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Bozzini S, Bozza E, Bagnera C, Zoppa MD, Lettieri S, Bincoletto V, Fante CD, Stella B, Briganti F, Primiceri C, Rinaldi P, Baietto G, Arpicco S, Meloni F. Assessment of an Innovative Liposomal Preparations on Precision-Cut Lung Slices (PCLS): An Ex-Vivo Model of EMT. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Secco G, Delorenzo M, Salinaro F, Zattera C, Barcella B, Resta F, Sabena A, Vezzoni G, Bonzano M, Briganti F, Cappa G, Zugnoni F, Demitry L, Mojoli F, Baldanti F, Bruno R, Perlini S. Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations. Intern Emerg Med 2021; 16:1317-1327. [PMID: 33646508 PMCID: PMC7917171 DOI: 10.1007/s11739-020-02620-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/24/2020] [Indexed: 12/21/2022]
Abstract
Bedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.
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Affiliation(s)
- Gianmarco Secco
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Marzia Delorenzo
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Francesco Salinaro
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Caterina Zattera
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Bruno Barcella
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Flavia Resta
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Anna Sabena
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Giulia Vezzoni
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Marco Bonzano
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Federica Briganti
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Giovanni Cappa
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Francesca Zugnoni
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Lorenzo Demitry
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy
| | - Francesco Mojoli
- Intensive Care Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Virology Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Infectious Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Stefano Perlini
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Internal Medicine, Vascular and Metabolic Disease Unit, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation, University of Pavia, P.Le Golgi, 19, 27100, Pavia, Italy.
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Lonati C, Baumeister P, Afferi L, Mari A, Minervini A, Krajewski W, Borghesi M, Schulz G, Rink M, Montorsi F, Briganti F, Hurle R, Zamboni S, Simeone C, Soria F, Teoh J, Roumiguié M, Rouprêt M, Masson-Lecomte A, Mir M, Antonelli A, Einerhand S, Mattei A, Moschini M. Survival outcomes after radical cystectomy versus conservative management for clinical T1 high grade non-muscle invasive squamous bladder cancer: A multicenter collaboration by the European Association of Urology–Young Academic Urologists. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vicentini A, Masiello L, D’Amore S, Baldi E, Ghio S, Savastano S, Sanzo A, Di Matteo A, Seminari EM, Lenti MV, Bosio M, Petracci B, Frigerio L, Sabena A, Tavazzi G, Oltrona Visconti L, Rordorf R, Gnecchi M, Totaro R, Ferlini M, Greco A, Magrini G, Scelsi L, Acquaro M, Coccia M, Digiacomo S, Foglia D, Jeva F, Montalto C, Moschella M, Pezza L, Perlini S, Alfano C, Bonzano M, Briganti F, Crescenzi G, Falchi AG, Maggi E, Guarnone R, Guglielmana B, Martino IF, Pioli Di Marco MS, Pettenazza P, Quaglia F, Salinaro F, Speciale F, Zunino I, Sturniolo G, Bracchi F, Lago E, Corsico A, Piloni D, Accordino G, Burattini C, Di Sabatino A, Pellegrino I, Soriano S, Santacroce G, Parodi A, de Andreis FB, Bruno R, Zuccaro V, Moioli F, Dammassi V, Albertini R. QTc Interval and Mortality in a Population of SARS-2-CoV Infected Patients. Circ Arrhythm Electrophysiol 2020; 13:e008890. [DOI: 10.1161/circep.120.008890] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lucrezia Masiello
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Sabato D’Amore
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology (S.G., S.S., L.O.V.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simone Savastano
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Sanzo
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Emergency Department (A.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine (A.S.), University of Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Maria Seminari
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine (M.V.L.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Bosio
- Division of Respiratory Diseases (M.B.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Barbara Petracci
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Frigerio
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Sabena
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guido Tavazzi
- Anaesthesia and Intensive Care (G.T.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of Anesthesia and Intensive Care (G.T.), University of Pavia, Italy
| | - Luigi Oltrona Visconti
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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LoMauro A, Aliverti A, Frykholm P, Alberico D, Persico N, Boschetti G, DeBellis M, Briganti F, Nosotti M, Righi I. Adaptation of lung, chest wall, and respiratory muscles during pregnancy: preparing for birth. J Appl Physiol (1985) 2019; 127:1640-1650. [PMID: 31697596 DOI: 10.1152/japplphysiol.00035.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
A plethora of physiological and biochemical changes occur during normal pregnancy. The changes in the respiratory system have not been as well elucidated, in part because radioimaging is usually avoided during pregnancy. We aimed to use several noninvasive methods to characterize the adaptation of the respiratory system during the full course of pregnancy in preparation for childbirth. Eighteen otherwise healthy women (32.3 ± 2.8 yr) were recruited during early pregnancy. Spirometry, optoelectronic plethysmography, and ultrasonography were used to study changes in chest wall geometry, breathing pattern, lung and thoraco-abdominal volume variations, and diaphragmatic thickness in the first, second, and third trimesters. A group of nonpregnant women were used as control subjects. During the course of pregnancy, we observed a reorganization of rib cage geometry, in shape but not in volume. Despite the growing uterus, there was no lung restriction (forced vital capacity: 101 ± 15% predicted), but we did observe reduced rib cage expansion. Breathing frequency and diaphragmatic contribution to tidal volume and inspiratory capacity increased. Diaphragm thickness was maintained (1st trimester: 2.7 ± 0.8 mm, 3rd trimester: 2.5 ± 0.9 mm; P = 0.187), possibly indicating a conditioning effect to compensate for the effects of the growing uterus. We conclude that pregnancy preserved lung volumes, abdominal muscles, and the diaphragm at the expense of rib cage muscles.NEW & NOTEWORTHY Noninvasive analysis of the kinematics of the chest wall and the diaphragm during resting conditions in pregnant women revealed significant changes in the pattern of thoracoabdominal breathing across the trimesters. That is, concomitant with the progressive changes of chest wall shape, the diaphragm increased its contribution to both spontaneous and maximal breathing, maintaining its thickness despite its lengthening due to the growing uterus. These results suggest that during pregnancy the diaphragm is conditioned to optimize its active role provided during parturition.
