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Biomedical subjects

R Villani

Publications and source records attributed to R Villani.

At least 55 records · Page 3Linked to original sources

Traumatic brain lacerations in children: surgical results and follow-up.

75 children ranging in age from 3 months to 14 years, operated on for post-traumatic cerebral lacerations, within an 18-year period, have been analyzed. These represent 2.1% of 3,460 children sustaining head injury and hospitalized during this same period. Total mortality was 16%. The cases were divided into 2 groups: (A) cerebral lacerations underlying a depressed fracture (coup lesion) -- 68 cases. In 42 cases the lacerations were focal without edema and/or intracerebral hematoma. 1 child died and 41 survived. In 26 cases the laceration was diffuse and accompanied by cerebral edema and/or intracerebral hematoma. 6 children died and 20 survived. (B) Brain lacerations following a contrecoup lesion -- 7 cases, 5 of these children died and 2 survived. The follow-up of the surviving patients in the above two groups has been discussed.

Adolescent↗

[Vertebro-medullary lesions: recent therapeutic approaches (author's transl)].

Before initiating the treatment of vertebro-medullary lesions, a precise classification of the lesion and stabilization of injured bone structures are necessary. Particular attention should be given to the differential diagnosis between total and partial transverse lesions, which requires an exact neurologic and radiological examination, analysis of liquor cerebrospinalis and, in some cases, myelography. Laminectomy proved to be of little value for 157 patients with total transverse lesions treated at the Department of Neurosurgery at the University of Milan. Better results were obtained with traction and stabilization (plaster jackets). Due to high incidence of trophic and septic complications, patients should be treated exclusively in highly specialized centres.

Adult↗

Basal, cAMP- and cGMP-dependent protein kinases in human brain tumors.

Since the effects of cyclic nucleotides are mediated via protein kinases activation, we have studied the properties and regulation of these enzymes in cytosol and particulate fraction of normal cerebral tissues and of some human brain tumors. We found that distribution and activity of cyclic nucleotide-dependent protein kinases are regulated differently among various brain tumors and in comparison to normal gray and white matter. Pathological tissues show an higher cGMP-dependent protein kinase and this biochemical pattern is particularly evident in tumors with more pronounced malignancy. These data further confirm the hypothesis of a correlation between the increase of cGMP function and cellular growth and malignancy.

Astrocytoma↗

Skull changes and intellectual status in hydrocephalic children following CSF shunting.

A total of 76 shunt-treated hydrocephalic children were examined at least once between two and 12-years after surgery to determine what skull changes had occurred and to assess the children's intellectual status. The high incidence of skull changes in shunt-treated, non-tumoral, hydrocephalic children was confirmed. A strict relationship existed between skull changes and low intracranial pressure. The results indicate that impairment of mental development parallels the degree of skull changes, suggesting a close relationship between impaired mental development and cerebrospinal fluid hypotension.

Cerebrospinal Fluid Shunts↗

Radioisotope cisternography in head-injured patients.

Of 600 patients submitted to radioisotope cisternography carried out with radioiodinated human serum albumin (I131-HSA) a group of 140 had head injuries. Our investigation was intended to study the modifications of CSF circulation and absorption which accompany cranio-cerebral trauma. Of 88 head injured patients who did not undergo operation 44 had transient loss of consciouness, and 44 were in prolonged coma. Fifty-two patients underwent operation. Of these 5 had skull fractures with dural lesions, 7 had extradural haematomas, 19 had subdural haematomas, and 21 had brain contusions. Cisternograms were performed at different time intervals after trauma, and in some instances the test was repeated in order to study the possible long tern alterations of CSF circulation and absorption. Abnormalities of cisternographic pictures are classified into the following groups: 1 degree asymmetric diffusion; 2 degree operative cavity stagnation; 3 degree ventricular reflux; 4 degree associated abnormalities. Cisternographic features are analysed in relation to the corresponding clinical and pneumoencephalographic patterns in the patients examined. These investigations may enable us to recognise possible indications for shunt procedures in the management of CSF absorption defects, which are so frequently apparent after head injury.

Brain Injuries↗

Follow-up study of brain stem tumors in children.

In a series of 180 patients affected by brain stem tumors, 70 cases of children up to 16 years are analyzed. Diagnosis was made with clinical examinations, neuroradiological tests and, in 20 cases, with surgical explorations. A description is made concerning the clinical status with regard to site, extension and features of the tumor. Then the authors analyze statistically the survival of such patients in connection with clinical symptomatology, the radiological picture, medical treatment, radiation and/or surgical therapy either in the few cases of subtotal removal of the tumors, or in the more numerous cases of palliative procedures such as intra- and extra-thecal CSF shunting.

Adolescent↗