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  1. Article ; Online: Bicentenary of Domenico Cotugno: the four experiments that marked a turning point on the modern research of cerebrospinal fluid.

    Longatti, Pierluigi

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2022  Volume 38, Issue 10, Page(s) 1839–1843

    Language English
    Publishing date 2022-09-22
    Publishing country Germany
    Document type Editorial
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-022-05666-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Liebau phenomenon: a translational approach to new paradigms of CSF circulation and related flow disturbances.

    Longatti, Pierluigi

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2017  Volume 34, Issue 2, Page(s) 227–233

    Abstract: Purpose: The aim of the study is to provide a comparison between Liebau's effect, underlying the working principles of impedance pumps, and the cerebrospinal fluid (CSF) circulation.: Methods: Gerhard Liebau was a cardiologist with a specific ... ...

    Abstract Purpose: The aim of the study is to provide a comparison between Liebau's effect, underlying the working principles of impedance pumps, and the cerebrospinal fluid (CSF) circulation.
    Methods: Gerhard Liebau was a cardiologist with a specific interest in severe aortic regurgitation. Such interest drew his scientific attention to the flow-driven efficiency of valveless pumps. During one of his experiments, he assembled two rubber tubes of different sizes and documented how water could be aspirated against gravity when the tube of larger diameter underwent rhythmic compression. He subsequently tested an elastic tube connected to glass pipes of the same size on both ends, immersed in a water bucket. When the elastic tube was periodically pumped with a finger, a net flow could be observed in both directions; depending on the pumping site on the elastic tube, the flow was directed towards the most closely connected glass tube. The principles of a hydraulic system of different elasticity and compliance were also recently applied to the physiology and fluid dynamics of embryonic hearts.
    Results: Impedance pumps and the CSF dynamics model are both valveless systems and can both be activated by the effects of the cardiac cycle. The novel hydraulic model of impedance pumps was the foundation for the development of modern valveless micropumps and contributes to explain how the embryonic valveless tubular heart is capable of generating blood flow.
    Conclusions: Liebau's effect and the mechanism of impedance pumps can enlighten some of the aspects of CSF dynamics and related flow disturbances.
    MeSH term(s) Aortic Valve Insufficiency/diagnosis ; Aortic Valve Insufficiency/physiopathology ; Cardiology/instrumentation ; Cardiology/methods ; Cerebrospinal Fluid/physiology ; Embryonic Development/physiology ; Humans ; Pulsatile Flow/physiology ; Translational Medical Research/instrumentation ; Translational Medical Research/methods
    Language English
    Publishing date 2017-11-09
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-017-3653-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Roof of the 4th Ventricle Seen From Inside: Endoscopic Anatomic Illustration-A Case Series.

    Longatti, Pierluigi / Feletti, Alberto / Basaldella, Luca / Boaro, Alessandro / Sala, Francesco / Fiorindi, Alessandro

    Operative neurosurgery (Hagerstown, Md.)

    2023  Volume 25, Issue 1, Page(s) 11–19

    Abstract: Background: The anatomy of the roof of the fourth ventricle has been illustrated in many laboratory investigations, but in vivo reports of the roof anatomy and its variants are still lacking.: Objective: To describe the topographical anatomy of the ... ...

