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Biomedical subjects

P A Donati

Publications and source records attributed to P A Donati.

15 recordsLinked to original sources
PubMed1999

Endoscopic surgery for monoventricular hydrocephalus.

BACKGROUND: Monoventricular hydrocephalus is usually treated with extrathecal shunting. However, today endoscopic fenestration of the septum pellucidum seems to be a very useful and less invasive technique. METHODS: Five patients with monoventricular hydrocephalus have been treated with neuroendoscopic techniques. In three cases with an excluded lateral ventricle due to contralateral shunt overdrainage, the normal-sized ventricle was first cannulated and fenestration of the septum pellucidum from the normal to the enlarged lateral ventricle was performed. RESULTS: Complete remission of intracranial hypertension symptoms and decrease in size of the enlarged ventricle were observed in all five patients. CONCLUSIONS: Endoscopic fenestration of the septum pellucidum is the technique of choice for treating monoventricular hydrocephalus. We advise first cannulating the normal lateral ventricle and then performing a septostomy from it to the enlarged ventricle. This approach allows one to easily recognize the protruding septum pellucidum and perform fenestration without difficulty using a direct trajectory. In exceptional cases of choroid plexus cyst obstructing one foramen of Monro, fenestration of the cyst wall is sufficient.

Adolescent↗
PubMed1999

Chronic hydrocephalus and suprasellar arachnoid cyst presenting with rhinorrhea.

Spontaneous CSF leak with rhinorrhea may be secondary to many intracranial congenital and acquired conditions. However, no cases of chronic hydrocephalus and suprasellar arachnoid cyst presenting with rhinorrhea as the unique clinical manifestation are reported in the literature. A 29-year-old-man with four-month history of episodic rhinorrhea had a large suprasellar arachnoid cyst with chronic hydrocephalus on magnetic resonance. Endoscopic ventricular fenestration of the cyst failed to obtain remission of the CSF leak, because it was not possible to fenestrate the cyst with the almost completely obliterated suprasellar cistern. Clinical remission occurred after restoration of the CSF flow from the cyst to the cisternal spaces by a direct approach. The CSF leak in this case was secondary to the chronic compression over the dural and bone structures of the sellar region by the cyst or chronic hydrocephalus.

Adult↗
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↗
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↗
PubMed1987

[Clinical evaluation of aztreonam in the prevention and therapy of infections in patients subjected to neurosurgical intervention].

Twenty-six neurosurgery patients were given prophylactic treatment with Aztreonam at a dose of 1 g every 8 hours (30 mg/kg every 12 hours in children) for 8-12 days after the operation. In 18 cases 300 mg Clindamycin was also given every 8 hours for 8 days. No local or general infections arose in the postoperative period. Three patients with infections caused by susceptible bacteria were given 1 g Aztreonam every 6 hours (30 mg/kg every 8 hours in children) for 8 days. In all cases all clinical and microbiological signs of the infection had disappeared by the end of treatment. Apart from one episode of mild nausea no side effects were noted. Aztreonam is therefore considered a safe and effective drug for the treatment and prophylaxis of postoperative infections in neurosurgery.

Adult↗
PubMed1987

Laparoscopy in the diagnosis and treatment of an unusual complication of ventriculo-peritoneal shunt.

A significant number of abdominal complications of ventriculoperitoneal shunts have been reported. Laparoscopy has proved to be extremely useful in the diagnosis and treatment of a number of these cases. A rare case of abdominal wall perforation is described. At laparoscopy the route taken by the catheter was detected, and the latter freed from adhesions and repositioned in the peritoneal cavity, with optimal functional results.

Abdominal Muscles↗
PubMed1987

[Experimental giant arterial aneurysm. Resection and reconstruction of the arterial wall].

The authors describe 3 experimental techniques for the treatment of giant arterial aneurysm, based on removal of the aneurysmal pouch and reconstruction of the arterial wall. The aneurysm is realized with a venous graft implanted with end-to-side anastomosis on the common carotid artery on the rabbit. In the first experimental model it is resected along its basis; the arterial wall is reconstructed by means of a patch of dural substitute (dacron coated with silicone rubber) fixed with biological glue (human fibrine). In the second model, the experimental aneurysm is hooded with a venous graft sutured to the adventitia of the artery with four angular stitches and biological glue. The artery is then clamped, the aneurysm is resected along its basis. The median incision in the venous graft is sutured, restoring the continuity of the arterial wall. In the third model, a small artery is implanted at the bottom of the aneurysmal sac, realizing a condition similar to a collateral vessel arising from an aneurysm. In this case, too, the aneurysm is hooded by a venous graft fixed only to the adventitia of the arterial wall with the above mentioned technique. The main and the collateral vessels are clamped, and this latter is severed; the aneurysm is resected along its basis; the median incision in the venous graft is sutured, restoring the continuity of the arterial wall; the collateral vessel is re-implanted along the suture line. These techniques aim to realize the reconstruction of the arterial wall without stenosis and shortening the clamping time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