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Biomedical subjects

M Salvati

Publications and source records attributed to M Salvati.

141 records · Page 8Linked to original sources
PubMedDate not supplied

Intramedullary teratoma: case report and review of the literature.

AIMS AND BACKGROUND: Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed. METHODS: The authors present a personal case with some unusual aspects. RESULTS: Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.

Adult↗
PubMedDate not supplied

Carcinoma of the prostate: brain stem metastasis as the only site of spread.

AIMS AND BACKGROUND: Metastasis to the brain from prostate carcinoma is a rare event; it is reported in less than 4% of postmortem examinations. The prevalence of cases detected antemortem is even smaller, and the prevalence of brain stem metastasis as the only site of metastasis has been reported in only two other cases. METHOD: The authors present a third such case. RESULTS: A 55-year-old man, treated for an adenocarcinoma of the prostate (prostatectomy and radiotherapy), started to complain of facial expression disturbances and headaches 2 years later. Physical examination showed a left VII cranial nerve palsy. MRI showed an enhancing mass in the pons. Total body CT was negative. The patient was treated with a course of whole-brain and brain stem radiotherapy following stereotactic biopsy. Four months after radiotherapy, the neurological symptoms had disappeared and the patient died of a myocardial infarct. The systemic disease was still clinically silent. CONCLUSION: Our case involved only brain stem metastasis, probably implicating Batson's direct route of the paravertebral venous pathway.

Adenocarcinoma↗
PubMedDate not supplied

Symptomatic cervicogenic headache.

Cervicogenic headache is a little-known clinical condition whose true importance has only recently been recognized. A number of causes may lie at the basis of the onset of headache (symptomatic cervicogenic headache). However, despite exhaustive attempts, sometimes it is not possible to identify a clear cause responsible for the onset of the syndrome (primitive cervicogenic headache). The genesis of symptomatic cervicogenic headaches sometimes may be easy to identify as a result of a close, pre-existing, cause-effect relationship (i.e. trauma). On other occasions it may be much more laborious to pinpoint the pathology responsible for headache (some cranio-cervical anomalies, etc.). Clinically, it is necessary to perform a thorough preliminary clinical and anamnestic evaluation which can orient subsequent investigations to achieve a diagnosis in the least time possible with the minimum discomfort to the patient and his relatives, not to mention lower costs for society.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Temozolomide in radio-chemotherapy combined treatment for newly-diagnosed glioblastoma multiforme: phase II clinical trial.

BACKGROUND: Continuous research into new strategies and chemotherapy agents for the treatment of malignant high-grade gliomas have led to the synthesis of a new chemotherapy drug, temozolomide (TMZ), with a lower toxicity profile compared to conventional chemotherapy agents, such as nitrosoureas. Temozolomide is an oral alkylating chemotherapy agent licensed for the treatment of recurrent high-grade gliomas, anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM). Because of its favorable pharmacokinetic and pharmacodynamic properties and improved tolerability, TMZ is now under investigation for concomitant use with radiotherapy in patients with newly-diagnosed GBM. We present a phase II clinical trial investigating the efficacy and safety of radio-chemotherapy combined treatment using TMZ, followed by six cycles of adjuvant chemotherapy with TMZ, in patients with newly-diagnosed GBM who have undergone debulking surgery or biopsy only. PATIENTS AND METHODS: Twenty-one patients with newly histologically-diagnosed GBM were enrolled into this phase II clinical trial. In phase I of the study, TMZ (75 mg/m2/day per 7 days/wk for 6 weeks) was orally administered to patients concomitantly with radiotherapy (RT) (2 Gy per fraction once daily, per 5 days/wk for 6 weeks). In phase II of the study, four weeks after completion of RT, a monochemotherapy using TMZ was administered at the dosage of 200 mg/m2/day per 5 days every 28 days for 6 cycles. Primary end-points were the safety and tolerability profile of this two-phase combined treatment and secondary end-points were the objective response and survival rates at twelve months and eighteen months from study entry. RESULTS: The one-year survival rate of patients treated with the investigated multimodality treatment was 58% and median survival time was 15.7 months. Concomitant RT plus TMZ (phase I) followed by adjuvant TMZ (phase 2) were well-tolerated; indeed, nonhematological adverse events were rare and mild to moderate in severity; grade 3 and 4 neutropenia and thrombocytopenia were the major-related hematological side-effects observed in only 2 and 3 of all patients in phase I and 4 patients in phase II. We found that the combination of radio- and chemo-therapy, in phase I of the study did not significantly increase the incidence and severity of hematological toxicity caused by the adjuvant TMZ-based chemotherapy administered in phase II of the study. CONCLUSION: The investigated multimodality treatment regimen was well-tolerated and prolonged survival while improving patients' quality of life.

