36 results on '"Angileri, Filippo F"'
Search Results
2. A Survey on Pituitary Surgery in Italy
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Solari, Domenico, Zenga, Francesco, Angileri, Filippo F., Barbanera, Andrea, Berlucchi, Silvia, Bernucci, Claudio, Carapella, Carmine, Catapano, Domenico, Catapano, Giuseppe, Cavallo, Luigi M., D'Arrigo, Corrado, de Angelis, Michelangelo, Denaro, Luca, Desogus, Nicola, Ferroli, Paolo, Fontanella, Marco M., Galzio, Renato J., Gianfreda, Cosimo D., Iacoangeli, Maurizio, Lauretti, Liverana, Locatelli, Davide, Locatelli, Marco, Luglietto, Davide, Mazzatenta, Diego, Menniti, Agazio, Milani, Davide, Nasi, Maria Teresa, Romano, Antonio, Ruggeri, Andrea G., Saladino, Andrea, Santonocito, Orazio, Schwarz, Andreas, Skrap, Miran, Stefini, Roberto, Volpin, Lorenzo, Wembagher, Giulio C., Zoia, Cesare, Zona, Gianluigi, and Cappabianca, Paolo
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- 2019
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3. Aggressive Pituitary Adenomas: The Dark Side of the Moon
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Priola, Stefano M., Esposito, Felice, Cannavò, Salvatore, Conti, Alfredo, Abbritti, Rosaria V., Barresi, Valeria, Baldari, Sergio, Ferraù, Francesco, Germanò, Antonino, Tomasello, Francesco, and Angileri, Filippo F.
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- 2017
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4. The Pioneering Contribution of Italian Surgeons to Skull Base Surgery
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Priola, Stefano M., Raffa, Giovanni, Abbritti, Rosaria V., Merlo, Lucia, Angileri, Filippo F., La Torre, Domenico, Conti, Alfredo, Germanò, Antonino, and Tomasello, Francesco
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- 2014
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5. Telo-velar approach to fourth-ventricle tumours: how I do it
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Tomasello, Francesco, Conti, Alfredo, Angileri, Filippo F., and Cardali, Salvatore
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- 2015
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6. The dramatic increase in sudden cardiac deaths and the alarming low survival: A global call to action to improve outcome with the engagement of tertiary education system.
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Fodale, Vincenzo, Angileri, Filippo F., Antonuccio, Pietro, Basile, Giorgio, Benedetto, Filippo, Leonetti, Danilo, Micari, Antonio, and Fodale, Michele F.
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- 2023
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7. miR-21 and 221 upregulation and miR-181b downregulation in human grade II–IV astrocytic tumors
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Conti, Alfredo, Aguennouz, M’Hammed, La Torre, Domenico, Tomasello, Chiara, Cardali, Salvatore, Angileri, Filippo F., Maio, Francesca, Cama, Annamaria, Germanò, Antonino, Vita, Giuseppe, and Tomasello, Francesco
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- 2009
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8. Nuclear Factor-κB Activation and Differential Expression of Survivin and Bcl-2 in Human Grade 2–4 Astrocytomas
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Angileri, Filippo F., Aguennouz, MʼHammed, Conti, Alfredo, La Torre, Domenico, Cardali, Salvatore, Crupi, Rosalia, Tomasello, Chiara, Germanò, Antonino, Vita, Giuseppe, and Tomasello, Francesco
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- 2008
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9. Neurosurgery on the web: an analysis of the web-visibility of the European Neurosurgical Societies.
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SCIBILIA, Antonino, RAFFA, Giovanni, PRIOLA, Stefano M., ESPOSITO, Felice, ANGILERI, Filippo F., CARDALI, Salvatore M., and GERMANÒ, Antonino
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- 2022
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10. Traumatic Intracerebellar Hemorrhage: Clinicoradiological Analysis of 81 Patients
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d’Avella, Domenico, Servadei, Franco, Scerrati, Massimo, Tomei, Giustino, Brambilla, Gianluigi, Angileri, Filippo F., Massaro, Fulvio, Cristofori, Luciano, Tartara, Fulvio, Pozzati, Eugenio, Delfini, Roberto, and Tomasello, Francesco
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- 2002
11. Time-related Ultrastructural Changes in an Experimental Model of Whole Brain Irradiation
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Cicciarello, Rocco, d'Avella, Domenico, Gagliardi, Maria Ester, Albiero, Francesca, Vega, Josè, Angileri, Filippo F., D'Aquino, Antonio, and Tomasello, Francesco
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- 1996
12. Natura non facit saltus: a phase 2 proposal to manage brain tumors cases from the Neuro-oncology section of the italian society of Neurosurgery (siNch®).
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ANGILERI, FILIPPO F., SABATINO, GIOVANNI, CAVALLO, LUIGI M., PESSINA, FEDERICO, IUS, TAMARA, DE DIVITIIS, ORESTE, ESPOSITO, FELICE, GRIMOD, GIANLUCA, RAFFA, GIOVANNI, SPENA, GIANNANTONIO, CARDALI, SALVATORE, ESPOSITO, VINCENZO, GERMANÒ, ANTONINO, MAIURI, FRANCESCO, FONTANELLA, MARCO, and CENZATO, MARCO
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- 2021
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13. Microvascular Decompression for Trigeminal Neuralgia: Technical Refinement for Complication Avoidance
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Tomasello, Francesco, Esposito, Felice, Abbritti, Rosaria V., Angileri, Filippo F., Conti, Alfredo, Cardali, Salvatore M., and La Torre, Domenico
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- 2016
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14. Giant sacral schwannoma excised under intraoperative neuromonitoring in an elderly patient: case report.
