bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trattamento endovascolare di 11 aneurismi della carotide intracranica mediante spirali MDS Balt
Authors: Resta F. , Bettinelli A. , Lucchi S. , Leonardi M. 
Published: April 2015

Dall'agosto 93 al novembre 95 sono stati affrontati complessivamente 39 aneurismi cerebrali in 38 pazienti, utilizzando spirali MDS Balt. Tra questi, in 11 casi l'aneurisma era localizzato a livello della carotide intracranica. In 10 casi su 11 il trattamento è stato effettuato entro i primi sette giorni dall'episodio di emorragia subaracnoidea; le condizioni cliniche degli 11 pazienti, secondo i valori della scala di Hunt ed Hess, erano così distribuite: 7 pazienti <=2 e 4 pazienti tra 3 e 5. Un'occlusione completa dell'aneurisma è stata ottenuta in 3 casi; in 1 di questi casi l'occlusione completa è stata raggiunta in due sedute successive. Un'occlusione subtotale intorno al 90% è stata raggiunta in 3 casi. In 1 di tali casi l'aneurisma è risultato occluso al 100% al controllo angiografico un mese dopo il trattamento. In 5 casi non è stato possibile effettuare il trattamento a causa di difficoltà tecniche; in 1 di questi 5 casi si è osservata rottura della sacca aneurismatica durante il trattamento. In un solo caso trattato si è verificata l'insorgenza, sette giorni dopo la procedura, di un'emiparesi da probabile fenomeno tromboembolico: il recupero clinico è stato comunque soddisfacente. I risultati ottenuti vengono analizzati con l'obbiettivo di contribuire ad un effettivo e motivato inserimento di questa tecnica nel protocollo terapeutico.
Clinical Value of Dynamic MRI in the Diagnosis of Pituitary Microadenoma
Authors: Farabola M. , Bettinelli A. , Resta F. , Muratori M. , Pizzocaro A. , Faglia G. , Motta T. , D'Alberton A. , Di Pace R. 
Published: April 2015

MRI is today the first-choice technique for detection of pituitary microadenomas. The combination of T1-weighted spin-echo, T2-weighted spin-echo and T1-weighted spin-echo after intravenous gadolinium administration gives a clearly positive result in about 70% of cases. In the remaining 30% the hypersignal generated by the contrast agent can hide the smallest lesions. Dynamic MRI is considered capable of visualizing some of the smallest pituitary microadenomas not visible on conventional MRI, and has therefore become the most promising technique to image pituitary lesions. The purpose of this study is to compare the effectiveness of conventional and dynamic MRI. Fifty patients were examined with dynamic contrast-enhanced MRI of the pituitary gland. They were thought to have pituitary adenoma on the basis of clinical and biological data. MRI was performed at 1.5T (Siemens SP 63) with the acquisition of three sequences: 1) T2-weighted sequence 2) Dynamic study: (temporal resolution 17 s) 3) T1-weighted postcontrast sequence. In 10 cases (20%) no pathological findings were seen. In 32 cases (64%) pathological findings were seen both in dynamic and in SE T1 and T2-weighted images. In 8 cases (16%) pathological findings were observed only in the dynamic study. In 8 studies out of 50 (16%) dynamic MRI showed small (less than 7 mm) focal relatively hypointense areas in the pituitary gland, visible neither on SE T2-weighted pre-contrast nor on SE T1-weighted postcontrast images, leading to a diagnostic sensitivity from 64% to 80%. Dynamic MRI did not miss any lesions although in 3 cases the picture was more clear on SE sequences. We can conclude that dynamic MRI study of the pituitary gland improves accuracy in the diagnosis of pituitary microadenomas.
Rapid Lumbar Spine MR Myelography: Imaging Findings Using a Single-Shot Technique
Authors: Demaerel P. , Van Hover P. , Broeders A. , Kiefer B. , Baert A.L. 
Published: April 2015

MR myelography has been performed by several authors. Most authors have used techniques based on three-dimensional gradient-echo pulse sequences or fast spin-echo pulse sequences. The examination time varied between 5 and 13 minutes and postprocessing with a maximum-intensity projection algorithm was necessary for three-dimensional visualization. The rapid acquisition with relaxation enhancement (RARE) was initially described by Hennig et Al. In this technical note we present our experience with a single-shot turbo spin-echo sequence, derived from RARE, of approximately 2 seconds to obtain one view. MR myelography can replace conventional myelography in all different types of pathology. In addition MR myelography provides additional information compared to MR imaging in a minority of the cases. Taking into account the ultra-rapid acquisition and the absence of postprocessing procedures, we recommended this technique in the appropriate clinical setting. The MR myelogram increases the level of conficence of the neuroradiologist.
Endovascular Treatment of Internal Carotid Artery Aneurysms with Guglielmi Coils (GDC)
Authors: Lavaroni A. , Biasizzo E. , De Colle M.C. , Janes P.P. , Fabris G. 
Published: April 2015

