Authors describe a giant intradiploic epidermoid cyst of the cranial vault with massive intra- an... more Authors describe a giant intradiploic epidermoid cyst of the cranial vault with massive intra- and extracranial extension and analyze the clinicopathological, imaging features and treatment of these lesions in the light of the most important published data. A 38-years old male patient with a history of chronic headache reported a painless subcutaneous swelling 4 months ago on the right frontoparietal scalp. CT and MRI evaluation revealed a large well-defined extracerebral mass in the frontoparietal scalp with destruction of both the inner and outer tables of the bone. The patient underwent a total microsurgical resection of the tumor and the cranial defect produced by the resection of the space-occupaying lesion was repaired with titanium wire mesh and methyl methacrylate cranioplasty. The histological examination has shown a cystic structure lined by squamous epithelium and containing laminated keratin material, aspects that are suggesting a epidermoid cyst. The patient post-operat...
The intracranial hypertension due to disorders in the cerebrospinal fluid dynamics is the intracr... more The intracranial hypertension due to disorders in the cerebrospinal fluid dynamics is the intracranial pressure increase caused by disorders of the cerebrospinal fluid circulation from at the moment of its formation at the level of the choroid plexuses and until its passage in the venous circulation. The dynamic disorders of the cerebrospinal fluid are: circulation disorders of the cerebrospinal fluid from formation to the resorption place and disorders of the cerebrospinal fluid passage in the venous drainage system (resorption). The obstructive hydrocephalus is caused by a partial or complete obstruction of the ventricular system or by a blockage of the CSF flow. Intracranial hypertension due to resorption disorders or of a meningeal cause is the intracranial pressure increase caused by the reduction in the cerebrospinal fluid resorption due to various causes, which directly affect the resorption mechanisms.
Ventriculo-peritoneal (VP) shunt placement represents the most widely accepted form of treatment ... more Ventriculo-peritoneal (VP) shunt placement represents the most widely accepted form of treatment for most patients with hydrocephalus. Despite significant improvements in VP shunt procedures, various complications remain a common situation. The diagnosis of shunt failure can be confounded by a variety of factors, mechanical failure being the most common cause of multiple shunt revisions in a lifetime. A better understanding of mechanisms of shunt failure will cause an improvement in the management of this neurosurgical procedure.
Achondroplasia is the most common form of human short-limbed dwarfism and is one of a spectrum of... more Achondroplasia is the most common form of human short-limbed dwarfism and is one of a spectrum of diseases caused by mutations in the FGFR3 gene. Achondroplasia is estimated to occur in 1 in 10,000–30,000 live births4,7. The disease is autosomal dominant, but 80% of patients have new mutations. It is commonly associated with several neurological conditions such as hydrocephalus, cervicomedullary compression, cervical or thoracic cord compression, and lumbar spinal compression due to bone stenosis along the neuraxis. We report a case with severe spinal stenosis at the lumbar and thoracic levels, with minimal involvement of the cervical spine with late neurological onset in an adult patient with achondroplasia. Neurological and radiological findings and surgical procedures are discussed. The patient was admitted with profound spastic lower paraparesis and urinary incontinence. In the first operation we performed lumbar decompression and the patient improved and on the fifth day she wa...
Acute Ischemic stroke in young patients has been increasingly diagnosed with the development of n... more Acute Ischemic stroke in young patients has been increasingly diagnosed with the development of neuroimaging technique. Early endovascular treatment can lead to significant improved functional outcome. We present a case of 19-years old boy with acute ischemic stroke by distal middle cerebral artery occlusion. A selective thrombus aspiration with Penumbra system was performed. Satisfactory recanalization was achieved with significant recovery of the patient.
The parenchymatous intracranial hypertension is the intracranial pressure increase caused by the ... more The parenchymatous intracranial hypertension is the intracranial pressure increase caused by the intracranial volume modifications due to an intrinsic parenchymatous lesion (expansive intra-parenchymatous lesion, brain edema, etc.) or an extrinsic lesion (tumor, traumatic, infectious extra-parenchymatous compression, etc.). Depending on the location and the development manner, intracranial expansive processes cause the progressive increase in the intracranial pressure and then the occurrence of the ICH syndrome by the development of a supplementary volume. Benign intracranial tumors have a slow volume increasing rate and the neurological syndrome is installed progressively, while the ICH syndrome may occur late. Malign tumors have a rapid development rate and the neurological syndrome occurs precociously. The clinical decompensation represents the aggravation of the symptomatology by the tumor extension or by exceeding the compensating capacities of the intracranial pressure increase.