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Colonna, Michele R, Costa, Alfio L, Mastrojeni, Claudio, Rizzo, Vincenzo, Nirta, Giuseppe, Angileri, Filippo F, Ieni, Antonio, Milone, Erica, and Macrì, Antonio
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SCHWANNOMAS ,OLDER patients ,SACRAL nerves ,SCHWANN cells ,BENIGN tumors ,PERIPHERAL nervous system - Abstract
Schwannomas are mainly benign tumors arising from the Schwann cells of the peripheral nerve sheath. These tumors can often be associated with non-specific symptoms, such as abdominal heaviness. In this article, we present a detailed description of the surgical management of a giant sacral schwannoma in an elderly patient, for which intraoperative neuromonitoring made it possible to distinguish easily the nerves of the sacral plexus from which the tumor originated and to remove it without complications. Treatment of these rare and symptomatic giant tumors is still a challenge for surgeons; to treat adequately these tumors; a multidisciplinary approach is required to ensure an optimal therapeutic approach to reduce the risk of recurrence and, on the other hand, is not associated with unnecessary iatrogenic neurological damage. [ABSTRACT FROM AUTHOR]
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- 2021
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15. Pituitary atypical teratoid rhabdoid tumor in a patient with prolactinoma: A unique description.
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Barresi, Valeria, Lionti, Simona, Raso, Alessandro, Esposito, Felice, Cannavò, Salvatore, and Angileri, Filippo F.
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CENTRAL nervous system tumors ,PROLACTINOMA ,ADENOMA ,CEREBRAL hemispheres ,EXONS (Genetics) - Abstract
Atypical teratoid rhabdoid tumor (ATRT) is an aggressive tumor of the CNS and characteristically occurs in the pediatric age. In adulthood, ATRT is rare and it is mainly localized in the cerebral hemispheres. Only 16 cases of ATRT have been described in the sellar region up to now. Interestingly, all sellar ATRTs occurred in adult female patients. Herein we report a novel case of sellar ATRT in a patient with previous history of lactotroph adenoma. Similar to other sellar ATRTs, this case occurred in a female adult patient. At histological examination, it was characterized by a small number of rhabdoid cells. In addition, it did not have homozygous deletion of SMARCB1 gene, but it rather showed a frameshift mutation at exon 4 of SMARCB1 which had not been previously found in ATRT. Clinico‐pathological and molecular findings observed in this case confirm previous evidence that sellar ATRT seems to be a distinct entity. Association with previous prolactin‐secreting pituitary adenoma is discussed. [ABSTRACT FROM AUTHOR]
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- 2018
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16. Role of Inflammation and Oxidative Stress Mediators in Gliomas.
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Conti, Alfredo, Gulì, Carlo, La Torre, Domenico, Tomasello, Chiara, Angileri, Filippo F., and Aguennouz, M'Hammed
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- 2010
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17. Timing of Examination Affects Reliability of 99mTc-Methoxyisobutylisonitrile SPECT in Distinguishing Neoplastic from Nonneoplastic Brain Hematomas.
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Minutoli, Fabio, Angileri, Filippo F., Conti, Alfredo, Herberg, Astrid, Aricò, Demetrio, Baldari, Sara, Cardali, Salvatore, de Divitiis, Oreste, Germanò, Antonino, and Baldari, Sergio
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- 2005
18. 99mTc-MIBI SPECT in Distinguishing Neoplastic from Nonneoplastic Intracerebral Hematoma.
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Minutoli, Fabio, Angileri, Filippo F., Cosentino, Sebastiano, Pecorella, Giorgio Restifo, Cardali, Salvatore, De Divitiis, Oreste, Germanò, Antonino, and Baldari, Sergio
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- 2003
19. Youmans andWinn Neurological Surgery, Seventh Edition, 4-Volume Set.
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Tomasello, Francesco, Angileri, Filippo F., and Conti, Alfredo
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- 2018
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20. Lamina terminalis fenestration.
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TOMASELLO, FRANCESCO, ANGILERI, FILIPPO F., CARDALI, SALVATORE, and CONTI, ALFREDO
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- 2014
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21. Response.
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TOMASELLO, FRANCESCO, C0NTI, ALFREDO, CARDALI, SALVATORE, and ANGILERI, FILIPPO F.
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- 2013
22. An Unusual But Possible Complication After Endoscopic Third Ventriculostomy.
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Gorgoglione, Nicola, Fazzari, Elena, Alafaci, Concetta, Vitulli, Francesca, Zaccaria, Rossella, Angileri, Filippo F., Germanò, Antonino, and Esposito, Felice
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CEREBROSPINAL fluid shunts , *HYDROCEPHALUS , *CATHETERS , *OSTOMY , *SYMPTOMS - Abstract
We present an unusual but possible complication after ETV for the treatment of acute hydrocephalus due to malfunction of a previously implanted V-P shunt. A 12-year-old male patient was urgently operated upon by means of an endoscopic third-ventriculostomy and the positioning of a temporary external ventricular catheter because of the malfunction of a previously implanted V-P shunt; immediately after the operation, the tip of the external catheter caused an obstruction of the ostomy, which was resolved with the withdrawn of catheter for circa 1 cm, left closed and ultimately removed after 4 days. The patient did not present any further symptom and remained shunt-free at the last 2-year follow-up visit. One should consider such occurrence in cases of early ETV failure when a ventricular catheter is left in situ, even though temporarily. [ABSTRACT FROM AUTHOR]
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- 2021
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23. Prediction of diabetes insipidus occurrence after endoscopic endonasal removal of sellar lesions using MRI-based radiomics and machine learning.