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.,Section of Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Peter Frykholm
- Section of Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Daniela Alberico
- Department of Obstetrics and Gynecology "L. Mangiagalli," Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Nicola Persico
- Department of Obstetrics and Gynecology "L. Mangiagalli," Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Giulia Boschetti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Michela DeBellis
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Federica Briganti
- Pneumology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Ilaria Righi
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
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Urso A, Briganti F, Nandakumar R, Benvenuto L, Costa J, Robbins H, Shah L, Sonett J, Cremers S, Arcasoy S, D’Ovidio F. Bile acid aspiration associated to early CLAD development and dysregulation of airway lipids. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa3358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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7
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Dicuio M, Creti S, Andrei F, Diazzi D, Mannini D, Severini E, Briganti F, Corona G. PO-02-023 Intravesical migration of stick float during sexual intercourse in a female. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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LoMauro A, Aliverti A, Privitera E, Vergari M, Righi I, Sgroia M, Tosi D, Rossetti V, Briganti F, Frykhol P, Colombo C, Nosotti M, Palleschi A. The diaphragm before and after lung transplant (LT). Transplantation 2018. [DOI: 10.1183/13993003.congress-2018.pa2589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Palleschi A, Mendogni P, Tosi D, Montoli M, Carrinola R, Mariolo AV, Briganti F, Nosotti M. Lung Transplantation From Donors After Previous Cardiac Surgery: Ideal Graft in Marginal Donor? Transplant Proc 2017; 49:686-691. [PMID: 28457372 DOI: 10.1016/j.transproceed.2017.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery. One donor had ascending aortic root (AAR) substitution, another had mitral valve substitution, and two had coronary artery bypass surgery. The others' eligibility criteria for organ allocation, such as ABO compatibility, PaO2/FiO2 ratio, absence of aspiration, or sepsis were respected. In one of the cases with previous coronary bypass grafting, the donor had a veno-arterial extracorporeal membrane oxygenation support. Consequently, the grafts required an ex vivo lung perfusion evaluation. We report the technical details of procurement and postoperative courses of recipients. All procurements were uneventful, without lung damage or waste of abdominal organs related to catastrophic intraoperative events. All recipients had a successful clinical outcome. We believe that successful transplantation is achievable even in a complicated setting, such as cases involving donors with previous cardiac surgery frequently are. Facing lung donor shortage, we strongly support any effort to avoid the loss of possible acceptable lungs. In particular, previous major cardiac surgery does not strictly imply a poor quality of lungs as well as unsustainable graft procurement.
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Affiliation(s)
- A Palleschi
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Mendogni
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - D Tosi
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Montoli
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - R Carrinola
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A V Mariolo
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Briganti
- Cardio-thoracic Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - M Nosotti
- Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Caranci F, Leone G, Ugga L, Cesarano E, Capasso R, Schipani S, Bianco A, Fonio P, Briganti F, Brunese L. Imaging of post-surgical treatment and of related complications in spinal trauma. Musculoskelet Surg 2017; 101:63-73. [PMID: 28168635 DOI: 10.1007/s12306-017-0457-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/15/2017] [Indexed: 11/26/2022]
Abstract
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation. The neuroradiological evaluation of the postoperative spine requires a general knowledge of the surgical approach to each spinal region and of the normal temporal evolution of expected postoperative changes. The neuroradiologist should evaluate the devices implanted, their related complications and promptly alert the surgeon of acute complications, mainly vascular and infective. During the follow-up, it is mandatory to know and search chronic complications as pseudomeningocele, accelerated degenerative disease, arachnoiditis, peridural fibrosis. Knowledge of specific complications relating to each surgical approach will assist the neuroradiologist in interpretation of postoperative images.
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Affiliation(s)
- F Caranci
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy.
| | - G Leone
- Neuroradiology Unit, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - L Ugga
- Neuroradiology Unit, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - E Cesarano
- Radiology Section, Health Service, Navy Command of Brindisi, Brindisi, Italy
| | - R Capasso
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - S Schipani
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - A Bianco
- Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Naples, Italy
| | - P Fonio
- Radiology Unit, Department of Surgical Sciences, University of Torino, Turin, Italy
| | - F Briganti
- Neuroradiology Unit, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - L Brunese
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
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Abstract
We studied five patients with gelastic epilepsy sustained by hamartoma of the tuber cinereum, submitted to EEG and Video-EEG study and to MR examination. The mechanism of ictal laughter, clinical associations and prognosis for seizure control are discussed. Hamartomas should be always suspected when gelastic seizures occur, and appropriate diagnostic tools should be employed for their diagnosis. In patients presenting with gelastic epilepsy, MR assessment of the hypothalamic region is necessary to identify a hamartoma of the tuber cinereum. Moreover, the resolution of MR imaging provides a basis to correlate some of the clinical manifestations with the anatomical disposition of the lesion within the hypothalamus. Gelastic epilepsy seems to correlate with large broad-based hamartomas in relationship with the mamillary bodies. In these cases, surgical treatment should be considered when symptoms are not sufficiently responsive to medical therapy.
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Affiliation(s)
| | | | | | | | - S. Striano
- Department of Neurological Sciences, “Federico II” University School of Medicine, Napoli
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Abstract
Gli autori, attraverso una revisione della letteratura ed uno studio retrospettivo su 125 esami RM, descrivono le alterazioni degenerative del rachide lombare in pazienti anziani, focalizzan-do l'attenzione sulla ricca semeiologia RM della patologia del complesso disco-somatico. Scopo del lavoro e quello di poter discernere le alterazioni a carattere francamente patologico da quelle che possono essere considerate segni del fisiologico invecchiamento rachideo. Viene in particolare evidenziato come la fissurazione radiale dell'anulus sia risultata, in base alla sua presenza significativamente più frequente nel gruppo dei pazienti sintomatici, il miglior segno predittivo di patologia estrusiva discale tra quelli esaminati.
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Affiliation(s)
- L. Simonetti
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - F. Spadetta
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - A. Manto
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - F. Briganti
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - G. Petrone
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - S. Cirillo
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
| | - R. Elefante
- Cattedra di Neuroradiologia e Cattedra di Radiologia II; II Facoltà di Medicina e Chirurgia dell'Università Federico II di Napoli
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13
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Affiliation(s)
- R De Simone
- Neurological Sciences, Federico II University of Naples, Italy
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14
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Di Maio L, Marcelli V, Vitale C, Menzione M, De Giorgio A, Briganti F, Perretti A, Marciano E, Filla A, De Michele G. Cervico-Oculo-Acoustic Syndrome in a Male with Consanguineous Parents. Can J Neurol Sci 2014; 33:237-9. [PMID: 16736738 DOI: 10.1017/s0317167100005059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACT:Background:The cervico-oculo-acoustic syndrome comprises Klippel-Feil anomaly, sensorineural deafness and Duane's retraction syndrome. Polygenic, autosomal dominant, and X-linked inheritance have been hypothesized. The disorder has rarely been reported in males.Case Report:A 42-year-old male, born of consanguineous parents, presented with Duane's syndrome, mixed hearing loss, C2-C3 fusion, neck stiffness, and right facial palsy. A variety of cardiac, neurological and urogenital anomalies occurred in his relatives. The electro-oculographic studies showed impaired abduction and adduction of the right eye and impaired abduction of the left eye. Vergence, vertical eye movements and peripheral vestibular responses were normal. Somatosensory evoked potentials showed absence of the N13 peak and brainstem auditory evoked potentials bilateral delay of the I-III interpeak latencies.Conclusions:Consanguinity of the patient's parents, not previously reported, suggests autosomal recessive inheritance, but autosomal dominant inheritance is indicated by the family history. The pattern of the oculomotor deficit is consistent with bilateral dysplasia of the abducens nuclei with preserved internuclear neurons in the right abducens nucleus. Neurophysiological investigations revealed lower brainstem and cervical cord involvement.
