bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polimicrogiria (PMG) parieto-occipitale parasagittale bilaterale: Studio RM in 7 pazienti
Authors: Farina L. , D'Incerti L. , Chiapparini L. , Cimino C. , Battaglia G. , Granata T. , Savoiardo M. 
Published: April 2015

Recentemente è stata identificata una nuova malformazione dello sviluppo corticale associata ad epilessia caratterizzata da corteccia polimicrogirica localizzata nelle regioni parieto-occipitali parasagittali bilateralmente. Presentiamo i dati RM di 7 nostri pazienti, con alterazioni analoghe, 5 maschi e 2 femmine sorelle gemelle, di età compresa tra 20 e 68 anni. Tutti i pazienti sono stati sottoposti ad almeno 1 esame RM, 5 con apparecchi 1.5 T e 5 con apparecchio 0.5 T. In tutti i casi la RM ha dimostrato la presenza di un solco abnormemente profondo posto nelle regioni parieto-occipitali bilateralmente in sede parasagittale e circondato da corteccia polimicrogirica. L'alterazione è bilaterale in tutti i pazienti, simmetrica in 4 casi e asimmetrica in 3 per maggior profondità del solco a sinistra. In tutti i pazienti la corteccia polimicrogirica si estendeva anteriormente nel lobulo parietale superiore fino alla regione rolandica: non è stato mai possibile identificare con sicurezza il solco centrale. Nei 3 casi con distribuzione asimmetrica e in 1 caso con distribuzione simmetrica il solco abnorme si estendeva fino alla porzione postero-superiore della scissura silviana anch'essa circondata da corteccia polimicrogirica. Il quadro clinico era caratterizzato da epilessia, impaccio motorio o segni piramidali e ritardo mentale di vario grado. Questa alterazione è stata interpretata dagli autori che l'hanno descritta come un disturbo dell'organizzazione corticale post-migrazionale correlata ad un danno ischemico corticale avvenuto in fase prenatale. La presenza di 2 sorelle gemelle affette nella nostra casistica suggerisce che un fattore genetico può essere coinvolto nella patogenesi della PMG parieto-occipitale parasagittale bilaterale come già evidenziato nella PMG perisilviana. La coesistenza di quest'ultima alterazione rafforza l'ipotesi genetica e suggerisce la possibile esistenza di quadri fenotipici molto diversi e complessi con una etiopatogenesi comune.
I foci iperintensi in corso di neurofibromatosi hanno sempre una evoluzione benigna?
Authors: Lanza P.L. , Auteri W. , Armentano A. , De Vuono G. , Santoro G. 
Published: April 2015

More than 70% of patients with neurofibromatosis type 1 (NF-1), present hyperintense foci in MR DP-T2 weighted images, located in deep grey and white matter. The true nature of these hyperintense foci is still unknown: they could be hamartomas, that is composition and organisation alterated areas of cytologic normal tissue, gliotic areas, delayed or disorganised areas of myelinisation and, finally, low grade glial tumors (astrocytoma). We present the case of a 17 years old pazient, who underwent 8 MR brain studies in a six years period. We analyzed the MR characteristics of the hyperintense foci in seriated studies and, particularly, the evolution of a single, simple, hyperintense periventricular lesion in cistic tumor with intramural nodule.
Imaging funzionale per diffusione (DWI) e ischemia cerebrale in fase acuta: Potenzialità diagnostiche e confronto con metodiche convenzionali
Authors: Sparacia G. , Gonzalez R.G. , Buonanno F. , Sorensen A.G. , Lagalla R. , De Maria M. 
Published: April 2015

Stroke is the third leading cause of death and is a major cause of long-term disability. Neuroprotective treatment within a 4-hour «therapeutic window» has proved highly efficacious in reducing morbility and mortality in animal model. It is with this background that the need for emergent diagnosis and therapy of acute stroke in strongly suggested. Computed tomography (CT) shows the parenchymal changes of acute stroke too late to be helpful, and its role has been primarily to evaluate the possibility of intracerebral or subarachnoid hemorrhage. While conventional magnetic resonance (MR) imaging can demonstrate parenchymal abnormalities 4–6 hours after ischemia, newer techniques such as diffusion-weighted MR imaging (DWI) hold promise that a diagnosis of ischemia can be made within minutes after the acute event. In this article compares different aspects of hyperacute cerebral ischemia depicted at diffusion-weighted imaging before infarction is depicted at conventional MR or CT scans. DWI techniques may improve stroke diagnosis and may contribute to advances in treatment.
Utilità delle sequenze turbo-flair e analisi volumetrica della regione ippocampale nella valutazione del paziente con epilessia temporale farmaco-resistente
Authors: Ferone E. , Pierallini A. , Bonamini M. , Bozzao A. , Quarato P.P. , Giallonardo M.T. , Fantozzi L.M. 
Published: April 2015