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Mastantuoni C, Ugga L, Solari D, D'Aniello S, Spadarella G, Cuocolo R, Angileri FF, and Cavallo LM
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Background: Pituitary adenomas and craniopharyngiomas are the most common lesions of the sellar region. These tumors are responsible for invasion or compression of crucial neurovascular structures. The involvement of the pituitary stalk warrants high rates of both pre- and post- operative diabetes insipidus. The aim of our study was to assess the accuracy of machine learning analysis from preoperative MRI of pituitary adenomas and craniopharyngiomas for the prediction of DI occurrence., Methods: All patients underwent MRI exams either on a 1.5- or 3-T MR scanner from two Institutions, including coronal T2-weighted (T2-w) and contrast-enhanced T1-weighted (CE T1-w) Turbo Spin Echo sequences. Feature selection was carried out as a multi-step process, with a threshold of 0.75 to identify robust features. Further feature selection steps included filtering based on feature variance (threshold >0.01) and pairwise correlation (threshold <0.80). A Bayesian Network model was trained with 10-fold cross validation employing SMOTE to balance classes exclusively within the training folds., Results: Thirty patients were included in this study. In total 2394 features were extracted and 1791 (75%) resulted stable after ICC analysis. The number of variant features was 1351 and of non-colinear features was 125. Finally, 10 features were selected by oneR ranking. The Bayesian Network model showed an accuracy of 63% with a precision of 77% for DI prediction (0.68 area under the precision-recall curve)., Conclusions: We assessed the accuracy of machine learning analysis of texture-derived parameters from preoperative MRI of pituitary adenomas and craniopharyngiomas for the prediction of DI occurrence.
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- 2024
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24. Italian consensus and recommendations on diagnosis and treatment of low-grade gliomas. An intersociety (SINch/AINO/SIN) document.
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Rudà R, Angileri FF, Ius T, Silvani A, Sarubbo S, Solari A, Castellano A, Falini A, Pollo B, Del Basso De Caro M, Papagno C, Minniti G, De Paula U, Navarria P, Nicolato A, Salmaggi A, Pace A, Fabi A, Caffo M, Lombardi G, Carapella CM, Spena G, Iacoangeli M, Fontanella M, Germanò AF, Olivi A, Bello L, Esposito V, Skrap M, and Soffietti R
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- Consensus, Humans, Italy, Medical Oncology methods, Medical Oncology standards, Neurology methods, Neurology standards, Societies, Medical, Brain Neoplasms diagnosis, Brain Neoplasms therapy, Glioma diagnosis, Glioma therapy
- Abstract
In 2018, the SINch (Italian Society of Neurosurgery) Neuro-Oncology Section, AINO (Italian Association of Neuro-Oncology) and SIN (Italian Association of Neurology) Neuro-Oncology Section formed a collaborative Task Force to look at the diagnosis and treatment of low-grade gliomas (LGGs). The Task Force included neurologists, neurosurgeons, neuro-oncologists, pathologists, radiologists, radiation oncologists, medical oncologists, a neuropsychologist and a methodologist. For operational purposes, the Task Force was divided into five Working Groups: diagnosis, surgical treatment, adjuvant treatments, supportive therapies, and follow-up. The resulting guidance document is based on the available evidence and provides recommendations on diagnosis and treatment of LGG patients, considering all aspects of patient care along their disease trajectory.
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- 2020
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25. Gelatin-thrombin hemostatic matrix in neurosurgical procedures: hemostatic effectiveness and economic value of clinical and surgical procedure-related benefits.
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Esposito F, Cappabianca P, Angileri FF, Cavallo LM, Priola SM, Crimi S, Solari D, Germanò AF, and Tomasello F
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- Adult, Blood Transfusion economics, Female, Humans, Length of Stay economics, Male, Middle Aged, Neurosurgical Procedures methods, Postoperative Complications, Time Factors, Blood Loss, Surgical prevention & control, Gelatin blood, Hemostatics blood, Hemostatics economics, Thrombin metabolism
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Background: Gelatin-thrombin hemostatic matrix (FloSeal®) use is associated with shorter surgical times and less blood loss, parameters that are highly valued in neurosurgical procedures. We aimed to assess the effectiveness of gelatin-thrombin in neurosurgical procedures and estimate its economic value., Methods: In a 6-month retrospective evaluation at 2 hospitals, intraoperative and postoperative information were collected from patients undergoing neurosurgical procedures where bleeding was controlled with gelatin-thrombin matrix or according to local bleeding control guidelines (control group). Study endpoints were: length of surgery, estimated blood loss, hospitalization duration, blood units utilized, intensive care unit days, postoperative complications, and time to recovery. Statistical methods compared endpoints between the gelatin-thrombin and control groups and resource utilization costs were estimated., Results: Seventy-eight patients (38 gelatin-thrombin; 40 control) were included. Gelatin-thrombin was associated with a shorter surgery duration than control (166±40 versus 185±55 minutes, P=0.0839); a lower estimated blood loss (185±80 versus 250±95 mL; P=0.0017); a shorter hospital stay (10±3 versus 13±3 days; P<0.001); fewer intensive care unit days (10 days/3 patients and 20 days/4 patients); and shorter time to recovery (3±2.2 versus 4±2.8 weeks; P=0.0861). Fewer gelatin-thrombin patients experienced postoperative complications (3 minor) than the control group (5 minor; 3 major). No gelatin-thrombin patient required blood transfusion; 5 units were administered in the control group. The cost of gelatin-thrombin (€ 268.40/unit) was offset by the shorter surgery duration (difference of 19 minutes at € 858/hour) and the economic value of improved the other endpoint outcomes (i.e., shorter hospital stay, lesser blood loss/lack of need for transfusion, fewer intensive care unit days, and complications)., Conclusions: The use of gelatin-thrombin hemostatic matrix in patients undergoing neurosurgical procedures was associated with better intra- and postoperative parameters than conventional hemostasis methods, with these parameters having substantial economic benefits.
