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  • 1
    Electronic Resource
    Electronic Resource
    Transverse Microincisions of the Outer Layer of the Dura mater Combined with Foramen Magnum Decompression as Treatment for Syringomyelia with Chiari I Malformation (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 134-139 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Chiari I malformation; foramen magnum decompression; syringomyelia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Numerous surgical procedures have been proposed for treatment of syringomyelia associated with Chiari I malformation, but the optimal treatment has not yet been uniformly standardised. The main aim of the surgical treatment of syringomyelia/Chiari I complex is directed toward restoration of physiological cerebrospinal fluid dynamic at the craniovertebral junction. We report the surgical results of eight patients, affected by syringomyelia and Chiari I malformation, age range from 18 to 62 years, treated by bony foramen magnum decompression combined with transverse microincisions of the outer layer of the dura mater. In an average postoperative follow-up period of two years neurological symptoms and signs improved in seven patients. Postoperative Magnetic Resonance showed a decrease in size of the syrinx in seven patients. These results suggest that foramen magnum decompression combined with transverse microincisions of the outer layer of the dura 1) is an effective and safe treatment option for syringomyelia and Chiari I malformation, 2) corrects the circulatory disturbances of cerebrospinal fluid dynamic, 3) leads to a decrease in size of the syrinx and to a significant improvement in neurological signs and symptoms, 4) avoids complications of intradural approaches and syringosubarachnoid shunting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050074
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  • 2
    Electronic Resource
    Electronic Resource
    Does Subarachnoid Blood Extravasation per se Induce Long-Term Neuropsychological and Cognitive Alterations? (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 805-812 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cognitive alteration; neuropsychological functions; subarachnoid haemorrhage.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Although recent advances in medical and management strategies have reduced the mortality and morbidity rates related to subarachnoid haemorrhage (SAH), patients who survive a SAH may remain nevertheless affected by persistent cognitive and neuropsychological disturbances. The presence of these deficits has been attributed to the neurotoxic effects of the widespread subarachnoid blood. To assess the long-term neuropsychological and cognitive outcome related to subarachnoid blood extravasation per se we evaluated 20 patients affected by an unknown origin subarachnoid haemorrhage, and having SAH characteristics generally considered predictive of a favourable outcome. Patients were enrolled after a one-year interval from the initial insult, and were selected accordingly to a pre-designed protocol. We employed a complete battery of tests, assessing general cognitive and language functions, memory and construction ability, attention and vigilance, anxiety and depression. The results were compared with normal reference values and with performances of a socio-demographically homogenous sample of control volunteers. This study did not evidence any significant long-term cognitive and neuropsychological alteration after subarachnoid blood extravasation. These results indicate that the presence of subarachnoid blood initiate a number of secondary mechanisms of pathology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050182
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  • 3
    Electronic Resource
    Electronic Resource
    Time-Course of Blood-Brain Barrier Permeability Changes After Experimental Subarachnoid Haemorrhage (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 575-581 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Blood-brain barrier; evans blue; rat; subarachnoid haemorrhage.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ An increase in blood-brain barrier (BBB) permeability after subarachnoid haemorrhage (SAH) has been described in humans and has been correlated with delayed cerebral ischemia and poor clinical outcome. Few studies examined in the laboratory the relationship between SAH and BBB, with contrasting results due to limitations in experimental probes adopted and in timing of observation. The aim of this study was to quantify the time-course of BBB changes after experimental SAH. Groups of eight rats received injections of 400 μl of autologous arterial blood into the cisterna magna. BBB was assessed 6, 12, 24, 36, 48, 60, and 72 hours after SAH and in sham-operated animals separately for cerebral cortex, i.e. frontal, temporal, parietal, occipital, subcortical gray matter (Caudate-Putamen-Thalamus), cerebellar cortex and nuclei, and brain stem by a spectrophotofluorimetric evaluation of Evans Blue dye extravasation. As compared to sham-operated controls, SAH determined a significant BBB permeability change beginning 36 hours after SAH, peaking at 48 hours, and normalizing on day 3. This study provides a quantitative description of the temporal progression and recovery of BBB dysfunction after SAH. These results have implications for the management of aneurysm patients and for assessing the rationale and the therapeutic window of new pharmacological approaches.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050472
