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Subthalamic nucleus deep brain stimulation (STN-DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD).Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN-DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow-up of ∼15 months, treated by Duodopa infusion rather than STN-DBS because of the presence of neurosurgical contraindications, age70 years-old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN-DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow-up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow-up for the two procedures.Both procedures showed a significant improvement in UPDRS-II, UPDRS-III, and UPDRS-IV and a considerable reduction in the percentage of waking day spent in "off," whereas only the STN-DBS group showed a significant improvement in dyskinesias duration and disability. STN-DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure-related complications occurred more frequently with Duodopa.STN-DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa-treated patients developed more procedure-related complications.

A 49-year-old woman presented with a rare atypical growth pattern of meningioma without evidence of dural attachment manifesting as chronic headache associated with transient paresthesia and left motor disorders. On admission, neurological examination showed no abnormalities. Magnetic resonance (MR) imaging revealed a right temporo-parieto-occipital lesion, which appeared to involve the subdural space and filling the cortical sulci. The lesion caused peritumoral white matter edema. The tumor appeared hypointense on T(1)-weighted and hyperintense on T(2)-weighted MR images, with homogeneous enhancement after contrast administration. A biopsy of the lesion was performed. Histological examination indicated that the lesion was a meningioma. Intraparenchymal meningiomas should be considered in the differential diagnosis of intraaxial lesions in patients of any age.

Meningiomas have been found to have receptors for several hormones, such as oestrogen, progesterone, somatostatin, dopamine and recently also for prolactin.To investigate any possible role of prolactin in the growth of those tumours we detected the presence of prolactin-receptors (PRL-R) in 22 meningiomas and we correlated these data with PRL serum levels in patients before surgery. We also studied 13 patients with schwannomas and 7 with other cerebral tumours (4 glioblastomas, 2 ependymomas and 1 astrocytoma).Increased prolactin binding was present in 10 (45.4 percent;) meningiomas, 9 (69.2 percent;) schwannomas and in the patient with astrocytoma. The presence of high PRL levels was present in 6 (27.2 percent;) patients with meningiomas, 8 (61.5 percent;) with schwannomas and in 3 (42.8 percent;) with other tumours. No direct correlation was present between serum PRL levels and PRL binding in all groups.In conclusion we confirmed the presence of PRL receptors in patients with meningiomas and we have also shown the presence of PRL receptors also in schwannomas. Moreover increased serum PRL were shown in some patients with different tumours of nervous tissue before surgery. Our data could suggest that PRL might have a role in the growth of meningiomas and schwannomas.