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Biomedical subjects

U Pasquini

Publications and source records attributed to U Pasquini.

At least 37 records · Page 2Linked to original sources

Traumatic cerebral mass lesions: correlations between clinical, intracranial pressure, and computed tomographic data.

After surveying the different phases of their previous experience with the diagnosis and management of traumatic cerebral mass lesions, the authors analyze the correlation between clinical, computed tomographic (CT), and intracranial pressure (ICP) data in 29 patients with traumatic intracerebral hematomas and/or brain lacerations. Clinically, the patients are classified in three groups: (a) deeply comatose patients (Glascow coma scale (GCS), 4 to 5); (b) patients with intermediate disturbances of consciousness (GCS, 6 to 10); and (c) patients with minor impairment of consciousness (GCS, more than 10). Sixteen patients were operated upon. Operation was ineffective in the patients who were already deeply comatose in the first hours after injury, even though elevated ICP was definitely reduced after operation in some of them. Conversely, patients with well-limited lesions, moderate disorders of consciousness, and persisting intracranial hypertension despite medical therapy seemed to be good candidates for delayed operation by limited procedures. In patients with intermediate disturbances of consciousness and no tendency to improvement or deterioration, ICP monitoring correlated with CT scan appearance may be of practical use for making the decision to operate. However, most cases diagnosed on CT scan have a benign course; the patients recover uneventfully with conservative management. In such patients careful clinical observation is usually sufficient. (Neurosurgery, 7: 337-346, 1980).

Adolescent↗

The reliability of computerized axial tomography in the diagnosis of infratentorial mass lesions. A neurosurgical appraisal.

The accuracy of CAT in the diagnosis of infratentorial expanding lesions is analysed on the basis of 224 personal cases. The posterior fossa lesions are classified in four groups according to the reliability of CAT as the only pre-operative examination. The present indications for conventional neuroadiological procedures are also outlined. Particular emphasis is laid on the information supplied by CAT in postoperative follow up to detect both immediate and delayed complications.

Adult↗

Computed tomography of the optic nerve: part I. Normal results.

In vivo visualization of the optic nerve (ON) by computed tomography (CT) has important clinical applications, both realized and potential. An accurate CT analysis of the ON is, however, hampered by a number of technical limitations. Sinuosity and gaze-shift-related motility of the ON tend to increase the difficulties of demonstrating in a consistently satisfactory fashion this anatomical structure. Nevertheless, if rigid imaging criteria are followed, adequate visualization of the ON may be attained in the majority of patients. Simultaneous visualization of the ON and the eyeball permits establishment of a neuroocular index for clinical use.

Humans↗

Computed tomography of the optic nerve: part II. Size and shape modifications in papilledema.

Increase in the caliber and course tortuosity of the optic nerve (ON) can be demonstrated by computed tomography (CT) in cases of papilledema due to intracranial tumors, hydrocephalus, pseudotumor cerebri, and other conditions causing increased intracranial pressure. The enlargement of the ON in these conditions is generally bilateral, although one of the nerves, usually of the side of the tumoral pathology, may be thicker. Enlargement on the ON may also be demonstrated by CT in papilledema due to optic neuritis. Occasionally, the thickened ON also display increased attenuation coefficient values.

Humans↗

Metrizamide demonstration of the subarachnoid space surrounding the optic nerves.

Intrathecal instillation of metrizamide has provided a useful tool for the in vivo evaluation of smaller structures adjacent to or within the subarachnoid cisterns. The authors report a case in which metrizamide filled the thin subarachnoid space surrounding the optic nerve in its course through the orbit. The finding appears to be infrequent, however, since it was not observed in any instance in a review of 80 metrizamide computed tomographic cisternograms in patients with normal intracranial pressure.

Adult↗

Periventricular hypodensity in hydrocephalus: a clinico-radiological and mathematial analysis using computed tomography.

The computed tomography (CT) scans carried out in hydrocephalic patients before and after surgical treatment [cerebrospinal fluid (CSF) shunting] were assessed by analysis of the densities. The numerical data were compared to the pictorial record on the display console. The periventricular hypodensity was correlated to the clinical parameters and to the time lapse after surgical treatment. The subependymal hypodensity shows good direct correlation to the transit of CSF from the ventricles to the white matter, and to the clinical status of the patients. The mathematical analysis supplies objective data and comparable indices. It constitutes the starting point for an automatic evaluation of the CT images of the process of transependymal CSF resorption in non-treated and treated hydrocephalus.

Absorptiometry, Photon↗

Evidence of central nervous system involvement in chronic demyelinating neuropathies associated with "benign" gammopathies.

Recent papers underline the possible involvement of the central nervous system when an acquired peripheral demyelinating disease occurs and vice-versa. We describe five patients with chronic polyneuropathy and "benign" gammopathy, monoclonal (IgM-K, IgA-k, IgG-k) in three cases and polyclonal (IgG, IgM) in two cases; the monoclonal gammopathies were detected in cases of peripheral nerve disease. Three patients showed tremor and signs of pyramidal system impairment when the peripheral damage had improved or was stable. All cases underwent a longitudinal assessment according to clinical, CSF, EMG-ENG, neuroradiological and pathological criteria. The MRI finding always showed multiple alterations of encephalic white matter. When related to neurophysiological and pathological data supporting a chronic demyelinating neuropathy, such results point to possible encephalic involvement in chronic polyneuropathies due to a pathogenetic mechanism common to both.

Aged↗

[Preliminary observations on computerized axial tomography (CAT) in 32 patients with various epileptic syndromes (author's transl)].

Thirty-two subjects affected by various types of epilepsy have been studied as follows: 1) from the clinical point of view with careful case history or by direct observation of the seizures; 2) from the EEG point of view by means of prolonged recordings during wakefulness and nocturnal sleep or with pharmacological activations; 3) from a radiological point of view with standard skull radiography, air-encephalography (PNX), brain scanning and, when necessary, with cerebral angiography, mono or bilateral. Furthermore, all the patients underwent a CAT at least once; in the majority of cases this examination was repeated after administration of contrast medium. The following results were obtained by comparing the various examinations: 1) anatomo-elector-clinical correlation was present only in some cases; 2) only in patients with cerebral neoplasms was there proof of an agreement in site between EEG, CAT and PNX; 3) it was not possible to detect in a definite manner epileptic glial lesions with CAT; 4) the EEG analysis, when repeated several times with different methods of investigations, whoed epileptic foci in a higher number compared to the anatomical focal lesions proved by CAT; 5) compared with air-encephalography and morphological brain scanning, CAT usually pointed out a higher number of focal and/or diffused cerebral lesions with a higher degree of precision; viceversa cerebral angiography proved to be irreplaceable in cases where it was necessary to study possible circulatory alterations.

Adolescent↗