Objective: To describe neuronavigation-guided percutaneous radiofrequency thermocoagulation in th... more Objective: To describe neuronavigation-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods: Neuronavigation guided percutaneous radiofrequency thermocoagulation of the Gasser ganglion was used in nine patients with trigeminal neuralgia who developed resistance to drugs used in the treatment of TN or have had adverse effects due to drug toxicity. The age of the patients was between 62 and 78 years. Results: All patients had immediate pain relief after thermocoagulation guided by neuronavigation. Neuronavigation allowed visualization of instrument position in relation to target and the related anatomical structures. The technique helped preoperative planning of the optimal trajectory for needle insertion. There were no complications of the procedure. Conclusion: Image guided percutaneous thermocoagulation in the treatment of trigeminal neuralgia is a safe and promising procedure. The technique has reduced the risk of postoperative co...
Intracerebellar hematomas are single or multiple hematic collections localized on the cerebellar ... more Intracerebellar hematomas are single or multiple hematic collections localized on the cerebellar parenchyma, with an evolution similar to an intracranial expansive process. If clinical examination opens the way to diagnose, the imagistics not only that can lead to an accurate diagnose in almost every case, but it also dictates the therapeutic strategy.Thus, our study is focused on establishing a link between imagistics and clinical presentation at the moment of patient's admission to hospital, patients with intracerebellar hematomas. Our study comprised a number of 57 patients, with an age ranging from 32 to 82 years, all of them admitted either to neurology or neurosurgery sections of Clinic Emergency Hospital, “N. Oblu”, Iasi, over a perioad of 7 years, it was retrospective, descriptive and longitudinal based on a selection of medical data taken from the medical history of the patients diagnosed with intracerebral hematoma. During our study the following aspects were taken int...
We present here some interesting points of view concerning head and brain injury with frontal sin... more We present here some interesting points of view concerning head and brain injury with frontal sinus involvement. MATERIAL AND METHODS: In general neurosurgical practice the frontal sinus traumatic involvement is about 3-5 per cent from all head trauma; we proposed to realise a extensive 5 years study to finnaly sumarise the characteristical elements for our geographical area. The amount of patients hospitalized in our clinic was about 80 000 in five years. RESULTS: Concerning our statistical data, there are 677 patients with frontal sinus injury, 490 from this were complicated with brain pathology. CONCLUSIONS: We concluded there are differences between our series and the other studies from developed countries, in our region the domestical (agricultural works) causes are about 10% higher. Language: ro
Orbital tumors are complex lesions representing a great challenge for the neurosurgeons and ophth... more Orbital tumors are complex lesions representing a great challenge for the neurosurgeons and ophthalmologist. Methods: We analyse the database for 57 patients who underwent surgery for the treatment of orbital tumors at our institution between 2001 and 2010. Data from clinical notes, surgical reports, and radiological findings were extracted for the statistical analysis. Results: Predominant symptoms were exophthalmos (68%), visual disturbance (42%) and ocular mobility limitation (37%). The most used surgical approache was superior orbitotomy. Orbital tumors histopathological results showed that hemangiomas were the most common tumors type (35%). Malignant tumors accounted for 23% of cases. Total resection of tumors was achieved in 78% of patients. Conclusion: Surgical treatment could be considered an optimal treatment option for most of the orbital tumor. A better imaging anatomy analysis of the orbit correlated with good surgical skills is needed to overcome the pitfalls of intraor...
The aim of this study was to determine the social impact of the patients suffering from lumbar di... more The aim of this study was to determine the social impact of the patients suffering from lumbar disc herniation. Although it is a very important medical condition that affects at least once in their lives more than 80% of the population at this point in time it is not analyzed in conjunction with the social and economic costs that can be generated. We have collected the data for a time span of four years from two representative hospital centers from North-East region of Romania. We took in consideration a total number of 7438 patients that were treated by surgical and physiotherapeutic means. Results showed an important correlation between medical decision making, types of medical treatment, number of days of work leave and cost per day of hospitalization. It is of high importance, when we want to reduce the social and economic burden, for the patients to be rigorously investigated and properly addressed to the right therapy treatment.
