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Article ; Online: Letter: Development of a Novel Device for Decompressive Craniectomy: An Experimental and Cadaveric Study and Preliminary Clinical Application.

Berra, Luigi Valentino / Armonda, Rocco Anthony

Operative neurosurgery (Hagerstown, Md.)

2023 Volume 25, Issue 6, Page(s) e382–e383

MeSH term(s)	Humans ; Decompressive Craniectomy ; Brain Ischemia/surgery ; Cadaver
Language	English
Publishing date	2023-10-12
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.0000000000000948
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Article ; Online: Radiological and surgical aspects of polymorphous low-grade neuroepithelial tumor of the young (PLNTY).

Armocida, Daniele / Berra, Luigi Valentino / Frati, Alessandro / Santoro, Antonio

Acta neurologica Belgica

2023 Volume 123, Issue 2, Page(s) 327–340

Abstract: Background: Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a low-grade epilepsy-associated tumor recently introduced in WHO 2021 classification. Since it has been recognized as an independent nosological entity, PLNTY has been ... ...

Abstract	Background: Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a low-grade epilepsy-associated tumor recently introduced in WHO 2021 classification. Since it has been recognized as an independent nosological entity, PLNTY has been mainly studied from a genetic and molecular perspective, not recognizing unique characteristic clinical and radiological features. Methods: A systematic literature research has been conducted aiming to identify all relevant studies about the radiological, clinical and surgical features of PLNTY. We described a representative case of a 45-year-old man treated with awake-surgery with confirmed diagnosis of PLNTY, reporting the radiological and surgical characteristics through imaging and intra-operative video. We performed a statistical meta-analysis attempting to assess the presence of relationships between surgical and radiologic tumor characteristics and clinical outcome and type of surgery. Results: A total of 16 studies were included in the systematic review. The final cohort was composed of 51 patients. Extent of resection (EOR) and outcome are not significantly associated with the different genetic profiling (p = 1), the presence of cystic intralesional component, calcification (p = 0.85), contrast-enhancing and lesion boundaries (p = 0.82). No significant correlation there is between EOR and remission or better control of epilepsy-related symptoms (p = 0.38). The contrast enhancement in the tumor is significantly associated with recurrence or poor control of epileptic symptoms (p = 0.07). Conclusions: In PLNTYs, contrast enhancement seems to impact prognosis, recurrence, and seizure control much more than radiological features, genetic features and type of resection of the tumor.
MeSH term(s)	Male ; Humans ; Middle Aged ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Brain Neoplasms/pathology ; Neoplasms, Neuroepithelial/diagnostic imaging ; Neoplasms, Neuroepithelial/genetics ; Neoplasms, Neuroepithelial/surgery ; Radiography ; Epilepsy/genetics ; Seizures/complications
Language	English
Publishing date	2023-03-10
Publishing country	Italy
Document type	Meta-Analysis ; Case Reports ; Journal Article ; Review
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-023-02231-z
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Article ; Online: Vascular intracranial malformations and dementia: An under-estimated cause and clinical correlation. Clinical note.

Berra, Luigi Valentino / Armocida, Daniele / D'Angelo, Luca / Norcia, Valerio Di / Santoro, Antonio

Cerebral circulation - cognition and behavior

2022 Volume 3, Page(s) 100146

Abstract: Cerebrovascular malformations (CVMs) such as arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) represent a possible source of intracranial hemorrhage, but these malformations can also manifest with neurologic disorders secondary ... ...

Abstract	Cerebrovascular malformations (CVMs) such as arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) represent a possible source of intracranial hemorrhage, but these malformations can also manifest with neurologic disorders secondary to ischemic penumbra from vascular steal. In the latter case, the clinical manifestations are less obvious and characteristic, and may include a varied clinical spectrum ranging from focal deficits to generalized malfunction of the brain parenchyma resulting in dementia. Dementias secondary to CVMs constitute a probably underestimated subpopulation of patients of great interest because they present with devastating but potentially reversible cognitive impairment. We examined the pertinent literature regarding the clinical manifestations of CVMs characterized by cognitive impairment and describe the distinctive clinical features. Our results confirm that cognitive impairment is one of the clinical manifestations of CVMs and is a frequently misrecognized and often late-diagnosed cause of reversible dementia.
Language	English
Publishing date	2022-05-18
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-2450
ISSN (online)	2666-2450
DOI	10.1016/j.cccb.2022.100146
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Article: Dorsal epidural "Spindle Cell Lipoma" in a pregnant female.