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- 2020
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26. Surgery of malignant motor-eloquent gliomas guided by sodium-fluorescein and navigated transcranial magnetic stimulation: a novel technique to increase the maximal safe resection.
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Raffa G, Picht T, Angileri FF, Youssef M, Conti A, Esposito F, Cardali SM, Vajkoczy P, and Germanò A
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- Humans, Neuronavigation methods, Brain Neoplasms surgery, Fluorescein pharmacology, Glioma surgery, Neurosurgical Procedures, Transcranial Magnetic Stimulation methods
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Background: Maximal safe resection is the goal of modern surgical treatment of high-grade gliomas (HGGs) located close to the motor cortex (M1) and/or the corticospinal tract (CST). Preoperative planning based on navigated transcranial magnetic stimulation (nTMS) and fluorescence-guided resection (FGR) using sodium-fluorescein have been separately described to increase the extent of resection (EOR) while preserving the motor pathway. We assessed the efficacy of the combination of these techniques for surgery of motor-eloquent HGGs., Methods: We enrolled patients with motor-eloquent HGGs operated at the Departments of Neurosurgery of the University of Messina, Italy, and of the Charitè Universitatsmedizin Berlin, Germany, between 2016 and 2019. All patients underwent nTMS mapping of M1, and nTMS-based DTI tractography of CST. Tumor resection was guided by intraoperative neurophysiological mapping (IONM) supported by sodium-fluorescein fluorescence and by intraoperative visualization of the nTMS-based information through neuronavigation. EOR and new permanent motor deficits were compared with a historical control group of patients operated exclusively with IONM guidance., Results: Seventy-nine patients were enrolled, while 55 patients were included as controls. The gross total resection (GTR) rate was significantly higher in patients operated using nTMS + FGR compared with controls (64.5% vs. 47.2%, P=0.04). As well, postoperative new permanent motor deficits were reduced in the study group vs. controls (11.4% vs. 20%)., Conclusions: In this series, the combination of sodium-fluorescein FGR with nTMS-based planning improved surgical treatment of motor-eloquent HGGs. It represents a valuable support to IONM-guided resection, increasing the GTR rate while reducing the occurrence of permanent motor deficits.
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- 2019
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27. The efficacy of 90cm-long peritoneal shunt catheters in newborns and infants.
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Raffa G, LA Torre D, Conti A, Cardali SM, Angileri FF, and Germanò A
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- Female, Humans, Incidence, Infant, Infant, Newborn, Male, Neurosurgical Procedures, Reoperation methods, Retrospective Studies, Treatment Outcome, Ventriculoperitoneal Shunt methods, Catheters, Indwelling, Hydrocephalus surgery, Reoperation instrumentation, Ventriculoperitoneal Shunt instrumentation
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Background: Ventriculoperitoneal (VP) shunt is one of the options for the treatment of hydrocephalus. The aim of this study is to describe the efficacy and safety of a 90cm-long peritoneal catheter in newborns and infants treated for hydrocephalus. We analyzed the incidence of distal-related complications and the need of successive surgeries for malfunction or for lengthening of the peritoneal catheter., Methods: We reviewed medical records of neonates and infants treated with a VP shunt using a 90cm-long peritoneal catheter. Function and integrity of shunts were assessed through abdominal echographic studies, skull, neck, chest and abdomen X-rays. We compared shunt revision rates due to distal complications and insufficient length of the peritoneal catheter in the study group with an historical control group composed by newborns and infants treated with a standard VP shunt at our Institution during the last twenty years., Results: Three neonates and 3 infants were treated with the insertion of the 90cm-long distal catheter into the peritoneal cavity for its total length. The mean follow-up was 7.6 years. As compared to controls, in the study group the revision rate for distal complications was not significantly increased (P=0.33), whereas revision surgeries due to insufficient peritoneal catheter length were significantly reduced (P=0.04)., Conclusions: This study demonstrates for the first time that the use of 90cm-long peritoneal catheters in neonates and infants is a safe and effective procedure. It does not increase the incidence of abdominal complications, avoiding the need of revision for insufficient length of the peritoneal catheter.
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- 2017
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28. MiRNA expression profiling in human gliomas: upregulated miR-363 increases cell survival and proliferation.