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  • 4
    Electronic Resource
    Electronic Resource
    Immunohistochemical tenascin-C expression in paediatric supratentorial glioblastoma multiforme (2000)
    Springer
    Child's nervous system 16 (2000), S. 357-362 
    Details
    ISSN: 1433-0350
    Keywords: Keywords Angiogenesis ; Glioblastoma multiforme ; Immunohistochemistry ; Tenascin-C
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Tenascin-C (TN-C) plays an important part in the growth of neoplastic tissue, leading to new vessel development. TN-C has been assessed in adult glioblastoma multiforme (GBM) and has been evaluated as anti-neoplastic therapy. No studies have focused on this tissue in paediatric GBM. Tissues were obtained from six paediatric supratentorial GBMs. Immunohistochemistry was performed using a mouse antibody directed against human TN-C, and expression in tumour vasculature was described on the basis of TN-C immunoreactivity. The expression was minimal in three, moderate in two, and intense in one specimen. TN-C was not correlated with clinical history, neurological findings, or with tumour site. Although based on a limited number of patients, this study provides additional insights into tumour growth modulation and cytogenetic profile of paediatric GBM. The detailed understanding of events responsible for GBM growth is a prerequisite for the development of therapeutic modalities leading to improved prognosis and cure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050531
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  • 5
    Electronic Resource
    Electronic Resource
    Reversible cerebral perfusion alterations in children with transient mutism after posterior fossa surgery (1998)
    Springer
    Child's nervous system 14 (1998), S. 114-119 
    Details
    ISSN: 1433-0350
    Keywords: Key words Children ; Mutism ; Posterior fossa surgery ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks in the absence of additional neurological alterations. The anatomical structures thought to be involved are the connections between the cerebellar dentate nucleus, the ventrolateral nucleus of the contralateral thalamus and the supplementary motor area. In an attempt to understand the pathophysiology of this syndrome, and to depict the perfusion of different brain areas semiquantitatively, in two children who had become mute after posterior fossa surgery we performed a Tc99M-HM-PAO SPECT study during the period of mutism and again when normal speech had returned. In one patient, who had a left cerebellar astrocytoma, the SPECT study showed a marked reduction of cerebral perfusion in the right fronto-parietal region, and in the other, who had a medulloblastoma, a left fronto-temporo-parietal perfusion alteration was observed. When the patients regained normal speech, the follow-up SPECT studies revealed normalization of the cerebral perfusion. This study demonstrates the occurrence of a focal dysfunction of cerebral perfusion in children with cerebellar mutism after posterior fossa surgery. These observations are useful in extending our understanding of the pathophysiology of this postoperative clinical syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050191
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  • 6
    Electronic Resource
    Electronic Resource
    Temporal osteoclastoma: an exceptional lesion in infancy (1998)
    Springer
    Child's nervous system 14 (1998), S. 213-217 
    Details
    ISSN: 1433-0350
    Keywords: Key words Giant cell tumour ; Immunohistochemistry ; MRI ; Osteoclastoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Osteoclastoma is a rare skeletal lesion, characterized by large multinucleated giant osteoclastic cells; this lesion usually affects young adults with a prevalence of 1 case/1 million population. We report the case of a 9-year-old girl with a right temporal tumescence: X-ray, CT and MRI revealed the presence of a right temporal hyperostotic ring-like area over the lambdoid suture, with irregular margins and calcareous deposits. The tumour was expanding mainly toward the endocranium involving both cranial tables and diploë, without infiltrating the brain parenchyma. The child underwent complete microsurgical removal of the lesion. Histopathological findings revealed the giant cell tumour osteoclastoma. Correct modern preoperative neuroimaging workup, coupled with microneurosurgical technique, allowed successful lesion removal with good outcome. A review of the more recent literature and of mechanisms of pathology together with neuroradiological protocol and results of treatment are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050214
