Michela Gatta

Headache in Children With Chiari I Malformation

Headache is the most common symptom of Chiari 1 malformation, a condition characterized by the herniation of cerebellar tonsils through the foramen magnum. However, the headache pattern of cases with Chiari 1 malformations is not well defined in the literature, especially in children.

Psycho-behavioral vulnerability of adolescent binge drinkers

Introduction: the aim of this work was to study the relationship between binge drinking and psychopathological vulnerability, in terms of internalizing and externalizing problems, in adolescents, based on the assumption that binge drinkers have worse psycho-behavioral problems than nondrinkers or moderate drinkers. Materials and Methods: our analysis was conducted on a sample of 441 students aged between 14 and 17 years (mean age 15.10 years ±1.23 SD) attending several secondary schools in Padua and the surrounding province who volunteered to take part in the study. They were administered the Youth Self Report (YSR 11-18, T. Achenbach) to identify elements of psychopathological vulnerability and an ad hoc Questionnaire on Adolescents’ Saturday evenings (QASS) to obtain information on the modality and quantity of their alcohol consumption. Results: a statistically significant relationship was identified between binge drinking and psychopathological vulnerability (F(2, 433)=22.214, p=0.00000). A correlation was also reported between the adolescents’ age and their alcohol consumption, older age corresponding to more units of alcohol (UA) being consumed, i.e. consumption rose from a mean 0.2 UA at 13 years old to a mean 2 UA at 17 years of age). By number of alcohol we consider the number of drinks taken by the subjects during a night. Alcohol abuse was found associated with gender and the adolescents’ social and recreational habits (in terms of their economic resources, the time they returned home, and the places where they spent the evening). Conclusions: an association was identified between binge drinking behavior and psycho-behavioral disorders of externalizing type. Other variables that influence alcohol consumption, such as adolescents, could be monitored by the parents, if properly sensitized, this opens a perspective on preventive interventions that also involve adults.

Bilateral Perysilvian Polymicrogyria With Cerebellar Dysplasia and Ectopic Neurohypophysis

Polymicrogyria (involving or not the sylvian scissure) with cerebellar cortical dysplasia or vermis hypoplasia has been reported in few cases. In addition, the association between ectopic neurohypophysis and other cortical malformations, including bilateral perisylvian polymicrogyria, has been documented. We describe a girl affected by focal epilepsy since the age of 2 years. Magnetic resonance imaging (MRI) at 11 and 22 years of age showed bilateral perisylvian polymicrogyria, dysplasia of the left cerebellar hemisphere, and ectopic neurohypophysis. Genetic tests, including fluorescent in situ hybridization 22q11.2 and array-comparative genomic hybridization, and pituitary hormones (at the age of 20 years) were normal. The patient is now 22 years old, and she is seizure free under therapy with lamotrigine and levetiracetam. To the best of our knowledge, this is the first description of this complex cerebral malformation. This finding confirms that bilateral perisylvian polymicrogyria can be associated with other cerebral malformations; cerebellum and neurohypophysis must be carefully evaluated in patients with polymicrogyria.

Adolescents with Mental Disorders: The Efficacy of a Multiprofessional Approach

Approaches to mental health problems can historically be grouped into three theoreticalmethodological systems, i.e. the psychological, the bio-pharmacological and the socioenvironmental. Operators often tend ideologically to support one of these approaches, thereby emphasizing a distinction that originates from an old-fashioned separation between body and mind, and between individual and setting. The therapist with a biological education thus often brings the issue down to choosing the appropriate drug to eliminate the symptom; the therapist with a background in psychology is only interested in giving patients the most fitting interpretation of their symptoms to enable the latter to deal with them; and the educational therapist tends to search for social breakdowns (seen as the reason for the patient’s pathological behavior) and suggest more adequate relational models. The different types of therapist remain locked in their own world and often mistrust the other possible approaches, running the risk of misunderstanding the patient’s needs and providing only partial or ineffective intervention as a result. Many studies have focused on and compared the benefits of different treatment settings for different mental disorders (psychoses, eating disorders, mood disorders, behavioral problems, ADHD, etc), and reviewed the various treatment methods that have proved helpful in managing young patients (Bachmann et al., 2008a, 2008b; Connor et al., 2006; MTA, 2004; Velligan et al., 2009). Although different settings and a multimodal treatment approach (including individual psychotherapy, pharmacology and family-based interventions) are described and recommended, evidence-based findings on the effects of the various treatment methods are still limited (Herpertz-Dahlmann & Salbach-Andrae, 2009; Masi et al., 2008; Nutzel, Schmid, Goldbeck & Fegert, 2005; Steiner & Remsing, 2007).