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Affiliation(s)
- L Di Maio
- Dipartimento di Scienze Neurologiche, Università Federico II Naples, Italy
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15
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Briganti F, Leone G, Napoli M, Lauriola W, Florio F, Maiuri F. Early Fatal Hemorrhage After Endovascular Treatment of a Giant Aneurysm with Flow Diverter Device and Coils. Clin Neuroradiol 2014; 25:201-5. [DOI: 10.1007/s00062-014-0310-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 04/25/2014] [Indexed: 11/29/2022]
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16
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Tortora F, Napoli M, Caranci F, Cirillo M, Pepe D, Cirillo S, Briganti F. Spontaneous regression of syringomyelia in a young patient with Chiari type I malformation. Neuroradiol J 2013; 25:593-7. [PMID: 24029095 DOI: 10.1177/197140091202500513] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 09/14/2012] [Indexed: 11/16/2022] Open
Abstract
Syringomyelia is a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called syrinx, can expand and elongate over time, destroying the spinal cord. We describe the case of a young patient with partial spontaneous regression of syringomyelia in Chiari I malformation, confirmed by magnetic resonance imaging three years after the diagnosis. During this period the patient did not experience any clinical symptoms. Although described in literature, spontaneous regression is an unusual event and very few cases have been reported. This case report supports the belief that conservative management together with both clinical and imaging periodic controls should be preferred in stable mild-symptomatic patients.
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Affiliation(s)
- F Tortora
- Department of Neurological Sciences, Neuroradiology Division, Second University of Naples; Naples, Italy -
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17
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Briganti F, Giordano A. Sala Gran Sasso - 16.30–17.18 Comunicazioni. Neuroradiol J 2013. [DOI: 10.1177/19714009130260s118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Caranci F, Briganti F, La Porta M, Antinolfi G, Cesarano E, Fonio P, Brunese L, Coppolino F. Magnetic resonance imaging in brachial plexus injury. Musculoskelet Surg 2013; 97 Suppl 2:S181-90. [PMID: 23949940 DOI: 10.1007/s12306-013-0281-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/13/2013] [Indexed: 12/20/2022]
Abstract
Brachial plexus injury represents the most severe nerve injury of the extremities. While obstetric brachial plexus injury has showed a reduction in the number of cases due to the improvements in obstetric care, brachial plexus injury in the adult is an increasingly common clinical problem. The therapeutic measures depend on the pathologic condition and the location of the injury: Preganglionic avulsions are usually not amenable to surgical repair; function of some denervated muscles can be restored with nerve transfers from intercostals or accessory nerves and contralateral C7 transfer. Postganglionic avulsions are repaired with excision of the damaged segment and nerve autograft between nerve ends or followed up conservatively. Magnetic resonance imaging is the modality of choice for depicting the anatomy and pathology of the brachial plexus: It demonstrates the location of the nerve damage (crucial for optimal treatment planning), depicts the nerve continuity (with or without neuroma formation), or may show a completely disrupted/avulsed nerve, thereby aiding in nerve-injury grading for preoperative planning. Computed tomography myelography has the advantage of a higher spatial resolution in demonstration of nerve roots compared with MR myelography; however, it is invasive and shows some difficulties in the depiction of some pseudomeningoceles with little or no communication with the dural sac.
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Affiliation(s)
- F Caranci
- Department of Advanced Biomedical Sciences, Unit of Neuroradiology, Federico II University of Naples, Via S. Pansini 5, 80131, Naples, Italy.
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Briganti F, Leone G, Panagiotopoulos K, Marseglia M, Mariniello G, Napoli M, Caranci F. Endovascular treatment of cerebral aneurysms using the hydrocoil embolic system. Neuroradiol J 2013; 26:420-7. [PMID: 24007730 PMCID: PMC4202812 DOI: 10.1177/197140091302600407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 07/05/2013] [Indexed: 11/16/2022] Open
Abstract
HydroCoils are platinum helical coils coated with a layer of hydrophilic acrylic polymer (hydrogel), which on contact with blood causes disentanglement of polymer chains and expansion. We retrospectively reviewed a series of 29 patients harboring 29 cerebral aneurysms treated with the Hydrocoil Embolic System in the period 2004-2005, discussing the results of endovascular procedures in terms of safety and efficacy. The immediate post-procedure angiographic control demonstrated complete aneurysm occlusion in 21 cases (72.4%), near-complete occlusion in seven cases (24.1%), whereas in one case (3.4%) there was a procedure failure with major perfusion of the sac. Five patients (17.2%) experienced thromboembolic complications, including an asymptomatic lacunar stroke of the head of the caudate nucleus, a thalamic infarct following hypotension secondary to pulmonary edema, temporal ischemia secondary to vasospasm and a small right occipital ischemic lesion. Only one patient (3.4%) suffered a major ischemic accident. No other procedure-related complication occurred. Three-month follow-up control with MR angiography and 12-month follow-up angiography demonstrated no recurrence of aneurysms. Overall, after a mean follow-up of 12 months, the clinical outcome was good recovery in 26 patients (89.6%), moderate disability in three patients (10.3%) and no vegetative status or death. Our HydroCoil series supports the safety and midterm durability of hydrogel-coated aneurysm coils in the treatment of cerebral aneurysms.
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Affiliation(s)
- F Briganti
- Department of Diagnostic Imaging, University of Naples; Naples, Italy -
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20
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Briganti F, Marseglia M, Leone G, Briganti G, Piccolo D, Napoli M, Caranci F. Endovascular treatment of a small aneurysm of the superior cerebellar artery with a flow-diverter device. A case report. Neuroradiol J 2013; 26:327-31. [PMID: 23859291 DOI: 10.1177/197140091302600313] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/10/2013] [Indexed: 11/16/2022] Open
Abstract
We describe the case of a 62-year-old woman who presented with a small fusiform left superior cerebellar artery (SCA) aneurysm. Aneurysms located on the SCA are uncommon and their presentation, natural history and clinical management are poorly understood. Reports on the endovascular or surgical management of SCA aneurysms are rare and usually incorporated in clinical series of basilar artery or posterior circulation aneurysms. The patient was treated by delivery of a flow-diverter Pipeline Embolization Device (PED - Chestnut Medical/ev3) at the origin of vessel. She had no procedural complications and the aneurysm volume was reduced. This paper presents additional evidence to literature reports suggesting that the new endovascular flow-diverter devices are an effective and well-tolerated treatment for complex aneurysms. Our review contributes data on the incidence of recurrence as a measure of long-term efficacy of this therapeutic approach.
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Affiliation(s)
- F Briganti
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
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21
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Briganti F, Leone G, Briganti G, Orefice G, Caranci F, Maiuri F. Spontaneous resolution of Chiari type 1 malformation. A case report and literature review. Neuroradiol J 2013; 26:304-9. [PMID: 23859287 DOI: 10.1177/197140091302600309] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/10/2013] [Indexed: 11/17/2022] Open
Abstract
We describe a 62-year-old woman who presented with a history of ataxia, dizziness and urinary urgency. Neurological examination disclosed a positive Romberg sign, ataxia and postural instability. A magnetic resonance imaging (MRI) scan showed Chiari type 1 malformation (CM1). Forty-eight months later, the patient was clinically improved and underwent a second MRI examination, which showed complete resolution of the Chiari 1 malformation. Spontaneous resolution of CM1 is exceptionally rare and has to be considered in the radiological and clinical management.
