Publications by authors named "Oreste De Divitiis"

Head and neck squamous cell carcinoma (HNSCC) can, in rare instances, metastasize to the CNS, which is often associated with a poor prognosis. We present the case of a 65-year-old male with a history of HNSCC who developed two enhancing brain lesions: one in the right parietal region and another in the right insular region. Initially, the patient was managed with CyberKnife radiosurgery targeting both lesions.

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Article Synopsis
  • The study examines the effectiveness of anterior vs. posterolateral surgical approaches for treating thoracic disc herniation (TDH) and highlights variations in technique across different institutions.
  • A systematic review and meta-analysis of existing literature revealed that the posterolateral approach is linked to fewer complications, less blood loss, and shorter hospital stays compared to the anterior approach.
  • Results indicate that the posterolateral technique not only promotes neurological recovery but also achieves higher rates of complete hernia resection, suggesting it may be a safer and more effective option for TDH surgery.
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Background: Biphenotypic sinonasal sarcoma (BSNS) is a low-grade tumor of the sinonasal tract with frequent extension to the orbit and skull base. Due to its rare incidence and recent histopathological and molecular characterization, little data are available in regard to its natural history, treatment and surveillance protocol.

Methods: A comprehensive literature review in Embase online electronic databases on BSNS was made.

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Article Synopsis
  • * It analyzed data from 98 patients treated between 2011 and 2023, comparing outcomes of various surgical techniques like laminectomy, thoracoscopic surgery, and open thoracotomy.
  • * Key findings suggest combined surgical approaches are better for certain types of TSs, and factors like patient sex, tumor location, and surgical resection extent play crucial roles in recurrence rates.
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Article Synopsis
  • - Biphenotypic sinonasal sarcoma is a rare, low-grade tumor found in the sinonasal tract, known for its aggressive growth and tendency to spread to surrounding areas like the orbit and skull base.
  • - A comprehensive study reviewed 31 cases, highlighting that it primarily affects middle-aged women, with surgery being the main treatment method, resulting in a gross total resection in two-thirds of the patients.
  • - The endoscopic endonasal approach was the most common surgical method, with a local recurrence rate of 19.3% and a low mortality rate, indicating that effective management of the tumor primarily relies on surgery.
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Background: While several risk factors for recurrences have been defined, the topographic pattern of meningioma recurrences after surgical resection has been scarcely investigated. The possibility of theoretically predicting the site of recurrence not only allows us to better understand the pathogenetic bases of the disease and consequently to drive the development of new targeted therapies, but also guides the decision-making process for treatment strategies and tailored follow-ups to decrease/prevent recurrence.

Methods: The authors performed a comprehensive and detailed systematic literature review of the EMBASE and MEDLINE electronic online databases regarding the topographic pattern of recurrence after surgical treatment for intracranial meningiomas.

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Orbital and ocular adnexal lymphoma (OAL) affects the orbit and the surrounding structures and can arise as several subtypes with variable prognoses. We performed an observational study on the relationship between OAL subtype, diagnostic features, and prognosis to offer valuable insights into imaging techniques, such as Positron Emission Tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with Computed Tomography (F-FDG PET-CT), in predicting outcomes. With this aim, we retrospectively reviewed 99 patients with OALs, recording demographics, cancer subtype, location and treatment, FDG avidity, and bone marrow positivity.

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Surgery stands as the primary treatment for spheno-orbital meningiomas, following a symptoms-oriented approach. We discussed the decision-making process behind surgical strategies through a review of medical records from 80 patients who underwent surgical resection at the University of Naples Federico II. Different surgical approaches were employed based on the tumor's location relative to the optic nerve's long axis, categorized into lateral (type I), medial (type II), and diffuse (type III).

