Traumatic posterior fossa extradural hematomas.

17 cases of operated Posterior Fossa Epidural Hematomas (PFEDH) of traumatic origin are reported. Clinical and neuroradiological findings are presented and discussed. Authors emphasize the importance of CT scan in determining a more precise diagnosis and the related improvement in the morbidity (13%) and mortality (12%) rates.

Traumatic posterior fossa extradural hematomas. A report of 22 new cases surgically treated and a review of the literature.

This study reports and discusses clinical and neuroradiological findings in 22 new cases of posterior fossa epidural hematomas (PFEDHs), all of whom underwent surgical treatment after having suffered an occipital head trauma. The authors emphasize the importance of serial CT scans in establishing prompt diagnosis and treatment and in reducing the rates of morbidity (15.7%) and mortality (13.6%).

[Evaluation of 2 modalities of use of propofol in cerebral angiography]. / Valutazione di due modalità di impiego del propofol nelle angiografie cerebrali.

Fifty eight adult patients suffering from different intracranial lesions and scheduled for cerebral angiography were given propofol. In the first group (38 patients) brief periods of anaesthesia were induced and reinduced by means of 1.5 mg/kg of propofol iv and sometimes extended with boluses of 25-50 mg of this anesthetic. The patients were premedicated with 0.5 mg atropine im 30-40 min before the induction. Fentanyl, droperidol and diazepam in various combinations and doses were injected, im together with the atropine and iv 1-2 min before the induction, to obtain long-lasting sedations. In the second group (20 patients) the induction of the anaesthesia started 20-35 min after 0.5 mg of atropine im and 1 min after 0.1 mg of fentanyl iv. The induction was based on a bolus of 2.5 mg/kg of propofol and it was followed by suxamethonium, tracheal intubation and mechanical ventilation with N2O 70% in O2. An adequate depth of anaesthesia was maintained with supplemental doses of 50 mg of propofol, frequently associated with 25 mg of suxamethonium. Both methods proved to be reliable and safe. Nevertheless, the second method provided a better stability as far as a number of physiologic variables is concerned.

Acute traumatic vertex epidural haematomas surgically treated.

Eleven consecutive cases of acute traumatic vertex epidural haematomas (VEDHs) among 416 epidural haematomas (EDHs) operated on during the same period in the Neurosurgical Clinic of the University of Genoa, are reported. Clinical features, neuroradiological aspects (X-ray, angiography and CT scan) and results are discussed, in order to point out the problems encountered in the diagnosis, expecially due to the mystifying clinical picture and the unsuitability of the axial CT scan in the detection of these lesions. In this series mortality rate was 18%, against 50% reported in the literature.

[Anatomo-surgical classification and surgical treatment of arteriovenous malformations in the posterior cranial fossa]. / Classificazione anatomo-chirurgica e trattamento operatorio delle malformazioni artero-venose della fossa cranica posteriore.

An increasing number of arteriovenous malformations of the posterior cranial fossa can be radically extirpated with good functional results, by using microsurgical techniques. Extensive involvement of the brain stem represents the limit for effective surgery. An anatomo-surgical classification of these lesions is presented, and the surgical indications are discussed.

Penetrating cranio-cerebral injury at the vertex. Report of an unusual case.

An unusual case is reported in which a nail was driven into the head with suicidal intention. Neuroradiological examination, surgical treatment and results are discussed.

Interhemispheric subdural hematoma. Case report.

A case of interhemispheric subdural hematoma following head injury is presented and discussed, and the literature reviewed. Clinical and neuroradiological features are described together with the surgical treatment and results.

Bilateral brain abscesses. Report of 2 cases.

This is a report about two cases with bilateral brain abscesses, who will be extirpated with success. The preoperative treatment with antibiotics was without success. CT-control demonstrated the complete removal of both abscesses. The surgical treatment may be indicated in patients affected by supratentorial bilateral cerebral abscesses.

Traumatic subdural hygromas: a report of 70 surgically treated cases.

The Authors present 70 cases of traumatic subdural hygromas, classified into acute, subacute and chronic, according to the interval between injury and the appearance of symptoms. The acute cases were 22.9% of our series. Criteria for surgical treatment were established by means of CT scan serial investigations. Pathogenesis, clinical aspects and results are discussed. Mortality rate was 17.1%.

Fast attempts at the photodynamic treatment of human gliomas.

Photodynamic therapy is based on the capacity of certain substances to preferentially stain neoplastic tissues in respect to healthy tissues, and on the property of such substances to produce cytotoxic agents when excited by light of an appropriate wavelength. The authors demonstrate the first attempts to photoradiant therapy in the treatment of human gliomas utilizing a hematoporphyrin derivative injected i.v. as a sensitizing drug. A He Ne Laser (632,8 nm) was used in order to trigger the photodynamic process. Immediately after surgical removal of the glioma the residual tumoral bed was exposed to the action of the Laser in order to provoke necrosis of the remaining neoplastic cells. Necrosis even if partial of the residual tumor was effected. Better and more definite results may be obtained in the future utilizing a Laser connected with fiber optics consenting an in-depth light penetration.

Subdural empyema: fourteen cases surgically treated.

Fourteen cases of subdural empyema are presented. Their clinical aspects are reported, and the factors that influenced mortality are discussed.

Utilization of one hundred subcutaneous reservoirs in neurosurgery.

The authors report the use of one hundred subcutaneous reservoirs in eighty nine patients. The various utilizations of the reservoirs correspond to the encountered diseases.