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1. Complex lava tube networks developed within the 1792-93 lava flow field on Mount Etna (Italy): insights for hazard assessment.

Author

Calvari, S., Giudice, G., Maugeri, R., Messina, D., Morgavi, D., Miraglia, L., La Spina, A., Spampinato, L., Lindsay, Jan Marie, and Nemeth, Karoly

Subjects
VOLCANIC fields, LAVA flows, LAVA, SURFACE texture, VOLCANOES
Abstract

Lava tubes are powerful heat insulators, allowing lava to practically keep the initial temperature and travel longer distances than when freely flowing on the ground surface. It is thus extremely important to recognize how, when and where these structures form within a lava flow field for hazard assessment purposes, in order to plan possible interventions should a lava flow approach inhabited areas. Often being formed within thick and complex lava flow fields, lava tubes are difficult to detect, study and explore. In this study, we analyse the 1792-93 Etna lava flow field emplaced on a steep slope (>4°) which comprises several lava tubes located at different distances from the eruptive fissure, at different levels within the lava flow field, and showing various inner morphologies, with peculiar inner features related to their maturity and eruptive history. Our aim is to verify whether it is possible to connect the underground features with features observed on the lava flow surface in order to reconstruct the extension of the tube network and unravel the genetic processes. Our results show that, in the studied lava flow field, a clear correspondence is possible between shallow tubes emplaced late during the lava flow field growth and surface textures. In addition, vertical and horizontal tube capture is very widespread, and might be the primary process for lava tube persistence and long life. Our results might be applicable to other lava tubes on Earth and other rocky planets. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Has intraoperative neuromonitoring changed the surgery for unruptured middle cerebral artery aneurysms? A retrospective comparative study

Author

Skrap, B., Di Bonaventura, Rina, Sturiale, Carmelo Lucio, Auricchio, Anna Maria, Maugeri, Maria Rosaria, Giammalva, G. R., Iacopino, D. G., Olivi, Alessandro, Marchese, Enrico, Albanese, Alessio, Di Bonaventura R., Sturiale C. L. (ORCID:0000-0002-4080-2492), Auricchio A. M., Maugeri R., Olivi A. (ORCID:0000-0002-4489-7564), Marchese E. (ORCID:0000-0001-8551-0357), Albanese A. (ORCID:0000-0001-8783-2974), Skrap, B., Di Bonaventura, Rina, Sturiale, Carmelo Lucio, Auricchio, Anna Maria, Maugeri, Maria Rosaria, Giammalva, G. R., Iacopino, D. G., Olivi, Alessandro, Marchese, Enrico, Albanese, Alessio, Di Bonaventura R., Sturiale C. L. (ORCID:0000-0002-4080-2492), Auricchio A. M., Maugeri R., Olivi A. (ORCID:0000-0002-4489-7564), Marchese E. (ORCID:0000-0001-8551-0357), and Albanese A. (ORCID:0000-0001-8783-2974)

Abstract

Intraoperative neurophysiological monitoring (IONM) represents one of the available technologies able to assess ischemia and aimed to improve surgical outcome reducing the treatment related morbidity in surgery for intracranial aneurysms. Many studies analyzing the impact of IONM are poised by the heterogeneity bias affecting the cohorts. We report our experience with IONM for surgery of unruptured middle cerebral artery (MCA) aneurysm in order to highlight its influence on functional and radiological outcome and surgical strategy. We retrospectively reviewed all MCA unruptured aneurysms treated between January 2013 and June 2021 by our institutional neurovascular team. Patients were divided into 2 groups according to the use of IONM. A total of 153 patients were included in the study, 52 operated on without IONM and 101 with IONM. The groups did not differ preoperatively regarding clinical status and aneurysm characteristics. Patients operated with IONM had better functional outcomes at discharge as well as at follow-up (p= 0.048, p=0.041) due to lower symptomatic ischemia and better radiological outcome due to lower rate of unexpected aneurysmal remnants (p= 0.0173). The introduction of IONM changed the use of temporary clipping (TeC), increasing its average duration (p= 0.01) improving the safety of dissecting and clipping the aneurysm. IONM in surgery for unruptured MCA aneurysm could improve the efficacy and safety of clipping strategy in the way it showed a role in changing the use of TeC and was associated to the reduction of unexpected aneurysmal remnants’ rate and improvement in both short- and long-term patient’s outcome.

Published
2023

4. Flow diversion for indirect carotid-cavernous fistula: Still an off-label indication?

Author

Brunasso, L, Casamassima, N, Abrignani, S, Sturiale, CL, Incandela, F, Giammalva, GR, Iacopino, D, Maugeri, R, Craparo, G, Brunasso, L, Casamassima, N, Abrignani, S, Sturiale, CL, Incandela, F, Giammalva, GR, Iacopino, D, Maugeri, R, and Craparo, G

Subjects
Carotid cavernous fistula, Flow diversion, Endovascular treatment, Surgery, Neurology (clinical), Indirect carotid cavernous fistula (Indirect CCF), Barrow B type fistula
Abstract

Background: Flow diversion (FD) is an established treatment for large or giant wide-necked unruptured intracranial aneurysms. In the past few years, the use of flow diverter devices was extended to several other “off-label” indications, including solitary or adjunctive treatment to coil embolization for direct (Barrow A type) carotid cavernous fistulas (CCFs). The use of liquid embolic agents still represents the first-line treatment for indirect CCFs. Typically, the ipsilateral inferior petrosal sinus or superior ophthalmic vein (SOV) is the preferred transvenous routes to access CCFs. In some cases, vessel tortuosity or different features make the endovascular access challenging, thus requiring different approaches and strategies. The aim of the study is to discuss rational and technical aspect in treating indirect CCFs referring to the most up-to-date literature. An alternative experience-based endovascular strategy with FD is described. Methods: We report the case of a 54-year-old woman diagnosed with indirect CCF and treated with flow diverter stent. Results: After multiple unsuccessful attempts at transarterial right SOV catheterization, a right indirect CCF fed by a single trunk at the ophthalmic origin from the internal carotid artery (ICA) was treated by ICA stand-alone FD. Blood flow was redirect and successfully reduced through the fistula, with immediately postprocedure improvement of the patient’s clinical status (ipsilateral proptosis and chemosis). Ten-months radiological follow-up showed the complete obliteration of the fistula. No adjunctive endovascular treatment was performed. Conclusion: FD appears a reasonable alternative stand-alone endovascular strategy also for selected difficult-to-access indirect CCFs, when all conventional routes are judged unfeasible. Further investigations will be necessary to better define and support this potential lesson-learned application.

