Publications by authors named "Luciano Savarese"
In this case report, real-time neuropsychological testing (RTNT) and music listening were applied for resections in the left temporal-parietal lobe during awake surgery (AS). The case is based on a 66-year-old with glioblastoma and alterations in expressive language and memory deficit. Neuropsychological assessment was run at baseline (2-3 days before surgery), discharge from hospital (2-3 days after surgery), and follow-up (1 month and 3 months).
View Article and Find Full Text PDFOur anesthetic technique proposed for awake craniotomy is the monitored anesthesia care (MAC) technique, with the patient in sedation throughout the intervention. Our protocol involves analgo-sedation through the administration of dexmedetomidine and remifentanil in a continuous intravenous infusion, allowing the patient to be sedated and in comfort, but contactable and spontaneously breathing. Pre-surgery, the patient is pre-medicated with intramuscular clonidine (2 µg/kg); it acts both as an anxiolytic and as an adjuvant in pain management and improves hemodynamic stability.
View Article and Find Full Text PDFSurgical access to the temporo-mesial area may be achieved by several routes such as the sub-temporal, the temporal trans-ventricular, the pterional/trans-sylvian, and the occipital interhemispheric approaches; nonetheless, none of them has shown to be superior to the others. The supra-cerebellar trans-tentorial approach allows a great exposure of the middle and posterior temporo-mesial region, while avoiding temporal lobe retraction. A prospective multicenter study was designed to collect data on patients undergoing endoscopic-enhanced SCTT approach to excise left temporo-mesial lesions.
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- The study explores the advantages of using an endoscopic approach for managing primary central nervous system lymphoma (PCNSL) located in the ventricles, comparing it to traditional surgical methods.
- A five-year retrospective multicentric study involving ten European centers included 60 patients, revealing that a majority had superficial lesions, and all surgeries were performed without complications.
- The findings suggest that endoscopic management is effective and minimal invasive, providing options for diagnosis and treatment, including biopsies, CSF diversion, and long-term device insertion.
Object: Interhemispheric arachnoid cysts are very rare, and they are often associated with complex brain malformations such as corpus callosum agenesis and hydrocephalus. Debate remains concerning the proper management of these lesions. Placement of shunts and microsurgical marsupialization of the cyst are the traditional options.
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- The study assessed the effectiveness of endoscopic aqueductoplasty, with or without stent placement, in treating isolated fourth ventricle (IFV) in seven children with loculated hydrocephalus resulting from hemorrhage or infection.
- All patients had previously implanted supratentorial shunts, and the procedure led to resolution of intracranial hypertension symptoms and improvement in neuroimaging results, particularly with stent placement in cases experiencing membranous aqueductal stenosis.
- The findings suggest that combining aqueductoplasty with stent placement is more effective at preventing aqueduct occlusion and should be considered the first-line treatment when anatomy allows.
Background: Craniocerebral penetrating injuries from nail-gun accidents are rare and usually are discovered immediately after the trauma. Several surgical procedures have been described to extract a foreign body that is infixed in the skull and has penetrated the surrounding structures; blind extraction, craniectomy, and craniotomy.
Case Description: We report the case of a 25-year-old ex-carpenter who presented with jacksonian seizure at the left limb.
Metastatic involvement of the cerebro-spinal fluid (CSF) pathway in oligodendrogliomas is not uncommon; however, symptomatic involvement of the spinal cord is very rare: less of 10 cases have been published. To our knowledge, an intracranial oligodendroglioma presenting with symptoms of drop metastases in the cauda equina has never been reported. We report a case of 67-year-old woman who after 1 month of severe low back and legs pain developed symptoms of raised intracranial pressure.
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