Management of nontraumatic intracranial hemorrhage.

The modern treatment of spontaneous intracranial hemorrhages requires a multidisciplinary approach including neurosurgery, interventional neuroredicology, vascular neurology and radiosurgery to determine the best management strategy.

An audit of treatment outcome in acromegalic patients attending our center at Bergamo, Italy.

Background: Acromegaly is a chronic disease impacting on morbidity and mortality. Increased mortality is reverted after the achievement of hormonal targets. The relative role of treatment options is still matter of debate.

Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report.

A 54 year old man was referred to the department of neurosurgery for frontal headache and vomiting. The patient was known in the department because of previous multiple surgery for a locally invasive pituitary prolactinoma (eight years, three years, and one year previously). The neurological examination revealed a frontal mass, which adhered to the dura, suggesting a meningioma.

Pure yolk sac tumors in genital and extragenital sites: study on three pedriatic cases, with cytological findings on two.

Cytopathological findings on three pedriatic gonadic-extragonadic pure yolk sac tumor are reported: the highly variable histological patterns (reticular, solid, festooning or pseudopapillary, polyvesicular vitelline), reflecting differentiation towards extraembryonic yolk sac structures, are not appreciated in cytologic samples. Since the tumor's cytologic spectrum is very broad, the most diagnostic differential difficulty with yolk sac tumor is adenocarcinoma. The presence of intracellular and extracellular hyaline globules, that are periodic acid-Schiff stain (PAS) positive and diastase resistant and correspond to alpha-fetoprotein production, alpha-fetoprotein positivity of the neoplastic cells; showing nuclear pleomorphism and vacuolated "bubbly" cytoplasm are the most consistent cytologic hallmarks of this neoplasm, which diagnosis would be confirmed by histologic, immunocytochemical and clinical findings.

Secretory meningioma, a rare meningioma subtype with characteristic glandular differentation: an histological and immunohistochemical study of 9 cases.

Aim: We studied the immunophenotype of 9 cases of secretory meningioma (SM), a rarely reported meningioma variant, characterized by small gland-like lumina filled with a PAS-positive, diastase-resistant substance.

Methods: Three samples of arachnoid tissue and 9 SMs were studied with a panel of monoclonal antibodies (MoAbs) against cytokeratins (Ck) 7,8, 20, vimentin, EMA, CEA and the mucin epitopes sialyl-Tn, Tn, CA19.9, CA125, against the BerEP4 and CD15; 3 colonic adenocarcinomas metastatic to the brain and a case of meningioma with metastasis from a gastric signet-ring cell carcinoma were also studied with the same panel of MoAbs for comparison.

Ganglioglioma: a clinical and pathological study of 12 cases.

We report the clinico-pathological and immunohistochemical findings of 12 cases of gangliogloma that were diagnosed at Legnano Civil Hospital over a period of 10 years. The patients' age at presentation ranged from 2-69 years with a mean duration of symptoms equal to 52 months. Seizures were the most common presenting symptoms.

[Our experience in the treatment of intrathoracic and intraspinal hourglass neurogenic neoplasms].

The authors describe their experience in the treatment of dumbbell neurogenic tumours, intrathoracic and intraspinal, with particular reference to clinical presentation, diagnostic for imaging, anatomo-pathological classification and surgical treatment, comparing their clinical cases (9) with the international literature, accurately reviewed. The authors think that the best surgical treatment is the combined approach, in only one stage, of thoracic surgeon and neurosurgeon by hemilaminectomy and extended costotrasversectomy, reserving hemilaminectomy and thoracotomy only for the tumours with big dimension of intrathoracic portion.

Medical management of acromegaly: effects of SMS 201-995 in 30 patients.

The effect of chronic administration of SMS 201-995, a long acting analogue of somatostatin, has been studied in 30 acromegalic patients (pts). CT-scan showed pituitary adenoma in 20/30 pts, empty sella in 9/30 pts and no sign of pituitary tumor in one case. SMS 201-995 was administered subcutaneously every 8 hours at the daily dose of 150-900 micrograms.

[Somatosensory evoked potentials in the evaluation and follow-up of patients with cervical vertebral and spinal cord injuries].

Somatosensory evoked potentials have been serially recorded in 21 patients with cervical spinal cord injury. Each patient received the SEP test and a full neurological examination within 1 day after admission, after surgery, and 3-6 weeks following admission. Further SEP test and clinical evaluation were carried out 3-6 months after injury.

Initial experience with SPECT of the brain using 99mTc-hexamethyl-propyleneamine oxime (99mTc-HM-PAO).

A recently developed 99mTc radiocompound, hexamethyl-propyleneamine oxime (99mTc-HM-PAO) exhibits favorable properties for regional cerebral tomograms in man utilizing conventional instrumentation (SPECT). Planar and tomographic studies using a rotating gamma camera equipped with a high sensitivity, low energy, collimator were performed in 5 normal subjects and 20 patients suffering from different cerebral diseases. SPECT abnormalities observed in patients with CVD, brain tumors and hydrocephalus were compared with results from X-ray CT.

Acute subdural hematoma. Spontaneous forms of arterial origin.

3 cases of acute subdural hematoma associated with bleeding from cortical arteries are described. There was no history of trauma. Referred cases in the literature and the possible mechanisms are discussed.

Neurological results in spinal cord metastases.

Btween 1971 and 1978 140 cases of spinal metastasis treated by decompression or possible removal of secondary neoplasm, were studied. Patients were divided according to their preoperative neurological conditions and then evaluated on the ground of regression of spinal cord and root symptom. The possibility of treating this type of compressive spinal pathology surgically is discussed.

Surgical treatment of thoracic disc protrusion.

The Authors report on nine cases of thoracic disc hernia operated on through Carson's posterolateral approach. Several steps were taken to protect the spinal cord, and to remove completely disc fragments and any calcifications. The importance of the combined use of the operating microscope and the posterolateral approach are emphasized, and the longterm results are evaluated.