1,721,072 research outputs found
Sequential measurements of cerebral blood flow in the acute phase of subarachnoid hemorrhage
No full textCerebral blood flow (CBF) measurements were made at predetermined intervals over the first 20 days after a subarachnoid hemorrhage (SAH) by the method of 133Xe inhalation clearance in 39 patients, Hunt and Hess degrees I, II or III. Mean hemispheral and regional blood flow showed a similar pattern of behavior over time: namely an initial hypoperfusion, being more marked in patients with consistent or thick blood deposition at CT scanning, followed by transient improvement and subsequent deterioration in the second week, this being especially conspicuous in patients who developed vasospasm; deterioration, at any rate, was distributed widely regardless of the initial CBF readings or magnitude of bleeding. Patients developing later neurological deficit (23% of the total) were those who showed a statistically significant increase of hemispheric asymmetries and regional hypoperfusion at the time when deterioration occurred. Accordingly, the Author calls attention to the practical value of CBF measurements in SAH patients, in view of the relationships that obtain between certain CBF patterns and the emergence of late neurologic deficits
Surgical management of lateral tentorial meningiomas
No full textOBJECTIVE: Tentorial meningiomas represent an heterogeneous group of tumors. Most of the published series deal with either a small number of patients or consider different locations as a whole, making indications for treatment and prognosis difficult to be drawn.We analysed the surgical management of the lateral tentorial meningiomas, a homogenous and rare sub-group.METHODS: 52 later tentorial meningiomas were operated between 1990 and 2010. Clinical, radiological features and surgical management of these patients were reviewed. Tumors were further subcategorized in posterior/intermediate and in supra/infratentorial subgroups. Surgical outcome, long-term results and prognostic factors are described.RESULTS: Mean age was 57 years(41 female,11 male). Mean tumor size was 46 mm; most had an infratentorial location(36vs16). Prevailing presenting symptoms were headache(n=28), vertigo/gait disturbances(n=25), confusion and visual disturbances(n=16). The infratentorial group presented with poorer clinical condition before as well as after operation. Extent of tumor resection was Simpson I in 10 patients, II in 26, III in 6 and IV in 10. Subtotal resection was statistically correlated with sinus invasion and tumor size. There was no surgical mortality. Permanent complications occurred in 3 patients. At latest follow-up(mean: 119 months)42/46 resumed their normal daily activity. Six cases recurred and remained stable after radiosurgery.CONCLUSION: Lateral tentorial meningomas are an homogeneous entity characterized by simple surgical approaches and favourable outcome(no mortality and low overall morbidity).Infratentorial location was more frequent and characterized by poorer outcome.The limiting factors for surgical removal were tumor size and sinus invasion. The latter point strengths the rationale for their classification into posterior and intermediate
Studio seriato del flusso ematico cerebrale nella fase acuta dell'emorragia subaracnoidea
No full text
Behavioural disorders in young patients with pineal region brain tumors [Disturbi del comportamento in giovani pazienti con tumori cerebrali della regione pineale]
No full textPineal region tumours are characterised by a variety of clinical signs and symptoms resulting from compression and displacement surrounding structures ranging from raised intracranial pressure to visual field defects, cerebellar symptoms and endocrine disorders. Alongside these historically well-established features of pineal region tumors, behavioural disorders have only been described sporadically. To define the incidence of these disorders in a population of children and young adults (aged 4 to 20 years), we reviewed ten cases (7 males and 3 females) treated for pineal region tumours at the Department of Neurosurgery, Verona, between 1986 and 1995. Behavioural or cognitive disorders (hypersomnia, irritability, psychiatric disorders, impaired memory) were recognised before and after surgery in seven patients (70%). Although these disorders are usually deemed aspecific signs of expanding brain lesions or associated hydrocephalus in children, this was not supported by the relatively high age of our seven patients (14 years, 4-19). At diagnosis, seven patients presented hydrocephalus (70%). A review of around 200 cases reported in similar series (pineal region tumours, age < 20, analysis of symptoms, hydrocephalus determination) disclosed a lower incidence of behavioural disorders (10%), despite a high incidence of hydrocephalus (93%). We suspect that these symptoms are more common in patients with pineal region tumours than in other patients of the same age with tumours in other subtentorial locations. Other clinical and experimental observations are briefly discussed: in agreement with these findings we suggest that behavioural disorders are directly correlated to the involvement of anatomical structures like Nauta's mesencephalon-limbic circuit, the mesencephalic reticular formation, the premesencephalic grey matter and the pineal gland whose importance has been underestimated to date. These symptoms therefore merit greater attention in young patients with pineal region tumours
Intracranial meningiomas in the elderly [Meningiomi endocranici negli anziani: una sfida diagnostica prima che terapeutica].
No full textNo abstract availabl
Papillomi dei plessi corioidei dell'angolo pontocerebellare: considerazioni su una serie di 9 pazienti
No full textno abstract availabl
- …