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Conti A, Romeo SG, Cama A, La Torre D, Barresi V, Pezzino G, Tomasello C, Cardali S, Angileri FF, Polito F, Ferlazzo G, Di Giorgio R, Germanò A, and Aguennouz M
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- Adult, Aged, Biomarkers, Tumor genetics, Blotting, Western, Brain Neoplasms genetics, Brain Neoplasms metabolism, Brain Neoplasms surgery, Follow-Up Studies, GAP-43 Protein genetics, GAP-43 Protein metabolism, Glioma genetics, Glioma metabolism, Glioma surgery, Histone Deacetylases genetics, Histone Deacetylases metabolism, Humans, Immunoenzyme Techniques, Male, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Prognosis, RNA, Messenger genetics, Real-Time Polymerase Chain Reaction, Repressor Proteins genetics, Repressor Proteins metabolism, Reverse Transcriptase Polymerase Chain Reaction, Survival Rate, Tumor Cells, Cultured, rap1 GTP-Binding Proteins genetics, rap1 GTP-Binding Proteins metabolism, Apoptosis, Biomarkers, Tumor metabolism, Brain Neoplasms pathology, Cell Proliferation, Gene Expression Regulation, Neoplastic, Glioma pathology, MicroRNAs genetics
- Abstract
The role of microRNAs (miRNAs) in glioma biology is increasingly recognized. To investigate the regulatory mechanisms governing the malignant signature of gliomas with different grades of malignancy, we analyzed miRNA expression profiles in human grade I-IV tumor samples and primary glioma cell cultures. Multiplex real-time PCR was used to profile miRNA expression in a set of World Health Organization (WHO) grade I (pilocytic astrocytoma), II (diffuse fibrillary astrocytoma), and IV (glioblastoma multiforme) astrocytic tumors and primary glioma cell cultures. Primary glioma cell cultures were used to evaluate the effect of transfection of specific miRNAs and miRNA inhibitors. miRNA microarray showed that a set of miRNAs was consistently upregulated in all glioma samples. miR-363 was upregulated in all tumor specimens and cell lines, and its expression correlated with tumor grading. The transfection of glioma cells with the specific inhibitor of miR-363 increased the expression level of tumor suppressor growth-associated protein 43 (GAP-43). Transfection of miR-363 induced cell survival, while inhibition of miR-363 significantly reduced glioma cell viability. Furthermore, miRNA-363 inhibition induced the downregulation of AKT, cyclin-D1, matrix metalloproteinase (MMP)-2, MMP-9, and Bcl-2 and upregulation of caspase 3. Together, these data suggest that the upregulation of miR-363 may play a role in malignant glioma signature.
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- 2016
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29. Post-Treatment Edema after Meningioma Radiosurgery is a Predictable Complication.
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Conti A, Pontoriero A, Siddi F, Iatì G, Cardali S, Angileri FF, Granata F, Pergolizzi S, Germanò A, and Tomasello F
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Symptomatic post-treatment edema (PTE) causing seizures, focal deficits, and intracranial hypertension is a rather common complication of meningioma radiosurgery. Factors associated to the occurrence of PTE still needs to be clarified. We retrospectively analyzed our patients' data to identify factors associated with the development of symptomatic PTE. Supposed risk factors were systematically analyzed. Between July 2007 and March 2014, 245 meningiomas in 229 patients were treated by a single fraction or multisession radiosurgery (2-5 fractions) or hypofractionated stereotactic radiotherapy (6-15 fractions) using the CyberKnife system (Accuray Inc., Sunnyvale, CA) at the University Hospital of Messina, Italy. Local tumor control was achieved in 200 of 212 patients with World Health Organization (WHO) Grade I meningiomas (94%) at a mean follow-up of 62 months. Symptomatic PTE on MRI was diagnosed in 19 patients (8.3%) causing seizure (n=17, 89%), aggravating headache (n=12, 63%), or focal deficits (n=13, 68%). Four variables were found to be associated with the likelihood of edema development, including tumor volume > 4.5 mL, non-basal tumor location, tight brain/tumor interface, and atypical histology. Nonetheless, when multivariate logistic regression analysis was performed, only tumor volume and brain-tumor interface turned out to be independent predictors of PTE development. Our results suggest that the factor associated with the risk of developing PTE is associated to characteristics of meningioma rather than to the treatment modality used. Accordingly, an appropriate patient selection is the way to achieve safe treatment and long-term disease control.
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- 2016
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30. Integration of functional neuroimaging in CyberKnife radiosurgery: feasibility and dosimetric results.
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Conti A, Pontoriero A, Ricciardi GK, Granata F, Vinci S, Angileri FF, Pergolizzi S, Alafaci C, Rizzo V, Quartarone A, Germanò A, Foroni RI, De Renzis C, and Tomasello F
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- Brain pathology, Diffusion Tensor Imaging methods, Diffusion Tensor Imaging standards, Feasibility Studies, Functional Neuroimaging standards, Humans, Radiosurgery standards, Retrospective Studies, Brain surgery, Functional Neuroimaging methods, Radiation Dosage, Radiosurgery methods
- Abstract
Object: The integration of state-of-the-art neuroimaging into treatment planning may increase the therapeutic potential of stereotactic radiosurgery. Functional neuroimaging, including functional MRI, navigated brain stimulation, and diffusion tensor imaging-based tractography, may guide the orientation of radiation beams to decrease the dose to critical cortical and subcortical areas. The authors describe their method of integrating functional neuroimaging technology into radiosurgical treatment planning using the CyberKnife radiosurgery system., Methods: The records of all patients who had undergone radiosurgery for brain lesions at the CyberKnife Center of the University of Messina, Italy, between July 2010 and July 2012 were analyzed. Among patients with brain lesions in critical areas, treatment planning with the integration of functional neuroimaging was performed in 25 patients. Morphological and functional imaging data sets were coregistered using the Multiplan dedicated treatment planning system. Treatment planning was initially based on morphological data; radiation dose distribution was then corrected in relation to the functionally relevant cortical and subcortical areas. The change in radiation dose distribution was then calculated., Results: The data sets could be easily and reliably integrated into the Cyberknife treatment planning. Using an inverse planning algorithm, the authors achieved an average 17% reduction in the radiation dose to functional areas. Further gain in terms of dose sparing compromised other important treatment parameters, including target coverage, conformality index, and number of monitor units. No neurological deficit due to radiation was recorded at the short-term follow-up., Conclusions: Radiosurgery treatments rely on the quality of neuroimaging. The integration of functional data allows a reduction in radiation doses to functional organs at risk, including critical cortical areas, subcortical tracts, and vascular structures. The relative simplicity of integrating functional neuroimaging into radiosurgery warrants further research to implement, standardize, and identify the limits of this procedure.