    Abstract Background: The anatomy of the roof of the fourth ventricle has been illustrated in many laboratory investigations, but in vivo reports of the roof anatomy and its variants are still lacking.
    Objective: To describe the topographical anatomy of the roof of the fourth ventricle explored through a transaqueductal approach that overcomes cerebrospinal fluid depletion, displaying in vivo anatomic images possibly quite close to normal physiological conditions.
    Methods: We critically reviewed the intraoperative video recordings of our 838 neuroendoscopic procedures, selecting 27 cases of transaqueductal navigation that provided good quality image details of the anatomy of the roof of the fourth ventricle. Twenty-six patients affected by different forms of hydrocephalus were therefore categorized into three groups: Group A: blockage of the aqueduct-aqueductoplasty, Group B: communicating hydrocephalus, and Group C: tetraventricular obstructive hydrocephalus.
    Results: Group A has shown what the roof of a normal fourth ventricle really looks like albeit the structures seemed overcrowded because of the narrow space. Images from groups B and C paradoxically allowed a more distinct identification of the roof structures flattened by ventricular dilation, making them more comparable with the topography traced on the laboratory microsurgical studies.
    Conclusion: Endoscopic in vivo videos and images provided a novel anatomic view and an in vivo redefinition of the real topography of the roof of the fourth ventricle. The relevant role of cerebrospinal fluid was defined and outlined, as well as the effects of hydrocephalic dilation on some structures on the roof of the fourth ventricle.
    MeSH term(s) Humans ; Fourth Ventricle/diagnostic imaging ; Fourth Ventricle/surgery ; Cerebral Aqueduct/diagnostic imaging ; Cerebral Aqueduct/surgery ; Neuroendoscopy/methods ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/surgery ; Neuroendoscopes
    Language English
    Publishing date 2023-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1227/ons.0000000000000669
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Where the central canal begins: endoscopic in vivo description.

    Longatti, Pierluigi / Fiorindi, Alessandro / Marton, Elisabetta / Sala, Francesco / Feletti, Alberto

    Journal of neurosurgery

    2021  Volume 136, Issue 3, Page(s) 895–904

    Abstract: Objective: Although evidence and descriptions of the central canal (CC) along the medulla oblongata and the spinal cord have been provided by several anatomical and radiological studies, a clear picture and assessment of the opening of the CC, or ... ...

    Abstract Objective: Although evidence and descriptions of the central canal (CC) along the medulla oblongata and the spinal cord have been provided by several anatomical and radiological studies, a clear picture and assessment of the opening of the CC, or apertura canalis centralis (ACC), into the fourth ventricle is lacking, due to its submillimetric size and hidden position in the calamus scriptorius.
    Methods: The authors reviewed all of their cases in which patients underwent ventricular transaqueductal flexible endoscopic procedures and selected 44 cases in which an inspection of the region of the calamus scriptorius had been performed and was suitable for study inclusion. Patients were divided into different groups, based on the presence or absence of a chronic pathological process involving the fourth ventricle. In each case, the visual appearance of the opening of the CC of the ACC was classified as no evidence (A0), indirect evidence (A1), or clear evidence (A2). Morphometric measurements were inferred from surrounding structures and the size of surgical tools visible in the field.
    Results: The opening of the CC could be clearly observed in all cases (A1 4.5%, A2 95.5%). In normal cases, a lanceolate shape along the median sulcus was most frequently found, with an average size of 600 × 250 µm that became rounded and smaller in size in cases of hydrocephalus. The distance between the caudal margin of the ACC and the obex was about 1.8 mm in normal cases, 2.1 mm in cases of obstructive hydrocephalus, and 1 mm in cases of normal pressure hydrocephalus. The two wings of the area postrema, variable in size and shape, were sited just caudal to the opening.
    Conclusions: A flexible scope inserted through the cerebral aqueduct can approach the hidden calamus scriptorius like a pen fits into an inkpot. With this privileged viewpoint, the authors provide for the first time, to their knowledge, a clear and novel vision of the opening of the CC in the fourth ventricle, along with the precise location of this tiny structure compared to other anatomical landmarks in the inferior triangle.
    MeSH term(s) Cerebral Aqueduct/pathology ; Cerebral Aqueduct/surgery ; Fourth Ventricle/surgery ; Humans ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/pathology ; Hydrocephalus/surgery ; Hydrocephalus, Normal Pressure/surgery ; Medulla Oblongata ; Neuroendoscopy/methods ; Ventriculostomy/methods
    Language English
    Publishing date 2021-08-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2020.12.JNS203649
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Development of Cerebral Endoscopy in Italy: Background, Narration, and Legacy.

