1,720,995 research outputs found
Spinal neurologic complications of systemic solid neoplasms
No full textSpinal cord dysfunctions represent a major cause of morbidity and suffering in cancer. There are four main manifestations of metastatic epidural spinal cord compression: pain, motor loss, sensory loss, and autonomic dysfunction. Any of these can be disabling potentially impairing, suddendly and drastically, the quality of life. Epidural spinal cord metastatic compression is the most frequent complication, affecting almost 5-10% of cancer patients. Understanding of early symptoms, clinical course and treatment could contribute to prevent or minimize neurologic deficit development. Early diagnosis is crucial because the most important prognostic factor for functional outcome is neurological function and current treatments usually stop the course of the disease but much less commonly restore lost neurological functions. In this paper we will review the more frequent causes of neoplastic spinal cord dysfunctions, paying attention in particular to early clinical signs and symptoms, to the more adequate neuroradiological investigations and to the more effective treatment options. Furthermore we will underline some aspects and causes of the diagnostic delay and review adjuvant therapies that will ameliorate quality of life of these patients. © Mattioli 1885 Casa Editrice
Primary leptomeningeal gliomatosis: Case report and review of the literature
No full textA 62-year-old woman developed dysphasia, signs of intracranial hypertension and seizures. An MRI scan evidenced extra-axial contrast enhancement in the absence of mass lesions. CSF analysis was negative for malignant cytology and viral or bacterial microbiology. In the absence of other evidence, considering the acute clinical onset and MRI picture, a viral encephalitis was suspected and antiviral therapy was started, however, with no effect. Death occurred three weeks after presentation because of acute brain swelling. Autopsy revealed leptomeningeal gliomatosis and diffuse parenchymal infiltration at the cerebellar and left temporal lobe. Primary leptomeningeal gliomatosis (PLMG) is a rare event. The reported case and the reviewed literature evidence that clinical signs at presentation are non-specific, CSF negative findings are common, the diagnosis is always delayed and the prognosis dismal. © Springer-Verlag Italia 2005
ESPERIENZA CLINICA DI TRE ANNI CON L'USO DELL'ECOENCEFLOGRAFIA A-SCOPE NELL'ICTUS CEREBRALE
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Surgery for intracerebral hemorrhage
No full textThe surgical treatment of intracerebral hemorrhage (ICH) is one of the most controversial areas of neurosurgery. Randomized trials are inconclusive due to the small number of patients enrolled or because performed in pre CT era. We analyze the 232 patients admitted to the Niguarda Hospital of Milano, Italy, for ICH during the period January 2001-December 2002. Sixty patients were operated: 29 had secondary haemorrhage, and 30 a primary one. The strategy followed in these patients is presented. The series suggests that indication to surgery is a complex process including several factors that have to be all considered in each patient
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