The aim of this study was to evaluate the hippocampal region using Fluid Attenuation Inversion Recovery sequences (Turbo-FLAIR) to detect signal intensity abnormalities, and volumetric sequences to detect cortical thickness changes, in patients with drug-resistant temporal epilepsy. We evaluated 30 patients with drug-resistant temporal epilepsy with a 1.5 Tesla unit (NT 15 Philips Gyroscan). Conventional SE, Turbo SE, IR, Turbo-FLAIR, volumetric 3D sequences on coronal plane, PD, T2weighted SE sequences on axial plane, T1-weighted SE on sagittal plane / were performed. Signal intensity and volumetric computerized measurements were obtained using the SUN system. Differences in signal intensity values between the two hippocampal regions were found in 18 patients with Turbo-FLAIR sequences. In 6 of the sepatients no significant differences in computerized evaluation of signal intensity were detected with either conventional or Turbo-SE sequences. Volumetric analysis showed hippocampal cortex thinning in 9 out of 18 patients with hippocampal signal intensity abnormalities. Turbo -FLAIR provided the best sequences for the detection of signal intensity changes in the hippocampal region. Such changes are strongly suggestive of hippocampal sclerosis, especially when associated with cortical atrophy.
Studio dell'arco aortico e dell'origine dei tronchi sovraortici: Validazione di una tecnica angio-RM con bolo di gadolinio
Authors: Strada L. , Anzalone N. , Scomazzoni F. , Origgi D. , Castellano R. , Zucca R. , Chiesa R. , Santino P. , Scotti G. 
Published: April 2015

Our purpose was to evaluate the utility of Gadolinium-enhanced MR angiography in the study of the aortic arch and arch vessels disease. Twelve patients with cerebrovascular diseases underwent MR examination at 1.5 T with a body coil and 3D FISP sequence (TRITE/flip angle 5.0–6.0/2.0/50°; acquisition time: 26–31 sec). Gadolinium infusion was timed for maximum arterial contrast during acquisition of central portion of K-space. For this purpose we administer a “test dose” of 2 ml of Gadolinium with a power injector. In all examinations we had a good visualization of the aortic arch and arch vessels up to carotid bifurcations. The evaluation of vertebral arteries and their origins was sometimes suboptimal because of the lower spatial resolution. Our preliminary results indicate that 3D Gadolinium enhanced MR angiography has the potential to become an accurate imaging method for detection of arch vessels diseases.
Calibro dei sifoni carotidei e asimmetria del poligono di Willis: Studio Angio-RM
Authors: Manfrè L. , Angileri R. , Caruso G. , D'Antonio V. , De Maria M. , Lagalla R. 
Published: April 2015

A differenza dell'Angiografia, l'esame Angio-RM consente la simultanea visualizzazione dei vasi del poligono. Si è valutata la correlazione esistente tra calibro dei sifoni e asimmetrie di sviluppo del poligono nella popolazione normale. Sono stati esaminati 3 casi di occlusione totale di una carotide. 120 pazienti privi di patologie vascolari o neoplastiche sono stati sottoposti ad esame Angio-RM 3DTOF con Magnetization Tranfer e TONE. Sono state valutate le immagini di sorgente e 3DMIP, prima e dopo sottrazione dei pixel non vascolari. I pazienti sono stati suddivisi in 5 gruppi: I = aplasia di A1, II = ipoplasia di A1, III = lieve asimmetria di A1, IV ? arteria comunicante posteriore fetale, V = poligono simmetrico. Inoltre i pazienti sono stati suddivisi in base al calibro della carotide interna in: A (simmetrico), B (lieve asimmetria), e C (marcata asimmetria). è stata calcolata la percentuale di differenza di calibro (PDC) tra carotide destra e sinistra (Cmin/Cmax). Sono stati posti in correlazione PDC e simmetria dei vasi del poligono. I pazienti del gruppo C sono stati sottoposti a color Doppler dei vasi al collo, per escludere vasculopatia a monte. Una differenza statisticamente significativa in termini di PDC tra sifone carotideo destro e sinistro è stata osservata unicamente nei pazienti di gruppo I e II. I pazienti affetti da occlusione del sifone carotideo con compenso via Al dimostravano un calibro di Al superiore rispetto ai gruppi III, IV e V. Per quanto una asimmetria di calibro dei sifoni carotidei possa suggerire l'esistenza di una patologia vascolare a monte, è necessario considerare le varianti anatomiche correlate all'asimmetrico del poligono di Willis. Il bilancio dei rami collaterali esistenti a livello del poligono di Willis mediante Angio-RM è importante per la valutazione dei possibili circoli di compenso.
Neoplasie extracraniche responsabili di sindromi dei nervi cranici
Authors: Roncallo F. , Giberti L. , Turtulici I. , Bartolini A. 
Published: April 2015

