[Group of study SIAARTI of anesthesia and recovery for neurosurgery and neurology. Present and future]. / Gruppo di studio SIAARTI di anestesia e rianimazione per la neurochirugia e la neurologia. Presente e futuro.

The authors present the results of a survey of anesthesiologists members of the "SIAARTI (Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva) Committee for anesthesia and critical care in neurosurgery and neurology". Among the aims of the survey, was to evaluate when the interest in neuroscience of the members of this group started, and the clinical work dedicated to neuroanesthesia and critical care. At present, the group has grown to 143 members. In the questionnaire 105 members indicated the topic discussed for the medical degree thesis, and 87 indicated the thesis discussed for the board in anesthesia. As emerged from the topic of the thesis discussed for the medical degree, in 47% of the responders the interest in anesthesia began during the college. Of this, 6% chose a topic in neuroanesthesia and critical care. During the residency, the interest in neuroscience increased to 33%, that is 32 out of 97 responders discussed a thesis in neuroanesthesia and critical care. Forty-eight per cent of the members performs clinical work "exclusively" in neuroanesthesia, while 39% does it "mainly", and only 13% works in neurosurgery "fiftfully".

[Competitive new generation myorelaxants in pediatric neuroanesthesia]. / I miorilassanti competitivi di nuova generazione in neuroanestesia pediatrica.

Two groups of 50 children were included in a study to examine the use of atracurium and vecuronium. In both groups, newborns and infants showed a shorter onset time and a longer clinical duration of the first dose of the neuromuscular blocking drug. The duration of subsequent doses in the various age groups was not significantly different. Atracurium and vecuronium both have a short recovery index, good cardiovascular stability and do not interfere with ICP. The Authors emphasise the importance of monitoring the use of neuromuscular blocking drugs.

[New anesthetics and myorelaxants. The behavior of intracranial pressure in pediatrics]. / Nuovi anestetici e miorilassanti. Il comportamento della PIC in pediatria.

The authors, following a report on cerebral physiology in childhood, report their experience of ICP and the administration of new drugs in anaesthesiologic practice. The effects of isoflurane, propofol, atracurium, vecuronium on ICP are reported.

[Psychic disorders. An unknown complication of surgery of the posterior cranial fossa]. / Disturbi psichici. Una complicanza misconosciuta della chirurgia in fossa cranica posteriore.

Psychic trouble is not generally recognised as a possible complication of posterior fossa surgery. Reviewing a series of 63 pediatric patients operated on for posterior fossa intraxial tumors, the Authors found 21 cases of psychic troubles in the post-operative period. The incidence was higher in: a) medulloblastoma; b) rostral vermis location; c) supracerebellar infratentorial and transvermian approach. The neuropathophysiological basis of the phenomenon is discussed.

[Operative posture in pediatric neurosurgery]. / La postura operatoria in neurochirurgia pediatrica.

Proper placement of the pediatric neurosurgical patient is strictly correlated to age (newborn, toddler, infant, juvenile). Each age group is reviewed on the basis of different morphological and pathophysiological aspects of typical neurosurgical positions (prone, supine, sitting, lateral).

[Severe head trauma in the pediatric patient. Our experience]. / Il trauma cranioencefalico grave nel paziente pediatrico. Nostra esperienza.

A retrospective study in a pediatric population of 324 severe head trauma patients hospitalized at Santobone Children's Hospital has been carried out; diagnostic investigations and therapeutic aspects are stressed on the baw of pathophysiological features of such patients.

[Intravenous immunoglobulin in the prevention of infections in high-risk pediatric neurosurgery]. / Immunoglobuline endovena (IgEv) nella prevenzione delle infezioni in neurochirurgia pediatrica ad alto rischio.

Sixty-four children undergoing "high risk" neurosurgery, were submitted in a comparative study performed to investigate the prophilactic effect of IgIv in reducing the risk of postoperative sepsis. Patients were divided in two groups that weren't different as to underlying disease, age and sex. 32 patients received IgIv 0.2 g/kg on day 0, day 2, day 5, day 12 and 32 placebo. IgIv reduced the number of postoperative respiratory and urinary infective events, thus resulting in a marked reduction of the therapeutic use of antibiotics. No side effects of administration of IgIv were observed.

[Anesthesia in the diagnostic stages of cerebral arteriovenous malformations in children under 3 years of age]. / Anesthésie dans les étapes diagnostiques des malformations artério-veineuses cérébrales des enfants de moins de trois ans.

From 1974 through 1989, 36 patients with arteriovenous malformations were treated in the neuroradiological unit of the Santobono Children's Hospital, in Naples, 7 of these patients were younger than 3 years of age. During such a time-span, dramatic improvements in diagnostic work-up were jelded by introduction of CT-scan and MRI; better angiographic techniques, progress in anaesthesia drugs, equipment and procedures and more rational surgical modalities. Anaesthesia must be tailored in each patient with special consideration of the clinical and neurological conditions of the patients as well of the neuroradiological procedure, specifically, with minimal side effects on cardiovascular and respiratory functions as well on intracranial pressure. The present paper discuss of equipment for cardiovascular assistance and drugs to be employed in the various steps of the diagnostic work-up of such patients.

[Peroperative recovery in surgery of arteriovenous malformations in children under the age of 3 years]. / Réanimation peropératoire dans la chirurgie des malformations artério-veineuses des enfants de moins de trois ans.

From 1974 through 1989, 36 patients with arteriovenous malformations were studied in the neurosurgical department of the Santobono Children's Hospital in Naples; 7 of these patients were younger than three years of age: 5 underwent surgery. The remaining 2 patients presented, respectively, an aneurysm of the vein of Galen and an arteriovenous malformation of the brain stem. Improvements in surgical and anesthesiological techniques allow to treat lesions considered as not amenable to surgery until recent years, with minimal occurrence of preoperative and postoperative complication and a significant amelioration of prognosis.

[An unusual case of atlanto-axial traumatic dislocation in a child]. / Un raro caso di dislocazione traumatica atlanto-assiale in un paziente in età pediatrica.

The authors refer about a rare case of traumatic atlo-axial dislocation observed three months after the accident. The traumatic etiology was caused by an episode of violence within child's family. The characteristic of the lesion, the months intervened since the traumatic accident, the involved health of the patient and the importance of neurological damage imposed the surgical corrective treatment of the lesion. The authors report about the care of the patient, particularly about the anesthesiological techniques and intensive care during the surgical treatment.