Published
2023
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5. Management of intracranial hypertension following traumatic brain injury: A best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy: Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Author

Iaccarino, C, Lippa, L, Munari, M, Castioni, C, Robba, C, Caricato, A, Pompucci, A, Signoretti, S, Zona, G, Rasulo, F, Aimar, E, Amato, S, Angileri, F, Anile, C, Assietti, R, Baratto, V, Barbanera, A, Basile, L, Battaglia, R, Bellocchi, S, Bertuccio, A, Blanco, S, Bolognini, A, Boniferro, B, Bordi, L, Bortolotti, C, Brandini, V, Broger, M, Brollo, M, Caffarella, D, Caggiano, C, Cantisani, P, Capone, C, Cappelletto, B, Capuano, C, Carangelo, B, Caruselli, G, Chessa, M, Chiara, M, Chibbaro, S, Cioffi, V, Ciprianocecchi, P, Colistra, D, Conti, C, Contratti, F, Costella, G, Cuoci, A, D'Avella, D, D'Ercole, M, Deangelis, M, Defalco, R, de Luca, G, de Marinis, P, Del Vecchio, C, Delfinis, C, Denaro, L, Deodato, F, Desogus, N, Disomma, A, Domenicucci, M, Dones, F, Fina, M, Fiori, L, Fricia, M, Gaetani, P, Gazzeri, R, Gentile, M, Germano, A, Ghadirpour, R, Gianfreda, C, Gigante, N, Gigli, R, Giorgetti, J, Giusa, M, Gravina, U, Grippi, L, Guida, F, Guizzardi, G, Iannuzzo, G, Kropp, M, Lattanzi, L, Lucantoni, D, Maffei, L, Magliulo, M, Marconi, F, Marruzzo, D, Martellotta, N, Marton, E, Maugeri, R, Mauro, G, Meli, F, Menniti, A, Merciadri, P, Milanese, L, Nardacci, B, Nasi, D, Orvieto, P, Pacca, P, Pansini, G, Panzarasa, G, Passanisi, M, Pavesi, G, Pizzoni, C, Pulera, F, Rapana, A, Ricci, A, Rispoli, R, Rotondo, M, Russo, N, Santilli, S, Scarano, E, Schwarz, A, Servadei, F, Simonetti, G, Stefini, R, Talamonti, G, Turrisi, A, Valente, V, Villa, A, Vindigni, M, Visocchi, M, Vitali, M, Wierzbicki, V, Zambon, G, Zanotti, B, Zenga, F, Alampi, D, Alessandri, F, Aloj, F, Amigoni, A, Aspide, R, Bertuetti, R, Betti, V, Bilotta, F, Bonato, V, Bosco, E, Brita, M, Buscema, G, Cafiero, T, Cappuccio, D, Caradonna, M, Caria, C, Casartelliliviero, M, Ciritella, P, Cirrincione, S, Citerio, G, Colelli, S, Coletta, F, Concordia, L, Congedo, E, Covotta, M, Crimella, F, Dall'Acqua, G, De Cassai, A, Defulviis, S, Deperi, E, Deana, C, Delgaudio, A, Denittis, N, Dicolandrea, S, Divezza, F, Ferri, F, Flocco, R, Fontana, C, Forastierimolinari, A, Frangiosa, A, Fumagalli, P, Fuselli, E, Garbarino, M, Gelormini, D, Geraci, C, Geraldini, F, Giacomucci, A, Giampaoli, V, Giorgetti, D, Gritti, P, Gualdani, S, Iacovazzo, C, Iermano, C, Latronico, N, Lugari, S, Lusenti, F, Maglione, C, Magnoni, S, Maiarota, F, Malla, M, Marchesi, M, Martino, C, Matteotti, I, Mazzeo, A, Morello, G, Nardiello, I, Paticchio, F, Pegoli, M, Perotti, V, Piazzolla, M, Picciafuochi, F, Rachedi, N, Radolovich, D, Recchia, A, Riccardi, S, Romagnoli, S, Sala, S, Scafuro, M, Sgarlata, P, Soragni, A, Stefani, F, Stival, E, Stofella, G, Terranova, F, Tinturini, R, Togni, T, Toto, R, Trapani, D, Tringali, E, Tullo, L, Valente, A, Valeo, T, Varelli, G, Villani, R, Zamacavicchi, F, Zanello, M, Zarrillo, N, Zugni, N, Iaccarino C., Lippa L., Munari M., Castioni C. A., Robba C., Caricato A., Pompucci A., Signoretti S., Zona G., Rasulo F. A., Aimar E., Amato S., Angileri F. F., Anile C., Assietti R., Baratto V., Barbanera A., Basile L., Battaglia R., Bellocchi S., Bertuccio A., Blanco S., Bolognini A., Boniferro B., Bordi L., Bortolotti C., Brandini V., Broger M., Brollo M., Caffarella D. D., Caggiano C., Cantisani P. L., Capone C., Cappelletto B., Capuano C., Carangelo B., Caruselli G., Chessa M. A., Chiara M., Chibbaro S., Cioffi V., Ciprianocecchi P., Colistra D., Conti C., Contratti F., Costella G. B., Cuoci A., D'Avella D., D'Ercole M., Deangelis M., Defalco R., de Luca G., de Marinis P., Del Vecchio C., Delfinis C., Denaro L., Deodato F., Desogus N., Disomma A., Domenicucci M., Dones F., Fina M., Fiori L., Fricia M., Gaetani P., Gazzeri R., Gentile M., Germano A., Ghadirpour R., Gianfreda C. D., Gigante N., Gigli R., Giorgetti J., Giusa M., Gravina U. G., Grippi L., Guida F., Guizzardi G., Iannuzzo G., Kropp M., Lattanzi L., Lucantoni D., Maffei L., Magliulo M., Marconi F., Marruzzo D., Martellotta N., Marton E., Maugeri R., Mauro G., Meli F., Menniti A., Merciadri P., Milanese L., Nardacci B., Nasi D., Orvieto P., Pacca P., Pansini G., Panzarasa G., Passanisi M., Pavesi G., Pizzoni C., Pulera F., Rapana A., Ricci A., Rispoli R., Rotondo M., Russo N., Santilli S., Scarano E., Schwarz A., Servadei F., Simonetti G., Stefini R., Talamonti G., Turrisi A., Valente V. M., Villa A., Vindigni M., Visocchi M., Vitali M., Wierzbicki V., Zambon G., Zanotti B., Zenga F., Alampi D., Alessandri F., Aloj F., Amigoni A., Aspide R., Bertuetti R., Betti V., Bilotta F., Bonato V., Bosco E., Brita M., Buscema G., Cafiero T., Cappuccio D., Caradonna M., Caria C. G., Casartelliliviero M., Ciritella P., Cirrincione S., Citerio G., Colelli S., Coletta F., Concordia L., Congedo E., Covotta M., Crimella F., Dall'Acqua G., De Cassai A., Defulviis S., Deperi E., Deana C., Delgaudio A., Denittis N., Dicolandrea S., Divezza F., Ferri F., Flocco R., Fontana C., Forastierimolinari A., Frangiosa A., Fumagalli P., Fuselli E., Garbarino M. M., Gelormini D., Geraci C., Geraldini F., Giacomucci A., Giampaoli V., Giorgetti D., Gritti P., Gualdani S., Iacovazzo C., Iermano C., Latronico N., Lugari S., Lusenti F., Maglione C., Magnoni S., Maiarota F., Malla M., Marchesi M., Martino C., Matteotti I., Mazzeo A. T., Morello G., Nardiello I., Paticchio F., Pegoli M., Perotti V., Piazzolla M., Picciafuochi F., Rachedi N., Radolovich D. K., Recchia A., Riccardi S., Romagnoli S., Sala S., Scafuro M. A., Sgarlata P., Soragni A., Stefani F., Stival E., Stofella G., Terranova F., Tinturini R., Togni T., Toto