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R Delfini

Publications and source records attributed to R Delfini.

At least 73 records · Page 4Linked to original sources
PubMed1996

Meningeal localization in a patient with Hodgkin's disease. Description of a case and review of the literature.

We report the case of a 21-year-old man in whom intracranial localization was discovered during initial staging at the onset of Hodgkin's disease (HD). The patient was treated by surgical excision, irradiation and chemotherapy and 50 months after completion of therapy is in remission with no evidence of HD. A brief review of the literature regarding 48 patients with intracranial Hodgkin's disease is presented.

Adult↗
PubMed1996

Thoracolumbar fractures without neurosurgical involvement: surgical or conservative treatment?

The decision whether to treat amyelic thoracolumbar fractures conservatively or by surgical approach depends mainly on radiographic and clinical evaluation of their potential stability. An angle of kyphosis of 20 degrees or more evaluated using the sagittal index (s.i.) described by Farcy et al. in 1990, may be a valid indication for invasine treatment using pedicular systems for correction and stabilization; on the other hand, conservative treatment may be adequate for ensuring satisfactory results in fractures with an angle of less than 20 degrees, which are less likely to become unstable in clinically negative patients. This study confronts the immediate and long-term radiographic and clinical results in 2 groups of patients treated for amyelic thoracolumbar fractures, one treated conservatively, the other surgically; in particular, angle of kyphosis, vertebral compression and clinical conditions (pain and functional impairment) at long-term follow-up were assessed. The study was extended to include an assessment of outcome in relation to the angle of post-traumatic kyphosis in both operated and non-operated patients. Thirty-one patients with a diagnosis of non-neurological thoracolumbar trauma of the segment between D11 and L3 were studied. Twenty patients (group A) were treated conservatively (reduction on Cotrel bed and plaster vest) and 11 (group B) surgically (Diapason instrumentation). The 31 patients were subdivided into 2 groups according to the initial angle of kyphosis calculated using the s.i.: the first consisted of 16 patients (group C) with a s.i. of 20 degrees or more and the other of 15 patients (group D) with a s.i. less than 20 degrees. Six of the 16 group C patients and 5 of the 15 group D patients had been surgically treated. On the basis of the case-material considered, we found that satisfactory short-term radiographic results may be obtained by both conservative and surgical treatment. However, long-term outcome is less favorable in patients treated conservatively because maintainance of the initial improvement of the deformity in the injured segment is not as good as in those treated surgically. This limitation of conservative treatment does not however appear to negatively influence clinical conditions in patients with a s.i. of less than 20 degrees. In other words, although conservative treatment is not as effective as surgery for maintaining radiographic improvement, this does not necessarily signify clinical deterioration in cases with a s.i. of less than 20 degrees in whom the two types of treatment gave similar results.

Adolescent↗
PubMed1995

Intraosseous cavernous hemangioma of the skull.

Intraosseous cavernous hemangioma is a vascular tumor that only rarely affects the cranial bones. We describe three patients with this unusual tumor and discuss the clinical and radiological features of this lesion in the light of published data.

Adolescent↗
PubMed1995

Delayed post-traumatic epidural hematoma. A review.

Post-traumatic acute epidural hematoma (EDH) is generally visible on the CT scan done immediately after admission: occasionally, it only comes to light at a later scan and is then termed delayed (DEDH). Since the introduction of CT, the frequency of this occurrence has gone up from 6-13% to 30%. The mechanisms responsible for the delayed appearance of the epidural hematoma a "tamponade" effect are usually increased endocranial pressure and post-traumatic arterial hypotension as well as, in a limited number of cases, coagulopathy, CSF drainage, and arterio-venous shunt. The authors report 5 of their own cases and 45 published cases and discuss the characteristics of this particular form of hematoma and its outcome.

Adult↗
PubMed1995

Solitary cerebral metastases from intestinal carcinoma.

