Leukocytoclastic vasculitis in a patient with HHV-6 infection.
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Biomedical subjects
Publications and source records attributed to P Rampini.
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The authors present the results of a long-term follow up of 52 juvenile head-injured patients who showed early epileptic seizures. The purpose of this study is to stress the role of long-term prognosis in the early seizures and to determine in which cases a treatment preventing late seizures is eligible. They consider long-term prognosis as to be favourable. Late epilepsy occurred in 15.3% of the cases and responded favourably to anticonvulsive therapy. They suggest prophylaptic treatment in those patients who had loss of consciousness immediately after trauma, recurring seizures, coma and/or surgery.
Twenty-three consecutive cases of traumatic C1-C2 fractures treated at the Department of Neurosurgery, University of Milano, are reported. Of these there were 13 cases of odontoid fractures, 6 hangman fractures, 2 anterior inferior corner fractures, 2 atlas-axis combination fractures and 2 Jefferson fractures. Almost all the patients were young people involved in motor vehicle accidents. Nineteen patients were treated with external immobilization (halo vest, Minerva) for 3-6 months while 4 odontoid fractures underwent early surgical posterior stabilization. At follow-up, 20 patients had a good fusion while 3, aged over 75 years, died due to cardiopulmonary or septic complications. The appropriate management of this type of lesion is still a matter of discussion. In our opinion the Halo device allows good stabilization after correct fracture reduction.
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A case of median nerve entrapment at the elbow between the supracondyloid process and the anomalous origin of the pronator teres on it is presented. The anatomical variant and the histological background of this syndrome are outlined. The pathophysiology of the neuralgia is discussed. A relatively simple surgical procedure afforded complete relief of symptoms.
Thirty-six patients with SAH were submitted to continuous ICP monitoring: in 33 cases a continuous ventricular fluid pressure recording was performed in acute stage. According to Hunt and Hess, 2 patients were graded I, one II, one III, 13 IV and 16 V. In the remaining 3 cases who developed a normal pressure hydrocephalus 15, 20 and 40 days from bleeding an extradural miniaturized transducer was applied. B and C waves were common findings in acutely recorded patients. Typical A waves accompanied base line recordings in patients with NPH. From analysis of data the authors evidenced that elevated ICP values have been registered not only in patients graded as III, IV and V but also in those graded I and II: as 89% of patients belong to grades IV and V it was impossible to correlate clinical status with ICP. In patients with spasm it was never noted ICP values higher than 20 mmHg during recording time (from 60 hours to 10 days). In order to reduce intracranial hypertension CSF drainage was performed in 33 patients acutely registered. In patients graded I and II this procedure was followed by an ICP reduction and an improvement of the clinical status. In none of the patients graded IV and V in spite of pressure maintained at 10 mmHg, CSF drainage affected clinical evolution.