29 research outputs found
Acute hemifacial ischemia as a late complication of carotid stenting
No full textConcerns about carotid artery stenting (CAS) center primarily on procedural complications like acute occlusion, stroke, and long-term intrastent restenosis. External carotid artery (ECA) thrombosis is observed during CAS follow-up, but it often remains asymptomatic or, at worst, results in jaw claudication. We report here a case of late occlusion of the ECA after CAS with symptoms of acute homolateral facial ischemia as well as pain, cyanosis, tongue numbness, and skin coldness. The patient was submitted to local thrombolysis and balloon angioplasty with regression of symptoms after recanalization. With this report, we add a caveat about blockage of the ECA ostium during CAS
A potential catastrophic trap : an unusually presenting sellar lesion
No full textA 63-year-old man was admitted to our emergency unit complaining headache, vomit and vertigo. A MR of the brain showed an expanding lesion within the sellar region. A subsequent angio-MR excluded any intracranial vascular malformations. Surprisingly, a cerebral angiography performed later on the basis of worsening of neurological signs and symptoms, demonstrated an aneurysm of the internal carotid artery. At the best of our knowledge, this is the first case of a thrombosis of an intracavernous carotid aneurysm mimicking a pituitary apoplexy documented by MR and angio-MR. The treatment of a milder syndrome of pituitary apoplexy is still controversial. This case would favour conservative treatment opposed to surgery at least when an intracavernous extension or invasion of the adenoma would limit the opportunity of a complete tumour removal
Lesività da arma bianca : aspetti patologico-forensi e tossicologico-forensi relativi alla casistica del settorato medico-legale milanese nel quadriennio 2000-2003
No full textCases of death ascribed to lesions from sharp instruments were selected from the necroscopy records of the Milan Institute of forensic medicine for the four years 2000-2003. Of the total number of 4.089 autopsies, 62 cases were found, of wich 45 were homicides, 16 suicides and 1 accidental. In addition to collecting epidemiological, anatomical, pathological, and history and circumstance data on each case, the autors considered the chemical-toxicological findings, where that was possible. Specifically a quantitative and qualitative examination was performed on samples of biological liquids (blood and urine) for determination of blood alcohol and of narcotic and psychotropic substances
Analisi della casistica del settorato medico-legale milanese nel decennio 1994-2003 in ambito di lesioni da arma bianca. Aspetti medi-legali, chimico-tossicologici e criminologici
No full textANGIOPLASTY AND STENTING FOR SYMPTOMATIC ATHEROSCLEROTIC INTACRANIAL STENOSIS: PROCEDURES AND OUTCOME IN 28 CONSECUTIVE PATIENTS WITH 33 INTRACRANIAL STENOSIS
No full textBackground/Objective Elective intracranial stenting with or without balloon angioplasty is an emerging innovative therapy for intracranial vessels stenosis. Few and heterogeneous data about safety and efficacy of this kind of procedure are available. No randomized controlled trial is available. The aim of this paper is to present the experience in stenting and angioplasty on a series of consecutive symptomatic patients with intracranial vessels stenosis. Patients and Methods In the Neuroradiology Department of IRCCS Policlinico Hospital of Milan, from January 2002 to July 2006 a series of 28 consecutive patients, undergone endovascular treatment for 33 symptomatic intracranial vessels stenosis, were evaluated. 22 patients (24 procedures), previously treated using ballon-mounted stent delivery systems for coronary use, were retrospectively reviewed. 7 patients, who were to be treated with self-expanding stent-systems (WingSpan), were prospectively enrolled from March 2006 to July 2006. For each patient we collected data about intra-procedural complications and short-term outcome. The technical success was defined as a residual stenosis of less than 50%. Results 14 internal carotid, 10 vertebral and 9 basilar were treated in 28 patients with recently symptomatic intracranial stenosis >/= 70% on angiography. A technical success was achieved in all cases. No intraprocedural complications were observed. Revascularization led to hemorrhagic complications in two patients. No vessel dissections or ruptures were observed. Three of 28 patients had new neurological symptoms within 24 hours (two transient ischemic attack and one non disabling stroke) and one patient developed a symptomatic basilar thrombosis at 10 days later successfully treated. Conclusions – Endovascular treatment can be performed with a high technical success rate. The procedures were performed with an acceptable complication rate according to literature
Fistole artero-venose durali spinali : esperienza chirurgica ed endovascolare nel periodo 2002-2005
No full textArmed kyphoplasty: An indirect central canal decompression technique in burst fractures
No full textBACKGROUND AND PURPOSE: Burst fractures are characterized by middle column disruption and may feature posterior wall retropulsion. Indications for treatment remain controversial. Recently introduced vertebral augmentation techniques using intravertebral distraction devices, such as vertebral body stents and SpineJack, could be effective in fracture reduction and fixation and might obtain central canal clearance through ligamentotaxis. This study assesses the results of armed kyphoplasty using vertebral body stents or SpineJack in traumatic, osteoporotic, and neoplastic burst fractures with respect to vertebral body height restoration and correction of posterior wall retropulsion. MATERIALS AND METHODS: This was a retrospective assessment of 53 burst fractures with posterior wall retropulsion and no neurologic deficit in 51 consecutive patients treated with armed kyphoplasty. Posterior wall retropulsion and vertebral body height were measured on pre- and postprocedural CT. Clinical and radiologic follow-up charts were reviewed. RESULTS: Armed kyphoplasty was performed as a stand-alone treatment in 43 patients, combined with posterior instrumentation in 8 and laminectomy in 4. Pre-armed kyphoplasty and post-armed kyphoplasty mean posterior wall retropulsion was 5.8 and 4.5 mm, respectively (P< .001), and mean vertebral body height was 10.8 and 16.7 mm, respectively (P< .001). No significant clinical complications occurred. Clinical and radiologic follow-up (1-36 months; mean, 8 months) was available in 39 patients. Three treated levels showed a new fracture during follow-up without neurologic deterioration, and no retreatment was deemed necessary. CONCLUSIONS: In the treatment of burst fractures with posterior wall retropulsion and no neurologic deficit, armed kyphoplasty yields fracture reduction, internal fixation, and indirect central canal decompression. In selected cases, it might represent a suitable minimally invasive treatment option, stand-alone or in combination with posterior stabilization
