17 results on '"Luglietto, D."'
Search Results
2. Intracranial complications of sinogenic and otogenic infections in children:an ESPN survey on their occurrence in the pre-COVID and post-COVID era
- Author
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Massimi, L., Cinalli, G., Frassanito, P., Arcangeli, V., Auer, C., Baro, V., Bartoli, A., Bianchi, F., Dietvorst, S., Di Rocco, F., Gallo, P., Giordano, F., Hinojosa, J., Iglesias, S., Jecko, V., Kahilogullari, G., Knerlich-Lukoschus, F., Laera, R., Locatelli, D., Luglietto, D., Luzi, M., Messing-Jünger, M., Mura, R., Ragazzi, P., Riffaud, L., Roth, J., Sagarribay, A., Pinheiro, M. Santos, Spazzapan, P., Spennato, P., Syrmos, N., Talamonti, G., Valentini, L., Van Veelen, M. L., Zucchelli, M., Tamburrini, G., Massimi, L., Cinalli, G., Frassanito, P., Arcangeli, V., Auer, C., Baro, V., Bartoli, A., Bianchi, F., Dietvorst, S., Di Rocco, F., Gallo, P., Giordano, F., Hinojosa, J., Iglesias, S., Jecko, V., Kahilogullari, G., Knerlich-Lukoschus, F., Laera, R., Locatelli, D., Luglietto, D., Luzi, M., Messing-Jünger, M., Mura, R., Ragazzi, P., Riffaud, L., Roth, J., Sagarribay, A., Pinheiro, M. Santos, Spazzapan, P., Spennato, P., Syrmos, N., Talamonti, G., Valentini, L., Van Veelen, M. L., Zucchelli, M., and Tamburrini, G.
- Abstract
Background: COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017–2019), COVID (2020–2021), and post-COVID period (2022–June 2023) looking for possible epidemiological and/or clinical changes. Material and methods: An English language questionnaire was sent to ESPN members about year of the event, patient’s age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. Results: Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses
- Published
- 2024
3. Meningioma en plaque A case report
- Author
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Carangelo, B. R., Muzii, F. V., Luglietto, D., Cellini, L., Vaiano, A., Gabriele, G., and Giovanni Muscas
- Subjects
Meningeal Neoplasms ,Brain ,Humans ,Female ,Meningioma ,Magnetic Resonance Imaging - Abstract
Meningiomas as anatomo-pathological entities were first described in the sixteenth century, but it was Harvey Cusching who in 1922 proposed to identify them with the term "meningioma". They are the most common intracranial tumors, occur between middle and late age and prefer female sex. The symptoms depend on their position with respect to the brain regions. These are mostly benign neoplasms, but there are atypical and even malignant forms. Plaque meningioma refers to a specific macroscopic aspect of the meningioma, due to diffuse dural involvement and usually with extracranial extension. We report here a case of plaque convex meningioma with typical grade I. Key Words: En plaque, Meningioma, WHO Meningioma.I meningiomi come entità anatomo-patologiche furono descritti per la prima volta nel XVI secolo, ma fu Harvey Cusching che nel 1922 propose di identificarli con il termine di “meningioma”. Sono i tumori intracranici più comuni, si manifestano tra la mezza e la tarda età e prediligono il sesso femminile. La sintomatologia è funzione della loro posizione rispetto alle regioni dell’encefalo. Si tratta per lo più di neoplasie benigne, ma esistono forme atipiche ed anche maligne. Il meningioma “a placca” si riferisce a un aspetto macroscopico specifico del meningioma, per coinvolgimento durale diffuso e solitamente con estensione extracranica. Riportiamo qui un caso di meningioma convessità en placca con tipico grado I.