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Affiliation(s)
- F Briganti
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
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22
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Briganti F, Tedeschi E, Leone G, Marseglia M, Cicala D, Giamundo M, Napoli M, Caranci F. Endovascular treatment of vertebro-vertebral arteriovenous fistula. A report of three cases and literature review. Neuroradiol J 2013; 26:339-46. [PMID: 23859293 DOI: 10.1177/197140091302600315] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 06/02/2013] [Indexed: 11/16/2022] Open
Abstract
This report describes endovascular approaches for occlusion of vertebro-vertebral arteriovenous fistula (VV-AVF) in a series of three cases and a review of the literature. Complete neuroimaging assessment, including CT, MR and DSA was performed in three patients (two female, one male) with VV-AVF. Based on DSA findings, the VV-AVF were occluded by endovascular positioning of detachable balloons (case 1), coils (case 2), or a combination of both (case 3) with parent artery patency in two out of three cases. In this small series, endovascular techniques for occlusion of VV-AVF were safe and effective methods of treatment. To date, there are no guidelines on the best treatment for VV-AVF. Detachable balloons, endovascular coiling, combined embolization procedures could all be considered well-tolerated treatments.
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Affiliation(s)
- F Briganti
- Department of Diagnostic Imaging, University of Naples, Naples, Italy.
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23
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Caranci F, Briganti F, Cirillo L, Leonardi M, Muto M. Epidemiology and genetics of intracranial aneurysms. Eur J Radiol 2013; 82:1598-605. [PMID: 23399038 DOI: 10.1016/j.ejrad.2012.12.026] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 12/16/2012] [Accepted: 12/17/2012] [Indexed: 11/18/2022]
Abstract
Intracranial aneurysms are acquired lesions (5-10% of the population), a fraction of which rupture leading to subarachnoid hemorrhage with devastating consequences. Until now, the exact etiology of intracranial aneurysms formation remains unclear. The low incidence of subarachnoid hemorrhage in comparison with the prevalence of unruptured IAs suggests that the vast majority of intracranial aneurysms do not rupture and that identifying those at highest risk is important in defining the optimal management. The most important factors predicting rupture are aneurysm size and site. In addition to ambiental factors (smoking, excessive alcohol consumption and hypertension), epidemiological studies have demonstrated a familiar influence contributing to the pathogenesis of intracranial aneurysms, with increased frequency in first- and second-degree relatives of people with subarachnoid hemorrhage. In comparison to sporadic aneurysms, familial aneurysms tend to be larger, more often located at the middle cerebral artery, and more likely to be multiple. Other than familiar occurrence, there are several heritable conditions associated with intracranial aneurysm formation, including autosomal dominant polycystic kidney disease, neurofibromatosis type I, Marfan syndrome, multiple endocrine neoplasia type I, pseudoxanthoma elasticum, hereditary hemorrhagic telangiectasia, and Ehlers-Danlos syndrome type II and IV. The familial occurrence and the association with heritable conditions indicate that genetic factors may play a role in the development of intracranial aneurysms. Genome-wide linkage studies in families and sib pairs with intracranial aneurysms have identified several loci on chromosomes showing suggestive evidence of linkage, particularly on chromosomes 1p34.3-p36.13, 7q11, 19q13.3, and Xp22. For the loci on 1p34.3-p36.13 and 7q11, a moderate positive association with positional candidate genes has been demonstrated (perlecan gene, elastin gene, collagen type 1 A2 gene). Moreover, 3 of the polymorphisms analyzed in 2 genes (endothelial nitric oxide synthase T786C, interleukin-6 G572C, and interleukin-6 G174C) were found to be significantly associated with ruptured/unruptured aneurysms: the endothelial nitric oxide synthase gene single-nucleotide polymorphisms increased the risk, while IL-6 G174C seemed protective. More recently, two genomic loci (endothelin receptor A and cyclin-dependent kinase inhibitor 2BAS) have been found to be significantly associated with intracranial aneurysms in the Japanese population; endothelin-1 is a potent vasoconstrictor produced by the endothelial cells. Until now, there are no diagnostic tests for specific genetic risk factors to identify patients who are at a high risk of developing intracranial aneurysms. Knowledge of the genetic determinants may be useful in order to allow clues on stopping aneurysm formation and obtain diagnostic tools for identifying individuals at increased risk. Further multicenter studies have to be carried out.
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Affiliation(s)
- F Caranci
- Unit of Neuroradiology, Department of Diagnostic Radiology and Radiotherapy, Federico II University, Naples, Italy.
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24
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Caranci F, Cirillo M, Piccolo D, Briganti G, Cicala D, Leone G, Briganti F. A rare case of intraosseous lipoma involving the sphenoclival region. Neuroradiol J 2012; 25:680-3. [PMID: 24029181 DOI: 10.1177/197140091202500607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 11/14/2012] [Indexed: 11/17/2022] Open
Abstract
We describe the case of a 23-year-old man whose CT scan revealed a hypodense lesion reshaping the superior and middle third of the clivus and partially invading the sphenoidal sinus. MRI showed an irregular-shaped lesion occupying the body of the sphenoid bone, involving the superior and middle third of the clivus and sprouting into the sphenoid sinus. The lesion was hyperintense on T1- and T2-weighted sequences with a thin peripheral rim of hypointensity, without enhancement after i.v. gadolinium injection. The pathology report confirmed an intraosseus lipoma. Intraosseous lipomas involving the spheno-clival region are extremely rare. CT and MRI scan interpretation can be troublesome but this rare pathology has to be considered in the differential diagnosis.
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Affiliation(s)
- F Caranci
- Unit of Interventional Neuroradiology, Department of Neurological Sciences, Federico II University; Naples, Italy -
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25
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Caranci F, Napoli M, Cirillo M, Briganti G, Brunese L, Briganti F. Basilar artery hypoplasia. Neuroradiol J 2012; 25:739-43. [PMID: 24029187 DOI: 10.1177/197140091202500613] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 11/13/2012] [Indexed: 11/15/2022] Open
Abstract
A rare case of segmental hypoplasia of the basilar artery is described in a 49-year-old man with transient vertebrobasilar ischemia, explored by magnetic resonance imaging (MRI) and digital angiography (DA). The embryology, clinical relevance and magnetic resonance findings of this arterial anomaly are discussed, with a review of six previously reported cases. Segmental aplasia was suggested in our case by magnetic resonance, and subsequently confirmed not only by time-of-flight magnetic resonance, but also by DA. Only ultrathin-slice T2-weighted images revealed the real finding of basilar artery hypoplasia. This sequence, not employed in previously reported cases, is mandatory to allow a clear differential diagnosis between basilar artery aplasia and hypoplasia.
