopic fenestration of the cyst must be considered today as the treatment of choice.

Adult↗
PubMed1997

Symptomatic subependymomas of the lateral ventricles. Report of eight cases.

Subependymomas are rare, slow-growing, benign intraventricular tumors, which often are asymptomatic and are discovered incidentally. The review of the literature shows more than 100 symptomatic cases, less than half located in the lateral ventricles. Here we report 8 cases of symptomatic subependymomas of the lateral ventricles, studied by CT and/or MR and treated by direct surgical approach. The suspicion of a subependymoma should arise when a patient older than 10-15 years with long clinical history presents an intraventricular tumor isodense on CT and isointense in T1 and hyperintense in T2 on MR, with scarce or discrete contrast enhancement. Surgical treatment is indicated in symptomatic subependymomas of the lateral ventricles and usually allows complete tumor removal. The prognosis is usually good, also without postoperative irradiation.

Adolescent↗
PubMed1996

Endoscopic ventricular fenestration of intracranial fluid cysts.

The authors report 5 patients with paraventricular or intraventricular fluid cysts, successfully treated by fenestration into the ventricular system using a neuroendoscopic technique. The series includes three paraventricular malformative CSF cysts, a cyst of the velum interpositum and a cystic astrocytoma with small, deeply located and unresectable mural nodule. In all cases the endoscopic fenestration was the unique treatment and allowed to avoid the definitive ventriculoperitoneal shunt. The surgical endoscopic technique and the postoperative radiological findings which indirectly confirm the patency of the fenestration are discussed. The authors conclude that endoscopic ventricular fenestration represents the treatment of choice for most paraventricular and intraventricular CSF collections.

Adolescent↗
PubMed1996

Giant spinal cord ependymoma in a child. Case report.

Ependymomas of the spinal cord extending to more than ten vertebral segments are rare. A case of a 14-month-old child is described and the other 13 reported cases are reviewed. The finding of a very extensive tumor (from T5 to L5) after only 14 months of life suggests that in our case the tumor was present since birth. Magnetic resonance well shows the real extent of the tumor in height and its different components. Complete removal is often possible even in very extensive ependymomas and results in clinical improvement. Postoperative radiotherapy is necessary only for incompletely removed or malignant ependymomas.

Ependymoma↗
PubMed1995

Substitutive hormonal treatment in postmenopause.

The social impact of menopause is stressed by the actual life expectancy of women. One of the most important post-menopausal alterations--"osteoporosis"--is considered. Particular attention is focussed on therapeutical aspects.

Calcitonin↗
PubMed1993

Rapid growth of a brain-stem cavernous angioma.

A rare case of rapidly enlarging cavernous angiomas of the cerebral hemispheres and brain stem in a child is reported. Rapid growth of cavernous malformations of the brain is rarely observed; it may be due to different mechanisms, including enlargement of the vascular channels, hemorrhage and cysts formation. The possibility of progressive enlargement of cavernomas makes periodical MR studies necessary in all cases. When the growth is radiologically documented, surgical removal is imperative even in patients with trivial symptoms.

Brain Neoplasms↗
PubMed1990

Transient visual symptoms and carotid artery disease. Exploration by real-time B-mode echotomography.

The real-time B-mode echotomographies of 100 patients with transient visual symptoms have been reviewed and their findings have been compared with those of other 100 patients with transient ischemic attacks, who never had visual disturbances in their clinical history. The rate of pathologic echotomographies was higher in the group of patients with transient visual symptoms (72%), who also had a higher percentage (50% of the positive cases) of small or mild plaques without significant hemodynamic effects. The amaurosis fugax, particularly when associated with hemispheric ischemic symptoms, should suggest a carotid disease. The non-invasive exploration by real-time B-mode echotomography and Doppler with spectral analysis is the method of choice for the diagnosis of patients with transient visual symptoms.

Adult↗
PubMed1990

Familial cerebral cavernous angiomas.