This paper evaluates the result of endovascular treatment in aneurysms arising in the internal carotid artery, intracranial tract, using Guglielmi detachable coils. We selected one years, from November 1995 to November 1996 in which we used GDC to breat 26 patients with intracranial aneurysm; 14 of them in the carotid siphon. Patients' ages ranged from 29 to 77 years (9 women and 5 men). Following, the Yasargil classification we divided the aneurysmal origin into: ICA lateral site (posterior communicating artery), 7 cases; ICA inferior site, 3; ACI medial distal site, 1; ICA bifurcation site, 3. Regarding size, the aneurysm was: small in 7 patients, medium in 6 and large in 1. The occlusion percentage was total in 9 patients, sub-total in 4, partial in 1. The clinical presentation was with subarachnoid haemorrhage in 11 patients (6 of them were treated within 3 days from the onset of symptoms); in three of them aneurysm detection was occasional (real occasional in 2, occasional in 1). All 14 patients were evaluated on discharge with the Glasgow Outcome Scale (GOS) modified, according to the Guglielmi proposals: 10 out of 14 patients had an excellent GOS with no deaths. All treatment was performed in anaesthesia with heparin infusion 5000 Ul ev in bolus + 1000 Ul each hour); the heparin infusion was suspended 12 hours after the treatment and then paediatric Aspirin or Fraxiheparin was administered for 4–5 days. No perforation of the aneurysmal sac occurred during treatment or cerebral haemorrhage due to the catheter positioning. In one patient with H-H IIIa, with a wide neck aneurysm and siphon dysplasia rebleeding occurred 21 days after treatment requiring prompt surgery; on discharge the GOS was fair. Regarding thrombo-embolic complications, one patient with H-H grade IIIa, had a hypodense ischaemic lesion, in a temporoparietal site ipsilateral to the aneurysm, without associated symptoms. Another patient, with IIIa H-H grade, presented a thromboembolic complication after treatment; the CT scan revealed multiple hypodense lesions in sub- and supratentorial sites; the GOS was poor on discharge with associated permanent neurological deficit. No patient died as a direct of the treatment. The radiation dose to patient and operator should not be underestimated: in our experience we had three cases of transient localised alopecia. The angiographic controls after treatment, at discharge and after 3–6 months, showed persistent occlusion; in one case of sub-total occlusion, total occlusion was achieved by re-do surgery. The GOS remained stable at 3–6 months after treatment in patients with an excellent result; one patient with GOS fair at discharge reached an excellent result; the other two patients with GOS poor and fair have improved during time reaching a fair and good outcome respectively.
Studio dei nervi cranici con RM ad alta risoluzione
Authors: D'Aprile P. , Medicamento N. , Stefanelli M. , Spagnolo L. , Carella A. 
Published: April 2015

Attualmente la RM rappresenta la sola modalità di studio neuroradiologico dei nervi cranici e la sua introduzione nella pratica clinica ha rappresentato un grande progresso nella diagnostica in questo campo. Abbiamo effettuato una valutazione dell'anatomia RM dei nervi cranici utilizzando tecniche differenti, caratterizzate essenzialmente da alta risoluzione spaziale e di contrasto; esse (sia Turbo Spin Echo sia ad eco di gradiente) consentono di ottenere immagini di ridotto spessore, anche inferiore al mm, e risultano perciò di grande utilità nello studio delle fini strutture anatomiche. Nel nostro lavoro illustriamo le potenzialità diagnostiche di queste tecniche più recenti rispetto alle tradizionali tecniche Spin Echo nello studio dei nervi cranici la cui complessa patologia richiede al radiologo grande esperienza nella scelta delle sequenze e dei piani di studio più idonei per la valutazione del singolo nervo cranico.
Approccio multidisciplinare integrato al Neuroblastoma Olfattivo
Authors: Roncallo F. , Turtulici I. , Macchia G. , Calautti C. , Scasso F. , Di Santillo L. Scotto , Toncini C. , Severi M. , Sanguineti G. , Bartolini A. 
Published: April 2015

