Quantified EEG, somatosensory evoked potentials and cerebral blood flow in monitoring experimental brain ischemia.

Cerebral ischemic lesions were induced in rabbits through internal carotid artery embolization by means of microspheres. Different models of stroke ranging from single focal cortical lesion to massive bilateral brain edema were reproduced and monitored up to the 24th hour by electroencephalogram (EEG and QEEG), somatosensory evoked potentials (SEPs), cerebral blood flow (CBF), platelet aggregation. The site and extent of the lesions were verified by histological examinations. Results obtained and physiopathological implications are discussed.

Spinal epidural hematoma without vertebral fracture or dislocation. Report of two cases and review of the literature.

Authors present 2 cases of spinal epidural hematoma without vertebral fracture or dislocation and review the literature. 169 fully described cases were found in literature and have been analyzed. Data confirm our opinion that the results of an early diagnosis is a better prognosis. The severity of preoperative neurological status is another important factor for the post-operative recovery, any way the absence of neurological function before the operation is not necessarily leading to a poor prognosis. Prognosis is usually poor when after the removal of the hematoma the dural pulsation is absent.

[Comparison of clinical examination, electromyography, myelography, computerized tomography and surgical findings in lumbar disc hernias]. / Confronto tra esame clinico, elettromiografia, saccoradicolografia, tomografia computerizzata e riscontro operatorio nelle ernie del disco lombare.

The authors report 152 cases of patients with suspected herniated lumbar disk, operated on by traditional surgical approach. Thirteen of 152 patients underwent exploratory surgery at two vertebral spaces as a result of their neuroradiological examinations. All patients were examined clinically before of instrumental devices. CT-scan was performed on 113 patients, 62 underwent myelography and 36 electromyography. The authors verified reliability of clinical and instrumental devices on the basis of surgical results. Clinical examination was reliable in 83% of cases, electromyography in 78%, myelography in 83% and CT-scan in 87%. The percentage of false positive was 11% for the clinical examination, 9% for CT-scan, 8% for myelography and 11% for electromyography. The percentage of false negative was 6% for the clinical examination, 4% for CT-scan, 9% for myelography, and 11% for electromyography. The authors conclude that the CT-scan is the most reliable method of examination. This is even truer when dealing with extreme lateral disk herniation.

[Cerebrospinal rhinorrhea from an ethmoido-sphenoidal mucocele. Description of a rare clinical case]. / Rinoliquorrea da mucocele etmoido-sfenoidale. Descrizione di un raro caso clinico.

The authors give a brief introduction on the subject of mucocele and emphasize the rarity of the ethmoid-sphenoid location (55 cases listed by Lundgren in 1961). The principal clinical features are discussed which are: ocular and periocular and sometimes, occipital pain; ocular symptoms, often bilateral, of compression of the optic nerve and of the 3rd and 4th cranial nerves; and only rarely, slight signs of nasal obstruction or of hypopituitarism. Of the various surgical approaches, the lower trans nasal septum operation seems to be the best choice. A case report of a patient with copious spontaneous rhinorrhea followed by meningitis is reported. The authors note that this symptom, not previously encountered in the literature, permitted a diagnosis to be made before the lesion became bilateral, which prior to this case, had always been observed. The lower trans-septum surgical approach with the aid of a microscope was employed, permitting total removal of the mucocele and tamponage of the cerebrospinal fluid fistula.

[Isotopic study of the C.S.F. hydrodynamic in the Arnold-Chiari malformation (author's transl)]. / Studio isotopico dell'idrodinamica liquorale nella malformazione di Arnold-Chiari

Six cases of Arnold-Chiari malformation Type I were studied according to the following instrumental protocol; skull and atlanto-occipital hinge X-rays, including the tomography of these regions, X-rays of the spine, vertebral angiography, isotopic cisternography using RIHSA injected intraspinally, fractionated pneumoencephalography, Dimer-X ventriculography and iodized myelography. The AA emphasize the importance of the cisternographic test with radioisotopes for pre-operative and post-operative control of the C.S.F. dynamic.