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- 2013
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31. Telemedicine-assisted treatment of patients with intracerebral hemorrhage.
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Angileri FF, Cardali S, Conti A, Raffa G, and Tomasello F
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- Adult, Algorithms, Cerebral Hemorrhage diagnostic imaging, Health Services Accessibility organization & administration, Humans, Italy, Middle Aged, Program Evaluation, Radiography, Referral and Consultation organization & administration, Retrospective Studies, Stroke diagnostic imaging, Young Adult, Cerebral Hemorrhage therapy, Neurosurgery organization & administration, Rural Health Services organization & administration, Stroke therapy, Telemedicine organization & administration
- Abstract
Object: Telemedicine provides a new approach to improve stroke care in community settings, delivering acute stroke expertise to hospitals in rural areas. Given the controversies in many aspects of the treatment of intracerebral hemorrhage (ICH) and the lack of guidelines, a prompt neurosurgical second opinion may facilitate the treatment of patients with ICH. Here, the authors' 8-year experience with the use of telemedicine in the management of ICH is reported., Methods: The medical records of patients with ICH treated through a telemedicine system in the district of Messina, Italy, between June 2003 and June 2011 were retrospectively reviewed. Neuroradiological and clinical data for patients were transmitted through a high-technology "hub-and-spoke" telemedicine network. Neurosurgical teleconsulting (at the hub) was available for 7 peripheral hospitals (spokes) serving about 700,000 people. The authors analyzed 1) the time between peripheral hospital admission and the specialized second opinion consultation, 2) primary and secondary transfers to the authors' neurosurgery department, and 3) the treatments (surgical or medical) of patients transferred to the hub., Results: The telemedicine network was used to treat more than 2800 patients, 733 with ICH. A neurosurgical consultation was provided in 38 minutes versus 160 minutes for a consultation without telemedicine. One hundred seventy-six (24%) of 733 patients were primarily transferred to the hub. Ninety-five patients (13%) underwent surgical treatment. The remaining 81 patients (11%) underwent neurointensive care. Eight (1.4%) of 557 patients treated at the spokes needed a secondary transfer for surgical treatment because of a worsening clinical condition and/or CT findings. Considering secondary and inappropriate transfers, the interpretation of data was correct in 96.5% of cases., Conclusions: Telemedicine allowed rapid visualization of neuroradiological and clinical data, providing neurosurgical expertise to community hospitals on demand and within minutes. It allowed the treatment of patients at peripheral hospitals and optimized resources. A small percentage of patients treated at the peripheral hospitals had secondary deterioration. Telemedicine allowed fast patient transfer when necessary and provided improved accuracy in patient care.
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- 2012
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32. Human leukocyte antigen frequency in human high-grade gliomas: a case-control study in Sicily.
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La Torre D, Maugeri R, Angileri FF, Pezzino G, Conti A, Cardali SM, Calisto A, Sciarrone G, Misefari A, Germanò A, and Tomasello F
- Subjects
- Aged, Brain Neoplasms classification, Case-Control Studies, Chi-Square Distribution, Confidence Intervals, Female, Gene Frequency, Genotype, Glioma classification, HLA Antigens classification, HLA Antigens genetics, Humans, Male, Middle Aged, Odds Ratio, Retrospective Studies, Sicily ethnology, Brain Neoplasms blood, Genetic Predisposition to Disease, Glioma blood, HLA Antigens blood
- Abstract
Objective: Human leukocyte antigens (HLAs) are widely expressed cell surface molecules that present antigenic peptides to T lymphocytes and modulate immune response against inflammatory and malignant diseases. The aim of this study was to compare HLA distribution in patients with newly diagnosed high-grade gliomas (HGGs) and 2 control groups from a restricted geographic area (eastern Sicily)., Methods: HLA allele frequency, as determined from peripheral blood of 56 adult patients with HGGs, was compared with that of 2 different control groups: 140 healthy bone marrow donors (group A) and 69 virtually brain tumor-free patients (group B). HLA expression was evaluated using a reverse transcriptase polymerase chain reaction-sequence-specific oligonucleotide probe., Results: There was significant expression of HLA-A*11 in patients with HGGs compared with control groups A and B (P < 0.003 and P < 0.018, respectively). Significant expression of HLA genotypes in patients with HGGs was also identified for HLA-DQB1*06 (P = 0.005), HLA-DRB1*14 (P = 0.001), and HLA-DRB3*01 (P = 0.007) compared with control group B. In HGG patients, there was statistically significantly decreased expression, compared with control groups A and B, of HLA-B*07 (P = 0.002 and P = 0.03, respectively) and HLA-C*04 (P = 0.007 and P = 0.016, respectively). There was statistically significant lower expression of HLA-C*05 in the HGG group compared with group B (P < 0.03)., Conclusion: This is the first study to describe the frequency of distribution of HLAs in a population from a restricted geographic area. The findings suggest a possible correlation between HLA allele distribution and the occurrence of newly diagnosed malignant astroglial brain tumors.