The incidence of multiple meningiomas (MMs) without stigmata of neurofibromatosis or family histo... more The incidence of multiple meningiomas (MMs) without stigmata of neurofibromatosis or family history of meningiomatosis is rare. MMs with atypical histology are even rarer, since most of them have benign histology. The authors report three cases of MMs, of which the symptomatic meningioma removed was an atypical meningioma (AM). We also review their possible pathogenesis and histopathology. Although there has not been established any MMs management and therapy strategy so far, our recommendation is to treat symptomatic and accessible lesions or growing tumours and also to prefer a conservative approach consisting of the imaging follow-up of asymptomatic lesions.
Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions loc... more Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions located in eloquent areas of the brain. On the one hand, positive mapping offers a view of the relationship between the anatomo-functional cortical organisation of the patient and the lesion, facilitating the choice of the cerebrotomy entry point and the resection until the functional borders are found. On the other hand, negative mapping does not offer certainty that the absence of the motor response, from the operative field, is the real feedback or is the result of the false-negative response. In such a situation, a differentiation between those two must be done. Materials and methods: We evaluated the results of direct cortical stimulation of lesion located in or near the primary motor area, which were diagnosticated with contrast-enhancement head MRI and admitted to the Third Department of Neurosurgery, "Prof. Dr N. Oblu” Emergency Clinical Hospital, Iasi, Romania, between January...
Even if meningiomas are the most common radio-induced tumors that occur in the adult population, ... more Even if meningiomas are the most common radio-induced tumors that occur in the adult population, the epidemiology of these types of tumors after Chernobyl nuclear accident, is still unclear. This paper aims to determine the tumoral behavior of intracranial meningiomas in North-Eastern Romania, affected by the radioactive cloud from Chernobyl nuclear accident , over a period of 25 years, namely between 1990 and 2015. Our research consists of an analytical, observational, cohort-based and retrospective study, conducted in Prof. Dr. N. Oblu Clinical Emergency Hospital of Iasi, Romania, on a group of 1287 patients diagnosed with intracranial meningiomas and operated between 1990 and 2015. In these period there was an increased number of intracranial meningiomas, with first peak between 1993-1996 and the second peak between 2007-2015, corresponding to 7-10 years and 21-30 years, after the Chernobyl accident. Regarding the annual frequency of histopathologic grading, for grade I meningiom...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagn... more Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and resp...
... with 3 mm thin sections postcontrast, centred on sella turcica and suprasellar region with T1... more ... with 3 mm thin sections postcontrast, centred on sella turcica and suprasellar region with T1WIfat suppression signal ... became diffuse, visual acuity in both eyes decreased, and diabetes insipidus remained persistent, in August 2008 a ... 23. Virik K, Turner J, Garrick R, Sheehy JP. ...
In this study, the biocompatibility and the osteogenic features of a new iron-modified alpha-tric... more In this study, the biocompatibility and the osteogenic features of a new iron-modified alpha-tricalcium phosphate (IM/alpha-TCP) and calcium sulphate dihydrate (CSD) biphasic cement (IM/alpha-TCP/CSD-BC) have been investigated in terms of the in vivo cement resorption, bone tissue formation and host tissue response on sheep animal model. Histological evaluation performed on undecalcified cement-bone specimens assessed the in vivo behaviour. It has been shown that the new IM/alpha-TCP/CSD-BC has the ability to produce firm bone binding in vivo (i.e. bioactivity). Qualitative histology proved cement biocompatibility, osteoconduction and favourable resorption, mainly through a macrophage-mediated mechanism. The results showed that the new cements have biocompatible and osteogenic features of interest as possible cancellous bone replacement biomaterial for minimally invasive spinal surgery applications.
The stent-assisted coil-jailing technique was initially introduced as an effective and secure met... more The stent-assisted coil-jailing technique was initially introduced as an effective and secure method in the treatment of large wide-necked intracranial aneurysms. Later on, this technique has proved its efficiency in the safety and optimal treatment of very small aneurysms. In this article, we will present the successful treatment of a very small middle cerebral artery aneurysm using the stent-assisted coil-jailing technique and review the current trends in this type of treatment.