R., Trapani D., Tringali E., Tullo L., Valente A., Valeo T., Varelli G., Villani R., Zamacavicchi F., Zanello M., Zarrillo N., Zugni N., Iaccarino, C, Lippa, L, Munari, M, Castioni, C, Robba, C, Caricato, A, Pompucci, A, Signoretti, S, Zona, G, Rasulo, F, Aimar, E, Amato, S, Angileri, F, Anile, C, Assietti, R, Baratto, V, Barbanera, A, Basile, L, Battaglia, R, Bellocchi, S, Bertuccio, A, Blanco, S, Bolognini, A, Boniferro, B, Bordi, L, Bortolotti, C, Brandini, V, Broger, M, Brollo, M, Caffarella, D, Caggiano, C, Cantisani, P, Capone, C, Cappelletto, B, Capuano, C, Carangelo, B, Caruselli, G, Chessa, M, Chiara, M, Chibbaro, S, Cioffi, V, Ciprianocecchi, P, Colistra, D, Conti, C, Contratti, F, Costella, G, Cuoci, A, D'Avella, D, D'Ercole, M, Deangelis, M, Defalco, R, de Luca, G, de Marinis, P, Del Vecchio, C, Delfinis, C, Denaro, L, Deodato, F, Desogus, N, Disomma, A, Domenicucci, M, Dones, F, Fina, M, Fiori, L, Fricia, M, Gaetani, P, Gazzeri, R, Gentile, M, Germano, A, Ghadirpour, R, Gianfreda, C, Gigante, N, Gigli, R, Giorgetti, J, Giusa, M, Gravina, U, Grippi, L, Guida, F, Guizzardi, G, Iannuzzo, G, Kropp, M, Lattanzi, L, Lucantoni, D, Maffei, L, Magliulo, M, Marconi, F, Marruzzo, D, Martellotta, N, Marton, E, Maugeri, R, Mauro, G, Meli, F, Menniti, A, Merciadri, P, Milanese, L, Nardacci, B, Nasi, D, Orvieto, P, Pacca, P, Pansini, G, Panzarasa, G, Passanisi, M, Pavesi, G, Pizzoni, C, Pulera, F, Rapana, A, Ricci, A, Rispoli, R, Rotondo, M, Russo, N, Santilli, S, Scarano, E, Schwarz, A, Servadei, F, Simonetti, G, Stefini, R, Talamonti, G, Turrisi, A, Valente, V, Villa, A, Vindigni, M, Visocchi, M, Vitali, M, Wierzbicki, V, Zambon, G, Zanotti, B, Zenga, F, Alampi, D, Alessandri, F, Aloj, F, Amigoni, A, Aspide, R, Bertuetti, R, Betti, V, Bilotta, F, Bonato, V, Bosco, E, Brita, M, Buscema, G, Cafiero, T, Cappuccio, D, Caradonna, M, Caria, C, Casartelliliviero, M, Ciritella, P, Cirrincione, S, Citerio, G, Colelli, S, Coletta, F, Concordia, L, Congedo, E, Covotta, M, Crimella, F, Dall'Acqua, G, De Cassai, A, Defulviis, S, Deperi, E, Deana, C, Delgaudio, A, Denittis, N, Dicolandrea, S, Divezza, F, Ferri, F, Flocco, R, Fontana, C, Forastierimolinari, A, Frangiosa, A, Fumagalli, P, Fuselli, E, Garbarino, M, Gelormini, D, Geraci, C, Geraldini, F, Giacomucci, A, Giampaoli, V, Giorgetti, D, Gritti, P, Gualdani, S, Iacovazzo, C, Iermano, C, Latronico, N, Lugari, S, Lusenti, F, Maglione, C, Magnoni, S, Maiarota, F, Malla, M, Marchesi, M, Martino, C, Matteotti, I, Mazzeo, A, Morello, G, Nardiello, I, Paticchio, F, Pegoli, M, Perotti, V, Piazzolla, M, Picciafuochi, F, Rachedi, N, Radolovich, D, Recchia, A, Riccardi, S, Romagnoli, S, Sala, S, Scafuro, M, Sgarlata, P, Soragni, A, Stefani, F, Stival, E, Stofella, G, Terranova, F, Tinturini, R, Togni, T, Toto, R, Trapani, D, Tringali, E, Tullo, L, Valente, A, Valeo, T, Varelli, G, Villani, R, Zamacavicchi, F, Zanello, M, Zarrillo, N, Zugni, N, Iaccarino C., Lippa L., Munari M., Castioni C. A., Robba C., Caricato A., Pompucci A., Signoretti S., Zona G., Rasulo F. A., Aimar E., Amato S., Angileri F. F., Anile C., Assietti R., Baratto V., Barbanera A., Basile L., Battaglia R., Bellocchi S., Bertuccio A., Blanco S., Bolognini A., Boniferro B., Bordi L., Bortolotti C., Brandini V., Broger M., Brollo M., Caffarella D. D., Caggiano C., Cantisani P. L., Capone C., Cappelletto B., Capuano C., Carangelo B., Caruselli G., Chessa M. A., Chiara M., Chibbaro S., Cioffi V., Ciprianocecchi P., Colistra D., Conti C., Contratti F., Costella G. B., Cuoci A., D'Avella D., D'Ercole M., Deangelis M., Defalco R., de Luca G., de Marinis P., Del Vecchio C., Delfinis C., Denaro L., Deodato F., Desogus N., Disomma A., Domenicucci M., Dones F., Fina M., Fiori L., Fricia M., Gaetani P., Gazzeri R., Gentile M., Germano A., Ghadirpour R., Gianfreda C. D., Gigante N., Gigli R., Giorgetti J., Giusa M., Gravina U. G., Grippi L., Guida F., Guizzardi G., Iannuzzo G., Kropp M., Lattanzi L., Lucantoni D., Maffei L., Magliulo M., Marconi F., Marruzzo D., Martellotta N., Marton E., Maugeri R., Mauro G., Meli F., Menniti A., Merciadri P., Milanese L., Nardacci B., Nasi D., Orvieto P., Pacca P., Pansini G., Panzarasa G., Passanisi M., Pavesi G., Pizzoni C., Pulera F., Rapana A., Ricci A., Rispoli R., Rotondo M., Russo N., Santilli S., Scarano E., Schwarz A., Servadei F., Simonetti G., Stefini R., Talamonti G., Turrisi A., Valente V. M., Villa A., Vindigni M., Visocchi M., Vitali M., Wierzbicki V., Zambon G., Zanotti B., Zenga F., Alampi D., Alessandri F., Aloj F., Amigoni A., Aspide R., Bertuetti R., Betti V., Bilotta F., Bonato V., Bosco E., Brita M., Buscema G., Cafiero T., Cappuccio D., Caradonna M., Caria C. G., Casartelliliviero M., Ciritella P., Cirrincione S., Citerio G., Colelli S., Coletta F., Concordia L., Congedo E., Covotta M., Crimella F., Dall'Acqua G., De Cassai A., Defulviis S., Deperi E., Deana C., Delgaudio A., Denittis N., Dicolandrea S., Divezza F., Ferri F., Flocco R., Fontana C., Forastierimolinari A., Frangiosa A., Fumagalli P., Fuselli E., Garbarino M. M., Gelormini D., Geraci C., Geraldini F., Giacomucci A., Giampaoli V., Giorgetti D., Gritti P., Gualdani S., Iacovazzo C., Iermano C., Latronico N., Lugari S., Lusenti F., Maglione C., Magnoni S., Maiarota F., Malla M., Marchesi M., Martino C., Matteotti I., Mazzeo A. T., Morello G., Nardiello I., Paticchio F., Pegoli M., Perotti V., Piazzolla M., Picciafuochi F., Rachedi N., Radolovich D. K., Recchia A., Riccardi S., Romagnoli S., Sala S., Scafuro M. A., Sgarlata P., Soragni A., Stefani F., Stival E., Stofella G., Terranova F., Tinturini R., Togni T., Toto R., Trapani D., Tringali E., Tullo L., Valente A., Valeo T., Varelli G., Villani R., Zamacavicchi F., Zanello M., Zarrillo N., and Zugni N.

Abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from “TBI Section” of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the “T

Published
2021

6. Pulsed radiofrequency energy device (PEAK plasmablade™) and CustomBone® Cranioplasty: an appealing surgical rendez-vous.

Author

Graziano, F., Maugeri, R., Giammalva, G. R., Lo Bue, E., Zabbia, G., and Iacopino, D. G.

Subjects
*RADIO frequency therapy, *SCARS, *HOSPITAL admission & discharge, *OPERATIVE surgery, *TREATMENT effectiveness, *RADIO frequency
Abstract

CustomBone® prosthesis is a widely recognized effective and successful technique for the reconstruction of cranial bone defects. Prior the cranioplasty implant, meticulous dissection within thick scar tissue is required. During this delicate surgical manoeuvre is vital to avoid damage to the skin flap itself and to the underlying cerebrovascular structures. We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc). It reduced the incidence of post operativesubgaleal hematoma, the operative times and the intra operative blood loss following cranioplasty compared to the traditional scalpel and scissor dissection. The authors present a one centre case series study to review the indications, safety and efficacy of the PEAK PlasmaBlade™ in adult patientsunderwent cranioplasty. Two surgical techniques for tissue dissection were compared: PEAK PlasmaBlade™ versus scalpel and scissor dissection (SSD). Treatment outcomes following each of these surgical approaches, relative to rate of post-operative subgalealhematoma formation, hospital admission, and operative times were compared. A total of 10 patients that had cranioplasty treatment were evaluated. In patients underwent scalp dissection with the PEAKPlasmaBlade™, we observed a reduction in the operative times, in the subgaleal hematoma formation and then in the hospital stay. PEAK PlasmaBlade™ revealed to be a safe and effective device in tissues dissection for cranioplasty implant. It provided reduction of the rate of subgaleal hematoma formation, operating times and less potential risk to damage cerebrovascular structures. [ABSTRACT FROM AUTHOR]

Published
2023
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7. Largest neurosurgical social media group and its impact on communication and research

Author

Chaurasia, B., Umana, G.E., Scalia, G., Barresi, F., Yağmurlu, K., Soldozy, S., Deora, H., Raudino, G., Graziano, F., Nicoletti, G.F., Cicero, S. Lo, Maugeri, R., Tomasi, S.O., Zileli, M., Graffeo, C.S., Herrera, R.R., Shah, A., Ha, Y., Chaurasiya, R.K., Kim, H.S., Sameshima, T., Borba, L., Rotta, J.M., Chowdhury, D., Chaurasia, R.K., Grotenhuis, J.A., Linfante, I., Sekhar, L.N., Chaurasia, B., Umana, G.E., Scalia, G., Barresi, F., Yağmurlu, K., Soldozy, S., Deora, H., Raudino, G., Graziano, F., Nicoletti, G.F., Cicero, S. Lo, Maugeri, R., Tomasi, S.O., Zileli, M., Graffeo, C.S., Herrera, R.R., Shah, A., Ha, Y., Chaurasiya, R.K., Kim, H.S., Sameshima, T., Borba, L., Rotta, J.M., Chowdhury, D., Chaurasia, R.K., Grotenhuis, J.A., Linfante, I., and Sekhar, L.N.

Abstract

Item does not contain fulltext, BACKGROUND: The use of social media to communicate and disseminate knowledge has increased exponentially, especially in the field of neurosurgery. 'Neurosurgery cocktail' (NC) was developed by a group of young neurosurgeons as a means of sharing didactic materials and clinical experiences via social media. It connects 35.000 neurosurgeons worldwide on multiple platforms, primarily Facebook and Twitter. Given the rising utilization of social media in neurosurgery, the popularity of NC has also increased since its inception. In this study, the authors surveyed the social media analytics of NC for both Facebook and Twitter. Besides, we reviewed the literature on the use of social media in neurosurgery. METHODS: Facebook and Twitter metrics were extracted through each respective platform's analytics tools from December 2020 (earliest available date for data analysis) through January 2021. A literature search was conducted using PubMed (MEDLINE) and Scopus databases. RESULTS: On Facebook, as of January 2021, the group had a total of 25.590 members (87.6% male), most commonly (29%) between 35 and 44 years of age with over 100 countries were represented. As of January 2021, they had amassed 6457 followers on Twitter. During the last 28 d between December 2020 and January 2021, the account published 65 tweets that garnered a total of 196,900 impressions. Twelve articles were identified in our literature review on the use of social media within the neurosurgical community. CONCLUSIONS: NC is one of the most widely utilized neurosurgical social media resources available. Sharing knowledge has been broadened thanks to the recent social media evolution, and NC has become a leading player in disseminating neurosurgical knowledge.

