10 results on '"Morace, A."'
Search Results
2. Multilevel Postoperative Cervical Epidural Hematoma: Complete Removal Through Catheter Drainage of the Unexposed Blood Collection
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Antonella Bua, Michelangelo de Angelis, Tommaso Vangelista, Vito Chiarella, Paolo di Russo, Roberta Morace, Vincenzo Esposito, and Nicola Gorgoglione
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Epidural Space ,Male ,medicine.medical_specialty ,Catheters ,Decompression ,medicine.medical_treatment ,Anterior cervical discectomy and fusion ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Lumbar ,Epidural hematoma ,medicine ,Humans ,Lumbar Vertebrae ,business.industry ,Laminectomy ,Middle Aged ,Decompression, Surgical ,Hematoma, Epidural, Spinal ,medicine.disease ,Spinal cord ,Epidural space ,Surgery ,Catheter ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cervical Vertebrae ,Drainage ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background Postoperative spinal epidural hematoma is a rare complication of anterior cervical discectomy and fusion. This condition may rapidly produce severe neurologic deficits, often requiring a prompt surgical decompression. A multilevel extension of the epidural bleeding has been rarely described after anterior cervical procedures. In such cases, the choice of the most suitable surgical approach may be challenging. Herein, we describe an effective surgical decompression of a C2-T1 ventral epidural hematoma following anterior cervical discectomy and fusion at the C5-C6 level. Methods By reopening the previous approach, the C5-C6 intersomatic cage was removed and the surgical field inspected for bleeding. After removal of the spinal epidural hematoma at this level, a lumbar external drainage catheter was inserted into the epidural space to perform multiple irrigations with saline solution until the washing fluid was clear. Results Immediate postoperative cervical computed tomography and magnetic resonance imaging revealed gross total removal of the epidural hematoma and complete decompression of the spinal cord all along the affected tract. Early postoperative neurologic examination revealed mild lower extremity weakness that fully recovered within hours. Conclusions Although rare, multilevel epidural hematoma following anterior cervical decompression represents a serious complication. The revision of the previous anterior cervical approach may be considered the first treatment option, allowing to control the primary bleeding site. Catheter irrigation of the epidural space with saline solution may be a useful technique for removal of unexposed residual blood collection, avoiding the need for posterior laminectomy or other unnecessary bone demolition.
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- 2021
3. Multilevel Postoperative Cervical Epidural Hematoma: Complete Removal Through Catheter Drainage of the Unexposed Blood Collection
- Author
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Morace, Roberta, di Russo, Paolo, Gorgoglione, Nicola, Bua, Antonella, Vangelista, Tommaso, Chiarella, Vito, De Angelis, Michelangelo, and Esposito, Vincenzo
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- 2021
- Full Text
- View/download PDF
4. Computed Tomography−Guided Posterolateral Transsacral Ala Approach to Presacral L5 Schwannoma: Technical Note
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Paolo di Russo, Valentina Pizzuti, Roberta Morace, and Vincenzo Esposito
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Adult ,Male ,Microsurgery ,Sacrum ,medicine.medical_specialty ,Intraoperative Neurophysiological Monitoring ,Nerve root ,Lumbar vertebrae ,Schwannoma ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,Ala of sacrum ,Peripheral Nervous System Neoplasms ,Humans ,Medicine ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Surgery ,Neurology (clinical) ,Radiology ,Spinal Nerve Roots ,Tomography, X-Ray Computed ,business ,Neurilemmoma ,030217 neurology & neurosurgery ,Lumbosacral joint ,Intraoperative neurophysiological monitoring - Abstract
Background Presacral schwannomas are rare benign tumors that may reach large size before becoming symptomatic. Total surgical removal has been considered the best treatment option. Tumors arising from the presacral area are commonly managed through anterior approaches, whereas posterior approaches are used for pure intrasacral tumors or large lesions with both intrasacral and presacral extension, alone or in combination with anterior approaches. Methods We describe a quick and minimally invasive navigation-guided posterolateral approach to a right presacral L5 schwannoma. The lesion was microsurgically removed through high-speed drilling of the upper portion of the right sacral ala, under intraoperative neurophysiologic monitoring. Results The postoperative course was unremarkable, and the patient experienced improvement in his sensory disturbance. Postoperative magnetic resonance imaging and computed tomography scan showed the complete excision of the lesion and the removal of the upper sacral ala with preservation of the right L5-S1 articular complex. The histologic examination confirmed a schwannoma (World Health Organization grade I). Conclusions The posterolateral transsacral ala approach may represent a minimally invasive option in the surgical management of presacral well-circumscribed benign tumors. Spinal navigation could be properly used to facilitate lesion exposure and to minimize the bone removal. The intraoperative neurophysiologic monitoring is an essential tool for the preservation of the lumbosacral nerve roots.