- Published
- 2022
4. A Survey on Pituitary Surgery in Italy
- Author
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Solari, D, Zenga, F, Angileri, Ff, Barbanera, A, Berlucchi, S, Bernucci, C, Carapella, C, Catapano, D, Catapano, G, Cavallo, Lm1, D'Arrigo, C, de Angelis, M, Denaro, L, Desogus, N, Ferroli, P, Fontanella, Mm, Galzio, Rj, Gianfreda, Cd, Iacoangeli, M, Lauretti, Liverana, Locatelli, D, Locatelli, M, Luglietto, D, Mazzatenta, D, Menniti, A, Milani, D, Nasi, Mt, Romano, A, Ruggeri, Ag, Saladino, A, Santonocito, O, Schwarz, A, Skrap, M, Stefini, R, Volpin, L, Wembagher, Gc, Zoia, C, Zona, G, Cappabianca, P, Lauretti L (ORCID:0000-0002-6463-055X), Solari, D, Zenga, F, Angileri, Ff, Barbanera, A, Berlucchi, S, Bernucci, C, Carapella, C, Catapano, D, Catapano, G, Cavallo, Lm1, D'Arrigo, C, de Angelis, M, Denaro, L, Desogus, N, Ferroli, P, Fontanella, Mm, Galzio, Rj, Gianfreda, Cd, Iacoangeli, M, Lauretti, Liverana, Locatelli, D, Locatelli, M, Luglietto, D, Mazzatenta, D, Menniti, A, Milani, D, Nasi, Mt, Romano, A, Ruggeri, Ag, Saladino, A, Santonocito, O, Schwarz, A, Skrap, M, Stefini, R, Volpin, L, Wembagher, Gc, Zoia, C, Zona, G, Cappabianca, P, and Lauretti L (ORCID:0000-0002-6463-055X)
- Abstract
BACKGROUND: Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint. METHODS: On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions. RESULTS: Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers. CONCLUSIONS: Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.
- Published
- 2019
5. Pituitary adenomas: Endoscopic endonasal transsphenoidal approach
- Author
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Cappabianca P, Cavallo LM, Caranci F, de Angelis M, Stagno V, Luglietto D, Solari D, Tschabitscher M, Cappabianca P, Cavallo LM, de Divitiis O, Esposito F, Cappabianca, P, Cavallo, Lm, Caranci, F, de Angelis, M, Stagno, V, Luglietto, D, Solari, D, and Tschabitscher, M
- Published
- 2016
6. L'efficacia della terapia corticosteriodea nel trattamento conservativo dell'ematoma subdurale cronico
- Author
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Vaiano, A., Muzii, VITALIANO FRANCESCO, Carangelo, BIAGIO ROBERTO, Luglietto, D., and Valacchi, D.
- Published
- 2017
7. A Survey on Pituitary Surgery in Italy
- Author
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Andreas Schwarz, Andrea Barbanera, Cosimo Damiano Gianfreda, Lorenzo Volpin, Miran Skrap, Andrea Ruggeri, Luca Denaro, Silvia Berlucchi, Domenico Catapano, Davide Milani, Carmine M. Carapella, Gianluigi Zona, Roberto Stefini, Michelangelo de Angelis, Davide Locatelli, Maria Teresa Nasi, Nicola Desogus, Orazio Santonocito, Cesare Zoia, Domenico Solari, Agazio Menniti, C D'Arrigo, Claudio Bernucci, Luigi Maria Cavallo, Renato Galzio, Marco Locatelli, Giuseppe Catapano, Paolo Ferroli, Antonio Romano, Paolo Cappabianca, Giulio C. Wembagher, Francesco Zenga, Andrea Saladino, Maurizio Iacoangeli, Liverana Lauretti, Diego Mazzatenta, Davide Luglietto, Filippo Flavio Angileri, Marco Maria Fontanella, Solari D., Zenga F., Angileri F.F., Barbanera A., Berlucchi S., Bernucci C., Carapella C., Catapano D., Catapano G., Cavallo L.M., D'Arrigo C., de Angelis M., Denaro L., Desogus N., Ferroli P., Fontanella M.M., Galzio R.J., Gianfreda C.D., Iacoangeli M., Lauretti L., Locatelli D., Locatelli M., Luglietto D., Mazzatenta D., Menniti A., Milani D., Nasi M.T., Romano A., Ruggeri A.G., Saladino A., Santonocito O., Schwarz A., Skrap M., Stefini R., Volpin L., Wembagher G.C., Zoia C., Zona G., Cappabianca P., 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, Andrea, Skrap, Miran, Stefini, Roberto, Volpin, Lorenzo, Wembagher, Giulio C., Zoia, Cesare, Zona, Gianluigi, and Cappabianca, Paolo
- Subjects
Endoscopic endonasal surgery ,medicine.medical_treatment ,Settore MED/27 - NEUROCHIRURGIA ,Pituitary neoplasm ,Neurosurgical Procedure ,Neurosurgical Procedures ,Craniopharyngioma ,Craniopharyngiomas ,Multidisciplinary team ,Pituitary adenomas ,Pituitary surgery ,Pituitary/hypothalamus ,Transsphenoidal surgery ,0302 clinical medicine ,inglese ,Central Nervous System Cysts ,media_common ,Teamwork ,Italy ,Pituitary/hypothalamu ,Pituitary Gland ,030220 oncology & carcinogenesis ,Neurosurgery ,Needs Assessment ,Human ,Adenoma ,medicine.medical_specialty ,Humans ,Patient Care Team ,Pituitary Neoplasms ,media_common.quotation_subject ,03 medical and health sciences ,Surgery ,Neurology (clinical) ,medicine ,business.industry ,General surgery ,Pituitary tumors ,medicine.disease ,Pituitary adenoma ,Clinical trial ,Central Nervous System Cyst ,business ,030217 neurology & neurosurgery - Abstract
Background Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint. Methods On behalf of the SINch (Societa Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions. Results Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers. Conclusions Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload.
