Leonello Tacconi

Leonello Tacconi
Azienda Ospedaliero - Universitaria "Ospedali Riuniti" Trieste · Department of Neurosurgery

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48
Publications
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Publications

Publications (48)
Article
Congenital atlas abnormalities are rare - often asymptomatic - findings, not requiring any specific treatment. They are frequently discovered, by chance, in trauma patients, in the course of the radiological work flow at the Emergency Department. In these cases they may represent a diagnostic challenge, since physicians are expected to differentiat...
Article
Background: The mean incidence of deep vein thrombosis (DVT) in neurosurgical reports is variable and surprisingly approaches 25%, whereas the incidence of pulmonary embolism (PE) is thought to be between 1.5% and 3%, with a mortality rate between 9% and 50%. Although DVT is probably the single most important, preventable cause of morbidity and mor...
Article
Full-text available
Background. Numerous reports have demonstrated how postoperative intracranial granulomas can often mimic neoplasm clinically, radiologically, and even macroscopically. Herein we present an unusual case of postsurgical intracranial aseptic granuloma secondary to a chronic inflammatory reaction without any identifiable retained foreign body. Case Des...
Article
Brain abscess continues to be a life-threatening disease. On rare occasions, this pathol-ogy can be concurrent with an intracranial neoplasia; to date, only 27 cases have been reported in literature. Intratumoral bleeding/necrosis or gaps in the blood brain barrier are supposed to facilitate a bacterial/fungal superimposition by haematogenous sprea...
Article
In a prospective study we compared the surgical outcome, length of hospital stay, complications and patient satisfaction for patients undergoing lumbar microdiscectomy (LM) under spinal anaesthesia (SA) in the sitting position (23 patients) to those of another cohort who underwent LM under general anaesthesia (GA) in the prone or genu-pectoral posi...
Article
The aim was to assess the effectiveness and safety of reconstructing a cranial bone defect after decompressive craniectomy using an autologous bone flap banked in a subcutaneous pocket in the patient's abdominal wall. A prospective pilot study was performed on 12 of 15 consecutive patients who had undergone decompressive craniotomy and subsequent a...
Article
Spontaneous spinal infection (SI) is a quite rare but serious entity. This study aimed to evaluate outcome and follow-up data of SI cases without a microbiological diagnosis (suspected SI). We undertook a retrospective, comparative study of 82 spontaneous SI cases in adults presenting over an 11-year period to two Italian hospitals. The diagnostic...
Article
Full-text available
Traditional skin sutures (TSS) and metal skin clips (SC) are the most common devices utilized for closure of surgical incisions. They are safe and effective, although they require instruments to apply them, are time consuming and, above all, create an extra staff and cost burden for removal of sutures/staples. The ideal incision closure should be s...
Article
Pharmacologic prophylaxis of deep vein thrombosis for intracranial surgery is still a controversial matter due to the concern of possible increased risk of postoperative hemorrhage. The objective of this prospective study was to assess the safety of the deep vein thrombosis prophylaxis protocol applied in our neurosurgical unit. This is a prospecti...
Article
Full-text available
The effects of decompressive craniectomy in the treatment of severe head injury remain unclear. Only very few randomized studies relating to this topic exist in the literature, including a very small number of patients with no class I evidence. We rretrospectively reviewed a series of 221 patients operated on for a head injury during a 25-month per...
Article
Idiopathic orbital eosinophilic granuloma is a rare condition which occur mainly in children and young patient involving the cranial vault more frequently than the skull base. Treatment is mainly surgical and adjuvant therapies can also be used only in selected cases. Eosinophilic granuloma is generally a solitary form of histiocytosis X which has...
Article
Full-text available
The optimal management of symptomatic cavernous sinus aneurysms remains controversial. Carotid occlusion is a simple procedure, but carries an ongoing risk of early and late stroke. Cerebral revascularisation is technically demanding and carries a risk of morbidity and mortality of around 10%. Eight patients treated with an extracranial-intracrania...
Article
Full-text available
Penetrating non-missile orbito-cranial injuries are uncommon civilian injuries which have some special features. Only limited case-reports are available in the international literature. We present a retrospective review of 18 such in presumed trivial orbital injury. Early identification and removal of retained foreign body fragments was achieved wi...
Article
A rare case of a young immunocompromised patient with calvarial tuberculosis as the first symptom of human immunodeficiency virus-1 positivity is presented and the pertinent literature is reviewed.