Published
2022

16. Management of intracranial hypertension following traumatic brain injury: A best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy: Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Author

Iaccarino, C., Lippa, L., Munari, M., Castioni, C. A., Robba, C., Caricato, Anselmo, Pompucci, Angelo, Signoretti, S., Zona, G., Rasulo, F. A., Aimar, E., Amato, S., Angileri, F. F., Anile, Carmelo, Assietti, R., Baratto, V., Barbanera, A., Basile, L., Battaglia, R., Bellocchi, S., Bertuccio, A., Blanco, S., Bolognini, A., Boniferro, B., Bordi, L., Bortolotti, C., Brandini, V., Broger, Maximilian, Brollo, M., Caffarella, D. D., Caggiano, Cinzia, Cantisani, P. L., Capone, C., Cappelletto, B., Capuano, C., Carangelo, B., Caruselli, G., Chessa, M. A., Chiara, M., Chibbaro, S., Cioffi, V., Ciprianocecchi, P., Colistra, D., Conti, C., Contratti, F., Costella, G. B., Cuoci, A., D'Avella, D., D'Ercole, Manuela, Deangelis, M., Defalco, R., de Luca, G., de Marinis, P., Del Vecchio, C., Delfinis, C., Denaro, Luca, Deodato, F., Desogus, N., Disomma, A., Domenicucci, M., Dones, F., Fina, M., Fiori, L., Fricia, M., Gaetani, P., Gazzeri, R., Gentile, M., Germano, A., Ghadirpour, R., Gianfreda, C. D., Gigante, N., Gigli, R., Giorgetti, J., Giusa, M., Gravina, U. G., Grippi, L., Guida, F., Guizzardi, G., Iannuzzo, G., Kropp, M., Lattanzi, L., Lucantoni, D., Maffei, L., Magliulo, M., Marconi, F., Marruzzo, D., Martellotta, N., Marton, E., Maugeri, R., Mauro, G., Meli, F., Menniti, A., Merciadri, P., Milanese, L., Nardacci, B., Nasi, D., Orvieto, P., Pacca, P., Pansini, G., Panzarasa, G., Passanisi, M., Pavesi, G., Pizzoni, C., Pulera, F., Rapana, A., Ricci, A., Rispoli, R., Rotondo, M., Russo, N., Santilli, S., Scarano, E., Schwarz, A., Servadei, Franco, Simonetti, G., Stefini, R., Talamonti, G., Turrisi, A., Valente, V. M., Villa, A., Vindigni, M., Visocchi, Massimiliano, Vitali, M., Wierzbicki, V., Zambon, G., Zanotti, B., Zenga, F., Alampi, D., Alessandri, F., Aloj, F., Amigoni, A., Aspide, R., Bertuetti, R., Betti, V., Bilotta, F., Bonato, V., Bosco, E., Brita, M., Buscema, G., Cafiero, T., Cappuccio, D., Caradonna, M., Caria, C. G., Casartelliliviero, M., Ciritella, P., Cirrincione, S., Citerio, G., Colelli, S., Coletta, F., Concordia, L., Congedo, E., Covotta, M., Crimella, F., Dall'Acqua, G., De Cassai, A., Defulviis, S., Deperi, E., Deana, C., Delgaudio, A., Denittis, N., Dicolandrea, S., Divezza, F., Ferri, F., Flocco, R., Fontana, C., Forastierimolinari, A., Frangiosa, A., Fumagalli, P., Fuselli, E., Garbarino, M. M., Gelormini, D., Geraci, C., Geraldini, F., Giacomucci, A., Giampaoli, V., Giorgetti, D., Gritti, P., Gualdani, S., Iacovazzo, C., Iermano, C., Latronico, N., Lugari, S., Lusenti, F., Maglione, C., Magnoni, S., Maiarota, F., Malla, M., Marchesi, M., Martino, C., Matteotti, I., Mazzeo, A. T., Morello, G., Nardiello, I., Paticchio, F., Pegoli, M., Perotti, Valerio, Piazzolla, M., Picciafuochi, F., Rachedi, N., Radolovich, D. K., Recchia, A., Riccardi, S., Romagnoli, S., Sala, S., Scafuro, M. A., Sgarlata, P., Soragni, A., Stefani, F., Stival, Eleonora, Stofella, G., Terranova, F., Tinturini, R., Togni, T., Toto, R., Trapani, D., Tringali, E., Tullo, L., Valente, A., Valeo, T., Varelli, G., Villani, R., Zamacavicchi, F., Zanello, M., Zarrillo, N., Zugni, N., Caricato A. (ORCID:0000-0001-5929-120X), Pompucci A. (ORCID:0000-0002-5427-9719), Anile C. (ORCID:0000-0002-0481-9713), Broger M., Caggiano C., D'Ercole M., Denaro L., Servadei F., Visocchi M. (ORCID:0000-0003-1087-0491), Perotti V. (ORCID:0000-0001-9461-2101), Stival E., Iaccarino, C., Lippa, L., Munari, M., Castioni, C. A., Robba, C., Caricato, Anselmo, Pompucci, Angelo, Signoretti, S., Zona, G., Rasulo, F. A., Aimar, E., Amato, S., Angileri, F. F., Anile, Carmelo, Assietti, R., Baratto, V., Barbanera, A., Basile, L., Battaglia, R., Bellocchi, S., Bertuccio, A., Blanco, S., Bolognini, A., Boniferro, B., Bordi, L., Bortolotti, C., Brandini, V., Broger, Maximilian, Brollo, M., Caffarella, D. D., Caggiano, Cinzia, Cantisani, P. L., Capone, C., Cappelletto, B., Capuano, C., Carangelo, B., Caruselli, G., Chessa, M. A., Chiara, M., Chibbaro, S., Cioffi, V., Ciprianocecchi, P., Colistra, D., Conti, C., Contratti, F., Costella, G. B., Cuoci, A., D'Avella, D., D'Ercole, Manuela, Deangelis, M., Defalco, R., de Luca, G., de Marinis, P., Del Vecchio, C., Delfinis, C., Denaro, Luca, Deodato, F., Desogus, N., Disomma, A., Domenicucci, M., Dones, F., Fina, M., Fiori, L., Fricia, M., Gaetani, P., Gazzeri, R., Gentile, M., Germano, A., Ghadirpour, R., Gianfreda, C. D., Gigante, N., Gigli, R., Giorgetti, J., Giusa, M., Gravina, U. G., Grippi, L., Guida, F., Guizzardi, G., Iannuzzo, G., Kropp, M., Lattanzi, L., Lucantoni, D., Maffei, L., Magliulo, M., Marconi, F., Marruzzo, D., Martellotta, N., Marton, E., Maugeri, R., Mauro, G., Meli, F., Menniti, A., Merciadri, P., Milanese, L., Nardacci, B., Nasi, D., Orvieto, P., Pacca, P., Pansini, G., Panzarasa, G., Passanisi, M., Pavesi, G., Pizzoni, C., Pulera, F., Rapana, A., Ricci, A., Rispoli, R., Rotondo, M., Russo, N., Santilli, S., Scarano, E., Schwarz, A., Servadei, Franco, Simonetti, G., Stefini, R., Talamonti, G., Turrisi, A., Valente, V. M., Villa, A., Vindigni, M., Visocchi, Massimiliano, Vitali, M., Wierzbicki, V., Zambon, G., Zanotti, B., Zenga, F., Alampi, D., Alessandri, F., Aloj, F., Amigoni, A., Aspide, R., Bertuetti, R., Betti, V., Bilotta, F., Bonato, V., Bosco, E., Brita, M., Buscema, G., Cafiero, T., Cappuccio, D., Caradonna, M., Caria, C. G., Casartelliliviero, M., Ciritella, P., Cirrincione, S., Citerio, G., Colelli, S., Coletta, F., Concordia, L., Congedo, E., Covotta, M., Crimella, F., Dall'Acqua, G., De Cassai, A., Defulviis, S., Deperi, E., Deana, C., Delgaudio, A., Denittis, N., Dicolandrea, S., Divezza, F., Ferri, F., Flocco, R., Fontana, C., Forastierimolinari, A., Frangiosa, A., Fumagalli, P., Fuselli, E., Garbarino, M. M., Gelormini, D., Geraci, C., Geraldini, F., Giacomucci, A., Giampaoli, V., Giorgetti, D., Gritti, P., Gualdani, S., Iacovazzo, C., Iermano, C., Latronico, N., Lugari, S., Lusenti, F., Maglione, C., Magnoni, S., Maiarota, F., Malla, M., Marchesi, M., Martino, C., Matteotti, I., Mazzeo, A. T., Morello, G., Nardiello, I., Paticchio, F., Pegoli, M., Perotti, Valerio, Piazzolla, M., Picciafuochi, F., Rachedi, N., Radolovich, D. K., Recchia, A., Riccardi, S., Romagnoli, S., Sala, S., Scafuro, M. A., Sgarlata, P., Soragni, A., Stefani, F., Stival, Eleonora, Stofella, G., Terranova, F., Tinturini, R., Togni, T., Toto, R., Trapani, D., Tringali, E., Tullo, L., Valente, A., Valeo, T., Varelli, G., Villani, R., Zamacavicchi, F., Zanello, M., Zarrillo, N., Zugni, N., Caricato A. (ORCID:0000-0001-5929-120X), Pompucci A. (ORCID:0000-0002-5427-9719), Anile C. (ORCID:0000-0002-0481-9713), Broger M., Caggiano C., D'Ercole M., Denaro L., Servadei F., Visocchi M. (ORCID:0000-0003-1087-0491), Perotti V. (ORCID:0000-0001-9461-2101), and Stival E.

Abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from “TBI Section” of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the “T

Published
2021

17. The Craniovertebral Junction in Rheumatoid Arthritis: State of the Art

Author

Ferrante A., Ciccia F., Giammalva G. R., Iacopino D. G., Visocchi M., Macaluso F., Maugeri R., Ferrante, A., Ciccia, F., Giammalva, G. R., Iacopino, D. G., Visocchi, M., Macaluso, F., and Maugeri, R.

Subjects
Inflammation, Joint Instability, Skull Base, Instrumentation and fusion procedure, Basilar invagination, Craniovertebral junction, Transoral decompression, Atlantoaxial dislocation, Arthritis, Rheumatoid, Atlanto-Axial Joint, Cervical spine, Cervical Vertebrae, Humans, Atlantoaxial synoviti, Rheumatoid arthriti, Transnasal decompression, Atlantoaxial instability
Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disorder, characterized by polyarticular inflammation causing progressive joint damage and disability. The mechanisms underlying its pathogenesis involve activation of innate and adaptive immunity, microvascular endothelial cell activation, and inflammatory infiltration of lymphocytes and monocytes into the synovium. Spinal involvement in RA is not typical; when it occurs, the main radiological features are (1) atlantoaxial subluxation (AAS), which is the most typical form of cervical spine involvement; (2) cranial settling—also known as basilar impression, atlantoaxial impaction or superior migration of the odontoid—which is the most severe form of associated spinal instability; and (3) subaxial subluxation. A combination of these alterations may occur. Synovitis is characterized by infiltration of innate and adaptive immune cells; joint destruction is a consequence of activation of synovial fibroblasts, which acquire aggressive, inflammatory, invasive features, associated with increased chondrocyte catabolism and synovial osteoclastogenesis. Neck pain is the most frequent symptom of spinal involvement in RA; it occurs in 40–80% of patients and is mostly localized at the craniocervical junction. Other symptoms—caused by compression of neural structures such as the greater occipital nerve (at C2), the nucleus of the spinal trigeminal tract and the greater auricular nerve—are occipital neuralgia, facial pain and ear pain, respectively. Irritation of the lesser occipital nerve (at C1) can cause pain in the suboccipital region. Sometimes patients may complain of a sensation of their head falling down with flexion, weakness, reduced endurance, loss of ability, gait alterations, paraesthesias or other symptoms due to cord and medullary compression, and upper or lower motor neuron signs, or both. Surgical management of RA remains a challenging field.

Published
2019

21. Minimally Invasive Management of Spontaneous Supratentorial Intracerebral Lobar Hemorrhages by a “Homemade” Endoscopic Strategy: The Evangelical Doctrine of “Venite ad Me” Allied to the Legacy of King Leonida

Author

Alberio, N., Cicero, S., Iacopino, D. G., Giammalva, G. R., Visocchi, Massimiliano, Olivi, Alessandro, Francaviglia, N., Battaglia, R., Spitaleri, A., Lipani, R., Ruggeri, L., Alessandrello, R., Cinquemani, A., Maugeri, R., Visocchi M. (ORCID:0000-0003-1087-0491), Olivi A. (ORCID:0000-0002-4489-7564), Alberio, N., Cicero, S., Iacopino, D. G., Giammalva, G. R., Visocchi, Massimiliano, Olivi, Alessandro, Francaviglia, N., Battaglia, R., Spitaleri, A., Lipani, R., Ruggeri, L., Alessandrello, R., Cinquemani, A., Maugeri, R., Visocchi M. (ORCID:0000-0003-1087-0491), and Olivi A. (ORCID:0000-0002-4489-7564)

Abstract

Background: Although the incidence of intracerebral hemorrhage (ICH) has appeared to be increasing over the years, its prognosis remains dismal. No consensus has yet been reached regarding the management of ICH; however, minimally invasive surgery should limit, if not avoid, intraoperative parenchymal damage. Therefore, we have presented a novel, modified “homemade” approach aimed to shorten the operative time and minimize the corticectomy and brain manipulation. Methods: From 2008 to 2017, 53 patients (32 men and 21 women; mean age, 63.8 years) were admitted to our neurosurgery department and surgically treated for a lobar ICH. A modified suction tube, coupled with the endoscope light source, was used. Clot evacuation was performed under loupe magnification without the use of the microscope or endoscope. The light source of the latter was only used to provide light in the working cavity. Results: The mean hematoma volume was 69.2 mL (range, 40–100) preoperatively and 12.1 mL (range, 0–20) postoperatively, with a mean clot evacuation of 84.3% (range, 60%–100%). The mean postoperative Glasgow coma scale score was 11.6, with an improvement of 14% from the admission score (mean, 9.2). Conclusions: The results from our clinical series have shown the effectiveness of endoscopic clot evacuation in surgical ICH. In addition, we have demonstrated an efficient technique that can be used in urgent cases and in less-developed areas owing to its reduced demand on resources and its shorter learning curve. The outcomes were good and comparable to those with the classical endoscopic approach.