Aim of this study is to examine the different routes by which extracranial neoplasms can spread to the cranial cavity through cranial nerves. Sixty pts were retrospectively evaluated (38 males, 22 females, age between 16 and 85 years); they showed isolated or multiple cranial nerve deficit, with evidence of an expansive lesion responsible for the symptoms. Images were obtained by third generation, spiral CT scanners and medium and high field MRI. The different possible ways of diffusion, also coexistent in the same patient, are the following: – erosion of skull foramina and canals; – perineural, perivascular ascending spread through pterygopalatine fossa to orbitary apex, to cavernous sinus through oval foramen, through stylomastoid foramen to pyamid, to posterior fossa through its foramina; – direct compressive effect on neighbouring structures (mainly cranial nerves) in the neck region. A perfect knowledge of the anatomy of the skull base and neck regions is necessary to correctly plan and examine neuroradiologic images, which in their turn must be susceptible to clever and variable schedules according to the different conditions. Altogether these factors can help physicians in the optimal choice of therapeutic interventions and formulating prognosis.
Displasie corticali familiari: Studio clinico-RM
Authors: Triulzi F. , Baldoli C. , Borgatti R. , Zucca C. 
Published: April 2015

Clinical and MRI studies in relatives of patients with cortical dysplasia (CD) can provide a new insight to the genetic aspect of this disease, in which some genetic anomaly in one of the three main process of cortical formation: proliferation, migration and organization, is one of the most frequent cause of the malformation. Three new families with more than one relative with CD were reported: a) Proband with lissencephaly and mother with bifrontal band heterotopia (X-linked lissencephaly) b) Proband with diffuse biopercolar CD; the sister, the mother, and the grandmother with focal biopercolar CD; the two aunt with mild intellectual impairment but apparently normal MRI c) Two sisters, monozygotic twins with biopercolar CD.
Diagnostica radiologica delle fistole artero-venose durali
Authors: Muras I. , Scuotto A. , Rispo A. , Maisto M. , Bernini F.P. 
Published: April 2015

Tra le malformazioni vascolari intracraniche, le fistole artero-venose durali rivestono particolare interesse, in relazione alla loro frequenza (10–15%) ma, soprattutto in relazione al tipo di drenaggio venoso. Codesto elemento, infatti, è quello che configura quadri clinici diversi, con conseguenti prognosi e terapia diverse. Le malformazioni artero-venose con drenaggio nelle vene subaracnoidee comportano spesso emorragie intra od extraparenchimali, laddove quelle che drenano direttamente ed esclusivamente nei seni, creano problemi clinici certamente meno imponenti. Gli AA. presentano la loro esperienza su 20 casi di fistole durali. I pazienti sono stati sottoposti a TC, RM e studio angiografico completo. La TC, praticata spesso d'urgenza per sospetto (spesso fondato!) di emorragia intracranica, e la RM sono utili anche per determinare la condizione globale dell'encefalo, la localizzazione della fistola e l'eventuale pervietà dei seni durali. L'esame angiografico implica lo studio selettivo dei vari elementi vasali che determinano la malformazione, delle eventuali anastomosi tra i distretti vasali e soprattutto dei drenaggi venosi. La conoscenza di questi elementi consente l'inquadramento dei tipi di fistola secondo i vari criteri classificativi. Il nostro studio è stato finalizzato alla più corretta strategia terapeutica.
Biopsia vertebrale TC guidata per ago sottile: Possibilità e limiti
Authors: Simonetti L. , Siam A. , Cascone A.M. , Russo R. , Giugliano V. , Greco L. , Sirabella G. 
Published: April 2015