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- 2019
5. The Interhemispheric Transgenual Approach for Microsurgical Removal of Third Ventricle Colloid Cysts. Technical Note
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Esposito, Vincenzo, di Russo, Paolo, Del Maestro, Mattia, Ciavarro, Marco, Vangelista, Tommaso, De Angelis, Michelangelo, Fava, Arianna, and Morace, Roberta
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- 2020
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6. The Interhemispheric Transgenual Approach for Microsurgical Removal of Third Ventricle Colloid Cysts. Technical Note
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Michelangelo de Angelis, Arianna Fava, Marco Ciavarro, Tommaso Vangelista, Paolo di Russo, Mattia Del Maestro, Roberta Morace, and Vincenzo Esposito
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Adult ,Male ,medicine.medical_specialty ,Microsurgery ,Adolescent ,Obstructive hydrocephalus ,Lesion ,Colloid Cysts ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Imaging, Three-Dimensional ,Occlusion ,Cerebrospinal fluid diversion ,medicine ,Humans ,Cerebrum ,Third Ventricle ,Third ventricle ,medicine.diagnostic_test ,Colloid cyst ,business.industry ,Magnetic resonance imaging ,Technical note ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Craniotomy - Abstract
Background Colloid cysts of the third ventricle are rare benign lesions, which amount to approximately 1% of all intracranial tumors. Because these lesions grow predominantly in the anterior aspect of the third ventricle, they may cause the occlusion of the foramina of Monro, generating obstructive hydrocephalus. Surgery is mandatory in cases of large cysts and/or in symptomatic patients. Among the different surgical strategies described in colloid cysts surgery, the microsurgical transcallosal approach still constitutes the procedure of choice in many centers. In this study, we describe a modified microsurgical transcallosal approach, the interhemispheric transgenual approach, in a series of 13 consecutive patients operated on for colloid cysts of the third ventricle. Methods All the procedures were performed by the senior author (V.E.) at Neuromed Institute of Pozzilli (Is, Italy). The operative procedure is described in its various steps, illustrating the differences and potential advantages compared with the traditional microsurgical transcallosal approach. Results No surgical complications or new-onset neurologic deficits were observed in the postoperative period. The postoperative magnetic resonance imaging confirmed in all cases complete lesion removal without any sign of parenchymal damage. No lesion recurrence or need for permanent cerebrospinal fluid diversion was detected in the patients of this series during the follow-up period. Conclusions In our experience, the interhemispheric transgenual approach has been effective in providing complete colloid cyst removal with minimal risk of vascular and parenchymal damage. Further studies are required to confirm its efficacy in improving the overall outcome of the microsurgical transcallosal approach.
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- 2020
7. Intracranial Capillary Hemangioma: A Description of Four Cases
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Morace, Roberta, Marongiu, Alessandra, Vangelista, Tommaso, Galasso, Vittorio, Colonnese, Claudio, Giangaspero, Felice, Innocenzi, Gualtiero, Esposito, Vincenzo, and Cantore, Giampaolo
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- 2012
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8. Computed Tomography−Guided Posterolateral Transsacral Ala Approach to Presacral L5 Schwannoma: Technical Note
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Pizzuti, Valentina, primary, di Russo, Paolo, additional, Esposito, Vincenzo, additional, and Morace, Roberta, additional
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- 2019
- Full Text
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9. Sedation with α2 Agonist Dexmedetomidine During Unilateral Subthalamic Nucleus Deep Brain Stimulation: A Preliminary Report
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Domenico Solari, LuigiMaria Cavallo, Roberta Morace, Emiliano Aglialoro, Michelangelo de Angelis, Gianni Maucione, Vincenzo Esposito, Marco Santilli, Nicola Modugno, Fulvio Aloj, Morace, Roberta, De Angelis, Michelangelo, Aglialoro, Emiliano, Maucione, Gianni, Cavallo, Luigimaria, Solari, Domenico, Modugno, Nicola, Santilli, Marco, Esposito, Vincenzo, and Aloj, Fulvio
