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ABSTRACT: The primary aim of this study is to report the long-term outcome of pineal and suprasellar germinoma after stereotactic biopsy and whole brain radiotherapy. The second purpose is to report an investigation of the biological features and cell kinetics of this peculiar and enigmatic brain tumour. Of 34 supratentorial germ cell tumours diagnosed and treated between 1980 and 1993, 20 patients were found to be affected by true germinoma localized in the pineal and/or suprasellar regions. The diagnosis was achieved by stereotactic biopsy in all cases. In 14 patients, the potential proliferative activity of the tumour was investigated by (3H)thymidine in vitro binding and labelling index determination. Chorionic gonadotropin, alpha-fetoprotein and embryonal carcinoma antigen were negative in the cerebrospinal fluid of these patients. All but 1 patient underwent whole brain radiotherapy. Clinical and neuroradiological follow-up ranged between 3 and 13 years (mean 8). Complete clinical and neuroradiological recovery was achieved in all patients after treatment. Fatal recurrences owing to neuraxis dissemination occurred in three cases. The labelling index in the whole series ranged between 0.1 and 5% (median 2.5). Only syncytiotrophoblastic cells had proliferative activity, while none of the lymphoid-like cells showed thymidine labelling.
Journal of Neurology 10/1998; 245(9):593-7. · 3.47 Impact Factor
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Movement Disorders 02/1996; 11(1):102-4. · 4.51 Impact Factor
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ABSTRACT: We give a description of stereotaxic methodology as originally elaborated by the S.te Anne Hospital School in Paris, and successively modified and utilised in Niguarda Hospital in Milan. Performing a stereotactic arteriography and ventriculography should allow the appreciation of minimal modification of vascular anatomy, identification of sulci and gyri by utilising stereoscopic technique and the proportional grid, based on bicommissural line, evaluation of the morphological abnormalities and their precise reconstruction in the intracranial space. Anatomical information obtained by this kind of examinations are essential for intracerebral stereo-EEG investigation and for planning surgical procedure.
Chirurgia italiana 02/1996; 48(6):35-8.
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ABSTRACT: The anterior interosseous nerve can become entrapped within the antecubital fossa at its origin from the median nerve, which results in the so-called Kiloh-Nevin syndrome. In this report, the authors describe an atypical anterior interosseous nerve syndrome due to neurovascular relationships with the anterior interosseous artery. The patient complained of unbearable analgesic-resistant pain within the forearm and focal myokymia in muscles innervated by branches of the anterior interosseous and distal median nerves. Pain and myokymia were alleviated by inflated blood pressure cuff compression in the bicipital region when the arterial pulse was abolished distally. Microsurgical correction of the pulsatile arterial compression resulted in relief from pain and myokymia. Neurophysiological considerations of the mechanism underlying "irritative" neuropathy and myokymia are discussed.
Journal of Neurosurgery 05/1995; 82(4):578-80. · 2.96 Impact Factor
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ABSTRACT: The natural history of 70 patients affected by low-grade astrocytomas was recorded after the histological diagnosis was obtained by serial stereotactic biopsy. Forty-three percent of these patients died within 3 years. The value of cell kinetics assessment at the time of stereotactic biopsy was investigated, and the labeling index percent may be considered the most accurate prognostic factor in these histologically homogeneous astrocytomas. It has been confirmed that the young age of patients predicts a more favorable course, but the value of this also seems to be linked to and dependent on cell kinetics. These data are discussed in view of the opportunity to perform more aggressive "cytoreductive" treatments in deep brain tumors when these indices support an expected poor prognosis.
Neurosurgery 12/1994; 35(5):817-20; discussion 820-1. · 2.79 Impact Factor
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ABSTRACT: One hundred patients affected by multifocal brain lesions were investigated by serial stereotactic biopsy. Systemic diseases and primary neoplasms elsewhere were previously ruled out. The histological diagnosis obtained in this series comprises malignant gliomas in 37% of patients; primary non-Hodgkin's brain lymphoma in 15%; metastatic brain tumours in 15% (no evidence of the primary tumour at the time of stereotactic surgery); low grade gliomas in 12%; infective diseases in 10% (including brain abscesses and multifocal viral encephalitis); and ischaemic lesions in 6%. In addition, two patients with germinomas, two with primitive neuroepithelial tumours, two with multiple telangiectases, and one with a teratoma were also included in this series. Histological findings obtained by stereotactic procedures guided the choice of treatment, avoiding the risks of blind treatments. Indications and future perspectives for stereotactic surgery in multifocal brain lesions are discussed with emphasis on advances in diagnostic and therapeutic tools.
Journal of Neurology Neurosurgery & Psychiatry 09/1994; 57(8):957-60. · 4.76 Impact Factor