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- 2009
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33. Patients with moderate head injury: a prospective multicenter study of 315 patients.
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Compagnone C, d'Avella D, Servadei F, Angileri FF, Brambilla G, Conti C, Cristofori L, Delfini R, Denaro L, Ducati A, Gaini SM, Stefini R, Tomei G, Tagliaferri F, Trincia G, and Tomasello F
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Confidence Intervals, Craniocerebral Trauma diagnostic imaging, Craniocerebral Trauma epidemiology, Disability Evaluation, Disease Progression, Female, Forecasting, Glasgow Outcome Scale, Humans, Italy, Male, Middle Aged, Odds Ratio, Outcome Assessment, Health Care, Prospective Studies, Tomography, X-Ray Computed methods, Young Adult, Craniocerebral Trauma etiology, Craniocerebral Trauma surgery, Craniotomy methods, Neurosurgery methods
- Abstract
Objective: To analyze the risk factors of worst outcome associated with moderate head injury., Methods: Data on patients with moderate head injury were collected prospectively in 11 Italian neurosurgical units over a period of 18 months. Patients older than 18 years with blunt head injury and at least one Glasgow Coma Scale (GCS) score between 9 and 13 were enrolled. The outcome was determined at 6 months using the Glasgow Outcome Scale., Results: We analyzed 315 patients. Initial computed tomographic scans showed a diffuse injury type I or II in 63%, a mass lesion in 35%, and traumatic subarachnoid hemorrhage in 42% of the patients. The risk of progression toward a mass lesion was 23% when the admission computed tomographic scan showed diffuse injury type I or II. An emergency craniotomy was performed in 22% of the patients, delayed surgery was performed in 14%, and both were performed in 25%. A favorable outcome was obtained in 74% of the patients. When the GCS score was 9 or 10, the predictor of worst outcome was a motor GCS score of 4 or lower (odds ratio [OR], 8.08; 95% confidence interval [CI], 1.22-67.35; P = 0.008), but when the GCS score was 11 to 13, the factors associated with worst outcome were neuroworsening (OR, 3.43; 95% CI, 1.45-8.17; P = 0.002), seizures (OR, 7.94; 95% CI, 1.18-64.48; P = 0.02), and medical complications (OR, 4.24; 95% CI, 1.74-10.33; P = 0.0006)., Conclusion: There is a high percentage of surgery and worsening on computed tomographic scans in patients with moderate head injury. Neuroworsening, seizures, and medical complications as outcome predictors were more strongly associated with a GCS score of 11 to 13, whereas a low motor GCS score was more outcome-related in patients with GCS scores of 9 and 10.
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- 2009
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34. Timing of examination affects reliability of 99mTc-methoxyisobutylisonitrile SPECT in distinguishing neoplastic from nonneoplastic brain hematomas.
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Minutoli F, Angileri FF, Conti A, Herberg A, Aricò D, Baldari S, Cardali S, de Divitiis O, Germanò A, and Baldari S
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- Adult, Aged, Aged, 80 and over, Brain Neoplasms complications, Diagnosis, Differential, Female, Hematoma etiology, Humans, Male, Middle Aged, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Time Factors, Brain Neoplasms diagnostic imaging, Hematoma classification, Hematoma diagnostic imaging, Image Enhancement methods, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Unlabelled: 99mTc-methoxyisobutylisonitrile (MIBI) SPECT has been reported to be 100% sensitive and specific in the early differential diagnosis between neoplastic and nonneoplastic intraparenchymal cerebral hemorrhage (ICH), because nonneoplastic ICH does not show 99mTc-MIBI accumulation on SPECT examinations performed within 48 h from the onset of clinical symptoms. The aims of this study were to investigate the behavior of nonneoplastic ICH on more delayed 99mTc-MIBI SPECT examinations and to determine how the timing of examination affects the reliability of 99mTc-MIBI SPECT in differentiating neoplastic from nonneoplastic ICH., Methods: We prospectively enrolled 32 patients with acute neurologic deterioration caused by nontraumatic ICH. Patients were randomly allocated to 4 groups of 8 patients each. Patients in the first, second, third, and fourth groups underwent 99mTc-MIBI SPECT 2, 5, 10, and 30 d, respectively, after the onset of clinical deterioration. Furthermore, patients in the first group underwent a second (99m)Tc-MIBI SPECT examination at 30 d. 99mTc-MIBI SPECT studies were visually and semiquantitatively evaluated. Patients were followed up to confirm the nonneoplastic etiology of the ICH., Results: Two of the 32 studied patients, 1 in the second and 1 in the fourth group, were excluded because the ICH turned out to be related to a neoplastic lesion. Visual analysis showed no 99mTc-MIBI uptake in any patient studied at 2 d, whereas increased radiotracer uptake was found in 1 (14%) of 7, 5 (62.5%) of 8, and 5 (71%) of 7 patients studied 5, 10, and 30 d, respectively, after clinical deterioration. Moreover, with the semiquantitative analysis, a statistically significant difference was found among 99mTc-MIBI indices in the 4 groups (P = 0.0011). All patients in group 1 showed a significant 99mTc-MIBI accumulation when studied at 30 d., Conclusion: Nonneoplastic ICH, showing no 99mTc-MIBI uptake within 2 d, can show 99mTc-MIBI accumulation on more delayed imaging. 99mTc-MIBI SPECT can clearly differentiate between neoplastic and nonneoplastic ICH only during the acute phase. Our findings suggest that examination be performed early after the onset of symptoms and certainly within 5 d.