La biopsia vertebrale TC guidata risolve in maniera definitiva il problema della tipizzazione delle lesioni litiche vertebrali, fondamentale per la programmazione terapeutica. Gli autori, propongono la propria esperienza di biopsie eseguite, invece che con i normali aghi di grosso calibro di tipi “ortopedico”, con aghi sottili (20–22 G) su 18 pazienti, 13 con sospetto di patologia neoplastica e 5 con sospetto di patologia infettiva. Nel primo gruppo la biopsia era richiesta per una tipizzazione della lesione neoplastica; nel secondo gruppo si richiedeva, oltre alla conferma del sospetto clinico-radiologico, la tipizzazione dell'agente patogeno. Vengono illustrate: la tecnica e le difficoltà legate all'uso di aghi sottili; i risultati, con particolare riguardo alla significatività dei reperti; i risvolti terapeutici, in particolar modo nei pazienti con patologia infettiva.
Terapia fibrinolitica intra-arteriosa in occlusione vertebrobasilare acuta
Authors: Mangiafico S. , Villa G. , Giordano G.P. , Scardigli V. , Pandolfo C. , Petacchi D. , Nori A. , Benvenuti L. , Serino D. , Mennonna P. 
Published: April 2015

Intra-arterial fibrinolytic therapy in acute vertebrobasilar occlusion is effective in saving the patient's life in 75% of cases if performed within 6 hours after the beginning of an ischemic event, without CT evidence of hypodense focal areas in the brain stem, cerebellum or thalamic nucleus. The initial clinical aspect of vertebrobasilar stroke is more often evolving. Only in 1/3 of cases is coma present at the beginning. In vertebro-basilar occlusion prognosis is determined by clinical and neuroradiological aspects. The outcome depends mainly upon how much brain stem function is lost during the reperfusion time, and the kind of vertebrobasilar occlusion. The case we present concerns a 38 year old man with acute onset of cerebral stroke without initial clinical signs of vertebrobasilar localization due to a basilar artery occlusion distal to AICA. Urokinase infusion was performed within three hours from the clinical onset up to a total amount of 1.400.000 UI. Reperfusion was observed one hour after the beginning of the intravascular therapy. The clinical course was favorable with good recovery (moderate superior right paresis, controlateral light cerebellar syndrome).
Turbo-FLAIR Sequence in Brain MRI
Authors: Polonara G. , Salvolini U. 
Published: April 2015

To compare a turbo-FLAIR sequence with Proton Density (PD) and T2-weighted Turbo Spin-Echo (TSE) sequences in several different brain diseases, 276 MRI examinations were performed on a 1.0 Tesla system. The positive cases were assessed for lesion detection and lesion conspicuity. Four quantitative criteria were also used to compare the contrast of the two techniques: lesion to background contrast, lesion to background contrast to noise ratio (CNR), lesion to Cerobrospinal fluid (CSF) contrast, lesion to CSF contrast to noise ratio. The turbo FLAIR sequence was found to be superior to PD and T2-weighted TSE for lesion detection: this sequence detected more lesions in 74 patients than PD and in 42 patients than T2, but missed some subtentorial lesions. For lesion conspicuity turbo-FLAIR was judged equivalent to PD and T2-weighted TSE respectively in 27% and 45% of the cases and better in 71% and 53% of the cases. Lesion to background contrast and lesion to background CNR were found to be significantly greater for turbo-FLAIR than for PD (p<0.001). Compared with T2-weighted TSE, turbo-FLAIR showed a significantly higher lesion to background contrast (p<0.001) and inferior lesion to background CNR (p<0.001). Our study indicates that turbo-FLAIR can replace PD TSE scans in most cases and can be used as a first choice sequence for cerebrovascular diseases, multiple sclerosis and for the evaluation of gliosis.
Intra-arterial Thrombolysis in Acute MCA Occlusion from an Extracranial ICA Aneurysm
Authors: Guglielmi G. , Ciceri E. , Quinones D. 
Published: April 2015

A case of acute occlusion of the right ICA and MCA from a fusiform/dissecting aneurysm of the upper cervical ICA was successfully treated with an entirely endovascular approach. Long-term clinical follow-up is available. This 41 year-old-woman presenting with TIAs underwent magnetic resonance angiography that showed total occlusion of the right ICA. The day after she suddenly became hemiplegic, hemianopic, and confused. Three vessel angiography demonstrated occlusion of the right ICA and MCA. Super-selective angiography showed a fusiform/dissecting aneurysm of the upper cervical ICA. Urokinase infusion in the occluded right MCA was performed, thus establishing collateral blood flow via the contralateral carotid artery within 4 hours from the onset of the symptomatology. To prevent further repeated thrombo-embolic events, the right ICA was permanently occluded with GDC coils, trapping the aneurysm. The patient gradually improved and, at the three-year follow-up she had resumed her previous occupation being completely independent, with only a mild difficulty in writing. This is the first reported case of an acute MCA embolism from a fusiform/dissecting extracranial ICA aneurysm treated with MCA thrombolysis followed by aneurysm trapping. The possible aetiology of the underlying lesion and the different therapeutic options are discussed.
Jugular Foramen Syndrome with Miosis: A Sign of Internal Carotid Artery Dissection
Authors: Lupo F.A. , Perfetto S.C. , Sticchi G. 
Published: April 2015

