Biphasic bioresorbable scaffold (TruFit Plug) for the treatment of osteochondral lesions of talus: 6- to 8-year follow-up.

Background: The ideal treatment of osteochondral lesions of the talus (OLT) is debatable. The TruFit plug has been investigated as a potential treatment method for osteochondral defects. This is a biphasic scaffold designed to stimulate cartilage and subchondral bone formation.

Intracranial and Spinal Dural Arterio-Venous Fistula (DAVF): A Surgical Series of 107 Patients.

Introduction: Dural arteriovenous fistulas (DAVFs) is a challenging condition in vascular neurosurgery. Development of new endovascular techniques has progressively modified treatment strategies; however, surgery is still considered a valid option of treatment of this pathology.

Materials And Methods: From a retrospective analysis of our database, we selected 107 patients who underwent surgical treatment for DAVFs.

A retrospective two-center study of antiepileptic prophylaxis in patients with surgically treated high-grade gliomas.

Background: The effectiveness of antiepileptic prophylaxis in patients with newly diagnosed high-grade glioma is debated. Craniotomy, surgical manipulation and bleeding are believed to favor the onset of seizures and, therefore, perioperative antiepileptic drugs (AEDs) are generally used. Nevertheless, evidence to initiate preoperative AED prophylaxis are weak.

Spinal dural arteriovenous fistulas: outcome and prognostic factors.

The aim of this study is to review the clinical outcome of patients treated for spinal dural arteriovenous malformations and investigate the presence of pretreatment indicators of outcome after short- and midterm follow-up. The authors retrospectively reviewed the records of 65 consecutive patients treated either surgically or endovascularly in 3 neurosurgery departments between 1989 and 2009. After treatment, 80% of patients reported improvement of at least 1 symptom.

Bubbles in the head: a new method for brain retraction during craniotomy.

Background: A key aspect of neurosurgery is the challenge of ensuring adequate visualization through brain retraction whilst ensuring that underlying brain remains protected. Self-retaining retractors (SRR) are specially designed for this purpose. Their limitation however is the potential for ischaemic damage that accompanies any pressure on the cerebral cortex.

Preoperative and intraoperative brain mapping for the resection of eloquent-area tumors. A prospective analysis of methodology, correlation, and usefulness based on clinical outcomes.

Background: Localization of brain function is a fundamental requisite for the resection of eloquent-area brain tumors. Preoperative functional neuroimaging and diffusion tensor imaging can display cortical functional organization and subcortical anatomy of major white matter bundles. Direct cortical and subcortical stimulation is widely used in routine practice, however, because of its ability to reveal tissue function in eloquent regions.

Preoperative chemotherapy for infiltrative low-grade oligoastrocytoma: a useful strategy to maximize surgical resection -case report-.

A 38-year-old woman presented with a large infiltrative left frontal low-grade glioma manifesting as partial seizures of the left arm and lower limb. First line chemotherapy with temozolomide reduced infiltration and volume, allowing subtotal surgical resection. The patient suffered postoperative supplementary motor area syndrome with right hemiparesis and mutism that resolved completely after approximately one month.

Clinical and radiological outcome of craniocervical osteo-dural decompression for Chiari I-associated syringomyelia.

The aim of this study was to analyze the long-term clinical and radiological outcomes of craniocervical decompression for patients affected by Chiari I-related syringomyelia. We performed a retrospective analysis of a group of patients affected by Chiari I-associated syringomyelia treated by craniocervical decompression (CCD). Surgical and technical aspects and preoperative factors predicting outcome were discussed.

Controlling inflammation in peritoneal dialysis: the role of pd-related factors as potential intervention targets.

Cardiovascular (CV) disease is the main cause of death in peritoneal dialysis (PD) patients, but the mechanisms mediating the increased CV risk observed in this group of patients are still largely unknown, which limits the perspective on effective therapeutic strategies. Patients on PD are already exposed to a number of traditional risk factors from the start of their chronic kidney disease (CKD), because many of those risk factors are common to CV disease and CKD alike. As renal dysfunction progresses, CKD-related risk factors are introduced, changing the profile of both the CV disease and the markers of risk.

The role of rehabilitation in juvenile low back disorders.

Both children and adolescents are frequently affected by low back pain--mainly when they are involved in sporting activities--but they rarely ask for medical help, because their symptoms are often mild and self-resolving. However, in the young patients who seek orthopaedic evaluation, especially in referral centres, there is a high incidence of organic causes of their back pain. Mechanical, developmental, inflammatory and tumoural or tumour-like disorders are the most frequent aetiologic factors.

Spinal dural arteriovenous fistulae: analysis of outcome in relation to pretreatment indicators.

Objective: The outcome of treatment for a spinal dural arteriovenous fistula is unpredictable. In this study, we reviewed the outcome of patients treated for this condition, in relation to pretreatment indicators.

Methods: We reviewed the records of 37 consecutive patients treated either surgically or endovascularly in our department between 1989 and 2002.

Vertebral arterio-venous fistula presenting with intracranial hemorrhage.

