Emanuele Occhipinti

Multiple Sclerosis Plaque Simulating Cerebral Tumor: Case Report and Review of the Literature

Multiple sclerosis rarely may present as a focal cerebral mass with clinical features and computed tomographic scan appearances of cerebral tumor. Distinguishing between these can be difficult or impossible. We report a case of a multiple sclerosis plaque involving the parietal lobe with mass effect; clinical and radiological features had led to a diagnosis of cerebral tumor.

Unilateral limited laminectomy as the approach of choice for the removal of thoracolumbar neurofibromas

Study Design. The paper reports a minimally invasive approach to the dorsolumbar spine for the removal of neurofibromas. Objectives. Demonstrating that a limited unilateral approach is the one of choice for this kind of tumors. Summary of Background Data. Spinal intradural extramedullary tumors are generally removed by single-level or multilevel laminectomy with midline dural incision. Cases of delayed postoperative kyphosis and spinal instability (6%) may be reduced by unilateral microsurgery, causing minimum damage to ligaments and joints. Methods. Ten patients with dorsolumbar neurofibroma were operated on between June 2000 and June 2002. There were 5 males (all with lumbar) and 5 females (2 with lumbar and 3 with inferior dorsal neurofibromas). One female had 3 lumbar tumors and required two operations. Surgery was performed in the prone position with a unilateral approach, sparing the joint and the ligamentum interspinosum. The dura was opened paramedially and the tumor dissected from the root and removed in one piece when possible. Water-tight dural closure was done with 5–0 or 6–0 stitches. Results. All the patients were mobilized on day 2 and discharged on day 4 or day 5. No complications resulting from the technique were observed. Static and dynamic plain radiograph films showed that none of them had kyphosis and/or instability 6 months postoperatively. Neurologic results were good. Conclusions. Hospital stay may be reduced and stability may be preserved with an appropriate microsurgical technique. The technique reported in the paper should thus become the one of choice and extended to other spinal intradural extramedullary tumors.

The transdural extension of gliomas

The extraneural spreading of gliomas is an infrequent occurrence which is not necessarily related to either tumor histology or site.This paper reports two cases, a glioblastoma and an oligodendroglioma, both presenting extradural diffusion. In the first case, where there was severe intracranial hypertension, the tumor found its way out from the neurocranium, far from the site of the operation, perforating the dura and the bone of the cranial base. In the second case, the operation may have facilitated the extraneural invasion.This unusual behaviour of glial tumors is probably less rare than presumed. It may go unnoticed if the attention is concentrated on the usually severe neurological syndrome which is present in these patients.

Angiographic Findings in some Malformations of the Brain

The angiographic patterns of some malformations of the brain, namely hydranencephaly, porencephaly, lobar holoprosencephaly, occipital en-cephalocele, Arnold-Chiari malformation and Dandy-Walker cyst,

The Direction of Blood Flow in the Cervical Cord

A study of retrograde brachial angiograms of 47 infants and children in which the anterior spinal artery of the cervical cord was visualised, the aim being to establish the directio

Spinal Chordomas in Infancy

Chordomas are extremely rare among the spinal tumors in pediatric age. The sacrococcygeal region is the typical site of such a lesion. A case of spinal chordoma in a child 4 years old, at the T12

Retrograde Brachial Angiography in the Diagnosis of Infratentorial Tumor in Infancy and Childhood

On the basis of 146 angiographic studies performed by retrograde brachial injection in patients aged 10 days – 10 years, this study analyzes normal arterial and venous pattern of the vertebro-basilar