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Male ,Intraoperative Neurophysiological Monitoring ,medicine.medical_treatment ,Deep Brain Stimulation ,Hypnotics and Sedative ,Stimulation ,Neuropsychological Tests ,Severity of Illness Index ,Antiparkinson Agents ,0302 clinical medicine ,Retrospective Studie ,030202 anesthesiology ,Adrenergic alpha-2 Receptor Agonists ,Hypnotics and Sedatives ,Parkinson ,Subthalamic nucleu ,Parkinson Disease ,Middle Aged ,Subthalamic nucleus ,Treatment Outcome ,Antiparkinson Agent ,Anesthesia ,Neuropsychological Test ,Female ,medicine.symptom ,Dexmedetomidine ,Human ,medicine.drug ,Agonist ,Levodopa ,medicine.medical_specialty ,Deep brain stimulation ,medicine.drug_class ,Sedation ,Motor Activity ,Follow-Up Studie ,03 medical and health sciences ,Adrenergic alpha-2 Receptor Agonist ,Subthalamic Nucleus ,medicine ,Reaction Time ,Humans ,Speech ,Key words α2agonist ,Aged ,Retrospective Studies ,business.industry ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Intraoperative neurophysiological monitoring ,Follow-Up Studies - Abstract
Objective The α 2 agonist dexmedetomidine (DEX) is an anesthetic agent that can provide sedation and analgesia without respiratory depression or changes in neuronal activity during microrecordings. The aim of our study was to confirm the efficacy and safety of anesthesia with DEX for unilateral deep brain stimulation of the subthalamic nucleus (STN) in patients with Parkinson disease. Methods In 2013 and 2014, a series of 11 consecutive patients received continuous low-dose DEX infusion during unilateral deep brain stimulation of the STN. Intraoperative microrecordings, stimulation results, and patient reaction times in executing verbal and motor tasks were retrospectively analyzed. Functional outcomes were evaluated by comparing preoperative and 1-year postoperative Unified Parkinson's Disease Rating Scale Part III scores. Results Typical activity of the STN was recorded in all patients, and the delay in the execution of both motor and verbal tasks was ≤2 seconds. No hemorrhagic complications occurred, and no postoperative side effects were observed. The mean percentage of Unified Parkinson's Disease Rating Scale Part III improvement at last follow-up was 39.01% (range, 23.70%–55.60%). The mean percentage of levodopa equivalent dose reduction was 45.86% (range, 21.50%–65.70%). Conclusions The results of our study confirm that the use of DEX in managing patients with Parkinson disease during unilateral deep brain stimulation of the STN is safe and effective and can be considered a promising option for sedation during this type of procedure.
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- 2015
10. Intracranial capillary hemangioma: a description of four cases
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Alessandra Marongiu, Claudio Colonnese, Giampaolo Cantore, Felice Giangaspero, Roberta Morace, Tommaso Vangelista, Gualtiero Innocenzi, Vittorio Galasso, and Vincenzo Esposito
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Male ,medicine.medical_treatment ,Middle cranial fossa ,Postoperative Complications ,Parietal Lobe ,Embolization ,Hemangioma, Capillary ,Neurologic Examination ,medicine.diagnostic_test ,Brain Neoplasms ,Capillary hemangioma ,Infratemporal fossa ,Middle Aged ,Combined Modality Therapy ,Embolization, Therapeutic ,Magnetic Resonance Imaging ,Temporal Lobe ,medicine.anatomical_structure ,Cavernous sinus ,Cavernous Sinus ,Female ,Radiology ,medicine.symptom ,Craniotomy ,Adult ,medicine.medical_specialty ,capillary hemangioma ,middle cranial fossa ,cavernous sinus ,radiotherapy ,surgery ,Adolescent ,Skull Base Neoplasms ,Lesion ,medicine ,Humans ,Cranial Fossa, Middle ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Surgery ,Cerebral Angiography ,body regions ,Radiation therapy ,Radiotherapy, Adjuvant ,Neurology (clinical) ,Neoplasm Recurrence, Local ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Objective Capillary hemangiomas are benign vascular lesions involving the skin and soft tissues that commonly occur at birth or an early age. Intracranial capillary hemangiomas are extremely rare; only 14 cases have been reported the literature. Case Description We describe four patients with capillary hemangiomas. In two of these patients the lesions arose from the cavernous sinus. In the third patient, a large capillary hemangioma arising from the middle cranial fossa extended into the infratemporal fossa. The fourth patient had a left hemorrhagic temporoparietal capillary hemangioma. Results The first two patients underwent a partial resection, followed by radiotherapy. Local tumor control was achieved in both cases, as shown by the follow-up magnetic resonance imaging. In the third patient the lesion was subtotally removed after embolization. Radiotherapy, performed one year after surgery because of recurrence, allowed tumor control. In the fourth patient surgical removal was total and no adjuvant radiotherapy was required after surgery; follow-up magnetic resonance imaging did not show any recurrence at the one-year follow-up. Conclusion Surgery is an option for symptomatic intracranial capillary hemangiomas. However, because partial removal is associated with a high recurrence rate, capillary hemangiomas that cannot be removed radically should be treated with radiotherapy, which offers the possibility of controlling lesion size and preventing tumor recurrence.
- Published
- 2011
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