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Biomedical subjects

M Savoiardo

Publications and source records attributed to M Savoiardo.

87 records · Page 5Linked to original sources
PubMed1978

Determination of cerebrospinal fluid shunt function with water-soluble contrast medium.

Determination of cerebrospinal fluid shunt patency with water-soluble contrast medium is a simple, rapid, reliable, and safe technique. Since September, 1974, the authors performed 113 examinations. With the Spitz-Holter valve, only the atrial catheter can be studied, but, with the Pudenz valve and with the shunting devices that have a double-dome reservoir, both the proximal and the distal catheter can be visualized. Through the ventricular catheter a full ventriculographic study can be made, demonstrating ventricular size, malposition of the catheter, and the lesion that caused the hydrocephalus, or its evolution. The problem of collapsed ventricules, in which clinical and "manual" evaluation of the flushing device can give misleading findings, is emphasized. The injection of the atrial or peritoneal catheter in the pathological cases demonstrated its blockage, level of disconnection, malposition, sleeve, or cyst formation. Computerized tomography has only slightly decreased the number of these studies: when the ventricles are large, the examination with water-soluble contrast medium is still needed to demonstrate the exact level of malfunction. This demonstration has decreased the number of the total revisions complete changes of shunting systems, eliminating some unnecessary changes of normally functioning catheters.

Adolescent↗
PubMed1976

Syringomyelia associated with postmeningitic spinal arachnoiditis. Filling of the syrinx through a communication with the subarachnoid space.

A patient is described who became paraplegic because of postmeningitic spinal arachnoiditis. Twelve years later, upper limb signs appeared. Syringomyelia of an unusal communicating type was demonstrated by air myelography: Air, introduced by lumbar route, filled syrinx up to the level of the first cervical vertebra, through a communication with the subarachnoid space at the thoracic level.

Adult↗
PubMedDate not supplied

Brain-stem auditory evoked potentials (BAEPs) and magnetic resonance imaging (MRI) in a case of facial myokymia.

The case of a 37-year-old woman with facial myokymia is reported. Magnetic resonance imaging (MRI), electromyography (EMG) and brain-stem auditory evoked potentials (BAEPs) supported the clinical diagnosis of suspected multiple sclerosis (MS). MRI showed a single area of abnormal signal in the pontine region. The authors discuss the possible relationship between the brain-stem lesion and the electrophysiological abnormalities demonstrated by BAEPs and the EMG of facial muscles.

Adult↗
PubMedDate not supplied

MR imaging in progressive supranuclear palsy and Shy-Drager syndrome.

Previous reports have suggested that putaminal hypointensity in T2-weighted images at high field strength (1.5 T) magnetic resonance (MR) is a common finding in atypical parkinsonian syndromes, including progressive supranuclear palsy (PSP) and Shy-Drager syndrome (SDS). We have reviewed nine patients with PSP and five with SDS, selected on strict clinical criteria. Only in one PSP patient was abnormal signal intensity (putaminal hypointensity more marked than pallidal) found. However, hypointensity was often marked in the substantia nigra and occasionally in the superior colliculi. Focal midbrain atrophy, involving particularly the upper part of the quadrigeminal plate, was obvious in five cases. In general there was no uniformity of findings and MR appears unable to consistently support the clinical diagnosis of PSP. In SDS patients the findings were more uniform, with hypointensity in the putamen, superior or equal to that of the pallidum. At low or intermediate field strength, there was absence of magnetic susceptibility effect in the putamen, which appeared hyperintense. This was probably because of increased water content due to gliosis and/or cell loss. The constancy of the MR findings in our SDS series suggests a supportive diagnostic role for MR imaging.

Aged↗
PubMedDate not supplied

Subacute cervical myelopathy in a child with cerebral palsy. Secondary to torsion dystonia?