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The resolution of the naked eye has been a challenge for the neurosurgical endeavor since the very first attempts of cranial surgery, and advances have been achieved over the centuries, driven by a synergism between the application of emerging technology into the surgical environment and the expansion of the capabilities of neurosurgery. The understanding of the principles of the optical properties of lenses by Abbè (1840-1905) led to the introduction of loupes in the surgical practice, increasing the visual performance during macroscopic procedures. Modern neurosurgery began with the possibility of illumination and magnification of the surgical field as provided by the microscope.

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Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both transcranial, or high, and endonasal, or low, routes.

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Background: The extent of resection constitutes one of the most important predictive risk factors of recurrence for spheno-orbital meningiomas; although gross total resection represents the gold standard, it is not always achievable, with a consequent high rate of recurrence. Management of these tumors is a surgical challenge and is represented by maximal safe resection with preservation of function. The aim of the present study is to discuss the risk factors for recurrence and the best management of the recurrent tumors.

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Vertebral fractures represent the most frequent complication associated with osteoporosis. Patients harboring a vertebral fracture complain physical impairment including low back pain and spine balance alteration, i.e.

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Background: The progesterone receptor (PR) is variably expressed in most meningiomas and was found to have prognostic significance. However, the correlation with patient age, tumor location, time to recurrence, and pattern of regrowth has scarcely been discussed.

Methods: A surgical series of 300 patients with meningiomas is reviewed.

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Background: There are several etiologies of craniocervical junction instability (CCJI); trauma, rheumatoid arthritis (RA), infections, tumors, congenital deformity, and degenerative processes. These conditions often require surgery and craniocervical fixation. In rare cases, breakdown of such CCJI fusions (i.

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Purpose: The clinical presentation of idiopathic normal pressure hydrocephalus (iNPH) may overlap with progressive supranuclear palsy (PSP). The Magnetic Resonance Parkinsonism Index (MRPI), MRPI 2.0, and the interpeduncular angle (IPA) have been investigated to differentiate PSP from healthy controls (HC) and other parkinsonisms.

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Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has an impact also on neurosurgical training and education, especially in most affected countries. We surveyed Italian neurosurgical residents, asking them to provide a brief description and analyze the situation they are experiencing and how the educational system reacted to the pandemic in one of the most affected countries all over the world.

Methods: An 18-question, web-based survey was administered to Italian neurosurgical residents from May 3 to May 11, 2020, by web-link or e-mail invitation.

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(1) Background In addition to conventional magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) has been investigated as a potential diagnostic and predictive tool for patients with degenerative cervical myelopathy (DCM). In this preliminary study, we evaluated the use of quantitative DTI in the clinical practice as a possible measure to correlate with upper limbs function. (2) Methods: A total of 11 patients were enrolled in this prospective observational study.

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The Coronavirus (COVID-19) pandemic has fast spread throughout the world in more than 200 countries, resulting in the need for a de-prioritization of elective medical care to face the demands of the global health crisis. Although the acute and catastrophic phase of the pandemic seems to have been left behind, it is also clear that the virus will not disappear soon, and we must live with it for a period of unpredictable length, the COVID-19 era. In this setting, a common coordinated approach to treat patients harboring brain tumors is urgently required to guarantee the best updated oncological care and to reduce the risk of viral infection during hospitalization.

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Meningiomas recur with a rate of 10-32% at 10 years. Several features influence the risk of recurrence. To define the pathological and surgical features at risk of multicentric-diffuse versus local-peripheral recurrence.

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Spinal meningiomas are slow-growing tumors with low recurrence rate after complete resection. The aim of this study is to investigate the risk factors correlated to the recurrence. Six patients with spinal WHO grade I meningiomas which recurred after complete resection were reviewed and compared to 50 patients with no recurrence; the data were also compared with those of 50 intracranial meningiomas which recurred and 50 which did not recur after complete resection.

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In the study and practice of neurosurgery at the "Federico II" University of Naples, a central role has always been reserved for anatomy. Based on worldwide cooperation, the meaning of anatomical research has evolved from methodological investigation to an educational and communication tool. The contribution of our school to the anatomical data on the sellar region has been chronologically reviewed in the present report.

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