di Norcia, Valerio / Berra, Luigi Valentino / D'Angelo, Luca / Santoro, Antonio

Surgical neurology international

2021 Volume 12, Page(s) 162

Abstract: Background: Spindle cell lipoma (SCL) constitutes just 1.5% of all lipomatous tumors. They typically occur in the upper back and shoulders. Here, we report a 37-year-old female presenting with a SCL in the dorsal epidural thoracic spine, during her 9: ...

Abstract	Background: Spindle cell lipoma (SCL) constitutes just 1.5% of all lipomatous tumors. They typically occur in the upper back and shoulders. Here, we report a 37-year-old female presenting with a SCL in the dorsal epidural thoracic spine, during her 9 Case description: A 37-year-old female presented with a subacute (2 months) progressive paraparesis during her Conclusion: SCL represents a variant of benign lipomas that may occur in the dorsal thoracic spine. Gross total excision may be followed by a benign clinical course without recurrence or malignant degeneration. Very atypical SCLs need closer follow-up to avoid the misdiagnosis of liposarcoma.
Language	English
Publishing date	2021-04-14
Publishing country	United States
Document type	Case Reports
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_128_2021
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Article ; Online: Awake Surgery for Arteriovenous Malformations in Eloquent Areas Does Not Increase Intraoperative Risks and Allows for Shorter-Term Recovery and Improved Status.

Armocida, Daniele / D'Angelo, Luca / Berra, Luigi Valentino / Pesce, Alessandro / di Palma, Veronica / Galati, Gaspare / Frati, Alessandro / Santoro, Antonio

World neurosurgery

2022 Volume 164, Page(s) e1015–e1023

Abstract: Background: Arteriovenous malformations (AVMs) located in eloquent areas are associated with a significant risk of neurologic deterioration. Awake surgery applied to intracranial AVMs could better identify eloquent areas, but its feasibility and ... ...

Abstract	Background: Arteriovenous malformations (AVMs) located in eloquent areas are associated with a significant risk of neurologic deterioration. Awake surgery applied to intracranial AVMs could better identify eloquent areas, but its feasibility and application are controversial and limited to small case series. Methods: We retrospectively reviewed a group of 59 brain AVMs located in eloquent areas surgically treated with asleep craniotomy and compared it with a combined group of patients treated with awake craniotomy. Patients were stratified into 2 groups: patients who underwent asleep surgery and patients who underwent awake surgery. With this study, we aimed to perform a complete analysis of surgical risks and outcomes for this subgroup of patients in order to provide a basis for a future prospective study. Results: We compared the asleep group of 25 patients and the awake group of 34 patients. No statistically significant differences were identified regarding the risk of postoperative complications, surgical radicality, presence of residual, and need for adjuvant treatment (P = 1.00). The improvement in Karnofsky Performance Status (KPS) was more rapid and effective during follow-up in patients treated with awake surgery compared with asleep surgery (KPS at day 30 >70%-80% versus 87.2%, P = 0.01 and at 1year KPS >70%-80% vs. 96.9%, P = 0.02). Conclusions: In contrast to what is commonly believed, applying awake surgery to this lesion does not involve increased intraoperative risks. Still, it seems to determine a significant improvement in the outcome of patients from postoperative day 30 onwards.
MeSH term(s)	Brain Neoplasms/surgery ; Craniotomy ; Humans ; Intracranial Arteriovenous Malformations/surgery ; Prospective Studies ; Retrospective Studies ; Wakefulness
Language	English
Publishing date	2022-05-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2022.05.085
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Article ; Online: Corrigendum to "Surgical management of giant calcified thoracic disc herniation and the role of neuromonitoring. The outcome of large mono centric series" [J. Clin. Neurosci. 100 (2022) 37-45].

