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Ozone autohemotherapy is an emerging therapeutic technique that is gaining increasing importance in treating neurological disorders. A validated and standard methodology to assess the effect of such therapy on brain metabolism and circulation is however still lacking. We used a near-infrared spectroscopy (NIRS) system to monitor the cerebral metabolism and a transcranial Doppler (TCD) to monitor the blood flow velocity in the middle cerebral arteries. Fifty-four subjects (32 neurological patients and 22 controls) were tested before, during, and after ozone autohemotherapy. We monitored the concentration changes in the level of oxygenated and deoxygenated haemoglobin, and in the level of the Cytochrome-c-oxidase (CYT-c). As a primary endpoint of the work, we showed the changes in the brain metabolism and circulation of the entire population. The concentration of oxygenated hemoglobin increased after the reinjection of the ozoned blood and remained higher than the beginning for another 1.5 hours. The concentration of the deoxygenated haemoglobin decreased during the therapy and the CYT-c concentration markedly increased about 1 hour after the reinjection. No significant changes were observed on the blood flow velocity. As secondary endpoint, we compared the NIRS metabolic pattern of 20 remitting-relapsing multiple sclerosis (MS) patients against 20 controls. We showed that by using only 7 NIRS variables it was possible to characterize the metabolic brain pattern of the two groups of subjects. The MS subjects showed a marked increase of the CYT-c activity and concentration about 40 minutes after the end of the autohemotherapy, possibly revealing a reduction of the chronic oxidative stress level typical of MS sufferers. From a technical point of view, this preliminary study showed that NIRS could be useful to show the effects of ozone autohemotherapy at cerebral level, in a long-term monitoring. The clinical result of this study is the quantitative measurement of the CYT-c level changes in MS induced by ozone autohemotherapy.

Progressive supranuclear palsy (PSP) also known as Steele, Richardson and Olszewski disorder is a neurodegenerative brain disease that has no known cause, treatment or cure. PSP has no known geographical, occupational or racial preference and affects brain cells that control walking, balance, mobility, vision, speech and swallowing. Symptoms begin on average in the early 60s, but may start as early as in the 40s: a good history and physical examination support the clinical diagnosis and latency of each feature makes us suspect a probable PSP, an atypical Parkinsonism. The diagnosis of a large number of cases of PSP is missed or delayed: 75% of the patients are never clinically diagnosed by neurologist and in most cases the median interval between onset and diagnosis is three years. Notwithstanding such differences in clinical presentation, there remains an overlap in symptoms making the differential diagnosis between such neurodegenerative disorders challenging. A few imaging techniques developed to evaluate brain anatomy and function are used extensively to improve the diagnostic accuracy of different forms of Parkinsonism. Noninvasive and safe methods can now document brain structures. Transcranial sonography (TCS) is a very low cost tool to assess the basal ganglia and mesencephalic echogenicity. Conventional magnetic resonance imaging (MRI) is a valuable tool to exclude secondary Parkinsonism. Our purpose is to define characteristic objectively measured imaging markers that point out normal biological processes, and pathogenic processes in PSP. Such markers should be sufficiently sensitive and specific to show the underlying biological disease and the pharmacological responses to therapy.

La duplicazione dell'ipofisi è una malformazione molto rara, che può essere associata ad altre anomalie della linea mediana, del corpo calloso, dei vasi, dei bulbi oculari, delle ossa craniche e del midollo spinale.L'eziopatogenesi di questa malformazione è da ricercare all'interno delle anomalie di sviluppo embrionale che compaiono tra la 3° e 6° settimana di gestazione, quando lo sviluppo si trova compreso fra il 10° ed il 17° stadio embrionale.Vengono descritti due casi di duplicazione ipofisaria, uno associato ad agenesia dell'arteria carotide interna di destra, a meningocele sfenoidale e a coloboma dell'occhio di destra, l'altro, associato a meningocele sfenoidale, agenesia del corpo calloso e ad ispessimento della lamina terminalis.

3D reformattations play an increasingly important role in the diagnosis of skull base pathological masses since they allow a direct study of bony and soft tissues. In this article we discuss usefulness of morphologic evaluation by CT and 3D-MPR in 64 patients examined for skull base tumors.3D imaging proved to be useful, especially before surgery; owing to its multiple projections, delineating perfectly the extension and limits of the lesion.Postoperatively time, CT allowed a good evaluation of the results obtained, permitting the study of bone grafts and the identification of tumoral portions larger than previously supposed by the neurosurgeon, warranting further therapy.

Knowledge of the natural history of atherosclerotic plaque at the carotid bifurcation, as well as the progression and regression of atherosclerosis, make it essential for a diagnostic approach more complete than angiography, whose only target is the degree of arterial stenosis.Besides, the invasivity of the technique discourages repeated controls in a disease where the main risk factor is aging. Among non invasive techniques, Angio — CT shows good sensitivity and specificity compared to the conventional angiography, and the intraoperative and histologic data in 21 patients submitted to TEA of the 92 examined. Beside the entity of stenosis, Angio-CT can evaluate the endoluminal growth and structure of plaque.Moreover, it provides a three dimensional representation of the region of interest. Reliefs emerge both from analysis of axial scans of the carotid bifurcation and from 3D and MP reformatting from raw data. Angio-CT data are integrated with results provided by Color Doppler-Ultrasonography in atherosclerotic screening.