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Article ; Online: Severe stroke in patients admitted to intensive care unit after COVID-19 infection: Pictorial essay of a case series.

Deana, Cristian / Bagatto, Daniele

Brain hemorrhages

2021 Volume 3, Issue 1, Page(s) 29–35

Abstract: Patients infected by COVID-19 could require intensive care unit admission especially due to acute respiratory failure. However, neurological manifestations are very common. Among these, ischemic stroke or cerebral hemorrhage may have unfavorable outcome. ...

Abstract	Patients infected by COVID-19 could require intensive care unit admission especially due to acute respiratory failure. However, neurological manifestations are very common. Among these, ischemic stroke or cerebral hemorrhage may have unfavorable outcome. The mechanisms leading to cerebral damage by SARS-CoV2 are still under debate. One of the most accepted theories implies an endothelial activation which in turns increase the risk of thrombus formation with the development of stroke, either ischemic or hemorrhagic. The more severe the COVID-19 disease, the higher the risk of stroke. Stroke in ICU patients are not frequent, but cerebral hemorrhage has devastating effects with high mortality. In these pictorial essay of case reports, main clinical aspects are discussed, along with a summary of the evidence about pathophysiology and treatment of these patients.
Language	English
Publishing date	2021-12-13
Publishing country	Netherlands
Document type	Case Reports
ISSN	2589-238X
ISSN (online)	2589-238X
DOI	10.1016/j.hest.2021.12.002
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Article: Double osseous flaps for simultaneous midfacial and mandible reconstruction: Automation in surgical complexity within an entirely computerized workflow.

Tel, Alessandro / Bagatto, Daniele / Sembronio, Salvatore / Ferrari, Silvano / Robiony, Massimo

Frontiers in oncology

2023 Volume 13, Page(s) 1103104

Abstract: Introduction: Broad maxillofacial surgical resections involving both the midface and the mandible represent a challenge in terms of reconstruction. Although several papers have explored the possibility of simultaneously using two microsurgical flaps, ... ...

Abstract	Introduction: Broad maxillofacial surgical resections involving both the midface and the mandible represent a challenge in terms of reconstruction. Although several papers have explored the possibility of simultaneously using two microsurgical flaps, reports on the implementation of a dual osseous flap strategy are limited, and mainly addressed to static anatomical reconstruction, regardless of functional implications. In particular, there is a lack in the literature of a unifying protocol which illustrates how technology including virtual planning, statistical shape modeling, virtual occlusion, 3D-printing and patient-specific implants can address the functional and accuracy needs required for an optimal reconstruction. Materials and methods: In this paper, the Authors present their preliminary experience in a two-center study, showing how broad maxillofacial defects, requiring a simultaneous reconstruction in both the mandible and the midface, can be successfully reconstructed using the combination of two osseous flaps in an automated sequence in which all steps are anticipately defined in a virtual plan, accounting for the optimal alignment of temporomandibular joint, predicting the final occlusion and defining a mandibular shape according to a statistical shape model. Results: Average RMSE for the iliac bone crest flap was of 3.2 ± 0.36 mm; for the fibula flap, RMSE value was of 2.3 ± 0.65 mm, for patient-specific implants, for mandibular prostheses the average RMSE was 2.46 mm with 0.76 mm standard deviation. Temporomandibular joint function increased when a TMJ prosthesis was placed. Conclusions: Double bone free flap is a valuable resource to reconstruct wide defects that simultaneously involve two thirds of the cranio-maxillo-facial skeleton, but a careful virtual planning study should be always performed before approaching this surgical option.
Language	English
Publishing date	2023-02-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1103104
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Article ; Online: Correlation does not mean causation: Proofs of COVID-19 associated strokes!

Deana, Cristian / Vetrugno, Luigi / Bagatto, Daniele

Brain hemorrhages

2022

Language	English
Publishing date	2022-10-28
Publishing country	Netherlands
Document type	Journal Article
ISSN	2589-238X
ISSN (online)	2589-238X
DOI	10.1016/j.hest.2022.10.006
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Article ; Online: Infratentorial Multinodular and Vacuolating Neuronal Tumor or Multinodular and Vacuolating Posterior Fossa Lesions of Unknown Significance? Clinico-Radiologic Findings from 2 Cases.

Morassi, Mauro / Bagatto, Daniele

World neurosurgery

2020 Volume 136, Page(s) 58–61

Abstract: Background: Infratentorial multinodular lesions resembling multinodular and vacuolating neuronal tumor of the cerebrum (MVNT) have been indicated in literature with 2 different names reflecting alternative perspectives: multinodular and vacuolating ... ...