Il Neuroblastoma Olfattivo o Estesioneuroblastoma rappresenta una rara neoplasia maligna della volta delle fosse nasali e dei seni etmoidali. La sua derivazione istologica ne fa un tumore ad elevato potenziale invasivo soprattutto nei confronti degli involucri meningei e del parenchima cerebrale della fossa cranica anteriore. Il parallelo sviluppo delle metodiche non invasive di diagnostica (tomografia computerizzata e risonanza magnetica), delle tecniche chirurgiche con approccio combinato facciale ed intracranico, radioterapiche e chemioterapiche, consente una possibile terapia radicale anche di forme neoplastiche naso-sinusali prima incurabili. Ne deriva quindi la necessità di ottenere una diagnosi possibilmente precoce, ma soprattutto un bilancio spaziale tridimensionale accurato ed una istologia precisa della neoplasia, allo scopo di formulare una prognosi e selezionare la terapia più idonea. Inoltre i pazienti trattati vanno seguiti nel tempo, anche per lunghi periodi, in rapporto alla maggiore sopravvivenza. Nel nostro lavoro abbiamo rivalutato criticamente una nostra casistica di 7 Neuroblastomi Olfattivi e rivisitato i dati della letteratura, analizzando i molteplici aspetti epidemiologici, anatomo-patologici, clinico-semeiologici e terapeutici di questa neoplasia, in modo da standardizzare linee guida per il suo trattamento e per il suo monitoraggio dopo terapia.
Viral Encephalitis
Authors: Andreula C.F. , Marano G. , Kambas I. 
Published: April 2015

Patients with viral infections of the central nervous system are encountered daily, but it is often difficult to establish a correct differential diagnosis. This paper attempts to “reorganize” our knowledge of such infections. Our starting point was virology, defining the different viruses according to the latest classifications, distinguishing RNA viruses from DNA viruses, assessing capsid shape and dividing each family into genera and species of interest. We then determined the pathophysiology: from initial viraemia we considered the mechanisms of CNS penetration and the pathological changes which ensue. The different species of viruses were found to behave in a broadly similar fashion, accounting for the often very similar radiological findings which make differential diagnosis arduous even for the expert. Lastly, we studied the different forms of slow and acute encephalitis aiming to separate crucial information from useful findings which together with clinical presentation will aid diagnosis. Among the acute forms of encephalitis, the main group comprises herpes encephalitis caused by herpes simplex virus types 1 and 2, cytomegalovirus and varicella-zoster virus. HS1 is usually responsible for severe necrotising meningo-encephalitis; type 2 often presents symmetrical malacic areas in the white matter with little involvement of the grey matter. Cytomegalovirus, which is dangerous mainly to the fetus and neonate, is responsible for dystrophic calcifications and neuronal migration disorders, sometimes resulting in lissencephaly; in immunodepressed patients, it causes atrophy and leukencephalopathy without damage to the brain barrier. Varicella-zoster virus is responsible for transverse myelitis, asectic meningitis and meningo-encephalitis, often presenting a characteristic subtentorial location, sometimes complicated by patchy haemorrhagic lesions. The slow forms of encephalitis include subacute sclerosing panencephalitis caused by measles-like paramyxovirus which presents aspecific signs from neuronal degeneration to atrophy. HIV encephalitis causes atrophy and leucoencephalopathy without damage to the blood brain barrier. Progressive multifocal leucoencephalopathy caused by papavirus is characterized by involvement of the subcortical oligodendrocytes resulting in a leucoencephalopathy presenting a typical finger shape often in a subtentorial site.
Ventrolateral Compression of the Brain Stem in Essential Hypertension: MR Angiography Study
Authors: Manfrè L. , Midiri M. , Cerasola G. , Platania N. , Accardi M. , Mangiameli A. , Lagalla R. 
Published: April 2015

Our purpose was to evaluate neurovascular compression at the level of ventrolateral medulla and NVC with the IXth and the Xth cranial nerves in patients with essential hypertension and in healthy volunteers using high resoluted Spoiled Recalled Gradient Echo (SPGR) sequences, allowing the detection of stationary tissues and moving spins. Thirty patients (19 men and 11 women) with essential hypertension were examined. Patient's ages ranged from 24 to 64 years-old (mean age was 48 y.o.). Patients older than 65 were excluded. The average of systolic blood-pressure of hypertensive patients was 183 ± 10 mmHg, while the diastolic pressure was 98 ± 10.5 mmHg. In conclusion, we consider axial single partitions from a three-dimensional TOF MRA sequence ideal to demonstrate both vascular and neural components of NVC. NVC could explain essential hypertension disease in a significant percentage of patients, even though true idiopathic hypertension - probably less frequent than believed- exists.
Brain Morphometry and Psychobehavioural Measures in Autistic Low-Functioning Subjects
Authors: Elia M. , Manfrè L. , Ferri R. , Musumeci S.A. , Panerai S. , Bottitta M. , Scuderi C. , Del Gracco S. , Stefanini M.C. 
Published: April 2015