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Affiliation(s)
- F Caranci
- Unit of Interventional Neuroradiology, Department of Neurological Sciences, Federico II University; Naples, Italy -
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26
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Briganti F, Cicala D, Tortora F, Leone G, Napoli M, Maiuri F. Endovascular treatment of a giant dissecting aneurysm of the posterior cerebral artery. A case report and literature review. Neuroradiol J 2012; 25:695-701. [PMID: 24029183 DOI: 10.1177/197140091202500609] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 11/13/2012] [Indexed: 01/25/2023] Open
Abstract
We describe the case of a 60-year-old man who presented with a giant dissecting aneurysm of the left P2 segment. Intracranial dissecting aneurysms often occur in the vertebrobasilar system, but rarely involve the posterior cerebral artery (PCA). PCA aneurysms tend to have some peculiar features and therefore may be considered a separate entity, even from the vertebrobasilar aneurysms. The patient was treated by endovascular occlusion of both parent vessel and the aneurysm, and he tolerated the procedure well with a complete resolution of clinical deficit, following volume reduction of the aneurysm. This paper presents additional evidence to literature reports suggesting that endovascular parent artery occlusion with coils is an effective and well-tolerated treatment for distal PCA aneurysms. Our review contributes to collect data regarding the incidence of recurrence as a measure of long-term efficacy of this therapeutic approach.
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Affiliation(s)
- F Briganti
- Unit of Interventional Neuroradiology, Department of Neurological Sciences; Federico II University; Naples, Italy -
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Mariniello G, Napoli M, Russo C, Briganti F, Giamundo A, Maiuri F, De Caro MDB. MRI Features of Spinal Solitary Fibrous Tumors. Neuroradiol J 2012; 25:610-6. [DOI: 10.1177/197140091202500516] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 09/14/2012] [Indexed: 11/17/2022] Open
Abstract
Spinal solitary fibrous tumors (SFT) are very rare neoplasms occurring in the spinal canal, with only 38 cases reported in ten years since the first description. We describe two cases of SFT of the spine and review 33 well-documented cases in the literature to define distinctive radiological and surgical features raising the suspicion of a spinal SFT before histological verification. A 67-year-old man with cervical myeloradiculopathy had a large extramedullary tumor of the cervical spinal canal extending from C4 to C7. On MRI the tumor was isointense on T1-sequences and hypointense on T2-sequences, and had marked contrast enhancement. At surgery, the tumor was intradural extramedullary, with no dural or root attachment, but it was adherent to the cord. Complete tumor removal was achieved with good outcome. A 75-year-old man with progressive thoracic myelopathy had an intramedullary tumor at C6 and C7 level, which was hypointense on T1- and T2-weighted images of MRI. At surgery, the tumor was intramedullary and strongly adherent to the cord; it was successfully removed. Both tumors were composed of elongated cells with a collagen-matrix background. Immunohistochemical staining was positive for vimentin, CD34, and bcl-2, and negative for EMA and S-100 protein. A careful analysis of our own and the other reported cases of spinal SFTs may disclose some peculiar features of this rare tumor. A spinal intramedullary or extramedullary tumor, hypointense on T2-weighted images of MRI, which intraoperatively shows hard consistency, scarce vascularization, no nerve root involvement, no or weak dural attachment, absence of arachnoidal interface, and adherence to the spinal cord may suggest the diagnosis of SFT.
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Affiliation(s)
- G. Mariniello
- Chair of Neurosurgery, Department of Neurological Sciences, “Federico II” University of Naples; Naples, Italy
| | - M. Napoli
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - C. Russo
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - F. Briganti
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - A. Giamundo
- Chair of Neurosurgery, Department of Neurological Sciences, “Federico II” University of Naples; Naples, Italy
| | - F. Maiuri
- Department of Imaging Diagnostics and Radiotherapy, “Federico II” University of Naples; Naples, Italy
| | - M.L. Del Basso De Caro
- Department of Biomorphology, Section of Pathology, “Federico II” University of Naples; Naples, Italy
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Di Stefano M, Meloni F, Oggionni T, Mengoli C, Briganti F, Bergonzi M, Zanaboni A, Pagani E, Miceli E, Luisetti M, Corazza G. 729 Abnormalities of Esophageal Motor Activity Are Highly Prevalent in Lung Transplanted Patients. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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29
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Parlato C, di Nuzzo G, Luongo M, Tortora F, Briganti F. Anatomical variant of origin of ophthalmic artery: case report. Surg Radiol Anat 2011; 33:275-8. [PMID: 21104253 DOI: 10.1007/s00276-010-0745-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 10/28/2010] [Indexed: 02/07/2023]
Abstract
We report on one case of variant origin of right ophthalmic artery (OA) from C4 choroidal segment of the right supraclinoid internal carotid artery. A 41-year-old woman affected by bitemporal hemianopsia performed Magnetic Resonance Imaging with gadolinium showing tuberculum sellae meningioma. During angiography we observed this variant of origin of OA. At surgical dissection, we observed this variant in carotid cistern.
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Affiliation(s)
- C Parlato
- Department of Neurosciences, Second University of Naples, Naples, Italy.
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Tortora F, Cirillo M, Ferrara M, Manto A, Briganti F, Cirillo S. DWI Reversibility after Intra-Arterial Thrombolysis. A Case Report and Literature Review. Neuroradiol J 2010; 23:752-62. [PMID: 24148733 DOI: 10.1177/197140091002300618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 11/05/2010] [Indexed: 11/16/2022] Open
Abstract
We report our case and review the literature on reversal DWI lesions, ADC thresholds and correlation between DWI lesion and outcome measured with clinical scales. A 30-years old woman was admitted to our hospital 18 hours after stroke onset. Considering the absence of alterations on CT and the worsening of symptomatology, the patient underwent MRI, which showed a slightly hyperintense signal in FLAIR images in the left portion of the pons and midbrain and a more evident bilateral DWI hyperintensity of the pons. The patient was treated with mechanical and pharmacological intra-arterial thrombolysis. The patient showed a rapid improvement of symptoms. Two weeks after the treatment her clinical conditions were characterized by a residual right hemiparesis and complete recovery of right motility, respiratory and swallowing difficulties. MR examination demonstrated a slight signal alteration of the pons left hemiportion and a disappearance of the mesencephalic signal alteration and of the right portion of the pons. DWI lesions represent irreversibly damaged tissue but new evidence suggests that DWI lesions may be reversible, especially with reperfusion, by now well demonstrated in animal models. Therefore acute DWI lesions probably contain not only irreversibly injured tissue but also parts of the penumbra. The debate on the capability of ADC maps to discriminate irreversibly from reversibly damaged tissue is a matter of controversy. ADC values in human stoke are not an independent indicator of tissue viability. The use of thresholds may improve reproducibility but not validity.