Abstract	Background: Infratentorial multinodular lesions resembling multinodular and vacuolating neuronal tumor of the cerebrum (MVNT) have been indicated in literature with 2 different names reflecting alternative perspectives: multinodular and vacuolating posterior fossa lesions of unknown significance (MV-PLUS), suggesting that these lesions may belong to a new entity, and MVNT of the brain, assuming that they actually correspond to infratentorial MVNT. Because of the limited number of cases reported and the absence of histopathologic data, it is unclear which denomination should be used. Cases description: Two patients, a 41-year-old man (case 1) suffering headache and a 44-year-old man (case 2) with vertigo, underwent magnetic resonance imaging (MRI) examination. MRI showed, in both cases, multinodular lesions involving the vermis, broadly extending to the superior part of the right cerebellar hemisphere in case 1, and involving the superior paravermian part of the left cerebellar hemisphere in case 2. The follow-up period was 3 years in case 1 and 14 years in case 2. Conclusions: Infratentorial lesions show nodules with cystic or cyst-like signal intensity on MRI, a feature infrequently reported in supratentorial MVNT, and may involve the cortex. No variations were noted during a prolonged follow-up supporting the benign behavior of these lesions.
MeSH term(s)	Adult ; Cerebellar Neoplasms/complications ; Cerebellar Neoplasms/diagnostic imaging ; Cerebellar Neoplasms/physiopathology ; Headache/etiology ; Humans ; Infratentorial Neoplasms/complications ; Infratentorial Neoplasms/diagnostic imaging ; Infratentorial Neoplasms/physiopathology ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Neoplasms, Neuroepithelial/complications ; Neoplasms, Neuroepithelial/diagnostic imaging ; Neoplasms, Neuroepithelial/physiopathology ; Perfusion Imaging ; Vertigo/etiology
Language	English
Publishing date	2020-01-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2019.12.166
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Article: Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach.

Tel, Alessandro / Bagatto, Daniele / Costa, Fabio / Sembronio, Salvatore / Robiony, Massimo

Frontiers in oncology

2022 Volume 12, Page(s) 875990

Abstract: Objective/hypothesis: This study describes the design and application of a novel advanced protocol for virtual three-dimensional anatomical reconstruction of the deep facial compartments, aiming to improve the preoperative understanding and the ... ...

Abstract	Objective/hypothesis: This study describes the design and application of a novel advanced protocol for virtual three-dimensional anatomical reconstruction of the deep facial compartments, aiming to improve the preoperative understanding and the intraoperative assistance in complex resective surgeries performed for malignant diseases which extend in complex spaces, including the pterygomaxillopalatine fossa, the masticator space, and the infratemporal fossa. Methods: This study is a non-profit, retrospective, and single-institution case series. The authors clearly describe in detail imaging acquisition protocols which are suitable to segment each target, and a multilayer reconstruction technique is presented to simulate anatomical structures, with particular focus on vascular networks. Virtual surgical planning techniques are individually designed for each case to provide the most effective access to the deep facial compartments. Intraoperative guidance systems, including navigation and virtual endoscopy, are presented, and their role is analyzed. Results: The study included seven patients with malignant disease located in the deep facial compartments requiring radical resection, and all patients underwent successful application of the protocol. All lesions, except one, were subject to macroscopically radical resection. Vascular structures were identified with overall reconstruction rates superior to 90% for major caliber vessels. Prominent landmarks for virtual endoscopy were identified for each case. Conclusions: Virtual surgical planning and multilayer anatomical reconstruction are valuable methods to implement for surgeries in deep facial compartments, providing the surgeon with improved understanding of the preoperative condition and intraoperative guidance in critical phases for both open and endoscopic phases. Such techniques allow to tailor each surgical access, limiting morbidity to strictly necessary approaches to reach the disease target.
Language	English
Publishing date	2022-05-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.875990
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Article ; Online: A multinodular and vacuolating neuronal tumor of the cerebrum (MVNT) with glioma-like appearance.

Bagatto, Daniele / Ius, Tamara / Pegolo, Enrico / Morassi, Mauro

Acta neurologica Belgica

2020 Volume 121, Issue 6, Page(s) 1851–1854

MeSH term(s)	Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/pathology ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/pathology ; Female ; Glioma/diagnostic imaging ; Glioma/pathology ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Seizures/diagnostic imaging ; Seizures/etiology
Language	English
Publishing date	2020-07-06
Publishing country	Italy
Document type	Case Reports ; Letter
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-020-01426-y
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Article ; Online: Disseminated nocardiosis after cladribine treatment for relapsing remitting multiple sclerosis: a case report.

