Biomedical subjects
Publications and source records attributed to M Salvati.
Benign osteoblastoma is a rare tumour of bone with a predilection for the spinal column and appendicular skeleton. The skull is an unusual site. We report a case in which the lesion affected the lesser wing of the sphenoid bone and extended from the middle cranial fossa to the orbital region. We discuss the distinguishing features of the tumour, reviewing the literature, and the treatment.
We report the outcome of a retrospective study on the frequency of pulmonary embolism during the hospital stay in a series of 7,250 neurosurgical patients. Of 4,500 patients who underwent surgery 25 (0.55%) developed pulmonary embolism at some point after the operation while 5 of the 2,750 patients not operated on (0.18%) developed a fatal pulmonary embolism. We analyze the general risk factors--age, sex, length of stay and paralysis of the limbs. Meningioma was the most frequent intracranial tumor to be affected by this complication. We discuss the connection between thromboembolism and meningioma.
Intramedullary glioblastomas are uncommon tumors. They occur chiefly in the cervicothoracic segments, have a slight tendency to occur in the early decades of life, and have a short clinical history before diagnosis. We report seven cases and discuss the salient features of these tumors, particularly the pathological features and treatment, in light of the relevant literature.
Actinomycosis is a bacterial infection that affects chiefly the cervico-oro-facial area, the abdomen and lungs. From these sites it may sometimes spread to the central nervous system. Extremely rare, and controversial, is the possibility of a primary infection of the central nervous system. We report an odd case of apparently primary brain abscess caused by Actinomyces israeli and review the literature.
We report a series of 12 cases of isolated lesions of the axillary nerve treated surgically. We discuss the pathogenesis, clinical pattern, and surgical treatment of this lesion together with the results obtained.
Intradiploic epidermoid cysts, fairly uncommon lesions in neurosurgical practice, are, as a rule, benign and slow-growing. Some attain great size, producing major neurological signs. Correct radiological assessment and complete removal of the tumour and its capsule are essential for adequate surgical treatment and good long-term prognosis. We report ten cases of intradiploic epidermoid cysts of the skull, three of which were giant lesions and one malignant, and analyze the clinicopathological and radiological features and treatment of these lesions in the light of the most important published data.
Five new cases of vertebral hemangioma with cord compression are reported. The role of preoperative selective angiography with embolization in the management of these lesions is discussed in the light of the most important literature on this topic.
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Giant cell reparative granuloma is an infrequent nontumoral lesion affecting particularly the maxillary and mandibular bones and only rarely the cranial bones. The etiopathogenesis is still controversial and differential diagnosis, especially from giant cell tumors of bone, is arduous. We report a case of giant cell reparative granuloma of the middle cranial fossa which behaved like an intracranial tumor and which we followed up for 15 years. We discuss the relevant literature and describe the essential features of this controversial lesion.
A case of meningioma induced by high-dose radiation therapy (40 Gy) is reported. The radiation had been given 11 years previously following operation for cerebral astrocytoma. Pertinent cases of benign meningioma occurring after radiation therapy are reviewed and analyzed.
We present 20 cases of primary intracranial lymphoma and review the most important published series on this subject. The clinical patterns and the differential diagnosis from other intracranial space-occupying lesions on the CT and angiographic evidence are discussed. Surgical treatment was given in 19 of our cases, followed in 17 cases by radiotherapy and in 4 by chemotherapy. One patient was treated by a ventriculo-peritoneal shunt. The effectiveness of the various modalities of treatment is discussed in the light of survival.
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.
Adult-onset tethered cord syndrome is uncommon. To date some 90 cases have been reported. We add three personal cases, review the principal features of the syndrome in adults and underline the chief differences between it and the more frequent childhood syndrome.
We report the results of surgical treatment in 13 patients operated on for compression of the spinal cord secondary to kyphosis or kyphoscoliosis between 1977 and 1985. In every case, an anterior decompression of the cord by transthoracic or thoracoabdominal route was followed in the same operation by anterior stabilization. Posterior fusion with Harrington's instrumentation was performed 15-20 days later. Neurological recovery was complete in 8 patients (61.5%) and partial in 4 (30.7%), while 1 patient died (7.6%). We review the relevant published work.
Vertebral hydatidosis is a rare localization of echinococcosis. In fact, its incidence is less than 1% of the cases in the literature. The authors report a personal observation and describe main features of the disease.
Spontaneous cerebellar haemorrhage is very rare in children and is often associated with blood diseases such as haemophilia A or acute lymphatic leukaemia. During 1995, two paediatric patients with spontaneous cerebellar haemorrhage underwent surgical treatment in the Neurotraumatology Division of "La Sapienza" University hospital in Rome. The authors discuss this unusual pathology with particular regard to the age of the patients described.
AIMS AND BACKGROUND: Although systemic metastases from thyroid cancer are relatively frequent, they rarely affect the nervous system and only exceptionally originate from well-differentiated carcinoma. METHODS: The authors describe 6 cases of solitary brain metastases from thyroid carcinoma, well-differentiated in 3 cases and anaplastic in the other 3 cases. RESULTS: Four patients were females and 2 males (M:F ratio, 1:2); average age was 51 yrs (range 48-56). On average, the interval between diagnosis of the thyroid tumor and appearance of the metastasis was 2.8 years (range 1-12 years) and was shorter in the anaplastic forms (1.2 versus 4.4 years). Average survival was 15 months (range 6-48 months); in particular, average survival was longer in patients with well-differentiated carcinoma (9 vs 21 months) as also in those who did not present other metastatic sites (6 vs 24 months). Death was due to systemic progression of the disease in 4 cases and to brain-relapse in the other 2 cases. CONCLUSIONS: Surgery, radioactive iodine (where uptake is demonstrable), and radiotherapy are the main therapies available for metastases from thyroid carcinoma. However, survival of patients appears to be modified by the type of treatment performed.
Nine patients with diagnosed breast cancer who developed meningiomas are reported. Articles suggesting that an association of these two tumors is possible. Some authors have noted hormonal sensitivity and the presence of hormonal receptors in some meningiomas. Since breast cancer is the most common tumor in women, an association between it and meningiomas might be fortuitous. However, it is important to fully investigate brain lesions in patients with breast cancer so that potentially curable meningiomas are not considered as metastases.