The authors report 34 cases of solitary cerebral metastases from intestinal cancer. In 24 cases the tumour was localized in the colonrectum and in 10 in the small intestine. In 8 patients (23%) neurological symptoms were the first clinical sign of systemic spread of the tumour; in 26 cases (77%) there was a long interval between treatment of the primary and appearance of the cerebral metastasis (average 24 months). Average survival was 10 months and was influenced solely by staging of the primary. Interestingly, the prognostic value of radiotherapy was minimal and none of the patients operated by the "no touch technique" presented with a recurrence.

Adult↗
PubMed1995

Tinnitus and hearing loss in pineal region tumours.

The authors report an underestimated symptom and sign arising in pineal region tumours: tinnitus and hearing loss. It has been observed in 13 out of 72 pineal region tumours (18%). Three illustrative cases are reported in this paper. The inferior colliculi, the structure more dense in fibres than any other auditory brain stem site and at which majority of the acoustic pathways relay, is closely adjacent to the pineal body. Displacement of this structure may be responsible for acoustic symptoms together with common visual symptoms.

Adult↗
PubMed1995

Intramedullary cavernous angiomas of the spinal cord: report of six cases.

The authors report six cases of intramedullary cavernoma. Symptoms evolved by episodes of stepwise neurologic deterioration or slow progression. All patients had preoperative and postoperative magnetic resonance imaging (MRI). Removal of the cavernoma was total in all cases and in one a transthoracic approach was performed because of the ventral and superficial position of the lesion. At follow-up, ranging from 6 to 18 months, two patients improved, two were unchanged, and one had deteriorated. Prognosis was influenced by the length of clinical history and the severity of preoperative symptoms. The principal clinical and therapeutic aspects of cavernoma are discussed in light of the published data.

Adult↗
PubMed1994

Epileptic seizures in intracerebral hemorrhage: a clinical and prognostic study of 55 cases.

Fifty-five cases of epileptic siezures associated with spontaneous intracerebral hemorrhage are reported. Seizures appeared as the first symptom in 23 patients, early (within two weeks after HI) in 18 and late (later than 2 weeks after HI) in 14. From the analysis of the observed cases we noticed that: 1) partial seizures were most frequent type (63%). These appeared mainly in cases with lobar hemorrhage above all; 2) development chronic epilepsy occurred frequently in the case of patients affected by late seizures. We compare our data with those reported in literature in order to highlight main factors which affect the onset and development of seizures associated with spontaneous intracerebral haemorrhage.

Adolescent↗
PubMed1994

Metastasis of breast carcinoma to intracranial meningioma. Case report.

A case of metastasis from breast carcinoma found within a cerebral meningioma is reported. Histological diagnosis of the cerebral tumor prompted radiological investigation that visualized the asymptomatic malignant systemic tumor and excluded other metastases elsewhere. The pathogenetic aspects of this exceptional occurrence are discussed in the light of the relevant literature.

Aged↗
PubMed1994

Choice of neurosurgical approach in the treatment of cranial base lesions.

The authors describe a series of surgical approaches that they found particularly useful for the exposure and removal of lesions involving the skull base. These are: 1) fronto-naso-orbital approach; 2) fronto-temporo-orbito-zygomatic approach; 3) subtemporal transpetrosal approach; 4) temporo-suboccipital transpetrosal approach (retrolabyrinthine presigmoid; transsigmoid; translabyrintine amend transcochlear presigmoid); 5) dorsolateral approach to the foramen magnum and lower clivus. As the approaches are complex and carry potential risks of morbidity, not only it is important to have a good knowledge of basic anatomy but also to closely follow the indications for each one. In this type of surgery where it is often difficult to achieve complete removal of the lesion by a single route of attack, more than one approach may be employed in different surgical steps. Finally, all these approaches demand extremely scrupulous surgical reconstruction to avoid dangerous postoperative complications that may jeopardize the previous work of the surgeon.

Craniotomy↗
PubMed1994

Surgical treatment of petroclival meningiomas: experience with 16 cases.

