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R D'Avanzo

Publications and source records attributed to R D'Avanzo.

11 recordsLinked to original sources
PubMed1998

[The recrudescence of spondylodiscitis due to migratory flows. The role of magnetic resonance as a method of first instance in diagnosis and follow-up].

PURPOSE: We report 15 cases of spondylodiscitis due to infective processes of different etiology and stress the role of MRI in the diagnosis and follow-up of this condition, whose high epidemiologic recrudescence is probably related to an increased westward migratory flow. PATIENT AND METHODS: February through December, 1996, fifteen patients with acute spinal pain were submitted to MRI (1.0 T superconductive magnet, Magnetom SP42E, Siemens, Erlangen, Germany). In all cases both the painful spinal tract and the rest of the spine were studied to detect any infiltrative processes elsewhere in the spine. All patients underwent MR follow-up, according to the evolution of subjective symptoms, until complete recovery of the infections. RESULTS: MRI always permitted the correct diagnosis to be made and the correct evaluation of infection evolution, allowing adequate (medical and/or surgical) treatment to be carried out in the early stage of infections. DISCUSSION: MRI can be considered the best diagnostic tool study osteomedullary inflammations and, particularly, to diagnose and follow-up spondylodiscitis. This technique permits clear differentiation between the different evolution stages of the infections, as well as the evaluation of bone, disks, epidural spaces and spinal cord involvement. Moreover the MR findings permit adequate treatment choices, which results in much fewer complications and therefore better prognosis. CONCLUSIONS: The role of MRI in the diagnosis and follow-up of spondylodiscitis has been fully discussed in the literature. Our report is aimed at stressing the important role of MRI as the technique of choice for the diagnosis of suspected spondylodiscitis, especially considering the high recrudescence of this condition in Western populations which is probably related to increased westward migrations.

Adolescent↗
PubMed1993

Transient "cerebellar" mutism in lesions of the mesencephalic-cerebellar region.

Four patients aged from 20 to 48 years with transient mutism are presented: 3 patients underwent surgery for midline tumours of the mesencephalic-cerebellar region (medulloblastoma in two cases and pinealoblastoma in one), at times attached to one or both lateral recesses of the IV ventricle. One patient was hospitalized and treated for brain-stem ischemia. All patients developed mutism 48 to 72 hours after surgery; in the patient with brain-stem softening mutism appeared 72 hours after admission. All the patients had unimpaired consciousness and no deficits of lower cranial nerves. Speech, always normal in the first hours after surgery, was regained after a period of 6-16 weeks. Various hypotheses for this speech disorder are analyzed.

Adult↗
PubMed1992

[Hypertensive pneumocephalus, postoperative complication of chronic subdural hematomas].

The authors report 3 cases of subdural tension pneumocephalus developed after surgery for subdural chronic hematomas. The mechanisms involved in the pathogenesis of this complication are discussed; the importance of the computed tomography in the assessment of the subdural tension pneumocephalus is stressed. Surgery is always indicated in cases of increased tension of the air collection and generally resolves the neurological deficits.

Aged↗
PubMed1992

[Postoperative lumbar discitis].

The authors report our experience on 19 cases of discitis developed after operations for herniated lumbar disc. Because of the negativity of the neuroradiological studies in the acute stage, the recognition of the typical syndrome (severe back pain, spasm of the paravertebral lumbar muscles, limited spinal motility, fever) beginning 3-30 days post-operatively and the study of some laboratory tests (elevated Erythrocyte sedimentation rate (ESR) and midly to moderately elevated white blood cells (WBC) are very important for diagnosis. The first radiographic findings (disc space narrowing, ecc.) are detectable only 4 to 6 weeks after the first symptoms; other X-ray findings are not seen post-operatively before 6 months-2 years. The CT-scan is diagnostic of discitis only when the following three specific signs are present: a) anterior paravertebral soft tissue swelling with obliteration of paravertebral fat planes; b) fragmentation or erosion of vertebral end plates; c) paravertebral fluid collection (abscess). In our experience a period of immobilization of the spine with a plaster body jackets and the use of adequate antibiotic therapy are the more effective treatment. Undoubtedly the discits are the results of an infection that must be prevented adhering to the aseptic principles not only during surgery but also during the procedures performed in the radiology suite.