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Affiliation(s)
- F Tortora
- Department of Neuroradiology, II University School of Medicine; Naples, Italy -
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31
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Mariniello G, Vecchione D, Di Martino G, Briganti F, Donzelli R, Maiuri F. Fusiform aneurysm of the proximal anterior cerebral artery (A1). ACTA ACUST UNITED AC 2009; 71:96-8. [PMID: 20358511 DOI: 10.1055/s-0029-1202358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Fusiform aneurysms of the A1 segment of the anterior cerebral artery (ACA) are exceptional, with only 15 reported cases. This article presents an additional case treated by microsurgical trapping. The aim is to discuss the treatment of these aneurysms based on the aneurysm morphology and the anatomy of the ACA complex. CASE REPORT A 52-year-old woman with subarachnoid hemorrhage (Hunt-Hess grade II) showed an aneurysm of the proximal part of the A1 segment of the left ACA involving the whole circumference of the arterial wall on computerized tomography angiography and digital angiography. There was good collateral blood flow from the right ACA to the distal left ACA. A left pterional craniotomy allowed us to expose a large aneurysm of the proximal part of the A1 segment; the artery entered into the aneurysm sac and could not be identified at the level of the aneurysm. Trapping of the aneurysm was performed with a distal clip placed just before the origin of the artery of Heubner. No neurological deficits were observed postoperatively. CONCLUSION Clipping of fusiform aneurysms of the A1 segment using an encircling clip is the treatment of choice but, more often, this is impossible. Trapping of the aneurysm with preservation of the perforating branches (mainly the Heubner artery) may be easily performed when collateral blood flow from the contralateral ACA is sufficient.
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Affiliation(s)
- G Mariniello
- Department of Neurological Sciences, University Federico II of Naples, Naples, Italy.
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Briganti F, Tortora F, Marseglia M, Napoli M, Cirillo L. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up. Interv Neuroradiol 2009; 15:185-90. [PMID: 20465897 DOI: 10.1177/159101990901500208] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 10/09/2008] [Indexed: 11/15/2022] Open
Abstract
SUMMARY Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years.
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Affiliation(s)
- F Briganti
- Federico II University of Naples; Naples, Italy -
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Stagni L, Romano MA, Romano A, Magli A, Briganti F, Del Pezzo MA, Buffolano W. Prenatal screening for congenital toxoplasmosis in Campania: preliminary report on activities and results. Mem Inst Oswaldo Cruz 2009; 104:374-7. [DOI: 10.1590/s0074-02762009000200035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 03/24/2009] [Indexed: 11/21/2022] Open
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Chernykh A, Myasoedova N, Kolomytseva M, Ferraroni M, Briganti F, Scozzafava A, Golovleva L. Laccase isoforms with unusual properties from the basidiomyceteSteccherinum ochraceumstrain 1833. J Appl Microbiol 2008; 105:2065-75. [DOI: 10.1111/j.1365-2672.2008.03924.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Papi G, Briganti F, Artioli F, Cavazza A, Carapezzi C, Roggeri A, Baldoni C, Carani C, Chiarini V, Roti E. Sarcoidosis of the thyroid gland associated with hyperthyroidism: review of the literature and report of two peculiar cases. J Endocrinol Invest 2006; 29:834-9. [PMID: 17114917 DOI: 10.1007/bf03347380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Sarcoidosis is a systemic disease characterized by non-caseating granulomas that rarely involve the thyroid gland. Thyroid sarcoidosis has seldom been documented, and few cases have so far been described in association with hyperthyroidism. Here, we review the literature on this association, report two patients presenting with hyperthyroidism and histologically-proven sarcoidosis, and discuss related clinical, biochemical, pathological and genetic findings.
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Affiliation(s)
- G Papi
- University of Modena and Reggio Emilia, Italy.
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Matera I, Ferraroni M, Bürger S, Stolz A, Briganti F. Preliminary crystallographic analysis of salicylate 1,2-dioxygenase from Pseudaminobacter salicylatoxidans. Acta Crystallogr Sect F Struct Biol Cryst Commun 2006; 62:553-5. [PMID: 16754979 PMCID: PMC2243090 DOI: 10.1107/s1744309106016435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 05/04/2006] [Indexed: 11/11/2022]
Abstract
Salicylate 1,2-dioxygenase, a new ring-fission dioxygenase from the naphthalenesulfonate-degrading strain Pseudaminobacter salicylatoxidans which oxidizes salicylate to 2-oxohepta-3,5-dienedioic acid by a novel ring-fission mechanism, has been crystallized. Diffraction-quality crystals of salicylate 1,2-dioxygenase were obtained using the sitting-drop vapour-diffusion method at 277 K from a solution containing 10%(w/v) ethanol, 6%(w/v) PEG 400, 0.1 M sodium acetate pH 4.6. Crystals belong to the primitive tetragonal space group P4(3)2(1)2 or P4(1)2(1)2, with unit-cell parameters a = 133.3, c = 191.51 A. A complete data set at 100 K extending to a maximum resolution of 2.9 A was collected at a wavelength of 0.8423 A. Molecular replacement using the coordinates of known extradiol dioxygenases structures as a model has so far failed to provide a solution for salicylate 1,2-dioxygenase. Attempts are currently being made to solve the structure of the enzyme by MAD experiments using the anomalous signal of the catalytic Fe(II) ions. The salicylate 1,2-dioxygenase structural model will assist in the elucidation of the catalytic mechanism of this ring-fission dioxygenase from P. salicylatoxidans, which differs markedly from the known gentisate 1,2-dioxygenases or 1-hydroxy-2-naphthoate dioxygenases because of its unique ability to oxidatively cleave salicylate, gentisate and 1-hydroxy-2-naphthoate with high catalytic efficiency.
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Affiliation(s)
- I. Matera
- Department of Chemistry, University of Florence, Via della Lastruccia 3, 50019 Sesto Fiorentino, Florence, Italy
| | - M. Ferraroni
- Department of Chemistry, University of Florence, Via della Lastruccia 3, 50019 Sesto Fiorentino, Florence, Italy
| | - S. Bürger
- Institut für Mikrobiologie, Universität Stuttgart, Allmandring 31, 70569 Stuttgart, Germany
| | - A. Stolz
- Institut für Mikrobiologie, Universität Stuttgart, Allmandring 31, 70569 Stuttgart, Germany
| | - F. Briganti
- Department of Chemistry, University of Florence, Via della Lastruccia 3, 50019 Sesto Fiorentino, Florence, Italy
- Correspondence e-mail:
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Briganti F, Tortora F, Volpe A, Elefante A, De Notaris M, Panagiotopoulos K. Stent implantation for treatment of symptomatic spontaneous cervical internal carotid artery dissecting aneurysm. A case report. ACTA ACUST UNITED AC 2006; 48:306-9. [PMID: 16320195 DOI: 10.1055/s-2005-915607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cervical internal carotid dissections are rare. Approximately one third of the cases are associated with pseudoaneurysm. The first-choice management of cervical carotid dissecting aneurysms consists in anticoagulation or antiplatelet therapy. Surgery is typically indicated in cases of failure of conservative therapy with recurrent cerebral ischemic attacks. In recent years, stent implantation has been also employed for the management of patients with carotid dissecting aneurysms whose neurological conditions were refractory to medical treatment. In the present case we describe the treatment of a patient with a carotid dissecting aneurysm, by means of endovascular stent application and provide angiographic control 24 months after the intervention.
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Affiliation(s)
- F Briganti
- Department of Neuroradiology, Federico II University School of Medicine, Naples, Italy.