This article presents the surgical results in a series of 16 petroclival meningiomas operated on from 1984-1990. Tumors with marked infiltration of the cavernous sinus, which belong to the category of spheno-petro-clival meningiomas, were excluded. The 16 petroclival meningiomas were all surgically treated using the combined transmastoid temporosuboccipital approach that offers a number of possible variants: retrosigmoidal, with or without recision of the sinus; presigmoidal retro-, or translabyrinthine. The choice of one or another of these variants depends on certain clinical (preoperative hearing status) and anatomic (size and extension, central or lateral, of the tumor; patency of the transverse sinuses; size and position, more or less anterior, of the sigmoid sinus; position, more or less high, of the jugular bulb) factors. The principle indications for each of these approaches are given with particular emphasis on their relative advantages and limitations.

Cranial Fossa, Posterior↗
PubMed1994

The surgical approaches to nasopharyngeal angiofibroma.

After a short summary of the aetiopathogenesis, the routes of extension and the diagnostic features of nasopharyngeal angiofibroma, the importance of early diagnosis and careful surgical planning is underlined. In particular the extension and topographic localization allows the choice of the best approach to optimize surgical radicality--the prime concern in the treatment of nasopharyngeal angiofibroma. Different surgical approaches are proposed for the tumour removal according to our experience in 17 patients.

Adolescent↗
PubMed1994

A simple method for stereotactic microsurgical excision of small, deep-seated cavernous angiomas.

Eight patients underwent microsurgical excision of small, deep-seated cavernous angiomas (maximum diameter, 0.9 to 2 cm; distance from cortical surface, 3.5 to 6.5 cm) by the stereotactic implantation of a guide catheter. In all cases, the lesion was quickly localized and completely removed. None of the patients had postoperative neurological deficits. Once the guide catheter has been implanted, the stereotactic headframe can be removed, allowing the unobstructed use of the operating microscope with frames not suitable for open surgery. Target localization is not affected by brain movement, which is inevitable during open surgery. The procedure described here is simple to perform and relatively inexpensive. It requires no specially designed equipment, only a standard stereotactic apparatus, an operating microscope, and the usual microsurgical instruments.

Adult↗
PubMed1994

Surgical management of orbital cavernous angiomas: prognosis for visual function after removal.

The authors report the outcome of surgical treatment in a group of 25 patients with cavernous angioma of the orbital cavity. In the majority of cases, good esthetic results were appreciable within a few days of surgery. However, the onset or deterioration of preexisting visual deficits, in spite of the complete preservation of the optic nerve in a third of these patients, draws attention to the need for accurate surgical timing.

Adult↗
PubMed1994

Solitary cerebral metastasis as first symptom of lung cancer.

The authors report 35 cases of solitary brain metastasis from lung cancer manifesting clinically before the primary tumor. Surgical removal was total in 27 cases and partial in 8. All patients received postoperative radiotherapy. The primary tumor was diagnosed during the hospital stay in 12 cases, within two months of discharge in 18 cases, at necropsy in 5 cases. Median survival of patients was 16 months and the main cause of death was progression of the primary cancer (72% of cases). The clinical and pathological characteristics of solitary brain metastasis from lung cancer are reported in the light of the present 35 cases and those reported in the literature.

Adult↗
PubMed1994

Medulloblastoma in late adults: report of two cases and critical review of the literature.

The authors describe two cases of medulloblastoma occurring in two men aged 71 and 67 years respectively. Medulloblastoma in late adults (older than 65 years) is an exceptional occurrence, and in this age group is generally of the classic type. Our first case was exceptional for the long survival of the patient compared with those so far reported for the same age group.

Aged↗
PubMed1994

[Anomalies of the inferior vena cava: observations on the anterior approach to the vertebral column].

The inferior vena cava is formed through a complex process of embryogenesis from the sixth to the tenth week of gestation. Improper completion of the process of embryogenesis may result in four anatomic anomalies: 1) duplication of the inferior vena cava; 2) left-sided inferior vena cava; 3) retroartic left renal vein and 4) circumaortic left renal vein. The Authors report the cases of two patients in which duplication of the inferior vena cava and retroartic left renal vein were respectively observed. The importance to avoid injuries and subsequent bleeding from these anomalous structures during surgical operations is stressed. Moreover, a correct preoperative diagnosis may reduce these complications.

Adult↗