Adult↗
PubMed1985

Surgical management of acute cerebellar infarction.

After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. For therapy the following policy is suggested: in alert and clinically stable patients: medical treatment (mannitol, glycerol, dexamethason), ICP and serial CT monitoring; in alert patients with hydrocephalus or mass effect: medical treatment and monitoring as mentioned before; ventricular drainage if ICP surpasses 350 mm H2O; in patients with impaired consciousness and hydrocephalus or mass effect: immediate ventricular drainage. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.

Adult↗
PubMed1981

Pontine hematomas.

Pontine hematomas are very rare lesions that in the past were found at postmortem examination rather than diagnosed from the clinical presentation. The advent of computed tomography allowed more frequent identification of those lesions which has shown a more favorable prognosis than formerly thought. Three patients suffering from intrapontine hematomas, revealed by computed tomography, are discussed. The etiopathogenesis, location, and clinical features of this lesion are discussed in an attempt to establish general criteria from adequate management. All 3 patients (2 treated conservatively and 1 by surgical evacuation) had a successful outcome. Repeat CT scans gave evidence of resolution of this lesion in all patients.

Adult↗
PubMedDate not supplied

Cavernous angioma does not exist?

12 cases of cerebral "venous angioma" are reported; pathological, clinical and radiological features of the lesion are reviewed. "Venous angioma" should be regarded as a developmental anatomic variation of the venous drainage system of the white matter. Its clinical significance is controversial, although it has been reported to cause hemorrhage, seizures, progressive neurological deficits, headaches. The clinical presentation of our patients was variable and, in some of them, dependent also on associated lesions. An hematoma was found in three patients, infarction in one and tumor in one. Angiography, CT and MRI demonstrated the typical appearance of the anomaly. Surgery was performed in one patient harboring a significant cerebellar hematoma and the coexistence of a cavernoma was pathologically confirmed. Venous developmental anomalies are often identified as the source of symptoms due to other conditions, that should be treated independently sparing the anomaly.

Adult↗
PubMedDate not supplied

Spinal ossifying arachnoiditis. Case report.

A case of low dorsal spinal cord compression, due to ossifying arachnoiditis, is reported. Its relationship with a venous malformation overlying the dorsal surface of the spinal cord is mentioned. The literature is reviewed and possible etiopathogenetic factors favouring this rare condition are discussed in the light of few similar reports. The value of surgical treatment is stressed.

Arachnoiditis↗
PubMedDate not supplied

The significance of microcirculatory modifications in traumatic lesions of the spinal cord. A preliminary, morphological study on experimentally induced spinal cord traumas.

The authors have studied the histological modifications in rabbit spinal cords after injury by a 20 g weight dropping from a 10 cm height. The animals were sacrificed at various time intervals from trauma (after 30', 60', 90', 2 h, 3 h, 4 h, 5 h, 6 h). The traumatized spinal cords are characterized by edema, regressive alterations of neurons as well as of glia and of fibres, and by microcentres of myelinolysis. The prominent and very precocious presence of edema is very likely one of the main factors causing regressive alterations in the cells present in myelinolysis centres.

Animals↗
PubMedDate not supplied

Valuation of some biological parameters in acute spinal cord trauma: experimental study in rabbits.

The authors investigated the formation of edema consequent to Spinal Cord Injury in rabbits. The goal of this project was to study the accumulation of Water, Sodium, Potassium and Ferrum in traumatized cords in the early time after the acute injury. To this aim a spinal cord trauma was induced in forty unselected animals using the weight-drop method; Water content was measured by wet and dry weight method; Sodium, Potassium and Ferrum content were measured by atomic absorbance spectrophotometry. These parameters were recorded at various time from the cord trauma (30 minutes up to 14 days). The results are presented and discussed with a particular view to the relationships between biological variation and time from the injury.

Animals↗