- Published
- 2019
8. Vertical Parasagittal Hemispherotomy in a Pediatric Case of Epilepsy Due to Rasmussen Encephalitis: 2-Dimensional Operative Video.
- Author
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De Benedictis A, Pepi C, Herur-Raman A, Barba M, Marasi A, Rossi-Espagnet MC, Napolitano A, Rossi S, Luglietto D, Capelli S, Zanus C, Savioli A, de Palma L, Specchio N, and Marras CE
- Abstract
Hemispherotomy is an effective disconnection technique for the treatment of different forms of drug-resistant epilepsy due to encephalopathies with unilateral hemispheric involvement.1-8 We describe the case of a 6-year-old child affected by Rasmussen encephalitis who underwent right vertical parasagittal hemispherotomy.9 The goal of the procedure was to isolate the basal ganglia region by interrupting the interhemispheric and intrahemispheric white matter connectivity. The main surgical steps include the transcortical approach to the lateral ventricle, the posterior callosotomy, the fimbria-fornix incision, the laterothalamic vertical incision, the anterior callosotomy, the frontobasal disconnection, and the transcaudate lateral incision to the anterior temporal horn.7,10 At 10-month follow-up, the patient was seizure free with a stable left hemiparesis. The antiepileptic therapy was progressively interrupted. The video describes the main surgical steps, using both intraoperative videos and advanced three-dimensional modeling of neuroimaging pictures. Patient' parents consented to the procedure. The participants and any identifiable individuals consented to publication of his/her image. Approval from the ethics committee was acquired., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
9. Calcium phosphate and titanium cranioplasty after total angular craniopagus separation.
- Author
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De Benedictis A, Sawant N, Marasi A, Rossi-Espagnet MC, Carai A, Luglietto D, Bua A, Randi F, Savioli A, Borro L, Zama M, and Marras CE
- Subjects
- Humans, Child, Skull surgery, Prostheses and Implants, Calcium Phosphates, Titanium, Plastic Surgery Procedures
- Abstract
Craniopagus separation requires careful planning and a multi-staged surgical approach, managed by a multidisciplinary team. Despite growing experience on surgical management, the long-term restoration of the cranial defect has been rarely discussed so far. Several alloplastic materials have been proposed as effective and safe solutions for cranioplasty even for pediatric patients, allowing for bone generation, good aesthetic results, and low complication rates. We report, for the first time, on a separated craniopagus child who underwent successful implant of a tailor-made system based on the combination of calcium phosphate ceramic reinforced with a titanium mesh., Competing Interests: Declaration of Competing Interest none., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
