Publications by authors named "Gianluca Scalia"
Background: The relentless integration of Artificial Intelligence (AI) into neurosurgery necessitates a meticulous exploration of the associated ethical concerns. This systematic review focuses on synthesizing empirical studies, reviews, and opinion pieces from the past decade, offering a nuanced understanding of the evolving intersection between AI and neurosurgical ethics.
Materials And Methods: Following PRISMA guidelines, a systematic review was conducted to identify studies addressing AI in neurosurgery, emphasizing ethical dimensions.
: Diffusion tensor imaging (DTI), a variant of Diffusion Weighted Imaging (DWI), enables a neuroanatomical microscopic-like examination of the brain, which can detect brain damage using physical parameters. DTI's application to traumatic brain injury (TBI) has the potential to reveal radiological features that can assist in predicting the clinical outcomes of these patients. What is the ongoing role of DTI in detecting brain alterations and predicting neurological outcomes in patients with moderate to severe traumatic brain injury and/or diffuse axonal injury? : A scoping review of the PubMed, Scopus, EMBASE, and Cochrane databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
View Article and Find Full Text PDFIntraoperative assessment of tumor margins can be challenging; as neoplastic cells may extend beyond the margins seen on preoperative imaging. Real-time intraoperative ultrasonography (IOUS) has emerged as a valuable tool for delineating tumor boundaries during surgery. However, concerns remain regarding its ability to accurately distinguish between tumor margins, peritumoral edema, and normal brain tissue.
View Article and Find Full Text PDF(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course.
View Article and Find Full Text PDFAim: This systematic review aims to synthesize the epidemiology, clinical presentation, diagnostic approaches, treatment strategies, and outcomes of spinal dumbbell meningiomas to enhance understanding and improve patient management.
Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four major databases (PubMed, Scopus, Web of Science, and Cochrane Library) were searched until June 2024. Studies included patients diagnosed with spinal dumbbell intradural-extradural meningiomas, focusing on patient demographics, tumor characteristics, diagnostic methods, treatment modalities, and clinical outcomes.
High-grade gliomas (HGGs) represent a formidable challenge in neuro-oncology due to their aggressive nature and resistance to current therapeutic interventions, which include surgery, radiation, chemotherapy, and emerging immunotherapies. Despite these efforts, the prognosis for patients remains poor, emphasizing the urgent need for novel treatment strategies. One promising avenue of exploration is microgravity, a condition experienced during spaceflight and simulated in laboratories on Earth, which induces significant physiological changes in cells and tissues.
View Article and Find Full Text PDFBackground: The dura mater, a fibrous membrane protecting the brain and spinal cord, is prone to lacerations during spinal surgery, often leading to complications such as cerebrospinal fluid (CSF) leakage. Anatomical differences in the spinal dura mater, particularly in regions under high biomechanical stress, suggest that chronic inflammatory processes may compromise its structural integrity. This pilot study investigates the molecular and anatomical characteristics of the spinal dura mater, focusing on its response to inflammation and the challenges of surgical repair.
View Article and Find Full Text PDFSurgical resection of a rare scalp arteriovenous malformation: a case report.
Ann Med Surg (Lond)
November 2024
Article Synopsis
- Scalp arteriovenous malformations (AVMs) are complex vascular issues that can cause severe complications and cosmetic problems, especially in young women; early diagnosis and a team-based treatment approach are critical.
- A 30-year-old female with a pulsatile scalp mass was diagnosed with a scalp AVM through various imaging techniques and successfully treated with endovascular embolization and surgical resection, resulting in significant symptom relief.
- The case highlights the importance of interdisciplinary collaboration and advanced imaging in managing scalp AVMs, emphasizing the need for ongoing monitoring to prevent recurrence and ensure long-term success.
Background And Purpose: Trigeminal neuralgia (TN) is a severe chronic pain condition, typically affecting patients over 50-year-old, caused by the compression of the nerve at the root entry zone (REZ) by blood vessels. While the diagnosis is clinical, advanced imaging like diffusion tensor imaging (DTI) is crucial to identify underlying causes and assessing nerve damage. DTI may help develop neuroimaging markers to improve understanding of TN and predict surgical outcomes.
View Article and Find Full Text PDFArticle Synopsis
- - MV PLUS lesions are benign brain cysts that usually do not cause symptoms but can lead to neurological issues like seizures and headaches; they are mainly found in the posterior fossa and detected through MRI scans showing high intensity on T2-FLAIR sequences.
- - A case of a 52-year-old woman with symptoms like dizziness and syncope revealed a multicystic lesion via MRI, which showed no harmful changes after treatment, highlighting the need for careful monitoring and further research.
- - These lesions pose diagnostic challenges due to their complex features; although benign, their management and pathogenesis are still being studied, stressing the importance of ongoing investigation in the field.
Article Synopsis
- - The paper discusses recurrent pleomorphic xanthoastrocytoma (PXA) with leptomeningeal dissemination, emphasizing the difficult management of such cases and the potential benefits of radiotherapy for symptom relief and extending life.
- - A specific case is described of a 27-year-old woman with recurrent anaplastic PXA who, after multiple treatments and disease progressions, benefited from radiotherapy to the spinal axis, achieving clinical stability.
