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Start Over Author "Morace, Roberta" Journal world neurosurgery
7 results on '"Morace, Roberta"'

6. Sedation with α2 Agonist Dexmedetomidine During Unilateral Subthalamic Nucleus Deep Brain Stimulation: A Preliminary Report

Author

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

Subjects
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.

Published
2015

7. Computed Tomography-Guided Posterolateral Transsacral Ala Approach to Presacral L5 Schwannoma: Technical Note.

Author

Pizzuti V, di Russo P, Esposito V, and Morace R

Subjects
Adult, Humans, Intraoperative Neurophysiological Monitoring, Lumbar Vertebrae, Magnetic Resonance Imaging, Male, Neurilemmoma diagnostic imaging, Peripheral Nervous System Neoplasms diagnostic imaging, Sacrum, Spinal Nerve Roots diagnostic imaging, Tomography, X-Ray Computed, Microsurgery methods, Neurilemmoma surgery, Neurosurgical Procedures methods, Peripheral Nervous System Neoplasms surgery, Spinal Nerve Roots surgery
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., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2019
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