Authors describe a giant intradiploic epidermoid cyst of the cranial vault with massive intra- an... more Authors describe a giant intradiploic epidermoid cyst of the cranial vault with massive intra- and extracranial extension and analyze the clinicopathological, imaging features and treatment of these lesions in the light of the most important published data. A 38-years old male patient with a history of chronic headache reported a painless subcutaneous swelling 4 months ago on the right frontoparietal scalp. CT and MRI evaluation revealed a large well-defined extracerebral mass in the frontoparietal scalp with destruction of both the inner and outer tables of the bone. The patient underwent a total microsurgical resection of the tumor and the cranial defect produced by the resection of the space-occupaying lesion was repaired with titanium wire mesh and methyl methacrylate cranioplasty. The histological examination has shown a cystic structure lined by squamous epithelium and containing laminated keratin material, aspects that are suggesting a epidermoid cyst. The patient post-operat...
The intracranial hypertension due to disorders in the cerebrospinal fluid dynamics is the intracr... more The intracranial hypertension due to disorders in the cerebrospinal fluid dynamics is the intracranial pressure increase caused by disorders of the cerebrospinal fluid circulation from at the moment of its formation at the level of the choroid plexuses and until its passage in the venous circulation. The dynamic disorders of the cerebrospinal fluid are: circulation disorders of the cerebrospinal fluid from formation to the resorption place and disorders of the cerebrospinal fluid passage in the venous drainage system (resorption). The obstructive hydrocephalus is caused by a partial or complete obstruction of the ventricular system or by a blockage of the CSF flow. Intracranial hypertension due to resorption disorders or of a meningeal cause is the intracranial pressure increase caused by the reduction in the cerebrospinal fluid resorption due to various causes, which directly affect the resorption mechanisms.
Ventriculo-peritoneal (VP) shunt placement represents the most widely accepted form of treatment ... more Ventriculo-peritoneal (VP) shunt placement represents the most widely accepted form of treatment for most patients with hydrocephalus. Despite significant improvements in VP shunt procedures, various complications remain a common situation. The diagnosis of shunt failure can be confounded by a variety of factors, mechanical failure being the most common cause of multiple shunt revisions in a lifetime. A better understanding of mechanisms of shunt failure will cause an improvement in the management of this neurosurgical procedure.
Achondroplasia is the most common form of human short-limbed dwarfism and is one of a spectrum of... more Achondroplasia is the most common form of human short-limbed dwarfism and is one of a spectrum of diseases caused by mutations in the FGFR3 gene. Achondroplasia is estimated to occur in 1 in 10,000–30,000 live births4,7. The disease is autosomal dominant, but 80% of patients have new mutations. It is commonly associated with several neurological conditions such as hydrocephalus, cervicomedullary compression, cervical or thoracic cord compression, and lumbar spinal compression due to bone stenosis along the neuraxis. We report a case with severe spinal stenosis at the lumbar and thoracic levels, with minimal involvement of the cervical spine with late neurological onset in an adult patient with achondroplasia. Neurological and radiological findings and surgical procedures are discussed. The patient was admitted with profound spastic lower paraparesis and urinary incontinence. In the first operation we performed lumbar decompression and the patient improved and on the fifth day she wa...
Acute Ischemic stroke in young patients has been increasingly diagnosed with the development of n... more Acute Ischemic stroke in young patients has been increasingly diagnosed with the development of neuroimaging technique. Early endovascular treatment can lead to significant improved functional outcome. We present a case of 19-years old boy with acute ischemic stroke by distal middle cerebral artery occlusion. A selective thrombus aspiration with Penumbra system was performed. Satisfactory recanalization was achieved with significant recovery of the patient.
The parenchymatous intracranial hypertension is the intracranial pressure increase caused by the ... more The parenchymatous intracranial hypertension is the intracranial pressure increase caused by the intracranial volume modifications due to an intrinsic parenchymatous lesion (expansive intra-parenchymatous lesion, brain edema, etc.) or an extrinsic lesion (tumor, traumatic, infectious extra-parenchymatous compression, etc.). Depending on the location and the development manner, intracranial expansive processes cause the progressive increase in the intracranial pressure and then the occurrence of the ICH syndrome by the development of a supplementary volume. Benign intracranial tumors have a slow volume increasing rate and the neurological syndrome is installed progressively, while the ICH syndrome may occur late. Malign tumors have a rapid development rate and the neurological syndrome occurs precociously. The clinical decompensation represents the aggravation of the symptomatology by the tumor extension or by exceeding the compensating capacities of the intracranial pressure increase.