A 12-year-old girl with a spastic dystonic tetraparesis due to cerebral palsy showed a subacute cervical myelopathy. X-ray films of the cervical spine demonstrated a subluxation of C4 on C5. Myelography and computerized tomography of the cervical spine performed under general anesthesia demonstrated only a minimal rotation of C3 with respect to C4 and a rather narrow cervical canal. In the reported case the most important factor in the spinal cord impairment was probably the anterior-slipping of the 4th cervical vertebra. The subluxation, secondary to torsion dystonia as demonstrated by its relief during general anesthesia, very likely caused a long-standing, although intermittent, spinal cord compression.

Cerebral Palsy↗
PubMedDate not supplied

Cerebral multiple glio-vascular dysplasias--a case report.

We describe the clinical and neuropathologic features of a patient complaining of increased intracranial pressure lasting over two years. Brain CT showed three cystic lesions in the supratentorial regions. Autopsy disclosed multiple small glio vascular abnormalities, in some instances connected with a cystic cavity. The lesions were scattered throughout the white matter of both cerebral hemispheres and suggested a complex dysplasia.

Biopsy↗
PubMedDate not supplied

The vascular territories in the cerebellum and brainstem: CT and MR study.

More than 100 CT and 15 MR studies of infarcts in the cerebellum and brainstem were reviewed to define the most typical distribution of infarcts in the different vascular territories. Posterior inferior cerebellar artery and anterior inferior cerebellar artery territories are variable in size and are in a sort of equilibrium with each other. The posterior inferior cerebellar artery territory in transverse sections reveals a characteristic posterior crescent caused by its cranial posterior extension. The anterior inferior cerebellar artery territory may be limited to the lateral inferior pontine and floccular regions but usually extends over the whole petrosal surface of the cerebellum up to the lateral angle. Superior cerebellar artery territory is the most extensive territory and includes the largest part of the deep white matter. Infarcts in a single-branch distribution, vermian or hemispheric, have a characteristic sagittal or oblique orientation. Watershed cerebellar infarcts can also be recognized. In the brainstem, paramedian, lateral, and dorsal penetrating arteries have characteristic distributions at the medullary, pontine, and mesencephalic levels. With MR, lateral medullary infarcts can be demonstrated. Paramedian penetrating arteries are paired, and symmetric and small infarcts at medullary and pontine levels are sharply delimited on the midline. At the mesencephalic level, infarcts in this distribution usually involve all the arteries originating from the tip of the basilar artery and from the precommunicating segment of the posterior cerebral arteries, resulting in a central mesencephalic infarct with bilateral upward extension in the thalami. The different vascular territories in the cerebellum and in the brainstem are illustrated in schematic drawings in transverse, coronal, and sagittal planes. Knowledge of the vascular territories gained by the multiplanar capabilities of MR, and knowledge of the CT patterns of enhancement and evolution, will improve recognition and definition of infarcts.

Brain Stem↗
PubMedDate not supplied

Computed tomography of olivopontocerebellar degeneration.

Computed tomographic (CT) studies of 17 cases of olivopontocerebellar degeneration are reported. In all cases, atrophy of brainstem and cerebellum was found. Atrophy of the cerebellar hemispheres was equal to, or more marked than, atrophy of the vermis. Dilatation of lateral ventricles and cerebral sulci was often present. These findings, which are in agreement with the pathologic data, are compared with those reported in other cerebellar atrophic processes. Knowledge of the distribution of the atrophic changes is essential in attempting a differential diagnosis among the degenerative diseases involving the posterior fossa nervous structures.

Adolescent↗
PubMedDate not supplied

Cavernous hemangiomas of the orbit: value of CT, angiography, and phlebography.

Neuroradiologic studies performed in 18 cases of surgically verified intraorbital cavernous hemangioma are reported. Skull films usually showed enlargement of the orbit and evidence of soft-tissue mass. Phlebography rarely demonstrated filling of the cavernous hemangioma or enlarged draining veins. On angiography, in addition to displacement of vessels, pooling of contrast medium in the cavities of the hemangioma was observed in more than half the cases. Computed tomography (CT) demonstrated a rounded, hyperdense, enhancing lesion usually in the superior segment of the intraconal space. Although CT may be sufficient for planning the surgical approach, in most cases a combination of CT and angiography will give better, more specific preoperative diagnosis.