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Abstract
We report a rare case of bilateral hypoplasia of the internal carotid arteries with an associated aneurysm of the basilar tip, studied by CT angiography, MR angiography and digital angiography. The patient became symptomatic with an episode of loss of consciousness, likely due to reduced blood perfusion. The other 20 reported cases of bilateral carotid hypoplasia (only four of which with an associated aneurysm) are reviewed. The findings of noninvasive procedures (including narrowing of the carotid canals on CT) may lead to a correct diagnosis before angiography is performed; they may also help to differentiate angiographic narrowing of the hypoplastic internal carotids from the string sign often observed in some acquired conditions.
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Affiliation(s)
- F Briganti
- Dipartimento di Scienze Neurologiche, Cattedra di Neuroradiologia, Università di Napoli Federico II, via S. Pansini 5, 80131, Napoli, Italy.
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39
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Ferraroni M, Travkin VM, Kolomytseva MP, Scozzafava A, Golovleva L, Briganti F. Substrate specificity of three new intradiol dioxygenases: an X-ray characterization. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305091117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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40
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Briganti F, Tortora F, Elefante A, Volpe A, Bruno MC, Panagiotopoulos K. An unusual case of vertebral arteriovenous fistula treated with electrodetachable coil embolization. ACTA ACUST UNITED AC 2005; 47:386-8. [PMID: 15674760 DOI: 10.1055/s-2004-830131] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Vertebral arteriovenous fistulas (VAF) are rare clinical entities. Most are post-traumatic in origin, following direct injury, or iatrogenic. Treatment options include endovascular occlusion or direct surgical closure. We present a rare case of a spontaneous VAF, presenting with cervical and upper limb pain in a patient with previous chiropractic manipulations, successfully treated with electrodetachable coil embolization. While the natural history of the VAFs is still to be settled, endovascular occlusion appears to be a safe and reliable method to deal with such lesions, mainly in symptomatic cases. The use of electrically detachable coils may be considered as an effective alternative for the endovascular occlusion of these fistulas.
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Affiliation(s)
- F Briganti
- Department of Neuroradiology, Federico II University School of Medicine, Via S. Pansini 5, 80131 Naples, Italy.
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41
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De Simone R, Marano E, Fiorillo C, Briganti F, Di Salle F, Volpe A, Bonavita V. Sudden re-opening of collapsed transverse sinuses and longstanding clinical remission after a single lumbar puncture in a case of idiopathic intracranial hypertension. Pathogenetic implications. Neurol Sci 2005; 25:342-4. [PMID: 15729498 DOI: 10.1007/s10072-004-0368-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Accepted: 12/28/2004] [Indexed: 01/09/2023]
Abstract
The aetiopathogenetic role of sinus venous obstructions carried by most idiopathic intracranial hypertension (IIH) patients is controversial. We report the case of a young woman diagnosed with IIH with papilloedema and narrowing of transverse sinuses, in which lowering of intracranial pressure by a single 20 ml cerebrospinal fluid (CSF) resulted in a strong dimensional increase of the transverse sinuses. Changes were followed by clinical remission and normalisation of optical nerve calibre, maintained after a 2-month follow-up. Our findings indicate that, although secondary to CSF hypertension, venous sinuses compression may have an important role in hypertensive status maintenance. Pathogenetic implications of venous sinus compression by hypertensive CSF in IIH are discussed.
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Affiliation(s)
- R De Simone
- Dipartimento di Scienze Neurologiche, Clinica Neurologica, Università di Napoli Federico II, Via S. Pansini 5, I-80131, Naples, Italy.
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42
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Cavallo LM, Briganti F, Cappabianca P, Maiuri F, Valente V, Tortora F, Volpe A, Messina A, Elefante A, De Divitiis E. Hemorrhagic Vascular Complications of Endoscopic Transsphenoidal Surgery. ACTA ACUST UNITED AC 2004; 47:145-50. [PMID: 15343429 DOI: 10.1055/s-2004-818489] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Two hundred and fifty consecutive patients operated on by an endoscopic endonasal transsphenoidal approach were retrospectively analyzed in order to evaluate hemorrhagic vascular complications occurring during or after the surgical procedure and their appropriate management. Vascular complications of endoscopic transsphenoidal surgery are identical to those of a microsurgical transsphenoidal approach. Damage to the sphenopalatine artery and to the internal carotid artery (ICA), which are the most frequent vascular troubles, may require technical tricks because of some aspects connected to the approach itself and of the physical properties of the endoscope. Furthermore, the progress in interventional neuroradiology in the last decades offers new solutions in respect to the past, where the use of the surgical microscope was already a tremendous progress. The anatomic substrate of each complication is discussed, along with the peculiar surgical details related to it.
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Affiliation(s)
- L M Cavallo
- Unit of Neurosurgery, Department of Neurological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy
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43
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Marano E, Briganti F, Tortora F, Elefante A, De Rosa A, Maiuri F, Filla A. Neurosyphilis with complex partial status epilepticus and mesiotemporal MRI abnormalities mimicking herpes simplex encephalitis. J Neurol Neurosurg Psychiatry 2004; 75:833. [PMID: 15145994 PMCID: PMC1739070 DOI: 10.1136/jnnp.2003.022285] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- E Marano
- Department of Neurological Sciences, Federico II University of Naples, S Pansini, 5 80131 Naples, Italy.
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44
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Bruno MC, Santangelo M, Panagiotopoulos K, Piscopo GA, Narciso N, Del Basso De Caro MI, Briganti F, Cerillo A. Bilateral chronic subdural hematoma associated with meningioma. Case report and review of the literature. J Neurosurg Sci 2003; 47:215-27; discussion 227. [PMID: 14978476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Gross intracranial hemorrhage associated with brain tumor has been reported to range from 3.6-10%. Brain metastases and malignant glioma are the most frequent underlying pathologies. Intracranial hemorrhage related to meningioma is a rare condition. Subarachnoid hemorrhage, acute subdural hematoma, intratumoral and intraparenchymal hematomas are the most common forms of bleeding associated with meningioma. By contrast, chronic subdural hematoma (cSDH) and intraventricular hemorrhage are seen less frequently. The authors report a very rare case of left fronto-parietal convexity meningioma associated with bilateral cSDH in a patient with history of recent minor head trauma and review the literature on hemorrhage associated with meningiomas.
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Affiliation(s)
- M C Bruno
- Department of Neurosurgey, Medical School, Federico II University of Naples, Naples, Italy.
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45
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Supuran CT, Briganti F, Mincione G, Scozzafava A. Protease inhibitors: Synthesis of L-alanine hydroxamate sulfonylated derivatives as inhibitors of clostridium histolyticum collagenase. J Enzyme Inhib 2003; 15:111-28. [PMID: 10938538 DOI: 10.1080/14756360009030345] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
L-alanine hydroxamate derivatives were obtained by reaction of alkyl/arylsulfonyl halides with L-alanine, followed by treatment with benzyl chloride, and conversion of the COOH moiety to the CONHOH group with hydroxylamine in the presence of carbodiimides. Other derivatives were obtained by reaction of N-benzyl-alanine with aryl isocyanates, arylsulfonyl isocyanates or benzoyl isothiocyanate, followed by a similar conversion of the COOH to the CONHOH moiety. The obtained compounds were assayed as inhibitors of Clostridium histolyticum collagenase, ChC (EC 3.4.24.3), a zinc enzyme which degrades triple helical collagen. The hydroxamate derivatives were generally 100-500 times more active than the corresponding carboxylates. In the series of synthesized derivatives, substitution patterns leading to the most potent ChC inhibitors were those involving perfluoroalkylsulfonyl- and substituted-arylsulfonyl moieties, such as pentafluorophenylsulfonyl, 3- and 4-protected-aminophenylsulfonyl-, 3- and 4-carboxy-phenylsulfonyl-, 3-trifluoromethyl-phenylsulfonyl-, or 1- and 2-naphthylsulfonyl among others. Similarly to the matrix metalloproteinase (MMP) hydroxamate inhibitors, ChC inhibitors of the type reported here must incorporate hydrophobic moieties at the P(2') and P(3') sites, in order to achieve tight binding to the enzyme.