Three families with two or more members affected by cavernous angiomas of the brain are described and the other 17 reported in the literature are reviewed. The familial occurrence of cerebral cavernous angiomas has been considered a rare event; nevertheless, the experience of the authors (positive familiarity in three patients where two or more relatives have been explored radiologically) suggests that cavernous angiomas of the brain might be, at least in most cases, a familial disease. Therefore, when a patient with cerebral cavernous angioma is observed, a careful familial history and the exploration of the familial members by computerized tomography or better still by magnetic resonance must be performed. The high frequency of multiple lesions in familial cases, the surgical indications and the role of the ultrasonic prenatal diagnosis are also discussed.

Adolescent↗
PubMed1990

Giant intracranial varix associated with venous angioma and intracerebral hemorrhage.

A rare case of giant cerebral varix with venous angioma and intracerebral hemorrhage, surgically treated with good outcome, is reported. Varices and venous angiomas are infrequent in the clinical practice and are usually asymptomatic. Giant venous varices are less rarely associated with vein of Galen aneurysms or high flow arteriovenous shunts, whereas isolated giant varices are exceptional. Association of varix and venous angioma has been reported only in three instances. The radiological diagnosis of the cerebral venous malformation is briefly discussed.

Adolescent↗
PubMed1989

Cerebral cavernous angiomas in the first year of life.

Two rare cases of cerebral cavernous angiomas in two infants, 9 and 6 months old, respectively, are reported and the other 11 cases in the literature concerning patients in the first year of life are reviewed. Cavernous angiomas of the brain occur rarely in the first year of life and present with seizures and head enlargement. On computed tomographic scan they typically appear as large, hyperdense, unenhanced masses, with large cysts and must be differentiated from tumors more common in infants, such as teratomas, ependymomas, and mixed tumors. Total removal is often possible, even with large lesions, because of the small amount of bleeding and the well-defined limits of the mass.

Brain Neoplasms↗
PubMed1989

Intracranial plasma cell granuloma.

An exceptional case of intracranial plasma cell granuloma, located in the right frontoparietal convexity in a 16-year-old boy is reported. Reports of these rare inflammatory lesions locate them primarily in the lungs and in other regions of the body, and only exceptionally in the nervous system; indeed, only three intracranial cases and one other arising from the spinal meninges have been reported. The computed tomographic and surgical aspects suggested a falx meningioma in our case. The pathological diagnosis differentiating these from other intracranial lesions with a plasma cell component, including meningioma with plasma cell infiltration and plasmacytoma, is discussed.

Adolescent↗
PubMed1989

Symptomatic meningeal diverticula of the sacral nerve roots in a girl. A case report.

The rare case of a 12-year-old girl with sciatic pain and bilateral meningeal diverticula of S1 and S2 nerve roots on both sides, is reported. Meningeal diverticula are a rare cause of sciatic pain and are exceptional in infants and children. Water-soluble myelography shows a rapid and complete opacification of the diverticulum, because of its large communication with the subarachnoid space; computerized tomography and magnetic resonance show an aspecific CSF collection, similar to all nerve root cysts. The complete removal of the cyst wall, with closure of its pedicle, results in the clinical remission in symptomatic cases.

Child↗
PubMed1989

Tumors of the neuron series presenting as cysts with mural nodules.

Two cases of tumors of the neuron series presenting as cysts with mural tumor nodules are described. This radiographic and surgical aspect may be observed in astrocytomas, meningiomas or ependymomas, whereas it is more rare for neuroblastomas and ganglioneuromas. There are not CT features which allow to differentiate cystic tumors of the neuron series from the other cystic tumors. The finding of cyst with enhancing mural tumor nodule and unenhanced wall is more favorable from a surgical point of view; the complete removal of the nodule with preservation of the reactive cyst wall results in the cure of patients with ganglioneuroma and ganglioglioma and in good long-term survival in those with cerebral neuroblastomas.

Adolescent↗
PubMed1988

Fibromuscular dysplasia of the carotid arteries. Clinical and radiological considerations.

Seven patients with fibromuscular dysplasia of the carotid arteries are described. Three were asymptomatic and four had ischemic troubles. Angiographically, 3 had a fibromuscular dysplasia of type 1 and 4 of type 2; one patient also had an associated aneurysm of the cervical internal carotid artery. The neurological troubles and their pathogenesis, the angiographic findings and the differential diagnosis of this angiopathy are briefly discussed; the surgical procedures and their risks are also analyzed.

Adolescent↗