Adolescent↗
PubMedDate not supplied

Intracranial cavernous hemangiomas: neuroradiologic review of 36 operated cases.

Neuroradiologic studies in 36 cases of histologically verified intracranial cavernous hemangiomas were reviewed. Radionuclide brain scans were positive in 17 of 19 examinations. Angiography, performed in 35 cases, usually showed an avascular area with absent or moderate mass effect. Capillary blush and/or early draining veins, often mentioned in single case reports, were observed in only seven cases. Computed tomography (18 cases) usually demonstrated a hyperdense, nodular, or irregular lesion without significant mass effect and always enhancing after contrast injection. The combination of a long clinical history of focal epilepsy with computed tomographic and angiographic findings should suggest the diagnosis of cavernous hemangioma. In all cases of so-called spontaneous hematoma with negative angiography, computed tomography should be repeated after a long interval to exclude the presence of a cavernous hemangioma or other cryptic vascular malformation.

Adolescent↗
PubMedDate not supplied

Hallervorden-Spatz disease: MR and pathologic findings.

PURPOSE: To compare the MR findings of eight cases with clinical diagnosis of Hallervorden-Spatz disease (HSD) with the pathologic findings of two other cases of HSD. MATERIALS AND METHODS: The eight imaged cases were studied with 0.5-T (seven cases) and/or 1.5-T (five cases) units. Six patients also had CT scans. The two other cases with proven HSD had detailed histologic evaluation. RESULTS: The 1.5-T findings showed abnormalities confined to the pallidum, which presented a diffuse low signal intensity in T2-weighted images, and an anteromedial area of high signal intensity (eye-of-the-tiger sign). In 0.5-T studies, low signal intensity was less evident and poorly detectable in spin echo, but gradient-echo images could enhance its demonstration; the area of high signal intensity was always well demonstrated. In three cases (three with 1.5 T, one with 0.5 T) a central spot of low signal intensity was seen in this area. The pathologic cases, in addition to neuroaxonal swellings and iron deposits, exhibited areas of "loose" tissue with vacuolization and lesser amounts of iron in the anteromedial part of the pallidum, in a location corresponding to the area of high signal intensity of the imaged cases. CONCLUSION: Comparison of MR findings with the pathologic studies demonstrates that the low signal intensity in T2-weighted images at 1.5 T corresponds to iron deposits in a dense tissue, and that the high signal intensity of the eye-of-the-tiger sign corresponds to an area of loose tissue with vacuolization. No correlation was found in the two pathologic cases for the central spot of low signal intensity.

Adolescent↗
PubMedDate not supplied

Superficial siderosis of the CNS: MR diagnosis and clinical findings.

PURPOSE: To report the clinical and neuroradiologic findings of superficial siderosis of the CNS, due to chronic subarachnoid bleeding of unknown origin. MATERIALS AND METHODS: We observed seven cases. The main clinical manifestations were progressive deafness and ataxia. Four patients had had previous cranial or cervical trauma, with root avulsion in two, many years before onset of deafness and ataxia. Neuroradiologic studies included MR (0.5 T in four and 1.5 T in three) and angiography of the brain in all cases, CT in six cases, MR of the spine in six, and myelography in four. RESULTS: MR demonstrated a rim of marked hypointensity in T2-weighted images, consistent with hemosiderin deposits, on the surface of cerebellum, brain stem, inferior part of cerebral hemispheres, and spinal cord. CT showed cerebellar atrophy in five cases, and a rim of mild hyperdensity around the brain stem in two. Angiographic studies were negative. Myelography showed cervical nerve root avulsion in two cases and a cervicodorsal extradural cyst in one. Cerebrospinal fluid contained RBCs in all the six examined cases. CONCLUSION: Although CT may occasionally suggest the diagnosis of superficial siderosis, MR demonstrates this abnormality to better advantage.

Adult↗