4 results on '"Morace, Roberta"'
Search Results
2. The endoscopic endonasal approach for the management of craniopharyngiomas
- Author
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SOLARI, DOMENICO, Morace, Roberta, CAVALLO, LUIGI MARIA, AMOROSO, FRANCESCA, CENNAMO, GILDA, DEL BASSO DE CARO, MARIALAURA, CAPPABIANCA, PAOLO, Solari, Domenico, Morace, Roberta, Cavallo, LUIGI MARIA, Amoroso, Francesca, Cennamo, Gilda, DEL BASSO DE CARO, Marialaura, and Cappabianca, Paolo
- Abstract
Craniopharyngiomas are disembryogenetic, benign, tumors that origin from squamous epithelial remnants of Rathke's pouch, developing from any segment of its course, virtually from rhino-pharynx to the hypothalamus. Historically, different microscopic transcranial routes, have been advocated as possible surgical options for the treatment of craniopharyngiomas. The endonasal technique offers a direct approach that permits access to the suprasellar, retrosellar and retroclival space, obviating brain retraction; it provides the advantage of appraoching cranioopharyngiomas without optic nerve manipulation and/or retraction. We herein present the surgical nuances of the endoscopic endonasal approach for the treatment of craniopharyngiomas, highlighting hints, advantages and drawbacks, also in regards of the anatomy dealt with. The endoscopic endonasal technique has been emerging as a viable approach/alternative for the treatment of this disease as the endoscope itself increased its safety and effectiveness. It allows the removal of both infra and supradiaphragmatic lesions - eventually involving the third ventricle chamber but not extending laterally off the ICA out of the visibility and maneuverability of the instruments - avoiding brain and optic nerve manipulation and retraction, with good visualization of the pituitary gland and stalk and the main neurovascular structures.
- Published
- 2016
3. Surgery after intracranial investigation with subdural electrodes in patients with drug-resistant focal epilepsy: outcome and complications
- Author
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Morace, Roberta, Giancarlo, Gennaro, Di Gennaro, G., Angelo, Picardi, Pier Paolo Quarato, Antonio, Sparano, Addolorata, Mascia, Giulio Nicolò Meldolesi, Liliana Graciela Grammaldo, Marco, Risi, De Risi, M., and Esposito, Vincenzo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Drug Resistance ,Subdural Space ,Electroencephalography ,Neurosurgical Procedures ,Temporal lobe ,Lesion ,Epilepsy ,Young Adult ,Postoperative Complications ,Seizures ,Monitoring, Intraoperative ,epilepsy surgery ,extratemporal epilepsy ,subdural electrodes ,outcome ,medicine ,Image Processing, Computer-Assisted ,Humans ,Epilepsy surgery ,Subdural space ,Child ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Electrodes, Implanted ,medicine.anatomical_structure ,Treatment Outcome ,Surgery, Computer-Assisted ,Female ,Neurology (clinical) ,Neurosurgery ,Epilepsies, Partial ,medicine.symptom ,business - Abstract
Video–EEG monitoring with intracranial subdural electrodes is a useful assessment tool for the localization of the epileptogenic zone in patients with drug-resistant focal epilepsy. We aimed at assessing the morbidity related to electrode implantation and the surgical outcome in patients who underwent epilepsy surgery after intracranial EEG monitoring. All patients (N = 58) admitted to our Epilepsy Surgery Centre for drug-resistant focal epilepsy who underwent resective surgery after intracranial monitoring with subdural electrodes and were followed up for at least 2 years were included in the study. Their mean age was 30.4 years (range 8–60 years), 25 (43 %) were female, and 44 (76 %) had a preoperatively detected structural lesion. The mean duration of invasive recording was 2.3 days (range 1–14 days). Extraoperative ECoG allowed the identification of the epileptogenic focus in all cases. The temporal lobe was involved in 21 (36 %) patients, whereas extratemporal foci were identified in 24 (41 %) patients. Thirteen patients (23 %) had multilobar involvement. Functional brain mapping was performed in 15 (26 %) patients. Transient complications related to electrode implantation occurred in three patients. Among patients with evidence of lesion on preoperative MRI, lesionectomy alone was performed in 12 cases (27 %), while it was combined with tailored cortical resection in the remaining cases. Tailored cortical resection was also performed in patients without evidence of lesion on MRI. After resective surgery, transient neurological deficits occurred in five cases, while another patient experienced permanent lateral homonymous hemianopia. At the last follow-up observation, 34 (57 %) patients were seizure-free (Engel class I). This study suggests that invasive EEG recording with subdural electrodes may be useful and fairly safe for many candidates for epilepsy surgery.
- Published
- 2011
4. Sedation with α2 Agonist Dexmedetomidine During Unilateral Subthalamic Nucleus Deep Brain Stimulation: A Preliminary Report
- Author
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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
- 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
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