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Affiliation(s)
- C T Supuran
- Università degli Studi, Laboratorio di Chimica Inorganica e Bioinorganica, Via Gino Capponi 7, I-50121, Florence, Italy.
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Briganti F, Tilli S, Mincione G, Mincione F, Menabuoni L, Supuran CT. Carbonic anhydrase inhibitors. metal complexes of 5-(2-chlorophenyl)-1,3,4-thiadiazole-2-sulfonamide with topical intraocular pressure lowering properties: the influence of metal ions upon the pharmacological activity. J Enzyme Inhib 2003; 15:185-200. [PMID: 10938543 DOI: 10.1080/14756360009030350] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Metal complexes of a sulfonamide possessing strong carbonic anhydrase (CA) inhibitory properties, 5-(2-chlorophenyl)-1,3,4-thiadiazole-2-sulfonamide (chlorazolamide) have been obtained from the sodium salt of the sulfonamide and the following metal ions: Mg(II), Zn(II), Mn(II), Cu(II), Co(II), Ni(II), Be(II), Cd(II), Pb(II), Al(III), Fe(III) and La(III). The original sulfonamide and its complexes were assayed for the in vitro inhibition of three CA isozymes, CA I, II, and IV, some of which play a critical role in ocular fluid secretion. All these compounds (the sulfonamide and its metal complexes) behaved as powerful inhibitors against the three investigated isozymes. The parent sulfonamide possessed an extremely weak topical pressure lowering effect when administered as a 1-2% suspension into the rabbit eye, but some of its metal complexes, such as the Mg(II), Zn(II), Mn(II) and Cu(II) derivatives, lower intraocular pressure (IOP) in experimental animals very well. Ex vivo data showed a 99.5-99.9% CA II inhibition in ocular fluids and tissues of rabbits treated with these agents, proving that the observed IOP lowering is due to CA inhibition. The influence of the different metal ions upon the efficiency of the obtained complexes as pressure lowering drugs are discussed, leading to the possibility of designing more selective/potent pharmacological agents from this class.
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Affiliation(s)
- F Briganti
- Laboratorio di Chimica Inorganica e Bioinorganica, Università degli Studi, Via Gino Capponi 7, I-50121, Florence, Italy
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47
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Briganti F, Della Seta D, Fontani G, Lodi L, Lupo C. Behavioral effects of testosterone in relation to social rank in the male rabbit. Aggress Behav 2003. [DOI: 10.1002/ab.10024] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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48
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Abstract
Freely interacting male rabbits were studied to establish the effect of exogenous testosterone on interferon-gamma (IFN-gamma) production in peripheral blood mononuclear cells (PBMCs) and to evaluate if this effect is related to season, social rank, plasma corticosterone and glucocorticoid receptors (GcR) in PBMCs. Dominance behavior increases after testosterone propionate (TP) administration only in rank 1 animals, while submission behavior increases after TP only in rank 4 animals, indicating a reinforcing effect of TP on the behavior. Corticosterone and IFN-gamma production are higher and GcR binding capacity is lower in spring than in autumn, suggesting that seasonal fluctuations in the immune system may be related to the pattern of secretion of immunomodulatory hormones. In autumn, corticosterone decreases after TP treatment and increases after social interaction, while GcR binding capacity decreases after TP treatment and social interaction. IFN-gamma production decreases in spring and increases in autumn after TP treatment plus social interaction, indicating that the modulating action of testosterone is related to the current immune status. The relationship between dominance, testosterone and the immune system in spring is suggested by the finding that GcR binding capacity after TP treatment is directly related to social rank, as confirmed by the positive correlation with dominance behavior frequency. The dominance index is positively correlated with GcR binding capacity and negatively with IFN-gamma production before TP treatment, indicating that high receptor activity in immunocompetent cells and low immunoreactivity could be prerequisites for dominance behavior. The immunosuppressive effect of corticosterone and the mechanism of down-regulation on GcR are confirmed by the negative correlations with IFN-gamma production and GcR binding capacity.
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Affiliation(s)
- Michela Muscettola
- Department of Physiology, University of Siena, Via Aldo Moro, I-53100 Siena, Italy.
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Briganti F, Cirillo S, Caranci F, Esposito F, Maiuri F. Development of "de novo" aneurysms following endovascular procedures. Neuroradiology 2002; 44:604-9. [PMID: 12136363 DOI: 10.1007/s00234-001-0732-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2001] [Accepted: 09/18/2001] [Indexed: 10/27/2022]
Abstract
Two personal cases of "de novo" aneurysms of the anterior communicating artery (ACoA) occurring 9 and 4 years, respectively, after endovascular carotid occlusion are described. A review of the 30 reported cases (including our own two) of "de novo" aneurysms after occlusion of the major cerebral vessels has shown some features, including a rather long time interval after the endovascular procedure of up to 20-25 years (average 9.6 years), a preferential ACoA (36.3%) and internal carotid artery-posterior communicating artery (ICA-PCoA) (33.3%) location of the "de novo" aneurysms, and a 10% rate of multiple aneurysms. These data are compared with those of the group of reported spontaneous "de novo" aneurysms after SAH or previous aneurysm clipping. We agree that the frequency of "de novo" aneurysms after major-vessel occlusion (two among ten procedures in our series, or 20%) is higher than commonly reported (0 to 11%). For this reason, we suggest that patients who have been submitted to endovascular major-vessel occlusion be followed up for up to 20-25 years after the procedure, using non-invasive imaging studies such as MR angiography and high-resolution CT angiography. On the other hand, periodic digital angiography has a questionable risk-benefit ratio; it may be used when a "de novo" aneurysm is detected or suspected on non-invasive studies. The progressive enlargement of the ACoA after carotid occlusion, as described in our case 1, must be considered a radiological finding of risk for "de novo" aneurysm formation.
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Affiliation(s)
- F Briganti
- Department of Neurological Sciences, Services of Neuroradiology, Federico II University, via S. Pansini 5, 80131 Naples, Italy
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Cappabianca P, Briganti F, Cavallo LM, de Divitiis E. Pseudoaneurysm of the intracavernous carotid artery following endoscopic endonasal transsphenoidal surgery, treated by endovascular approach. Acta Neurochir (Wien) 2001; 143:95-6. [PMID: 11345725 DOI: 10.1007/s007010170144] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- P Cappabianca
- Department of Neurosurgery, Federico II University, Naples, Italy
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