Morphology and TGF-beta1 Concentration Analysis of Ligamentum Flavum in Patients with Lumbar Canal Stenosis and Lumbar Disc Herniation.

The most common spinal disorder in elderly patients is lumbar spinal canal stenosis, causing low back and leg pain and paresis. The aetiology of degenerative changes occurring in lumbar stenosis remain unclear: some authors hypothesize hyperplasia and others hypertrophy of the LF. The change in LF is known to be related to degenerative changes secondary to the aging process or mechanical instability.

Spontaneous spinal epidural haematoma. A case report.

Spinal epidural haematomas are infrequent events caused mainly by trauma or are iatrogenic following invasive spinal procedures (lumbar puncture, surgery or peridural anaesthesia). Spontaneous spinal epidural haematoma is a rare entity requiring emergency intervention in most cases. The incidence is estimated at about two to six cases per year.

Epidural hematoma caused by a spinal osseous epidural arteriovenous fistula in a 14-year-old patient. A case report.

Spinal dural arteriovenous fistulae are the most common type of spinal vascular malformations (AVMs). They have been classified into four types: dural AVM (type I), glomus AVM (type II), juvenile AVM (type III), and intradural direct arteriovenous fistula (type IV). Intradural AVMs manifest as subarachnoid or intramedullary hemorrhages, whereas dural AVM manifest as epidural hematoma.

Bilateral acute foot drop in a case of axonal injury. A case report.

Head trauma of varying severity may induce diffuse axonal injury. Areas most commonly affected are white matter in the hemispheres (particularly parasagittal zone), corpus callosum and the brain stem. We describe a case of diffuse axonal injury after brain trauma in a 51-year-old man.

[Intracranial meningiomas in the elderly].

Background: Since the introduction of CT and then MRI in the clinical practice, the number of elderly patients with intracranial meningiomas observed in neurosurgical departments has increased to three/four times. Considering that some patients die because of their meningioma and others die with their meningioma, the neurosurgeon should not only be able to eradicate surgically the lesion, but also to decide if that benign tumor should be treated or not.

Materials And Methods: Forty-three patients with intracranial meningioma, aged over 65 were operated upon between 1989 and 1995.

Clinical relevance of 111In-octreotide scans in CNS tumors.

Sixty-six patients with a clinical and neuroradiological diagnosis of CNS tumors were evaluated by 111In-octreotide scintigraphy. Planar images were acquired at 2-4 and 24 hours after the injection of 111-185 MBq of 111In-octreotide (Octreoscan, Byk-Gulden). In the positive scans the tumor/non-tumor ratio was evaluated using a standard ROI method, and an uptake index (U.

The transdural extension of gliomas.

The extraneural spreading of gliomas is an infrequent occurrence which is not necessarily related to either tumor histology or site. This paper reports two cases, a glioblastoma and an oligodendroglioma, both presenting extradural diffusion. In the first case, where there was severe intracranial hypertension, the tumor found its way out from the neurocranium, far from the site of the operation, perforating the dura and the bone of the cranial base.

Lonidamine in the combined treatment of malignant gliomas. A randomized study.

Lonidamine (LND) is a drug that interferes with energy metabolism of cancer cells, principally inhibiting aerobic glycolytic activity, by its effect on mitochondrially-bound hexokinase (HK). In such way LND could impair energy-requiring processes, as recovery from potentially lethal damage, induced by radiation treatment and by some cytotoxic drugs. A randomized study started in November 1983, to evaluate the efficacy of LND in association with radiotherapy as first line treatment in malignant gliomas, after surgical procedure.

The role of immunocytochemical assays in the diagnosis of stereotactic biopsies from intracranial tumors.

A selected panel of monoclonal antibodies (MoAbs) directed to distinct tumor associated antigens (TAA) has been tested to define the capability of these reagents to differentiate among metastatic carcinoma, lymphoma and primary brain tumor on cytologic specimens obtained with stereotactic techniques. Results obtained on 50 patients bearing either single or multiple brain lesions demonstrated that immunocytochemical (ICC) methods can distinguish between primary brain tumor and brain metastasis suggesting, in 90% of patients with cryptic primary neoplasia, the site of origin of the tumor.

Cystic appearance of meningiomas: considerations on a series of 12 patients.

Twelve patients affected with meningiomas with a fluid component are reviewed. Six presented with intratumoral cysts and 6 with extratumoral fluid collections that in 3 cases were of clear CSF. The formation mechanism of the two types are quite different.

Mucocele of neurosurgical interest: clinical considerations on five cases.

The authors present five patients with mucocele, submitted to neurosurgery. Two had mucoceles spreading from the frontal and/or the anterior ethmoidal sinuses and had only compressive mass symptoms, either on the ocular globe or on the frontal lobe or on both. Three patients had mucoceles growing from the sphenoid and/or posterior ethmoidal sinuses.

Methodology of stereotactic biopsy.

The great technological improvement in the neurosurgical tools and in the neuroradiological imaging has brought about the diffusion of the stereotactic techniques. They are crucial for the diagnosis and treatment of intracranial expanding lesions of small dimensions or located in sites inaccessible to conventional techniques. The Authors describe the most common systems and methodologies for the stereotactic biopsy.

Multiple sclerosis plaque simulating cerebral tumor: case report and review of the literature.

Multiple sclerosis rarely may present as a focal cerebral mass with clinical features and computed tomographic scan appearances of cerebral tumor. Distinguishing between these can be difficult or impossible. We report a case of a multiple sclerosis plaque involving the parietal lobe with mass effect; clinical and radiological features had led to a diagnosis of cerebral tumor.

CT iopamidol cisternographic diagnosis of coexisting partial empty sella and pituitary adenoma. Report of two cases.

In the last 3 years 86 patients were referred for suspected primary intrasellar pathology. Two of them had coexisting pituitary adenoma and partial empty sella. This situation has been diagnosed pre-operatively thanks to CT Iopamidol cisternography.

[Primary empty sella. Clinico-radiologic considerations in 18 cases].

18 patients with "primary empty sella" were reviewed for this study. In 3 of them the sellar enlargement was discovered occasionally by performing skull radiographs for other reasons. The galattorrhea-dismenorrhea or amenorrhea syndrome and obesity were the most common clinical features.

Bilateral temporal lobectomy for late radionecrosis after radiotherapy for acromegaly. A case report.

A patient with right temporal radionecrosis was submitted to temporal lobectomy for acute intracranial hypertension developed two years after radiotherapy for a GH-secreting pituitary adenoma. Eight months later, a partial left temporal lobectomy was performed because of further radionecrosis. In both instances the cerebral radionecrosis had the clinical and radiological characteristics of a space-occupying lesion.

Calcified pituitary adenoma associated with severe hyperprolactinemia. Case report.

A patient with a completely calcified chromophobe adenoma is reported. Endocrine evaluation revealed very high prolactin levels. Such extensive calcifications in prolactin-secreting adenomas are extremely rare.

Spinal chordomas in infancy. Report of a case and analysis of the literature.

Chordomas are extremely rare among the spinal tumors in pediatric age. The sacrococcygeal region is the typical site of such a lesion. A case of spinal chordoma in a child 4 years old, at the T12-L1 level, is reported.