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4 results on '"Giovanna Fanelli"'

1. Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

Author

Davide Strambo, Luca Peruzzotti-Jametti, Aurora Semerano, Giovanna Fanelli, Franco Simionato, Roberto Chiesa, Enrico Rinaldi, Vittorio Martinelli, Giancarlo Comi, Marco Bacigaluppi, and Maria Sessa

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

Published
2017
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3. Reduction of Circulating HLA-DR

Author

Enrico, Ammirati, Marco, Magnoni, Francesco, Moroni, Simona, Di Terlizzi, Isabella, Scotti, Chiara, Villa, Federico, Sizzano, Matteo, Impellizzeri, Giovanna, Fanelli, Gloria, Esposito, Roberto, Chiesa, and Paolo G, Camici

Subjects
CD4-Positive T-Lymphocytes, Carotid Artery Diseases, Male, Neovascularization, Pathologic, Sulfur Hexafluoride, Contrast Media, HLA-DR Antigens, Middle Aged, Prognosis, Plaque, Atherosclerotic, Carotid Arteries, Phenotype, Predictive Value of Tests, Risk Factors, Asymptomatic Diseases, Humans, Female, Phospholipids, Aged, Ultrasonography
Published
2015

4. Computer-assisted EEG monitoring during carotid endarterectomy

Author

Giovanna Fanelli, C. Fornara, Marco Cursi, Roberto Chiesa, Maria Vittoria Meraviglia, Cristiano Rizzo, Amelia Tirelli, Giancarlo Comi, Laura Giacomotti, Fabio Minicucci, Minicucci, F, Cursi, M, Fornara, C, Rizzo, C, Chiesa, R, Tirelli, A, Fanelli, G, Meraviglia, Mv, Giacomotti, L, and Comi, G

Subjects
Male, genetic structures, Physiology, medicine.medical_treatment, Carotid endarterectomy, Physiology (medical), Monitoring, Intraoperative, Medicine, Humans, Spectral analysis, Carotid Stenosis, Diagnosis, Computer-Assisted, Endarterectomy, Aged, Aged, 80 and over, Endarterectomy, Carotid, business.industry, Eeg analysis, Electroencephalography, Middle Aged, Neurology, Anesthesia, Female, Neurology (clinical), business, Eeg monitoring
Abstract

The purpose of this study was to develop a reliable method of EEG analysis during carotid endarterectomy. EEGs of 104 patients under general anesthesia were processed by three different methods: a) 'on-line' visual analysis during surgery, b) 'off-line' visual analysis in laboratory, and c) computer analysis. To identify pathological EEGs, variability and asymmetry indexes of the 0.5-3.5 Hz and 8-15 Hz bands, absolute power and variability indexes of spectral edge frequency (SEF), and main dominant frequency were evaluated. On-line visual analysis showed clamp-related modifications in 29 EEGs (27.9%). Off-line visual analysis detected 24 pathological EEGs (23.1%): 18 with major changes and 6 with moderate changes. Computer analysis showed 21 EEGs (20.19%)with at least one altered index and 7 (6.7%) with altered variability for both SEF and 8-15 Hz power. The statistical analysis was significant for SEF variability and for 8-15 Hz power variability and asymmetry (P < 0.0001, analysis of variance test). While SEF and 8-15 Hz power variability did not appear influenced by anesthesia and single electrode artifacts, 8-15 Hz power asymmetry index was confounded by the presence of contralateral internal carotid occlusion. The data show that the use of these spectral indexes adds objective information to visual analysis, supporting and making easier intraoperative strategies. Their routine clinical use does not involve additional costs remaining technical requirements unchanged compared to traditional recording.

Published
2000

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