In the last two decades neurological research has significantly increased knowledge on the neuroanatomic bases of autism. Several autopsy and quantitative magnetic resonance imaging (MRI) studies have reported central nervous system (CNS) abnormalities which may underlie the social, language and cognitive dysfunction typical of the autistic disorder. Despite the wealth of evidence that the “autistic brain” is different from normal in a number of structures, the relationship between the severity of the developmental impairment in autism and the degree of the brain abnormality remains unknown. The aim of the present study is to correlate the areas of some brain regions, as calculated on the basis of MRI morphometry, with the Childhood Autism Rating Scale (CARS) and with the Psychoeducational Profile Revised (PEP-R) scores in a group of 22 autistic mentally retarded male subjects.
Imaging of “Malignant” External Otitis
Authors: Manfrè L. , Casto A. Lo , Tortorici M. , Angileri T. , Onorato D. , Barbiera F. , De Maria M. 
Published: April 2015

“Malignant” external otitis or necrotizing external otitis (NEO) is a rare and severe infection of the external auditory meatus, causing destructive changes of the petrous bone, infiltrating inframastoid and intracranial tissues, with potentially lethal consequences. Five male diabetic patients, aged 61 to 85 years-old (mean age was 74 y.o), referred with biopsy-proven NEO, underwent CT and MRI studies for the assessment of the extension of the disease. Clinical data concerning the examined patients are summarized in table 1. Contrast-enhanced MRI does not seem to help in differentiating granulation from neoplastic tissues, as both demonstrate inhomogeneous enhancement. In conclusion, NEO remains a life-threatening disease and early diagnosis is necessary for adequate pharmacological and hyperbaric therapy. Although non-specific, MRI appears to be the choice modality in demonstration of the extension and follow-up of NEO and related complications. CT, however, still maintains a complementary role in the assessment of bony erosion secondary to the disease.
Transcranial Colour Doppler Ultrasound of Cerebral Arteriovenous Malformations in Patients with Persistent Migraine
Authors: Lagalla R. , Caruso G. , Manfrè L. , D'Antonio V. 
Published: April 2015

The use of transcranial color Doppler ultrasound (TCCD) in the evaluation of children with arterio-venous intracranial malformations (AVM) has been previously described, but only recently has the use of TCCD been extended to adults. Our Department, with the contribution of the University centre for migraine treatment, has used TCCD experimentally used in 100 patients with persistent migraine resistant to therapy, for the evaluation of TCCD sensitivity in detecting flow hemodynamic abnormalities. Correlating with the normal flow measurement findings of the cerebral vessels 2/100 (2%) patients, who underwent TCCD examination, showed direct and indirect signs suggesting cerebral vessels anomalies, that were correlated with AVM.
Odontogenic Keratocyst of the Maxillary Sinus
Authors: Latona A. , Cirino A. , Manfrè L. 
Published: April 2015

Malignant tumours of the maxillary sinus and benign conditions including fibro-osseus dysplasia, mucocele, and different odontogenic cystic lesions may present with expansile maxillary masses. Odontogenic keratocystis in the maxilla is relatively rare and invasion of the maxillary sinus unusual. We describe a patient with odontogenic keratocyst of the maxillary sinus. Differential diagnosis with expanding intrasinusal cyst can be assessed on the basis of CT findings: upward displacement of the inferior floor of the maxillary sinus is a peculiar finding in extrasinusal masses: as a consequence, the size of maxillary sinus is reduced, mimicking antral hypoplasia. The superiorly displaced maxillary sinus floor should not be misinterpreted as the calcified wall of an intrasinusal mucocele. MRI is valuable in demonstrating the relation between the odontogenic keratocyst and surrounding structures. However, as the cyst may show high signal intensity on T1-weighted scans because of its contents (epithelial debris, blood degradation products), differential diagnosis of extrasinusal masses involving the sinus and intrasinusal mucocele may be difficult.
Multifocal Haemangioblastoma: Usefulness of MR Examination with a High Dose of Contrast-Medium and Late Acquisition
Authors: Aprile I. , Biasizzo E. , De Colle M.C. , Dolso P. , Fabris G. 
Published: April 2015