10. Vertical Hemispherotomy: Contribution of Advanced Three-Dimensional Modeling for Presurgical Planning and Training.
- Author
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De Benedictis A, Marasi A, Rossi-Espagnet MC, Napolitano A, Parrillo C, Fracassi D, Baldassari G, Borro L, Bua A, de Palma L, Luisi C, Pepi C, Savioli A, Luglietto D, and Marras CE
- Abstract
Vertical hemispherotomy is an effective treatment for many drug-resistant encephalopathies with unilateral involvement. One of the main factors influencing positive surgical results and long-term seizure freedom is the quality of disconnection. For this reason, perfect anatomical awareness is mandatory during each step of the procedure. Although previous groups attempted to reproduce the surgical anatomy through schematic representations, cadaveric dissections, and intraoperative photographs and videos, a comprehensive understanding of the approach may still be difficult, especially for less experienced neurosurgeons. In this work, we reported the application of advanced technology for three-dimensional (3D) modeling and visualization of the main neurova-scular structures during vertical hemispherotomy procedures. In the first part of the study, we built a detailed 3D model of the main structures and landmarks involved during each disconnection phase. In the second part, we discussed the adjunctive value of augmented reality systems for the management of the most challenging etiologies, such as hemimegalencephaly and post-ischemic encephalopathy. We demonstrated the contribution of advanced 3D modeling and visualization to enhance the quality of anatomical representation and interaction between the operator and model according to a surgical perspective, optimizing the quality of presurgical planning, intraoperative orientation, and educational training.
- Published
- 2023
- Full Text
- View/download PDF
11. Covid-19 pandemic: the impact of Italian lockdown on maxillofacial trauma incidence in southern Tuscany.
- Author
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Gabriele G, Nigri A, Pini N, Carangelo BR, Cascino F, Fantozzi V, Funaioli F, Luglietto D, and Gennaro P
- Subjects
- Communicable Disease Control, Humans, Incidence, Italy epidemiology, Pandemics, SARS-CoV-2, COVID-19 epidemiology, Maxillofacial Injuries epidemiology, Maxillofacial Injuries etiology
- Abstract
The outbreak of the Covid-19 pandemic has seriously affected our society. Governments have difficult situations by adopting strict and severe mitigation measures in order to contain the pandemic spreading. These decisions influenced significatively people's behavior changing their habits and routines. This study offers a statistical analysis of the incidence of the Maxillo-Facial traumas in Tuscany southern area, during the pandemic lockdown. The statistical analyzed has been obtained comparing the maxillo-facial trauma occurrence during the Italian lockdown between the 9th of March and the 18th of May 2020 in comparison with same period of the five previous years. KEY WORDS: Covid-19, Italian covid-19, Maxillofacial surgery, Maxillofacial trauma, Pandemic, Surgery management, Trauma incidence in Italy.
- Published
- 2022
12. Meningioma en plaque A case report.
- Author
-
Carangelo BR, Muzii FV, Luglietto D, Cellini L, Vaiano A, Gabriele G, and Muscas G
- Subjects
- Brain, Female, Humans, Magnetic Resonance Imaging, Meningeal Neoplasms diagnostic imaging, Meningeal Neoplasms surgery, Meningioma diagnostic imaging, Meningioma surgery
- Abstract
Meningiomas as anatomo-pathological entities were first described in the sixteenth century, but it was Harvey Cusching who in 1922 proposed to identify them with the term "meningioma". They are the most common intracranial tumors, occur between middle and late age and prefer female sex. The symptoms depend on their position with respect to the brain regions. These are mostly benign neoplasms, but there are atypical and even malignant forms. Plaque meningioma refers to a specific macroscopic aspect of the meningioma, due to diffuse dural involvement and usually with extracranial extension. We report here a case of plaque convex meningioma with typical grade I. Key Words: En plaque, Meningioma, WHO Meningioma.
- Published
- 2021
13. Cerebral Venous Sinus Thrombosis in a Pediatric Patient With COVID-19.
- Author
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Ippolito Bastidas H, Márquez-Pérez T, García-Salido A, Luglietto D, García Moreno R, Martínez de Azagra-Garde A, Nieto-Moro M, Leoz-Gordillo I, Budke M, and Rivero-Martín B