Objective: To describe neuronavigation-guided percutaneous radiofrequency thermocoagulation in th... more Objective: To describe neuronavigation-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods: Neuronavigation guided percutaneous radiofrequency thermocoagulation of the Gasser ganglion was used in nine patients with trigeminal neuralgia who developed resistance to drugs used in the treatment of TN or have had adverse effects due to drug toxicity. The age of the patients was between 62 and 78 years. Results: All patients had immediate pain relief after thermocoagulation guided by neuronavigation. Neuronavigation allowed visualization of instrument position in relation to target and the related anatomical structures. The technique helped preoperative planning of the optimal trajectory for needle insertion. There were no complications of the procedure. Conclusion: Image guided percutaneous thermocoagulation in the treatment of trigeminal neuralgia is a safe and promising procedure. The technique has reduced the risk of postoperative co...
Intracerebellar hematomas are single or multiple hematic collections localized on the cerebellar ... more Intracerebellar hematomas are single or multiple hematic collections localized on the cerebellar parenchyma, with an evolution similar to an intracranial expansive process. If clinical examination opens the way to diagnose, the imagistics not only that can lead to an accurate diagnose in almost every case, but it also dictates the therapeutic strategy.Thus, our study is focused on establishing a link between imagistics and clinical presentation at the moment of patient's admission to hospital, patients with intracerebellar hematomas. Our study comprised a number of 57 patients, with an age ranging from 32 to 82 years, all of them admitted either to neurology or neurosurgery sections of Clinic Emergency Hospital, “N. Oblu”, Iasi, over a perioad of 7 years, it was retrospective, descriptive and longitudinal based on a selection of medical data taken from the medical history of the patients diagnosed with intracerebral hematoma. During our study the following aspects were taken int...
We present here some interesting points of view concerning head and brain injury with frontal sin... more We present here some interesting points of view concerning head and brain injury with frontal sinus involvement. MATERIAL AND METHODS: In general neurosurgical practice the frontal sinus traumatic involvement is about 3-5 per cent from all head trauma; we proposed to realise a extensive 5 years study to finnaly sumarise the characteristical elements for our geographical area. The amount of patients hospitalized in our clinic was about 80 000 in five years. RESULTS: Concerning our statistical data, there are 677 patients with frontal sinus injury, 490 from this were complicated with brain pathology. CONCLUSIONS: We concluded there are differences between our series and the other studies from developed countries, in our region the domestical (agricultural works) causes are about 10% higher. Language: ro
Orbital tumors are complex lesions representing a great challenge for the neurosurgeons and ophth... more Orbital tumors are complex lesions representing a great challenge for the neurosurgeons and ophthalmologist. Methods: We analyse the database for 57 patients who underwent surgery for the treatment of orbital tumors at our institution between 2001 and 2010. Data from clinical notes, surgical reports, and radiological findings were extracted for the statistical analysis. Results: Predominant symptoms were exophthalmos (68%), visual disturbance (42%) and ocular mobility limitation (37%). The most used surgical approache was superior orbitotomy. Orbital tumors histopathological results showed that hemangiomas were the most common tumors type (35%). Malignant tumors accounted for 23% of cases. Total resection of tumors was achieved in 78% of patients. Conclusion: Surgical treatment could be considered an optimal treatment option for most of the orbital tumor. A better imaging anatomy analysis of the orbit correlated with good surgical skills is needed to overcome the pitfalls of intraor...
The aim of this study was to determine the social impact of the patients suffering from lumbar di... more The aim of this study was to determine the social impact of the patients suffering from lumbar disc herniation. Although it is a very important medical condition that affects at least once in their lives more than 80% of the population at this point in time it is not analyzed in conjunction with the social and economic costs that can be generated. We have collected the data for a time span of four years from two representative hospital centers from North-East region of Romania. We took in consideration a total number of 7438 patients that were treated by surgical and physiotherapeutic means. Results showed an important correlation between medical decision making, types of medical treatment, number of days of work leave and cost per day of hospitalization. It is of high importance, when we want to reduce the social and economic burden, for the patients to be rigorously investigated and properly addressed to the right therapy treatment.