Vertebral arteriovenous fistulas are rare lesions consisting of an abnormal shunt between the extracranial vertebral artery and the neighboring veins. The authors present a case of post-surgical high-flow left vertebral arteriovenous fistula presenting with intracranial hemorrhage. The patient underwent endovascular balloon occlusion of the fistula: after endovascular treatment a reduction of the flow was evident but the patient presented neurological deterioration related the occurrence of intraventricular-subarachnoid hemorrhage.

Fatal carotid dissection after blunt head trauma.

Occurrence of internal carotid artery injuries associated with skull base fracture has been reported. A. report a case of fatal intracranial carotid dissection related to petrous fracture involving the carotid canal.

Introduction of GDC embolization in the clinical practice as treatment synergical to surgery: impact on overall outcome of patients with subarachnoid hemorrhage.

The GDC endovascular approach represent an effective alternative to surgery for treatment of intracranial aneurysms. Anyway no data are available about the impact of endovascular embolization with GDC on overall outcome of patients with subarachnoid hemorrhage. We analyse retrospectively a series of 234 patients admitted for ruptured intracranial aneurysm.

Surgical treatment of poor-grade aneurysm patients.

Patients who are severely struck by subarachnoid hemorrhage (the so called poor-grades) have been usually considered almost hopeless. Conversely, it is now becoming apparent that a significant number of poor grades could be perhaps salvageable during the first hours after the hemorrhage. In this paper we are reporting the results of an aggressive management protocol including immediate intensive care management and early surgery.

Complex arteriovenous fistula of the brain in an infant. Case report.

A rare case of complex cerebral arteriovenous fistula in an infant is reported. An 8-month-old boy first presented with a syndrome of increased intracranial pressure. Neuroradiological assessment showed a direct intracerebral arteriovenous shunt with marked venous engorgement.

Comparison of pediatric and adult cerebral arteriovenous malformations.

The authors report 19 consecutive children with cerebral arteriovenous malformations over the period 1978-1992. These patients are compared with a series of 120 consecutive adult patients with the same pathology, managed during the same period. The main clinical and angiographic features, as well as the treatment modalities and outcome are reviewed and compared.

Aneurysms of the vertebro-basilar junction area: preliminary experience in endovascular and surgical management.

Aneurysms of the vertebro-basilar junction area have been considered the most difficult to be surgically treated because of their deep location, the proximity of the brain stem and the cranial nerves. However, at present, new endovascular techniques and new transbasal surgical approaches offer valuable management strategies. This paper concerns six consecutive patients whom we managed either endovascularly or surgically during a period of eighteen months.

Surgical interruption of leptomeningeal drainage as treatment for intracranial dural arteriovenous fistulas without dural sinus drainage.

Intracranial dural arteriovenous fistulas (AVFs) have been recognized as acquired lesions that can behave aggressively depending on the pattern of venous drainage. Based on the type of venous drainage, they can be classified as fistulas drained only by venous sinuses, those drained by venous sinuses with retrograde flow in arterialized leptomeningeal veins, and fistulas drained solely by arterialized leptomeningeal veins. Serious symptoms, including hemorrhage and focal deficit, are related to the presence of arterialized leptomeningeal veins.

"High risk" anterior basal skull fractures. Surgical treatment of 64 consecutive cases.

Anterior Basal Skull Fractures (ABSFs) may be complicated by Cerebrospinal Fluid (CSF) fistulae and intracranial infections. An initially non-operative management is usually suggested since most fistulae spontaneously stop within a few days thus requiring no surgical repair. However, if the fistula fails to stop or recurs, surgical treatment is to be considered.

Delayed complications of ethmoid fractures: a "growing fracture" phenomenon.

Delayed complications of ethmoid fractures are considered relatively rare. However, meningitis, recurrence of previously ceased cerebrospinal fluid rhinorrhea and delayed onset of cerebrospinal fluid rhinorrhea are possible even years after trauma. We report 10 consecutive patients with delayed complications of ethmoid fractures, whom we treated over the past 11 years.

Leptomeningeal dissemination of juvenile pilocytic astrocytoma: case report.

The authors report a case of leptomeningeal spinal metastasis of chiasmatic juvenile pilocytic astrocytoma. A 7-year-old boy underwent surgery and radiation therapy for a chiasmatic pilocytic astrocytoma. Three years later he experienced a syndrome of medullary compression.

Progressive myelopathy caused by intracranial dural arteriovenous fistula: report of two cases and review of the literature.

We report two rare cases of progressive myelopathy caused by intracranial dural arteriovenous fistulae with venous drainage into the spinal medullary veins. Both patients were referred to us with a history of progressively worsening quadriparesis. A posterior fossa dural arteriovenous fistula with spinal venous drainage was discovered by angiography in both cases.

Foraminal syringomyelia: suggestion for a grading system.

The standard treatment of foraminal syringomyelia includes foramen magnum decompression and duraplasty. Improvement or stabilization of the disease are achieved in most of cases. However, at least one third of patients are reported to receive little or no benefit.