- Published
- 2021
- Full Text
- View/download PDF
14. Complex craniomaxillofacial gunshot wounds A step-by-step multidisciplinary approach.
- Author
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Cellini L, Vaiano A, Tiezzi G, Oliveri G, Di Pietro G, Carangelo BR, Gabriele G, Zerini F, Cascino F, and Luglietto D
- Subjects
- Adult, Female, Humans, Neck, Retrospective Studies, Skull injuries, Suicide, Attempted, Tomography, X-Ray Computed, Maxillofacial Injuries surgery, Plastic Surgery Procedures, Wounds, Gunshot diagnostic imaging, Wounds, Gunshot surgery, Wounds, Penetrating
- Abstract
Background: Gunshot injuries of the viscerocranium are rarely reported. Penetrating wounds to the cranio-maxillofacial region pose a significant challenge for surgeons as they often comprise serious soft tissue, bone and cerebral defects. We present a case report of a 42-year old female with a gunshot wound to the viscerocranium after suicidal attempt. Series of image of the disease course are available., Case Description: A 42-year-old female presented with gunshot wound to the viscerocranium after a suicidal attempt. At the arrival GCS was 8/15 and general examination showed the inlet wound in the submental region whereas the outlet one in the left temporal skull area. After first rescue procedures, ICP was monitored before proceeding surgically. Due to massive hemorrhage, embolization of ianternal maxillary artery was performed. Afterwards, tracheostomy, surgical reduction of multiple maxillo-facial fractures and ocular avulsion were performed. In a second time, ICP monitoring and CT scan revealed ICH signs due to intraparenchimal injures. The patient underwent to a second surgical procedure, consisting of bifrontal decompressive craniectomy. The patient was discharged on 20th post-op day to a rehabilitation center. She returned to our department after 4 months to perform a craniomaxillofacial recostruction. She presented 15 in GCS, left ptosis, left VII cranial nerve deficit, decannulated, KPS 100%., Conclusion: A step-to-step multidisciplinary approach both with Neurosurgeons and Maxillo-facial surgeons is mandatory in Cranial Gunshot Injuries where extensive damage is linked to a higher mortality., Key Words: Cranial gunshot inuuries, Cranial reconstruction, Maxillofacial reconstruction.
- Published
- 2020
15. Intracranial soft-tissue glomus tumor (glomangioma) in a young-woman. A case report and review of the literature.
- Author
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Carangelo BR, Lavalle L, Gabriele G, and Luglietto D
- Subjects
- Adult, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Neoplasm Recurrence, Local, Glomus Tumor diagnostic imaging, Glomus Tumor radiotherapy, Glomus Tumor surgery, Soft Tissue Neoplasms diagnostic imaging, Soft Tissue Neoplasms radiotherapy, Soft Tissue Neoplasms surgery
- Abstract
Background: Glomus tumors, or glomangiomas, are benign vascular tumors typically seen at distal extremities. These tumors differ from paragangliomas and classically present in the female population between the 4th and 5th decade. Intracranial localizations have not been described in literature in the adult population., Case Description: We present a case of a 32 year-old woman with a 3 months history of progressive left-sided visual loss and headache. A pre-operative MRI showed a homogeneously enhancing lesion extending from the left cavernous sinus to middle cranial fossa at first suspected to be a cavernous sinus meningioma. Eventually, histopathological analysis concluded for a glomangioma diagnosis. Post-operative RT was also performed., Conclusions: From our experience it is very important for clinical management considering glomangiomas in differential diagnosis of a homogeneously enhancing extra axial mass. Subtotal resection followed by radiation therapy determined no recurrence of the disease up to 7 years., Key Words: Glomangioma, Glomus tumor, Soft-tissue tumor.