    Longatti, Pierluigi / Fiorindi, Alessandro / Bruscella, Sara / Cappabianca, Paolo

    World neurosurgery

    2019  Volume 134, Page(s) 396–401

    Abstract: Bibliometric analysis shows that neuroendoscopy (NE) overcame its pioneering phase in the late 1980s, and became a significant technological and clinical innovation in the early 1990s. During those years the charge-coupled device digital video cameras ... ...

    Abstract Bibliometric analysis shows that neuroendoscopy (NE) overcame its pioneering phase in the late 1980s, and became a significant technological and clinical innovation in the early 1990s. During those years the charge-coupled device digital video cameras were introduced and videoendoscopy had its decisive breakthrough, laying the foundation for NE take-off. NE can be considered an early product of artificial intelligence, as much as neuroimaging and neuronavigation. In Italy, cerebral NE started in 1993 and, despite a couple of years of relative delay, gained ground rapidly thanks also to the personal contribution of Michelangelo Gangemi (1949-2017), to whose memory this article is dedicated. In this paper we try to re-create the history of Italian NE through original documents and other testimonials, in the context of the general worldwide development of NE. The modality of its rapid diffusion throughout our peninsula seems a good paradigm of how cooperation without unnecessary competition can be rewarding and constructive.
    MeSH term(s) History, 20th Century ; Humans ; Italy ; Neuroendoscopy/history
    Language English
    Publishing date 2019-11-04
    Publishing country United States
    Document type Historical Article ; Journal Article ; Review
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2019.10.165
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: "Brain-walker" (Italy, 1992): focus on the neglected story of one of the very first neuronavigators.

    Longatti, Pierluigi / Fiorindi, Alessandro / Gioffrè, Giorgio / Canova, Giuseppe / Carteri, Alessandro

    Journal of neurosurgical sciences

    2019  Volume 64, Issue 2, Page(s) 221–223

    MeSH term(s) History, 20th Century ; Humans ; Italy ; Neuronavigation/history
    Language English
    Publishing date 2019-02-04
    Publishing country Italy
    Document type Historical Article ; Journal Article
    ZDB-ID 193139-8
    ISSN 1827-1855 ; 0390-5616 ; 0026-4881
    ISSN (online) 1827-1855
    ISSN 0390-5616 ; 0026-4881
    DOI 10.23736/S0390-5616.19.04651-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Domenico Felice Cotugno and the rationale of his discovery of CSF.

    Longatti, Pierluigi

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2008  Volume 24, Issue 2, Page(s) 161–162

    MeSH term(s) Anatomy/history ; Cerebrospinal Fluid ; History, 18th Century ; History, 19th Century ; Medical Illustration ; Neurology/history ; Portraits as Topic
    Language English
    Publishing date 2008-02
    Publishing country Germany
    Document type Historical Article ; Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-007-0458-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Stereotactic injection of nondiffusible dyes.

    Feletti, Alberto / Longatti, Pierluigi

    Journal of neurosurgery

    2015  Volume 123, Issue 2, Page(s) 475

    MeSH term(s) Brain Neoplasms/surgery ; Coloring Agents ; Female ; Glioma/surgery ; Humans ; Indigo Carmine ; Male ; Neuronavigation/methods ; Neurosurgical Procedures/methods
    Chemical Substances Coloring Agents ; Indigo Carmine (D3741U8K7L)
    Language English
    Publishing date 2015-08
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2014.12.JNS142909
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Opto-chiasmatic apoplexy as a compartment syndrome? Anatomical and surgical considerations on two bleeding cavernous malformations.

    Fiorindi, Alessandro / Gallinaro, Paolo / Marton, Elisabetta / Canova, Giuseppe / Fontanella, Marco M / Longatti, Pierluigi

    Clinical neurology and neurosurgery

    2020  Volume 201, Page(s) 106439

    Abstract: Objective: Opto-chiasmatic (OC) cavernous malformations are sporadic lesions that are often misdiagnosed clinically and radiologically. Presenting symptoms range from incidental findings to the more frequent and dramatic "chiasmal apoplexy." The present ...

