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Biomedical subjects

R Villani

Publications and source records attributed to R Villani.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Functional MRI: primary motor cortex localization in patients with brain tumors.

PURPOSE: Our goal was (a) to test the ability of functional MRI (fMRI) to localize the hand primary motor cortex in patients with brain neoplasms using a conventional scanner and (b) to compare within the same subject the location and morphology of the activated motor areas in the affected hemisphere with the contralateral ones. METHOD: Seventeen right-handed patients with frontoparietal intra- and extraaxial tumors were studied. Hand motor performance ranged from normal to slight impairment of finger dexterity. The fMRI study was based on a series of FLASH images. Two or three contiguous slices parallel to the bicommissural plane were acquired through the level of frontoparietal cortex. Each patient was requested to perform with each hand a finger-tapping task or a simpler repetitive flexion-extension of the last four fingers. Pseudo-color activation maps were then calculated by a Z-score method and superimposed on high resolution images. RESULTS: Five patients were excluded because of gross motion artifacts. In all other patients, areas of significant signal increase were detected on the precentral gyrus. They had a spot-like appearance, and no substantial side-to-side differences in shape or extension could be observed. In the presence of severe compression of the gyri, a displacement of the activated areas in the affected hemisphere with respect to the contralateral ones was noticeable. CONCLUSION: fMRI localization of the primary motor area using a conventional scanner can be obtained also in patients with brain tumors, although with a lower success rate than in normal volunteer studies, mainly because of subject compliance problems. Areas of significantly increased signal are detectable even in cortex where normal anatomical patterns are lost.

Adolescent↗
PubMedDate not supplied

Glomus tumor of the lower lip. A case report.

A glomus tumor is a benign neoplasm originating from the modified smooth muscle cells of the vascular glomus. This neoplasm was firstly considered by Masson in 1924, and generally it has a solitary lesions but in some cases multiple lesions were described. Differential diagnosis is usually made with Kaposi sarcoma and hemangiopericytoma. The histopathologic examination is essential together with the immunohistochemical study. The clinical case of a 65-year-old man with a glomus tumor of the lower lip is described.

Aged↗
PubMedDate not supplied

Posttraumatic diffuse cerebral lesions. Relationship between clinical course, CT findings and ICP.

One hundred and fifty patients with posttraumatic diffuse cerebral lesions were reviewed. Criteria of inclusion were immediate coma and CT appearance of diffuse lesions, that were classified as follows: (a) Diffuse axonal injury (70 cases): patients with normal CT scan (50 cases) and patients with shearing injury (focal hemorrhages in corpus callosum, basal ganglia and brain stem; gliding contusions) (20 cases); (b) Diffuse brain swelling (80 cases): reduced or absent lateral ventricles, absence of 3rd ventricle and basal cisterns. Many of these patients had either subarachnoid haemorrhage or subdural blood effusion. Clinical course and mortality rate were in a ranking order in the considered groups. Patients with normal CT had a less severe coma and a better outcome than patients with shearing injury and diffuse brain swelling. There was evidence of high intracranial pressure in 75% of the patients with brain swelling, whereas no patient with normal CT had ICP elevation. Diffuse axonal injury represents a primary posttraumatic diffuse lesion. Secondary vascular involvement, due to hypoxia, shock and other unknown causes, is responsible for the appearance of vasoparesis, hyperemia and diffuse brain swelling.

Adult↗
PubMedDate not supplied

Acute spontaneous subdural hematomas.

Fifteen cases of spontaneous subdural hematoma are presented. A review of the literature reveals the rarity of this pathology. Symptomatological onset cannot be distinguished from the other cerebrovascular lesions. High mortality is connected with patient's consciousness level. CT scan performed in all patients presenting symptoms of cerebral stroke permitted to demonstrate this clinical entity is not so rare as the literature asserted.

Acute Disease↗
PubMedDate not supplied

Evaluation of brainstem function, using acoustic evoked potentials, in 26 patients harbouring a CSF shunt for non-tumoral aqueductal stenosis hydrocephalus.

26 patients harbouring a CSF shunt for non-tumoral aqueductal stenosis hydrocephalus underwent Brainstem Acoustic Evoked Potentials (BAEPs) recording, to evaluate brainstem function. Only 6 patients presented with normal responses both at standard and at sensitized tests. In the remaining 19 patients, BAEPs were abnormal, bilaterally in 10 cases, monolaterally in 9. Four out of the 6 normal responses belonged to the group recognized of congenital origin. As refers to ventricular size BAEPs were abnormal in 62% of patients with normal ventricle and in 92% of patients with enlarged ventricles. The most significant BAEPs abnormalities were found in patients with maximal ventricular dilation. It appears that BAEPs abnormalities are to the ascribed to both primary and secondary brainstem dysfunction: no reliable criterion to differentiate between these two possibilities is evident. In the individual patient, serial BAEPs recording may contribute to recognize the early phase of supratentorial hypertension due to shunt dysfunction.

Adolescent↗
PubMedDate not supplied

The value of brain scanning in the diagnosis of recurrences of brain tumours.

The Authors consider critically the possibilities of brain scanning in the diagnosis of recurrences of brain tumours. They examine a series of 143 cases subjected in 180 brain scans exams. The accuracy of the diagnosis is demonstrated by operative controls and verified by the results of the Common neuroradiologic investigations (angiography and air study). The analysis of patients according to the different types of tumours, enabled us to make the following conclusions: 1) Percentages of positivity of recurrences with astrocytomas and localisations in the posterior fossa are highest than that obtainable with the primitive tumour. 2) Flap activity is not considered as a limitative factor of the diagnostic possibilities of recurrence, except in meningiomas of small dimensions, near the longitudinal sinus. 3) In our series, there is only a false negative, surgically verified, and diagnosis of negativity is confirmed by the percentages of accordance with neuroradiogical methods. 4) Pneumoencephalography is more valuable than arteriography in the diagnosis of recurrence, but only the association of the two methods provides percentages of exact diagnosis comparable to the results of brain scanning. 5) Brain scanning gave false positive results only in cases of radionecrosis.

Adenoma↗