Deana, Cristian / Bagatto, Daniele / Battezzi, Alessandra / Pecori, Davide / Lorenzut, Simone / Tuniz, Francesco

Journal of neurology

2022 Volume 269, Issue 8, Page(s) 4557–4559

MeSH term(s)	Cladribine/adverse effects ; Humans ; Immunosuppressive Agents/adverse effects ; Multiple Sclerosis ; Multiple Sclerosis, Relapsing-Remitting/complications ; Multiple Sclerosis, Relapsing-Remitting/diagnostic imaging ; Multiple Sclerosis, Relapsing-Remitting/drug therapy ; Nocardia Infections/diagnosis ; Nocardia Infections/drug therapy
Chemical Substances	Immunosuppressive Agents ; Cladribine (47M74X9YT5)
Language	English
Publishing date	2022-03-30
Publishing country	Germany
Document type	Case Reports ; Letter
ZDB-ID	187050-6
ISSN	1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
ISSN (online)	1432-1459
ISSN	0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
DOI	10.1007/s00415-022-11097-9
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Article ; Online: The Role of Advanced MRI Sequences in the Diagnosis and Follow-Up of Adult Brainstem Gliomas: A Neuroradiological Review.

Guarnera, Alessia / Romano, Andrea / Moltoni, Giulia / Ius, Tamara / Palizzi, Serena / Romano, Allegra / Bagatto, Daniele / Minniti, Giuseppe / Bozzao, Alessandro

Tomography (Ann Arbor, Mich.)

2023 Volume 9, Issue 4, Page(s) 1526–1537

Abstract: The 2021 WHO (World Health Organization) classification of brain tumors incorporated the rapid advances in the molecular, genetic, and pathogenesis understanding of brain tumor pathogenesis, behavior, and treatment response. It revolutionized brain tumor ...

Abstract	The 2021 WHO (World Health Organization) classification of brain tumors incorporated the rapid advances in the molecular, genetic, and pathogenesis understanding of brain tumor pathogenesis, behavior, and treatment response. It revolutionized brain tumor classification by placing great emphasis on molecular types and completely splitting adult-type and pediatric-type diffuse gliomas. Brainstem gliomas (BSGs) are the leading primary tumors of the brainstem, although they are quite uncommon in adults compared with the pediatric population, representing less than 2% of adult gliomas. Surgery is not always the treatment of choice since resection is rarely feasible and does not improve overall survival, and biopsies are not generally performed since the location is treacherous. Therefore, MRI (Magnetic Resonance Imaging) without and with gadolinium administration represents the optimal noninvasive radiological technique to suggest brainstem gliomas diagnosis, plan a multidisciplinary treatment and for follow-up evaluations. The MRI protocol encompasses morphological sequences as well as functional and advanced sequences, such as DWI/ADC (Diffusion-Weighted Imaging/Apparent Diffusion Coefficient), DTI (Diffusion Tensor Imaging), PWI (Perfusion-Weighted Imaging), and MRS (Magnetic Resonance Spectroscopy), which improve the accuracy of the diagnosis of BSGs by adding substantial information regarding the cellularity, the infiltrative behavior toward the v fiber tracts, the vascularity, and the molecular changes. Brainstem gliomas have been divided into four categories on the basis of their MRI radiological appearance, including diffuse intrinsic low-grade gliomas, enhancing malignant gliomas, localized tectal gliomas, and other forms. The aim of our review is to provide insight into the role of advanced MRI sequences in the diagnosis and follow-up of adult brainstem gliomas.
MeSH term(s)	Adult ; Child ; Humans ; Diffusion Tensor Imaging ; Follow-Up Studies ; Magnetic Resonance Imaging ; Brain Stem Neoplasms/diagnostic imaging ; Brain Stem Neoplasms/therapy ; Glioma/diagnostic imaging ; Glioma/therapy
Language	English
Publishing date	2023-08-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2379-139X
ISSN (online)	2379-139X
DOI	10.3390/tomography9040122
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Article: Isolated insular stroke: topography is the answer with respect to outcome and cardiac involvement.

Kuris, Fedra / Tartaglia, Sara / Sperotto, Roberto / Ceccarelli, Laura / Bagatto, Daniele / Lorenzut, Simone / Merlino, Giovanni / Janes, Francesco / Gentile, Carolina / Marinig, Roberto / Verriello, Lorenzo / Valente, Mariarosaria / Pauletto, Giada

Frontiers in neurology

2024 Volume 15, Page(s) 1332382

Abstract: Background and purpose: Isolated insular strokes (IIS) are a rare occurrence due to the frequent concomitant involvement of adjacent territories, supplied by the M2 segment of the middle cerebral artery (MCA), and clinical aspects are sometimes ... ...