- Published
- 2020
16. The management of clival chordomas: an Italian multicentric study.
- Author
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Cavallo LM, Mazzatenta D, d'Avella E, Catapano D, Fontanella MM, Locatelli D, Luglietto D, Milani D, Solari D, Vindigni M, Zenga F, Zona G, and Cappabianca P
- Abstract
Objective: In the last 2 decades, the endoscopic endonasal approach in the treatment of clival chordomas has evolved to be a viable strategy to achieve maximal safe resection of this tumor. Here, the authors present a multicentric national study, intending to analyze the evolution of this approach over a 20-year time frame and its contribution in the treatment of clival chordomas., Methods: Clival chordoma cases surgically treated between 1999 and 2018 at 10 Italian neurosurgical departments were included in this retrospective study. Clinical, radiological, and surgical findings, adjuvant therapy, and outcomes were evaluated and compared according to classification in the treatment eras from 1999 to 2008 and from 2009 to 2018., Results: One hundred eighty-two surgical procedures were reviewed, with an increase in case load since 2009. The endoscopic endonasal transclival approach (EETA) was performed in 151 of 182 cases (83.0%) and other approaches were performed in 31 cases (17%). There was an increment in the use of EETA, neuronavigation, and Doppler ultrasound after 2008. The overall postoperative complication rate was 14.3% (26 of 182 cases) consisting of 9 CSF leaks (4.9%), 7 intracranial hemorrhages (3.8%), 5 cases of meningitis (2.7%), and 5 cerebral ischemic injuries (2.7%). Gross-total resection (GTR) was achieved in 93 of 182 cases (51.1%). Extent of resection (EOR) improved in the second era of the study. Signs and/or symptoms at presentation worsened in 27 cases (14.8%), and the Katz Index worsened in 10 cases (5.5%). Previous treatment, dural involvement, EETA, and intraoperative Doppler ultrasound correlated with GTR. Patients received adjuvant proton beam radiation in 115 of 182 cases (63.2%), which was administered more in the latter era. Five-year progression-free survival (PFS) and overall survival (OS) were 62.3% and 73.5%, respectively. GTR, EETA, proton beam therapy, and the chondroid subtype correlated with a better survival rate. The mean follow-up was 62 months., Conclusions: Through multicentric data collection, this study encompasses the largest series in the literature of clival chordomas surgically treated through an EETA. An increase in the use of this approach was found among Italian neurosurgical departments together with an improved extent of resection over time. The satisfactory rate of GTR was marked by low surgical morbidity and the preservation of patient quality of life. Surgical outcome was reinforced, in terms of PFS and OS, by the use of proton beam therapy, which was increasingly performed along the period of study.
- Published
- 2020
- Full Text
- View/download PDF
17. A Survey on Pituitary Surgery in Italy.
- Author
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Solari D, Zenga F, Angileri FF, Barbanera A, Berlucchi S, Bernucci C, Carapella C, Catapano D, Catapano G, Cavallo LM, D'Arrigo C, de Angelis M, Denaro L, Desogus N, Ferroli P, Fontanella MM, Galzio RJ, Gianfreda CD, Iacoangeli M, Lauretti L, Locatelli D, Locatelli M, Luglietto D, Mazzatenta D, Menniti A, Milani D, Nasi MT, Romano A, Ruggeri AG, Saladino A, Santonocito O, Schwarz A, Skrap M, Stefini R, Volpin L, Wembagher GC, Zoia C, Zona G, and Cappabianca P
- Subjects
- Adenoma epidemiology, Central Nervous System Cysts epidemiology, Craniopharyngioma epidemiology, Humans, Italy epidemiology, Needs Assessment, Patient Care Team organization & administration, Pituitary Gland surgery, Pituitary Neoplasms epidemiology, Adenoma surgery, Central Nervous System Cysts surgery, Craniopharyngioma surgery, Neurosurgical Procedures statistics & numerical data, Pituitary Neoplasms surgery
- Abstract
Background: Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented. Thus, we decided to perform a multicenter study among Italian neurosurgical centers performing pituitary surgery to provide an actual depiction from the neurosurgical standpoint., Methods: On behalf of the SINch (Società Italiana di Neurochirurgia), a survey was undertaken with the participants to explore the activities in the field of pituitary surgery within 41 public institutions., Results: Of the 41 centers, 37 participated in the present study. The total number of neurosurgical procedures performed in 2016 was 1479. Most of the procedures were performed using the transsphenoidal approach (1320 transsphenoidal [1204 endoscopic, 53 microscopic, 53 endoscope-assisted microscopic] vs. 159 transcranial). A multidisciplinary tumor board is convened regularly in 32 of 37 centers, and a research laboratory is present in 18 centers., Conclusions: Diagnosing pituitary/hypothalamus disorders and treating them is the result of teamwork, composed of several diverse experts. Regarding neurosurgery, our findings have confirmed the central role of the transsphenoidal approach, with preference toward the endoscopic technique. Better outcomes can be expected at centers with a multidisciplinary team and a full, or part of a, residency program, with a greater surgical caseload., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
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