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- 2005
35. 99mTc-MIBI SPECT in distinguishing neoplastic from nonneoplastic intracerebral hematoma.
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Minutoli F, Angileri FF, Cosentino S, Pecorella GR, Cardali S, De Divitiis O, Germanò A, and Baldari S
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- Adult, Aged, Aged, 80 and over, Brain Neoplasms classification, Cerebral Hemorrhage classification, Diagnosis, Differential, Female, Hematoma classification, Hematoma complications, Hematoma diagnostic imaging, Humans, Male, Middle Aged, Predictive Value of Tests, Radiography, Radiopharmaceuticals, Reproducibility of Results, Sensitivity and Specificity, Brain Neoplasms complications, Brain Neoplasms diagnostic imaging, Cerebral Hemorrhage complications, Cerebral Hemorrhage diagnostic imaging, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon methods
- Abstract
Unlabelled: Distinguishing neoplastic from nonneoplastic intracerebral hematoma has great clinical relevance for the appropriate management of patients. Imaging is not always able to clearly identify a tumor-related intraparenchymal cerebral hemorrhage (ICH), especially in the acute phase, the diagnosis being frequently based on evolution patterns. The aim of this study was to test the value of (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-MIBI) SPECT as a noninvasive diagnostic tool in early diagnosis of hemorrhagic brain neoplasm., Methods: We prospectively studied 29 patients harboring a nontraumatic acute onset of clinical deterioration caused by ICH with atypical clinical or neuroradiologic features. All patients underwent (99m)Tc-MIBI SPECT within 48 h from the clinical onset. Early and delayed images were obtained. Both visual and semiquantitative analyses were performed. The (99m)Tc-MIBI index was obtained from both early and delayed images and the retention index was calculated., Results: In 19 patients (65.5%), a nonneoplastic hemorrhage (15 vascular degenerative diseases, 2 cavernous angiomas, 1 thrombosed middle cerebral artery giant aneurysm, and 1 sinus rectus thrombosis) was diagnosed by clinical and neuroradiologic follow-up or open surgery. In 10 patients (34.5%), a neoplastic hemorrhage (6 metastases, 2 glioblastomas multiforme, 1 ependymoma, and 1 intracranial angioblastic meningioma) was diagnosed by direct histologic typing (open surgery or stereotactic biopsy). In all neoplasm-related hemorrhages, a focal increased tracer uptake was observed in the area of the lesion, whereas no focal increased tracer uptake was noted in all nonneoplastic hematomas. A wide cutoff in the early ratio between neoplastic and nonneoplastic hemorrhages was found. Moreover, a statistically significant difference was found in the delayed ratio (P < 0.01) and the retention index (P < 0.05) between the 2 groups., Conclusion: Our data suggest that (99m)Tc-MIBI SPECT could play a role in the early noninvasive diagnostic work-up of hemorrhagic brain lesions, allowing a clear differentiation between neoplastic and nonneoplastic ICHs. The high availability and low cost of this nuclear medicine technique can be considered additional advantages.
- Published
- 2003
36. Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients.
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d'Avella D, Servadei F, Scerrati M, Tomei G, Brambilla G, Angileri FF, Massaro F, Cristofori L, Tartara F, Pozzati E, Delfini R, and Tomasello F
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Brain Concussion diagnostic imaging, Brain Concussion surgery, Brain Hemorrhage, Traumatic surgery, Child, Child, Preschool, Female, Glasgow Coma Scale, Hematoma diagnostic imaging, Hematoma surgery, Humans, Intracranial Embolism diagnostic imaging, Intracranial Embolism surgery, Italy, Male, Middle Aged, Prognosis, Retrospective Studies, Treatment Outcome, Brain Hemorrhage, Traumatic diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Objective: We report 81 patients with a traumatic intracerebellar hemorrhagic contusion or hematoma managed between 1996 and 1998 at 13 Italian neurosurgical centers., Methods: Each center provided data about patients' clinicoradiological findings, management, and outcomes, which were retrospectively reviewed., Results: A poor result occurred in 36 patients (44.4%). Forty-five patients (55.6%) had favorable results. For the purpose of data analysis, patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (39/81 cases; GCS score, > or =8), the outcome was favorable in 95% of cases. In Group 2 (42/81 cases; GCS score, <8), the outcome was poor in 81% of cases. Twenty-seven patients underwent posterior fossa surgery. Factors correlating with outcome were GCS score, status of the basal cisterns and the fourth ventricle, associated supratentorial traumatic lesions, mechanism of injury, and intracerebellar clot size. Multivariate analysis showed significant independent prognostic effect only for GCS score (P = 0.000) and the concomitant presence of supratentorial lesions (P = 0.0035)., Conclusion: This study describes clinicoradiological findings and prognostic factors regarding traumatic cerebellar injury. A general consensus emerged from this analysis that a conservative approach can be considered a viable, safe treatment option for noncomatose patients with intracerebellar clots measuring less than or equal to 3 cm, except when associated with other extradural or subdural posterior fossa focal lesions. Also, a general consensus was reached that surgery should be recommended for all patients with clots larger than 3 cm. The pathogenesis, biomechanics, and optimal management criteria of these rare lesions are still unclear, and larger observational studies are necessary.
- Published
- 2002
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