Abstract	Background and purpose: Isolated insular strokes (IIS) are a rare occurrence due to the frequent concomitant involvement of adjacent territories, supplied by the M2 segment of the middle cerebral artery (MCA), and clinical aspects are sometimes contradictory. We aimed to describe clinical and radiological characteristics of a pure IIS case series, focusing on its functional outcome and cardiac involvement. Methods: We identified 15 isolated insular ischemic strokes from a pool of 563 ischemic strokes occurred between January 2020 and December 2021. Data collection consisted of demographic and baseline clinical characteristics, comorbidities, electrocardiograms, echocardiograms, stroke topography and etiology, reperfusive treatments, and outcome measures. Descriptive statistical analysis was carried out. Results: Newly detected cardiovascular alterations were the prevalent atypical presentation. Cardioembolism was the most frequent etiology. Most of patients had major neurological improvement at discharge and good outcome at 3-months follow-up. Discussion and conclusion: IIS are extremely rare, representing according to our study about 2.6% ischemic strokes cases per year, and patients have peculiar clinical manifestations, such as dysautonomia and awareness deficits. Our data suggest the possibility for these patients to completely recover after acute ischemic stroke notwithstanding the pivotal role of the insula in cerebral connections and the frequent association with MCA occlusion. Moreover, given the central role of the insula in regulating autonomic functions, newly detected cardiac arrhythmias must be taken into consideration, as well as a full diagnostic work-up for the research of cardioembolic sources. To our knowledge, this is the largest monocentric case series of IIS and it might be useful for future systematic reviews.
Language	English
Publishing date	2024-02-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2024.1332382
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Article ; Online: Intravoxel incoherent motion magnetic resonance imaging in the assessment of brain microstructure and perfusion in idiopathic normal-pressure hydrocephalus.

Bagatto, Daniele / Piccolo, Daniele / Fabbro, Sara / Copetti, Stefano / D'Agostini, Serena / De Colle, Maria Cristina / Belgrado, Enrico / Tereshko, Yan / Valente, Mariarosaria / Vindigni, Marco / Tuniz, Francesco

Neuroradiology

2024 Volume 66, Issue 4, Page(s) 557–566

Abstract: Purpose: To determine the relationship between intravoxel incoherent motion (IVIM) MRI parameters and clinical changes post-tap test (TT) in idiopathic normal-pressure hydrocephalus (iNPH) patients.: Methods: Forty-four probable iNPH patients ... ...

Abstract	Purpose: To determine the relationship between intravoxel incoherent motion (IVIM) MRI parameters and clinical changes post-tap test (TT) in idiopathic normal-pressure hydrocephalus (iNPH) patients. Methods: Forty-four probable iNPH patients underwent 3 T MRI before and after TT. IVIM parameters were calculated from eight different bilateral regions of interest in basal ganglia, centrum semiovale, and corona radiata. Patients were categorized based on TT response into positive (group 1) and negative (group 2) groups. A Welch two-sample t-test was used to compare differences in D, D, f, and ADC between the two groups, while a paired t-test was employed to assess the changes within each group before and after TT. These parameters were then correlated with clinical results. Results:* In the lenticular and thalamic nuclei, D value was significantly lower in the group 1 compared to group 2 both pre- and post-TT (p = 0.002 and p = 0.007 respectively). Post-TT, the positive response group exhibited a notably reduced D* value (p = 0.012) and significantly higher f values (p = 0.028). In the corona radiata and centrum semiovale, a significant post-TT reduction in D* was observed in the positive response group (p = 0.017). Within groups, the positive response cohort showed a significant post-TT increase in ADC (p < 0.001) and a decrease in D* (p = 0.007). Conclusion: IVIM permits the acquisition of important non-invasive information about tissue and vascularization in iNPH patients. Enhanced perfusion in the lenticular and thalamic nuclei may suggest the role of re-established microvascular and glymphatic pathways, potentially elucidating the functional improvement in motor function after TT in iNPH patients.
MeSH term(s)	Humans ; Diffusion Magnetic Resonance Imaging/methods ; Magnetic Resonance Imaging ; Perfusion ; White Matter ; Hydrocephalus ; Motion
Language	English
Publishing date	2024-01-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-024-03291-5
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