- - This case highlights the significance of considering palliative radiotherapy as a strategy to enhance quality of life and possibly prolong survival for patients with challenging PXA conditions.
Contralateral transcallosal transfalcine approach for bilateral intra-extraventricular anaplastic ganglioglioma 'the trans-tumoral route': a technical case instruction.
Br J Neurosurg
September 2024
Background: Bilateral, biventricular lesions present a challenging scenario in neurosurgery, often requiring complex surgical techniques for management. Gangliogliomas (GG), while typically indolent, can manifest as anaplastic variants (AGG), necessitating comprehensive treatment strategies. This case study explores a unique surgical approach for a patient with bilateral, intra-extraventricular lesions infiltrating the corpus callosum, highlighting the complexities of managing such cases.
View Article and Find Full Text PDFArticle Synopsis
- This study evaluates the challenges in radiation therapy for recurrent glioblastoma (GBM) and compares the effectiveness of C-methionine PET (MET-PET), Ga-PSMA PET, and MRI in accurately delineating tumor targets during treatment planning.
- A 37-year-old female patient with recurrent GBM underwent all three imaging modalities, and the study measured the agreement in volume delineations using various statistical methods.
- Results indicated that MET-PET and MRI provided more consistent target volumes compared to PSMA-PET, suggesting that relying solely on MRI may be insufficient, and combining PET with MRI could enhance tumor detection for better treatment planning.
Article Synopsis
- Intraventricular glioblastomas (IVGBMs) are rare brain tumors located in the ventricular system, complicating diagnosis and treatment.
- A systematic review of literature revealed that these tumors mostly affect middle-aged males, presenting symptoms like increased intracranial pressure and seizures, with surgical resection being the main treatment.
- Results indicate that while surgical and adjuvant therapies are standard, outcomes are still uncertain, highlighting the need for further research to improve strategies for managing IVGBMs.
Introduction And Importance: Focal cortical dysplasia (FCD) is a significant cause of drug-resistant epilepsy, often necessitating surgical intervention. Type IIb FCD poses challenges due to its strong association with drug-resistant seizures. Effective management involves advanced imaging, intraoperative neurophysiological monitoring, and precise surgical techniques.
View Article and Find Full Text PDFBackground: The Precentral Cerebellar Vein (PCV) plays a crucial role as an anatomical landmark in neurosurgery, and the possibility of its safe sacrifice is controversial. Understanding its anatomical nuances and clinical implications is fundamental in enhancing neurosurgical practice.
Methods: A systematic review following PRISMA guidelines was conducted to consolidate literature on the PCV.
Article Synopsis
- Glioblastomas are aggressive brain tumors that disrupt the glymphatic system, which affects how the brain drains waste and could influence disease severity.
- Research highlighted significant changes in lymphatic outflow and cerebrospinal fluid drainage in glioblastoma patients, suggesting the glymphatic system plays a critical role in managing these tumors.
- The study emphasizes the need for future research to understand the molecular mechanisms behind these changes and to improve treatment strategies, including drug delivery and immunotherapy.
Purpose: This systematic review aims to investigate the role of nuclear imaging techniques in detecting incidentalomas and their impact on patient management.
Methods: Following PRISMA guidelines, a comprehensive literature search was conducted from February to May 2022. Studies in English involving patients undergoing nuclear medicine studies with incidental tumor findings were included.
Key Clinical Message: can cause rare odontogenic brain abscesses in immunocompetent patients, highlighting the importance of considering uncommon pathogens in central nervous system infections. With only three reported cases of cerebral abscesses and one pituitary abscess caused by this microorganism, tailored diagnostic methods and individualized treatment regimens are crucial for accurate management.
Abstract: Brain abscesses present diagnostic and therapeutic challenges, with infections being exceptionally rare in the central nervous system.
Background/aim: Craniopharyngiomas pose challenges in diagnosis and management due to their rare occurrence and diverse clinical manifestations. This study aimed to provide a comprehensive analysis of cranio-pharyngioma, including its epidemiological trends, clinical presentations, radiological characteristics, surgical interventions, and the role of radiotherapy.
Patients And Methods: A retrospective observational study was conducted on 23 patients diagnosed with craniopharyngioma at our hospital from August 2017 to July 2019.
Background: Radiofrequency thermal ablation (RFA) coupled with vertebroplasty or kyphoplasty offers a minimally invasive, safe, and efficacious approach to palliate polymetastatic spine disease, particularly in medically fragile individuals. However, the application of robotic assistance to RFA for spinal metastases remains unexplored. This study elucidates the technical viability of robot-assisted RFA combined with vertebroplasty in patients afflicted by multiple spinal metastases and presents preliminary outcomes.
View Article and Find Full Text PDFBackground: Spondylodiscitis (SD) is an inflammatory condition affecting the intervertebral discs and adjacent structures, often leading to serious complications, including epidural abscesses. This study aimed to differentiate postoperative SD from spontaneous cases caused by osteoporotic defects and associated pathologies, evaluating the frequency of SD in spinal diseases at a single center.
Materials And Methods: A retrospective observational study involving 25 patients was conducted, analyzing variations between postoperative revisions in SD patients and spontaneous SD due to concurrent pathology and osteoporotic defects.