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  • 7
    Electronic Resource
    Electronic Resource
    Morphological modifications of the choroid plexus in a rodent model of acute ventriculitis induced by gram-negative liquoral sepsis (1995)
    Springer
    Child's nervous system 11 (1995), S. 511-516 
    Details
    ISSN: 1433-0350
    Keywords: Escherichia coli ; Infection ; Choroid plexus ; Hydrocephalus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gram-negative bacterial infections of the central nervous system are generally associated with high morbidity and mortality rates. In patients with ventriculitis induced by gram-negative liquoral sepsis, a reduction in cerebrospinal fluid formation has been reported, suggesting that gram-negative ventriculitis is able per se to alter the normal functioning of the choroid plexus. The aim of the present study was to analyse, for the first time in the rat, the effects of tcute ventriculitis on the ultrastructure of the choroid plexus. A simple and inexpensive experimental model of acute ventriculitis was developed: we injected into the cisterna magna of rats 103 CFU of liveEscherichia coli, inducing septic ventriculitis without major neurological deficits. Histological examinations of rodent choroid plexus 24 h after the injection revealed patches of altered epithelium, with swollen and vacuolated ependymal cells associated with leukocyte infiltration. Electron microscopy demonstrated a reduced number of microvilli and flattening of the epithelial surface. These results (a) indicate that gramnegative septic ventriculitis is able to induce visible ultrastructural alterations of the choroid plexus which (b) are consitent with a picture of marked reduction of the functioning epithelial choroid plexus surface, and (c) highlight the potential usefulness of our rodent acute ventriculitis model for developing treatment modalities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00822840
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  • 8
    Electronic Resource
    Electronic Resource
    Reply to the letter from Dr. Erşahin (1998)
    Springer
    Child's nervous system 14 (1998), S. 612-613 
    Details
    ISSN: 1433-0350
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050284
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  • 9
    Electronic Resource
    Electronic Resource
    Autoradiographic assessment of pineal gland glucose utilization and capillary permeability in the unanesthetized rat (1990)
    Springer
    Child's nervous system 6 (1990), S. 222-224 
    Details
    ISSN: 1433-0350
    Keywords: Pineal gland ; Glucose metabolism ; Capillary permeability ; Quantitative autoradiography ; Positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pineal gland glucose utilization (GU) and capillary permeability (CP) were measured in unanesthetized rats, using complementary quantitative autoradiographic techniques. GU values within the pineal tissue were homogeneously distributed around 70 μmol of glucose/100 g each min, i.e., they were approximately 30% lower than in the cortical gray structures. The blood-to-brain transfer constant of [14C]-α-aminoisobutyric acid, as an index of CP, was up to ten orders of magnitude higher than that for the rest of the brain. These measurements were carried out at that point in the circadian rhythm that corresponds to the minimum level of neurosecretory activity of the pineal gland.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01850978
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  • 10
    Electronic Resource
    Electronic Resource
    Xanthomatous posterior pyramid meningioma in a 2-year-old girl (1997)
    Springer
    Child's nervous system 13 (1997), S. 406-411 
    Details
    ISSN: 1433-0350
    Keywords: Key words Childhood ; Posterior cranial fossa tumour ; Xanthomatous meningioma ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Meningiomas are common lesions in adults but unusual in infancy and meningiomas located in the posterior cranial fossa are even more rare. Metaplastic changes of meningothelial meningiomas can lead to the rarely observed xanthomatous form. We describe the case of a posterior pyramid xanthomatous meningioma in a 2-year-old girl. After detailed neuroradiological evaluation, the histological diagnosis was confirmed with the aid of immunohistochemical evaluation. A critical case evaluation in the light of the more recent literature, the surgical strategy and technique, and an immunohistological hypothesis are reported.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050109
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