Published
2019

22. A new concept to treat lumbar spine stenosis in a mini invasive way

Author

Maugeri R, Graziano F, Giugno A, Domenico Iacopino, Maugeri R., Graziano F., Giugno A., and Iacopino D.

Subjects
Indocyanine Green, Male, Cerebral Revascularization, Settore MED/27 - Neurochirurgia, Angiography, Digital Subtraction, Intracranial Aneurysm, Aneurysm, Ruptured, Middle Aged, Neurosurgical Procedure, Brain Ischemia, Cerebral Angiography, Postoperative Complication, Patient Safety, Coloring Agents, Human
Published
2017

23. Is there still a role for lesioning in functional neurosurgery: the Italian experience of delivering focused ultrasound high energy through a 1,5 tesla MR apparatus

Author

IACOPINO, Domenico, GIUGNO, Antonella, Maugeri, R., GAGLIARDO, Cesare, Franzini, A., Catalano, C., MIDIRI, Massimo, Iacopino, D., Giugno, A., Maugeri, R., Gagliardo, C., Franzini, A., Catalano, C., and Midiri, M.

Subjects
Settore MED/27 - Neurochirurgia, Settore MED/37 - Neuroradiologia, Settore MED/36 - Diagnostica Per Immagini E Radioterapia, functional neurosurgery, trans-cranial Magnetic Resonance guided Focused Ultrasound Surgery (tcMRgFUS), Magnetic Resonance Imaging (MRI), High Intensities Focused Ultrasounds (HI-FU)
Published
2017

24. Unusual case of dorsal vertebral metastases from a male breast cancer

Author

Maugeri, R., Giammalva, G., Cicero, G., DE LUCA, R., Gulã¬, C., Graziano, F., Basile, L., Giugno, A., Iacopino, D., Maugeri, R., Giammalva, G., Cicero, G., DE LUCA, R., Gulã¬, C., Graziano, F., Basile, L., Giugno, A., and Iacopino, D.

Subjects
Medicine (all), Dorsal vertebral metastatic, Male breast cancer, Metastatic breast cancer, Surgery, Therapy
Abstract

Introduction: Breast cancer is a malignant neoplasm arising from mammary glands and is a rare entity in the male patient. Spine is a common site for skeletal metastases. Case presentation: A 53-years-old male was admitted to our Neurosurgical unit because of an untreatable dorsal pain. He had been treated 3 years before for breast cancer. A dorsal Magnetic Resonance Imaging (MRI) evidenced pathological masses at T8 level. A total body Computed Tomography (CT) scan revealed lungs and liver metastases. After a multidisciplinary consult, a posterior T8 decompression, a radiofrequency thermoablation in T8 vertebral body followed by screws and rods fixation (T7-T9) was performed. Post-operative course was uneventful and the patient experienced a significant improvement of dorsal pain. Cycles of adjuvant chemo-radiotherapy followed. After 8 months, patient is still alive and in good general conditions but a spine MRI revealed a rapid and widespread diffusion of ostelytic metastases. Conclusion: Despite the high incidence of breast cancer metastases to the spine, very few clinical reports (just eight, whose only one treated surgically) in the literature deal specifically with metastases from male breast cancer, which is rarer and with a worst prognosis than female counterpart. In spite of the poor course, surgery still plays a role in treating these kind of malignancies and in improving quality of life.

Published
2017

26. Impasse in the management of recurrent basal cell carcinoma of the skull with sagittal sinus erosion1

Author

Maugeri R., Basile L., Giugno A., Graziano F., Iacopino D, Maugeri R., Basile L., Giugno A., Graziano F., and Iacopino D

Subjects
Settore MED/27 - Neurochirurgia, Basal cell carcinoma, Superior sagittal sinu, Conservative management
Abstract

Basal cell carcinoma (BCC) is a non melanocytic skin cancer that arises from basal cells, affecting commonly fair-skinned human beings. Although the tumor is well known for local recurrences, extension into the intracranial space is reported. A case of a giant BCC of the scalp invading the middle and posterior third of the superior sagittal sinus (SSS) is reported. A 70-year-old male with a basal cell carcinoma history presented with a massive bleeding from the SSS invaded by the tumor. Since the patient refused surgery the bleeding was managed through direct compression by applying a thrombin-based hemostatic agents and sterile dressings. This procedure was performed daily in order to stimulate the spontaneous thrombosis of the dural sinus and development of collateral circle. BCC invading the SSS is rarely reported. A technical description of this case is provided. This case underscores the importance of early and appropriate treatment for high risk BCC, and whenever surgical procedure is not suitable appropriate conservative treatment may be efficacious.

Published
2015

27. Emergency Surgery ina a patient with large spontaneous epidurl hematoma determinig exellent neurological recovery: review of the literature

Author

IACOPINO, Domenico, Giugno, A, Basile, L, Maugeri, R., Iacopino, D, Giugno, A, Basile, L, and Maugeri, R

Subjects
Settore MED/27 - Neurochirurgia, Spinal hematoma, Emergency surgery
Abstract

Study Design: Case report Objectives: we report a case of a 75-year-old woman suffering voluminous idiopathic spontaneous spinal epidural hematomas (SSEH) that was rapidly diagnosed and successfully treated Methods: Clinical presentation was characterized by sudden and intense back pain that rapidly evolved into plegia of the right leg and severe paresis of the left leg. Hypoesthesia below T6 and urinary retention were also present. The MRI showed a significant posterior spinal compression from T6 through L3 caused by an epidural hematoma that involved 10 metameric levels, extending for approximately 20 cm, with a maximum thickness of 1.6 cm from T12 to L1. Results: Within 12 hours, emergency decompressive laminectomy from T10 to L1 was performed, and evacuation of the hematoma was achieved. The post-operative course and neurological recovery of the patient were optimal. After discharge, the patient continued the rehabilitative treatment started during hospitalization, achieving an excellent functional outcome in one month. Conclusions: Spinal epidural hematomas SEH are rare clinical findings that can occur following trauma or spontaneously (SSEH). We describe, to the best of our knowledge, the second most extensive idiopathic SSEH and the longest with involvement of the dorso-lumbar spine that had a excellent functional outcome due to emergency decompressive laminectomy which is emphasized in the treatment of these rare pathologies.