We describe a case of left extra and intracranial internal carotid artery dissection in a 59-year-old man who presented with the clinical features of left jugular foramen syndrome (dysphonia, dysphagia, ageusia, paralysis of the sternocleidomastoid muscle) and ipsilateral miosis with acute onset, worsening in the first 24 hours and spontaneous remission over the next thirty days. The patient was investigated by computed tomography magnetic resonance and digital angiography and received conservative treatment. The clinical aspects are discussed, emphasizing the major role of magnetic resonance in the diagnosis of the syndrome.
Ethical and Legal Aspects Relating to the Use of the Neural Microcomputer C40
Authors: Borea L. 
Published: April 2015

My project deals with an instrument for neurosurgery and electronics, a neural microcomputer, together with its ethical and legal implications. The essay is presented in the form of a report from the legal department of the CyberSys Corporation to the Board of Directors of the same firm. The introductory background information is followed by a description by the department of the ethical and legal observations made by the Ethical and Legal Commission of the European Court of Justice regarding the application of high technology. The debate between the various members of the Commission is particularly delicate as the potential impact of this new technology could prove revolutionary.
Isolated Leptomeningeal Spinal Tuberculosis
Authors: Andreula C.F. , Recchia-Luciani A.N.M. 
Published: April 2015

Leptomeningeal granulomatous radiculomyelitis is usually an extension of basal cisternal arachnoiditis or evolves from haematogeous or contiguous spread from juxtameningeal foci, choroid plexus foci or osseous infection. Isolated intradural and/or intramedullary lesions are much less common than leptomeningeal involvement of the basal cisterns. Furthermore, the frequency of isolated intradural TB lesions in non-AIDS patients is exceptional. The type, severity and extent of the lesions depend on the number and virulence of acid fast bacilli, and the immune status of the patient. Alcohol abuse is known as an important immunosuppressant. Herein we report one case of multiple intradural extramedullary tuberculomas without cranial involvement. Magnetic resonance imaging revealed intradural lesions confirmed as tuberculomata at pathology, with no evidence of tuberculosis elsewhere.
Intradiscal Gas and Disc Herniation
Authors: Muras I. , Conforti R. , Maisto M. , Scuotto A. , Bernini F.P. 
Published: April 2015

The development of air within the degenerated disc is secondary to the movements of the spine. Because of the negative intradiscal tension produced with hyperextension of the spine, the vacuum phenomenon increases with extension and decreases with flexion. The presence of air in the epidural space is more uncommon and may be associated with a disc herniation and even located within the herniated disc itself. We reviewed the clinical and CT findings of 750 patients. Intradiscal gas was found in 130 out of the 750 patients, 65 men and 65 women, whose age ranged from 17 to 81 years; 20 patients were under 40 years old. The gas was at a single level in 83 cases, mainly L5-S1 (43 cases) and L4-L5 (20 cases). In 22 other patients the gas collection was at a level other than disc herniation.
Reflections on the Nucleus Pulposus
Authors: Simonetti L. , Barbara C. 
Published: April 2015

The intervertebral disc is usually divided into two parts, the anulus fibrosus and the nucleus pulposus. However, they are not considered two separate anatomic parts since one is essentially part of the other and this should be borne in mind to understand the process of ageing. The intervertebral disc should therefore be thought of as a dynamically evolving anatomo-functional unit. The dynamics of this process were investigated by studying the histobiochemistry of the acellular matrix of the joint cartilage in general and that of the intervertebral disc in particular to understand the effects of this arrangement on the stuctural changes to the disc induced by biomechanical stress, especially during ageing. Lastly, we focussed on the disc's nutritional mechanisms in order to examine “disc degeneration” as a sign of metabolic impairment of the nucleus pulposus and “disc regeneration”. This concept was unknown until recently and is currently monitored in percutaneous controls following treatment for disc disease.