Adult↗
PubMedDate not supplied

Interhemispheric subdural hematoma (ISH). Case report.

Interhemispheric subdural hematoma (ISH) is a rare form of post-traumatic intracranial hemorrhage. The Authors report a further case and review the relevant literature. ISH most frequently gives a clinical picture corresponding to the falx syndrome. The possibility of an interhemispheric hematoma evolving into a chronic subdural hematoma of the convexity is considered together with both surgical and medical therapeutic indications.

Accidental Falls↗
PubMedDate not supplied

[Heart disorders secondary to cerebral ischemic infarct. A clinical study of 20 patients and diagnostico-therapeutic considerations].

The role of heart disorders in the onset of stroke has been examined in depth, but scarce attention has been paid to the relationship between cerebral ischemic stroke and subsequent heart disorders. The paper reports the results of a study of this relationship. The present state of knowledge is outlined together with the possible risk factors which might be useful in constructing a suitable therapeutic-prophylactic protocol to reduce the cardiological risks of "acute" neurosurgical treatment.

Brain Ischemia↗
PubMedDate not supplied

[Differential diagnosis of multiple gliomas, multicentric gliomas and the other main endocranial multifocal lesions. Presentation of a case].

Multifocal gliomas represent an uncommon lesion, particularly if the supra-tentorial and infra-tentorial spaces are involved. The Authors describe a particular case and they outline the main differences between multiple gliomas and multicentric gliomas. Then, they consider the various possibilities of diagnosis and differential diagnosis of multiple endocranial lesions.

Brain Neoplasms↗
PubMedDate not supplied

[Familial cerebral aneurysms: case report and review of the literature].

Familial occurrence of cerebral aneurysms is rare. About 80 families affected by these lesions have been reported in the international literature to date. The authors describe three members of a family presenting intracranial aneurysms without other congenital associated anomalies. Clinico-pathological features, with regard to the possibility of an early and a more effective diagnostic and therapeutic approach, are presented and discussed in the light of the available literature on this topic.

Carotid Arteries↗
PubMedDate not supplied

[Multicentric glioma: presentation of a case].

A case of multiformis glioblastoma with a parieto-temporal and brainstem localization is presented. Multicentric gliomas are unfrequently reported in the literature, and very often rise diagnostic problems with other multiple lesions of the Central Nervous System, either of neoplastic nature or not. After briefly reviewing the pathogenetic hypothesis concerning this lesion, indication and limits of clinical and radiological investigations are discussed.

Adult↗
PubMedDate not supplied

Gliomas of the conus medullaris.

AIMS AND BACKGROUND: Gliomas of the conus medullaris often show characteristic clinical, radiological, and intraoperative features which differ from gliomas involving other parts of the spinal cord. METHODS: Eight patients with histologically verified gliomas of the conus medullaris were diagnosed and studied. RESULTS: There were five men and three women ranging in age from 21 to 59 years. Predominant initial symptoms were back pain (4 cases) and leg weakness (4 cases). The most common findings on admission were flaccid paraparesis with impaired sensation and bladder dysfunction. Postoperative magnetic resonance (MR) images with more than 95% removal of a tumour were defined as "subtotal removal" (noted in 4 of 8 cases), and less than 95% as "partial removal" (4 of 8 cases). All patients had postoperative radiotherapy. During the follow-up period ranging from 3 to 10 years, there was no tumour recurrence or regrowth on MR images. CONCLUSIONS: The postoperative radiotherapy in gliomas of the conus medullaris where total resection is not possible seems provide a beneficial effect on preventing tumour regrowth.

Adult↗
PubMedDate not supplied

Occult dysraphism in adulthood. A series of 24 cases.

The results of a retrospective study of 24 adult patients with occult dysraphism are described. There were 15 males and 9 females, with an average age of 31.1 years. Specific circumstances precipitated symptomatic onset in 67% of patients. Pain, often referred to the anorectal region, was the most common presenting symptom. Bladder and bowel dysfunction were also common findings. The most common tethering lesions were intradural lipoma and a short thickened filum terminale. Myelography revealed the diagnosis of tethered conus in most cases, but the addition of CT and MRI images provided valuable structural details. The surgical outcome was gratifying in relation to pain and sensory-motor deficits but disappointing in the resolution of sphincter disorders. Our conclusion is that symptoms and/or signs of TCS with onset in adult life are not invariably irreversible.

Adult↗