Article
Full-text available
Image-guided neurosurgery has become a standard practice in the last few years, with more than 2000 surgical navigation stations installed worldwide. In the same time several reports have also demonstrated the efficacy and accuracy of computed tomography angiography (CTA) in assessing cerebral vascular pathologies. Therefore, the CTA data have rece...
Preprint
Full-text available
Background Image-guided neurosurgery has become a standard practice in the last few years, with more than 2000 surgical navigation stations installed worldwide. In the same time several reports have also demonstrated the efficacy and accuracy of computed tomography angiography (CTA) in assessing cerebral vascular pathologies. Therefore, the CTA dat...
Article
Full-text available
Pneumorachis is a very rare entity to occur after a major trauma. It is even rarer when its occurrence is not associated with injuries in the skull base, chest, abdomen, pelvis, or spine. Pneumorachis extending through the entire spinal canal has never been reported. We report a case of traumatic air penetration into the spinal canal in a patient,...
Article
There have been significant developments in ultrasound technology in the last few years which have resulted in an increase in the clinical value of this technique. An illustrative case is presented of how ultrasound technology has been used in the intraoperative and postoperative period to evaluate graft patency and function in patients undergoing...
Article
In order to gain a better understanding of the clinical and histological features of central neurocytoma and the role of radiotherapy in the treatment of these tumours, we present an unusual paediatric case and review the pertinent literature. Most patients present in the second and third decade of life, rarely in the teenage years and exceptionall...
Article
An unusual case of recurrent iliac crest donor site pain secondary to heterotopic bone formation is described. The literature is reviewed with a special emphasis on the aetiology and treatment of this entity.
Article
In order to illustrate the inherent problems of managing bilateral trigeminal neuralgia a retrospective study of the 16 cases of bilateral trigeminal neuralgia, out of just over 300 cases of trigeminal neuralgia, treated over a 14-year period, has been performed. All the patients, presented with a typical history of trigeminal neuralgia and underwe...
Article
We describe the clinical presentation, neuroradiological and histological findings of an unusual case of pilocytic astrocytoma of the neurohypophysis, and discuss the related surgical and prognostic issues of this neoplasm which invaded the skull base and the sphenoid sinus. Only four histologically proven cases of such a tumour have been reported...
Article
A patient with radiologically evident superficial siderosis of the central nervous system secondary to a thalamic hamartoma is reported. Cerebral hamartomas are rare, benign congenital lesions which when vascular can cause repeated subarachnoid haemorrhages, which results in deposition of iron (haemosiderin) in the leptomeninges and in the subpial...
Article
Multiple meningiomas in different neuraxial compartments are quite rare. The authors report two new cases of association between cranial and spinal meningiomas, one of them in a patient operated upon for multiple intracranial meningiomas. The first case was a 60-year-old woman with progressive paraparesis who had been operated on 13 years earlier f...
Article
Full-text available
EDITOR—Kmietowicz reports the start of the CRASH trial, a multicentre trial of steroids for treating head injury.1 The meta-analysis which forms the basis for the trial is a good example of how one small study can potentially expose thousands of patients to unnecessary risk. The dose of steroids used in CRASH (2 g methyl prednisolone over 1 …
Article
Full-text available
The PTEN gene, located on 10q23.3, has recently been described as a candidate tumour suppressor gene that may be important in the development of advanced cancers, including gliomas. We have investigated mutation in the PTEN gene by direct sequence analysis of PCR products amplified from samples microdissected from 19 low grade (WHO Grade I and II)...
Article
Choroid plexus papillomas (CPPs) are rare, usually slow growing neoplasms. Their biological behaviour cannot be predicted in an individual case. Furthermore, the neuropathological diagnosis of these neoplasms is occasionally difficult because light and electron microscopical and immunohistochemical features may overlap with those of other neoplasms...
Article
Choroid plexus papillomas (CPPs) are neuroectodermal neoplasms constituting 0.4% to 0.6% of all central nervous system tumors; 70% to 90% of all CPPs occur in the first 2 years of life. CPPs are usually slow-growing and cause symptoms related to increased intracranial pressure because of concomitant hydrocephalus or focal neurologic signs. Up to 10...
Article
We discuss the clinical, neuroradiologic and histopathologic features of a case not apparently associated with neurofibromatosis (type 2), reviewing the relevant literature.