A rare cerebral tumour is described with a particular enhancement pattern in post-contrast medium administration magnetic resonance images. The tumour was a supratentorial, multifocal haemangioblastoma, whose solid components did not enhance in pulse sequences acquired after contrast medium administration (double dose), but only in later acquisitions (after about 1 hour). This particular behaviour suggests using contrast medium at high doses with late acquisitions when a cerebral haemangioblastoma is suspected.
Applicazioni cliniche degli studi RM perfusionali
Authors: Gallucci M. 
Published: April 2015

In clinical practice, perfusional MR has been successfully proposed in the study of pathophysiology of stroke, seeming able to help in distinguishing ischaemic necrosis from penumbra. In tumor evolution, the main application concerns the attempt of grading and follow up the lesions: areas in initial malignant transformation with microvascular proliferation in absence of endotelial (and BBB alterations), can be recognized. For the above, the tecnique is recommended in guiding cerebral biopsies toward correct triggers. For similar reason the differential evaluation of post-treatment necrosis from recurrency can take advantage from perfusional MR. Moreover, it could be predictable the possibility of employement in following tumors treated with genic therapy, in a simple and atraumatic way. In the field of epilepsy good correlations with PET and SPET has stayed on evaluating temporal perfusion in case of parahippocampal sclerosis. Promising perspectives are also present in metabolic-degenerative field. The correlation with PET studies in case of Alzheimer disesease, in fact, reaches 80%, with clear documentation of temporal and parietal cortical hypoperfusion. Our experience, performed with a 0.5 T operating magnet on more than 80 patients, confirms the results already reported in literature.
La risonanza magnetica funzionale nello studio della riorganizzazione plastica cerebrale, post-ictale
Authors: Pelliccioli G.P. , Presciutti O. , Floridi P. , Campanella S. , Chiarini P. , Tarducci R. , Zampolini M. 
Published: April 2015

Negli ultimi anni lo studio dei meccanismi di recupero funzionale dopo ictus è progredito grazie all'utilizzo di nuove tecniche di indagine sia con immagini che con registrazione elettrofisiologiche. L'interesse è accentuato dal potenziale utilizzo di queste conoscenze per mettere a punto opportuni programmi terapeutici e riabilitativi. Scopo di questo lavoro è stato quello di indagare mediante Risonanza Magnetica funzionale (fMR) quali aree motorie fossero coinvolte nel recupero dopo ictus cerebrale. Sono stati studiati 10 pazienti con ictus sottocorticale ischemico (5 con emiparesi destra e 5 con emiparesi sinistra) in buon recupero funzionale. L'età media era 59,1 anni (min 37, max 84). Tutti i pazienti sono stati indagati effettuando uno studio per immagini e funzionale. La fMR è stata realizzata con apparecchiatura General Electric 1,5 T mediante sequenze SPGR (TR/TE 64/48 ms, Flip Angle 17°, FOV 22×6 cm2, matrice 256times128, spessore di strato 6 mm) costituite da 3 sezioni assiali oblique contigue, parallele alla linea inter-commissurale, condotte a livello della corteccia motoria. L'esame funzionale è stato preceduto da uno studio convenzionale utilizzato per dimostrare le lesioni, per programmare le sequenze funzionali e per fornire una correlazione anatomica ai pixel attivati. La fMR è stata effettuata alternando acquisizioni ottenute durante un movimento delle dita con sequenze eseguite in condizioni di riposo sia per la mano paretica che per quella sana. Per l'elaborazione è stata usata la tecnica “cross correlation” con soglia usando la “box-car” come forma d'onda di riferimento. Sono stati considerati “attivati” i pixel con coefficiente di correlazione (CC) ≥ 70% del CC massimo. I pixel selezionati, codificati mediante colorazione e sovrapposti alle immagini anatomiche, sono stati quantificati con apposito programma, suddivisi per aree motorie corticali. I risultati hanno evidenziato un'attivazione bilaterale durante il movimento della mano paretica mentre si è registrata un'attivazione controlaterale più selettiva durante il movimento della mano sana. Nell'emisfero omolaterale alla paresi si è inoltre rilevato un incremento dell'attivazione nelle aree premotoria e supplementare motoria. Questi dati sembrerebbero dimostrare che una maggiore attivazione delle aree motorie corticali omolaterali alla lesione sia un importante meccanismo di compenso al danno funzionale conseguente ad ictus. Tale attivazione può avere un duplice significato: un rinforzo delle vie discendenti cortico-spinali già presenti nel soggetto sano e un ausilio funzionale da parte delle aree premotoria e supplementare motoria verso il lato lesionato.