Published
2014

40. Chronic inflammation causing spinal cord compression in human immunodeficiency virus infection

Author

Grasso, G., Meli, F., Graziano, F., Stagno, V., Imbrucè, P., Florena, A. M., Maugeri, R., Domenico Iacopino, GRASSO G, MELI F, GRAZIANO F, STAGNO V, IMBRUCÈ P, FLORENA AM, MAUGERI R, and IACOPINO DG

Subjects
Adult, Inflammation, Male, Settore MED/27 - Neurochirurgia, Chronic Disease, AIDS, Chronic inflammation, spinal cord compression, Humans, HIV Infections, Magnetic Resonance Imaging, Spinal Cord Compression
Abstract

BACKGROUND: The incidence of central nervous system involvement has increased in the setting of acquired immune deficiency syndrome (AIDS). Although rarely reported, spinal cord compression, in the setting of AIDS, has been associated with primary lymphoma or opportunistic infections. CASE REPORT: The authors describe the case of a young man who was admitted to our institution with rapid and progressive paraplegia. Imaging studies revealed an extramedullary lesion compressing the spinal cord spanning 3 thoracic levels. Surgical treatment was performed, and the compressing process completely excised. Histologic examination of the lesion showed a chronic inflammatory tissue with many necrotic areas without signs of infection or lymphoma. The patient progressively regained normal strength in his legs and was discharged home. CONCLUSIONS: In patients with HIV, chronic inflammation can lead to a lesion that compresses the spinal cord and should be considered in the differential diagnosis. Knowledge of this entity gains importance with the increasing incidence of HIV because timely excision can restore neurologic deficits. This condition may be considered a new clinical entity, the true incidence of which will be established using the diagnostic protocols provided and further case reports

Published
2008

42. Geochemical monitoring on water springs over the seismically active area of NE Italy

Author

Ditta, M., Bonfanti, P., Italiano, F., Maugeri, R., Petrini, Riccardo, Riggio, A., Slejko, FRANCESCA FEDERICA, Santulin, M., D. Slejko, A.M. Riggio, M. Santulin, Ditta, M., Bonfanti, P., Italiano, F., Maugeri, R., Petrini, Riccardo, Riggio, A., Slejko, FRANCESCA FEDERICA, and Santulin, M.

Subjects
seismically active area, groundwater, geochemical monitoring, groundwaters, Friuli
Published
2007

43. Caratteristiche chimiche ed isotopiche di acquiferi in zone di faglia nel settore orientale delle Alpi Meridionali: implicazioni sui modelli di flusso in aree sismogeniche

Author

PETRINI, RICCARDO, SLEJKO, FRANCESCA FEDERICA, Carulli G. B., Italiano F., Ditta M., Bonfanti P., Maugeri R., Caracausi A., D. Slejko, A. Rebez, Petrini, Riccardo, Slejko, FRANCESCA FEDERICA, Carulli, G. B., Italiano, F., Ditta, M., Bonfanti, P., Maugeri, R., and Caracausi, A.

Subjects
isotopi dello Sr, circuiti idrologici, aree di faglia, Friuli, caratterizzazione geochimica
Published
2006

44. I fluidi come strumento per individuare e valutare l’attività di strutture tettoniche: risultati nell’area Friuli-Slovenia

Author

Italiano, F., Bonfanti, P., Caracausi, A., Ditta, M., Martinelli, G., Maugeri, R., Petrini, Riccardo, Pizzullo, S., Riggio, A., Santulin, M., Slejko, F., D. Slejko, A. Rebez, Italiano, F., Bonfanti, P., Caracausi, A., Ditta, M., Martinelli, G., Maugeri, R., Petrini, Riccardo, Pizzullo, S., Riggio, A., Santulin, M., and Slejko, FRANCESCA FEDERICA

Subjects
geochimica dei fluidi, lineamenti tettonici, Regione Friuli-Venezia Giulia
Published
2006

45. La fase gassosa disciolta nelle acque circolanti in zona di faglia: esempio dell’applicazione dell’indagine geochimica nell’area Friuli-Slovenia

Author

Ditta, M., Bonfanti, P., Caracausi, A., Italiano, F., Martinelli, G., Maugeri, R., Petrini, Riccardo, Pizzullo, S., Riggio, A., Santulin, M., Slejko, F., D. Slejko, A. Rebez, Ditta, M., Bonfanti, P., Caracausi, A., Italiano, F., Martinelli, G., Maugeri, R., Petrini, Riccardo, Pizzullo, S., Riggio, A., Santulin, M., and Slejko, FRANCESCA FEDERICA

Subjects
acquiferi, gas disciolti, zone di faglia, Friuli-Slovenia
Published
2006

47. Ruolo dell’imaging funzionale nel management delle emorragie cerebrali atipiche: proposta di un protocollo diagnostico derivato dalla sperimentazione clinica

Author

Angileri, Filippo, Conti, Alfredo, Minutoli, Fabio, Giusa, M., Cardali, Salvatore Massimiliano, Grasso, Giovanni, LA TORRE, Domenico, Maugeri, R., Baldari, Sergio, Tomasello, Francesco, ANGILERI F, CONTI A, MINUTOLI F, GIUSA M, CARDALI S, GRASSO G, LA TORRE D, MAUGERI R, BALDARI S, TOMASELLO F, F. F. Angileri, A. Conti, F. Minutoli, M. Giusa, S. Cardali, G. Grasso, D. La Torre, R. Maugeri, S. Baldari, and F. Tomasello

Subjects
functional neuroimaging, intracerebral hemorrhage
Published
2005

50. Videoassisted anterior surgical approaches to the craniocervical junction: rationale and clinical results

Author

Visocchi, Massimiliano, Di Martino, A, Maugeri, R, González Valcárcel, I, Grasso, V, Paludetti, Gaetano, Visocchi, Massimiliano (ORCID:0000-0003-1087-0491), Paludetti, Gaetano (ORCID:0000-0003-2480-1243), Visocchi, Massimiliano, Di Martino, A, Maugeri, R, González Valcárcel, I, Grasso, V, Paludetti, Gaetano, Visocchi, Massimiliano (ORCID:0000-0003-1087-0491), and Paludetti, Gaetano (ORCID:0000-0003-2480-1243)

Abstract

In this narrative review, we aim to give an update on the anatomic fundamentals of endoscopic assisted surgery to the craniocervical junction (transnasal, transoral and transcervical), and to report on the available clinical results.

Published
2015

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