Biomedical subjects
Publications and source records attributed to P Dettori.
A case of a 64-year-old man with stenosis of the lumbar canal and symptoms of compression of the cauda equina is described. This symptomatology increased after walking and was associated with spontaneous priapism. All symptoms were relieved after surgical decompression.
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In the authors' technique, the stereotactically localized target is fixed to the isocenter of a 4 MV linear accelerator. The irradiation is carried out along 9-17 non-coplanar arcs distributed on a 160 degrees cylindrical sector. High doses (10-50 Gy) are delivered in one or two sessions. From 1982, 65 patients have been treated (shortest follow-up 6 months). The dose was chosen according to the pathology and to the volume of the lesion. Good clinical results have been obtained in low-grade gliomas, acoustic neuromas, arteriovenous malformations, and other selected types of intracranial lesions. Therapeutic effects in terms of clinical condition and size of the lesions have been plotted in relation to time elapsed and dose employed.
Computerized cranial tomography was performed in 14 patients affected with hepatolenticular degeneration (4 presymptomatic and 10 with a hepatic form). 1 case showed brain stem atrophy with atypically located hypodense areas and another subject showed frontal atrophy with prevalence to the right side. The abnormalities found in another 7 cases were slight. In 5 patients, CT was normal.
A review of immediate and delayed side effects noted in a consecutive series of 1,138 myelograms made with Iopamidol in the Services of Neuroradiology of various hospitals and university clinics at Pavia, Perugia, Vicenza, and Parma (all in Italy). The contrast was administered by lumbar spinal route at iodine concentrations of 200, 300 and 370 mg/ml, in amounts varying from 5 to 20 ml depending on segments being examined and extant clinical indications. The incidence and characteristics of complications (headache, nausea, vomiting, evidence of radicular irritation, etc.) were assessed in relation to examination technics, segments of spine being explored, iodine concentrations, and amounts of contrast injected.
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CT studies were made on 38 patients receiving different dialytic treatment, 10 patients with chronic renal failure not yet dialyzed, and 15 healthy subjects. No morphological modifications were observed. On the contrary, significant changes of density were demonstrated after a dialysis session in the population treated intermittently. In these patients the density values were similar to those registered in the controls 1-6 h after a dialysis session. End stage renal failure and CAPD patients always had normal density values. Therefore cerebral density changes are caused only by the intermittent dialytic treatment.
30 patients on hemodialysis or peritoneal dialysis have been investigated by computerized tomographic (CT) scan. To evaluate possible cerebral alterations induced by dialysis, CT examinations were carried out before, immediately after and 6 h after the end of dialysis with an Evaluskop, which provides an objective precise evaluation of even slight variations in brain density. No morphological variations were noted after dialysis, while the brain density fell significantly during and after the treatment. A decrease in density was not observed in normal subjects or in patients on continuous peritoneal dialysis. The changes in the densitometric values of brain tissue suggest that there is a postdialysis gain in cerebral water linked to the intermittent treatment. CT may represent a simple reliable method for studying uremic encephalopathy and investigating the pathogenesis of the dialysis disequilibrium syndrome.
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