Bernardo Fraioli

Publications (53) View all

• Article: Transsphenoidal removal of huge pituitary adenomas with marked suprasellar extension: Results with modified surgical technique.

  Mario Francesco Fraioli, Elisabetta Catena, Mario Lecce, Bernardo Fraioli
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  ABSTRACT: OBJECTIVE: A modified transsphenoidal technique to remove huge pituitary adenomas with marked suprasellar extension (4.5-8cm of maximum diameter) is presented. METHODS: The technique allowed to avoid the occurrence of a precocious descent of the suprasellar cisternal plane into the sellar plane during tumour removal and its related consequences (incomplete tumour removal, occurrence of cerebrospinal fluid leak, prolonged time of postoperative stay in hospital). Technique is performed opening at the beginning only the lateral parts of peritumoral dura mater, leaving the central part of the dura mater in support of the central part of tumour and suprasellar cisternal plane. After removal of lateral parts of the tumour, the central part of peritumoral dura mater is opened and the central intra- and supra-sellar parts of the tumour are removed. RESULTS: Total removal was accomplished in 64% and 45% in groups two and one respectively. Intraoperative CSF leak occurred in 2.4% and 22.5% respectively in groups two and one. Postoperative CSF fistula did not occur in group two, while it occurred in 7.4% of patients of group one. Average time of postoperative stay in hospital was 4.3 and 8.2 days in groups two and one respectively. CONCLUSION: The presented modified transsphenoidal microsurgical technique for removal of huge pituitary adenomas allowed to achieve better results than patients operated by standard transsphenoidal surgery.
  Clinical neurology and neurosurgery 07/2012; · 1.30 Impact Factor
• Article: Extended transsphenoidal microsurgical approach for diaphragma sellae and tuberculum meningiomas.

  M F Fraioli, L Moschettoni, R Floris, E Catena, B Fraioli
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  ABSTRACT: Diaphragma sellae meningiomas represent a difficult challenge for neurosurgeons; they are generally operated on by a transcranial approach. Some authors reported transsphenoidal surgery in selected cases, but without accurately focusing the surgical technique that should be necessary for removing the typical hard fibrous tissue of the meningioma, that is not aspirable, by this approach. We present the surgical technique and the useful instrumentarium for removing a diaphragma sellae meningioma through an extended microsurgical transsphenoidal approach.
  min - Minimally Invasive Neurosurgery 10/2009; 52(5-6):267-70. · 0.70 Impact Factor
• Article: Fibrous dysplasia of the clivus with a second T8 bone lesion: case report.

  Filiberto Contratti, Filiberto Contratt, Agazio Menniti, Mario Francesco Fraioli, Bernardo Fraioli
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  ABSTRACT: We present a rare case of a probably poliostotic fibrous dysplasia of the clivus in a young woman with a clival and vertebral involvement. We also compare our case with data reported in tables that include all cases of clival fibrous dysplasia present in literature. Thirty-year-old women presented with headache. We reviewed radiological and clinical literature before surgery. It was possible to perform a preoperative diagnosis of fibrous dysplasia of the clivus so it was possible to adopt a minimally invasive surgical approach on the clivus. The diagnosis of fibrous dysplasia of the clivus was confirmed after the operation. As the patient was asymptomatic, we did not operate on the vertebral lesion which was stable after 1 year. We draw the conclusion that it is possible to obtain a correct preoperative diagnosis of fibrous dysplasia based on magnetic resonance imaging and computed tomographic scans; this makes it possible to avoid major surgical operations. The reported case is particularly interesting because apart from the clival fibrous dysplasia, a vertebral involvement of the same type can be assumed; this association has never been reported in literature.
  Surgical Neurology 03/2006; 65(2):202-5; discussion 205-6. · 1.67 Impact Factor
• Article: Calcifying pseudo-tumor of the spine: description of a case and review of the literature.

  Giovanni Liccardo, Pierpaolo Lunardi, Agazio Menniti, Roberto Floris, Francesco Saverio Pastore, Bernardo Fraioli
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  ABSTRACT: A case of calcifying pseudo-tumor of the thoracic spine, a rare lesion with tumor-like behavior and a probable inflammatory-reactive origin, is described. The clinical-pathological and neuro-radiological aspects of this lesion are discussed in relation to surgical treatment. In accordance with the other cases reported in the literature, the case observed confirmed the benign behavior of the lesion and the effectiveness of surgical treatment for achieving complete resolution of clinical symptoms without any recurrences, even when removal is only subtotal.
  European Spine Journal 11/2003; 12(5):548-51. · 1.97 Impact Factor
• Article: Calcifying pseudo-tumor of the spine: description of a case and review of the literature

  Giovanni Liccardo, Pierpaolo Lunardi, Agazio Menniti, Roberto Floris, FrancescoSaverio Pastore, Bernardo Fraioli
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  ABSTRACT: A case of calcifying pseudo-tumor of the thoracic spine, a rare lesion with tumor-like behavior and a probable inflammatory-reactive origin, is described. The clinical-pathological and neuro-radiological aspects of this lesion are discussed in relation to surgical treatment. In accordance with the other cases reported in the literature, the case observed confirmed the benign behavior of the lesion and the effectiveness of surgical treatment for achieving complete resolution of clinical symptoms without any recurrences, even when removal is only subtotal.
  European Spine Journal 09/2003; 12(5):548-551. · 1.97 Impact Factor