The incidence of multiple meningiomas (MMs) without stigmata of neurofibromatosis or family histo... more The incidence of multiple meningiomas (MMs) without stigmata of neurofibromatosis or family history of meningiomatosis is rare. MMs with atypical histology are even rarer, since most of them have benign histology. The authors report three cases of MMs, of which the symptomatic meningioma removed was an atypical meningioma (AM). We also review their possible pathogenesis and histopathology. Although there has not been established any MMs management and therapy strategy so far, our recommendation is to treat symptomatic and accessible lesions or growing tumours and also to prefer a conservative approach consisting of the imaging follow-up of asymptomatic lesions.
Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions loc... more Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions located in eloquent areas of the brain. On the one hand, positive mapping offers a view of the relationship between the anatomo-functional cortical organisation of the patient and the lesion, facilitating the choice of the cerebrotomy entry point and the resection until the functional borders are found. On the other hand, negative mapping does not offer certainty that the absence of the motor response, from the operative field, is the real feedback or is the result of the false-negative response. In such a situation, a differentiation between those two must be done. Materials and methods: We evaluated the results of direct cortical stimulation of lesion located in or near the primary motor area, which were diagnosticated with contrast-enhancement head MRI and admitted to the Third Department of Neurosurgery, "Prof. Dr N. Oblu” Emergency Clinical Hospital, Iasi, Romania, between January...
Even if meningiomas are the most common radio-induced tumors that occur in the adult population, ... more Even if meningiomas are the most common radio-induced tumors that occur in the adult population, the epidemiology of these types of tumors after Chernobyl nuclear accident, is still unclear. This paper aims to determine the tumoral behavior of intracranial meningiomas in North-Eastern Romania, affected by the radioactive cloud from Chernobyl nuclear accident , over a period of 25 years, namely between 1990 and 2015. Our research consists of an analytical, observational, cohort-based and retrospective study, conducted in Prof. Dr. N. Oblu Clinical Emergency Hospital of Iasi, Romania, on a group of 1287 patients diagnosed with intracranial meningiomas and operated between 1990 and 2015. In these period there was an increased number of intracranial meningiomas, with first peak between 1993-1996 and the second peak between 2007-2015, corresponding to 7-10 years and 21-30 years, after the Chernobyl accident. Regarding the annual frequency of histopathologic grading, for grade I meningiom...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagn... more Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and resp...
... with 3 mm thin sections postcontrast, centred on sella turcica and suprasellar region with T1... more ... with 3 mm thin sections postcontrast, centred on sella turcica and suprasellar region with T1WIfat suppression signal ... became diffuse, visual acuity in both eyes decreased, and diabetes insipidus remained persistent, in August 2008 a ... 23. Virik K, Turner J, Garrick R, Sheehy JP. ...
In this study, the biocompatibility and the osteogenic features of a new iron-modified alpha-tric... more In this study, the biocompatibility and the osteogenic features of a new iron-modified alpha-tricalcium phosphate (IM/alpha-TCP) and calcium sulphate dihydrate (CSD) biphasic cement (IM/alpha-TCP/CSD-BC) have been investigated in terms of the in vivo cement resorption, bone tissue formation and host tissue response on sheep animal model. Histological evaluation performed on undecalcified cement-bone specimens assessed the in vivo behaviour. It has been shown that the new IM/alpha-TCP/CSD-BC has the ability to produce firm bone binding in vivo (i.e. bioactivity). Qualitative histology proved cement biocompatibility, osteoconduction and favourable resorption, mainly through a macrophage-mediated mechanism. The results showed that the new cements have biocompatible and osteogenic features of interest as possible cancellous bone replacement biomaterial for minimally invasive spinal surgery applications.
The stent-assisted coil-jailing technique was initially introduced as an effective and secure met... more The stent-assisted coil-jailing technique was initially introduced as an effective and secure method in the treatment of large wide-necked intracranial aneurysms. Later on, this technique has proved its efficiency in the safety and optimal treatment of very small aneurysms. In this article, we will present the successful treatment of a very small middle cerebral artery aneurysm using the stent-assisted coil-jailing technique and review the current trends in this type of treatment.
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