Article
Central neurocytoma (CN) is a rare, benign tumour of neuronal differentiation which affects young patients and is generally found in the lateral or third ventricles. Its radiological features are non-specific and, in the past, these tumours were confused with other intraventricular lesions. Only recently, thanks to their characteristic features on...
Article
From a total of 78 patients surgically treated for a spinal dural arteriovenous fistula, in whom long-term follow-up was available, 25 have been reviewed. Their outcome at different postoperative stages and the long-term prognostic factors is discussed. Excision or coagulation of the nidus, as well as disconnection of the draining vein offers bette...
Article
A rare case of monophasic synovial sarcoma of the brachial plexus with its neuroradiological and histological features is presented and the relevant literature reviewed.
Article
The presence of cerebral lesions in patients affected by the acquired immune deficiency syndrome (AIDS) has been estimated to be around 10%, with the majority being infective lesions or primary central nervous system lymphomas. The co-occurrence of a cerebral glioma in such patients is rare. The aim of this report is to present four more cases, dis...
Article
Subependymomas are benign lesions of the central nervous system. Their occurrence in the spinal cord is rare. It is important to recognize these lesions because their total surgical excision is feasible and leads to long term symptom remission-a case of a spinal subependymomas localized in the cervical region is discussed and a review of the releva...
Article
With the aim of understanding better the behaviour of an uncommon lesion such as the choroid plexus papilloma, we have analysed a surgical series of 33 cases operated on at the Neurosurgical Department, University of Rome “La Sapienza”, between 1955 and 1992 and have reviewed the relevant literature. Our results support the view that a radical rese...
Article
Abscess formation in the spinal epidural space is a very rare lesion, occurring once in 10,000 admissions to a tertiary centre and often requiring emergency neurosurgical treatment commonly presenting late. We present our experience of ten cases of spinal epidural abscess treated at our institution between January 1984 and July 1994 and review the...
Article
A rare localization of adenocarcinoma in Meckel's cave is reported in a 58-year-old woman, who had a 5-month history of pain and altered sensation in the second division of the left trigeminal nerve. Removal of the lesion was achieved by a subtemporal route. Histology showed this to be an adenocarcinoma. The patient underwent investigations for a p...
Article
An anomalous vessel is reported in a patient with an anterior circulation aneurysm. The presence of an accessory middle cerebral artery arising from the postcommunicating segment of the anterior cerebral artery is described. The clinical relevance and possible etiology of the anomaly are reviewed.
Article
Intramedullary spinal cord abscesses are rare lesions with a poor prognosis unless diagnosed and treated promptly. We report a case of a Nigerian man with tuberculous meningitis that was complicated by an intraspinal cord abscess and was treated surgically. The literature regarding this uncommon clinical entity is reviewed.
Article
Mycosis fungoides is a rare malignant T-cell lymphoma, involving mainly the skin. It can, in 50%-75% of cases, involve visceral organs and, in 11%-14% of cases, metastasize to the central nervous system. The prognosis is poor. A case with cerebral involvement is presented and the relevant literature reviewed.
Article
Posterior fossa arteriovenous malformations are uncommon lesions accounting for between 7 and 18% of all intracranial arteriovenous malformations. They have a greater incidence of haemorrhage and a higher morbidity and mortality if untreated compared with those localized in the supratentorial compartment. We report our experience with 28 cases of p...
Article
Electrocardiographic (ECG) alterations in the course of sub-arachnoid hemorrhage (SAH) have frequently been reported. The most frequent anomalies reported were lengthening of the QT interval, very negative or positive deep T waves, elevation or depression of the ST segment and the presence of U waves. We report 70 cases of SAH secondary to rupture...
Article
A case of double unruptured intracranial aneurysm associated with aortic coarctation is presented. The main characteristics of the unusual association, the diagnostic criteria and the surgical strategies are reviewed.
Article
Reporting two cases of dorsally located cervico-medullary hemangioblastomas the Authors discuss clinico-biological features, diagnosis and therapy of this vascular neoplasms, analyzing the cases reported in detail in the available literature. In this site the tumor has often an exophitic development, adhering more or less extensively to the posteri...
Article
The case of a 42-year-old man with Kartagener's syndrome (bronchiectasis, sinusitis and dextrocardia), complicated by the formation of a left occipital abscess presenting with an episode of palinopsia is reported and discussed.

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