    Abstract Objective: Opto-chiasmatic (OC) cavernous malformations are sporadic lesions that are often misdiagnosed clinically and radiologically. Presenting symptoms range from incidental findings to the more frequent and dramatic "chiasmal apoplexy." The present study aims to evaluate the potential role of arachnoidal membranes of the basal cisterns in the onset of OC apoplexy. A possible mechanism resembling a compartment syndrome is discussed through the description of two cases of bleeding cavernomas.
    Methods: We describe clinical, radiological, intraoperative findings in two cases of young patients presenting with OC apoplexy from bleeding cavernoma. The first was a 38-year-old man diagnosed with optic neuritis at the first episode of visual acuity deterioration. The second patient was a 22 -year-old woman who suffered two OC apoplexy episodes from a recurrence, which also presented with bleeding.
    Results: Both patients were operated on via pterional craniotomy and presented a postoperative improvement of visual symptoms. The second patient experienced deterioration 30 months after surgical resection due to rebleeding from a recurrence and required a second operation. Follow-up revealed a good recovery of visual disturbances; MRI at 6 and 3 years showed in both patients an apparent complete removal of the cavernous malformations.
    Conclusion: The cisternal environment where OC cavernous malformations develop and the paradigm of a compartment syndrome could explain the clinical presentation variability. This very rare subset of cavernomas would benefit from a classification system using ad hoc neuroimaging protocols and consistent indications.
    MeSH term(s) Adult ; Compartment Syndromes/etiology ; Female ; Hemangioma, Cavernous/complications ; Hemangioma, Cavernous/pathology ; Hemangioma, Cavernous/surgery ; Hemorrhage/etiology ; Humans ; Male ; Optic Chiasm/pathology ; Optic Nerve Neoplasms/complications ; Optic Nerve Neoplasms/pathology ; Optic Nerve Neoplasms/surgery ; Stroke/etiology ; Young Adult
    Language English
    Publishing date 2020-12-15
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 193107-6
    ISSN 1872-6968 ; 0303-8467
    ISSN (online) 1872-6968
    ISSN 0303-8467
    DOI 10.1016/j.clineuro.2020.106439
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Treatment of Posttubercular Syringomyelia Not Responsive to Antitubercular Therapy: Case Report and Review of Literature.

    Canova, Giuseppe / Boaro, Alessandro / Giordan, Enrico / Longatti, Pierluigi

    Journal of neurological surgery reports

    2017  Volume 78, Issue 2, Page(s) e59–e67

    Abstract: Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after ... ...

    Abstract Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after successful chemotherapy. We reviewed the literature related to posttubercular syringomyelia treatment and suggest a new combined surgical approach. A 25-year-old Nigerian male patient presented with legs numbness, urinary disturbance, and legs weakness. Spinal magnetic resonance revealed a T5-T7 syringomyelia, secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis. Adhesiolysis by direct visualization with a flexible endoscope was performed and a handmade S-italic syringe-subdural shunt was placed to restore CSF flow. During the postoperative course, the neurological deficits improved together with the resolution of the syrinx. Long-term magnetic resonance imaging follow-up documented no recurrences or shunt displacements. We suggest that, when antitubercular therapy is not effective to resolve postarachnoiditis syrinx, arachnolysis with a flexible endoscope together with the placement of an S-italic shunt allowed free CSF communication between the syrinx and the subarachnoid space. Furthermore, we support that the use of an s-shaped shunt could prevent displacement or migration of the device and allows an easier revision in case of acute or late complications.
    Language English
    Publishing date 2017-03-17
    Publishing country Germany
    Document type Case Reports
    ZDB-ID 2653397-2
    ISSN 2193-6366 ; 2193-6358
    ISSN (online) 2193-6366
    ISSN 2193-6358
    DOI 10.1055/s-0037-1601327
    Database MEDical Literature Analysis and Retrieval System OnLINE

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