Armocida, Daniele / D'Angelo, Luca / Paglia, Francesco / Pedace, Francesca / De Giacomo, Tiziano / Berra, Luigi Valentino / Frati, Alessandro / Santoro, Antonio

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2022 Volume 107, Page(s) 8

Language	English
Publishing date	2022-11-29
Publishing country	Scotland
Document type	Published Erratum
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2022.11.012
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Article ; Online: Role of endoscopic surgical biopsy in diagnoses of intraventricular/periventricular tumors: review of literature including a monocentric case series.

D'Angelo, Luca / Armocida, Daniele / Sampirisi, Luigi / Paglia, Francesco / Berra, Luigi Valentino / Santoro, Antonio

Acta neurologica Belgica

2020 Volume 120, Issue 3, Page(s) 517–530

Abstract: The intra- and periventricular location tumor (IPVT) of a brain remains a hard challenge for the neurosurgeon because of the deep location and eloquent anatomic associations. Due to this high risk of iatrogenic injury, many surgeons elect to perform ... ...

Abstract	The intra- and periventricular location tumor (IPVT) of a brain remains a hard challenge for the neurosurgeon because of the deep location and eloquent anatomic associations. Due to this high risk of iatrogenic injury, many surgeons elect to perform biopsies of such lesions to establish a diagnosis. On the one hand, stereotaxic needle biopsy (SNB) is a minimally invasive procedure but with a significant risk of complications and a high risk of lack of tissue for molecular analyses for this region [Fukushima in Neurosurgery 2:110-113 (1978)]; on the other hand, the use of endoscopic intraventricular biopsy (EIB) allows for diagnosis with minimal surgical intervention [Iwamoto et al. in Ann Neurol 64(suppl. 6):628-634 (2008)]. IPVTs and related CSF pathway obstructions can be safely and effectively treated with endoscopic techniques. It is not possible to compare EIB with diagnoses made by any other method or with the established treatment. We aim to analyze the accuracy of EIB results by comparing them with results of biopsies performed later, in other methods and thereby evaluating the treatment evolution considering our personal experience. The difficulties and complications encountered are presented and compared with those reported in the literature to obtain the best review possible for this topic. A systematic review of literature was done using MEDLINE, the NIH Library, PubMed, and Google Scholar yielded 1.951 cases for EIB and 1912 for SNB, according to standard systemic review techniques. Review was conducted on 50 studies describing surgical procedures for lesions intra- and para-ventricular. The primary outcome measure was a diagnostic success. We also consider 20 patients with IPVT treated in our department. Clinical characteristics and surgical outcome were evaluated and a systematic review of the literature was performed. Overall, all our biopsies were diagnostic, with a positive histologic sample in 100% of our patients. 8 patients underwent a concurrent endoscopic third ventriculostomy. 4 patients underwent a concurrent ventriculostomy combined with septostomy. For 1 patient was necessary the only septostomy combined with biopsy. Every case has obtained a histological diagnosis. The percentage of complications was very low with only 1 case of post-operative infection and 1 case of hemorrhage. It was impossible to create a specific comparison from literature data of IPVTs between a stereotactic and endoscopic procedure, it presents only the collection of pineal gland tumor [Kelly in Neurosurgery 25(02):185-194 (1989); Quick-Weller in World Neurosurgery 96:124-128 (2016)] or unknown location of the lesion in major review [Marenco-Hillembrand et al. in Front Oncol 8:558 (2018)]. The present study aims to report our experience with the surgical management of IPVTs. The EIB sample yields an accurate histologic diagnosis tumor, with a positive histologic sample in 87, 95% of patients. The choice of the appropriate procedure should consider not only the preference and the experience of the neurosurgeon but also the several other variables as the location. While some periventricular lesions are better approached by endoscopic techniques, others are more suited for stereotactic-guided approaches. The ability to perform an EIB and relieve tumor-associated hydrocephalus by neuroendoscopy is considered to be a benefit of this procedure since this is less invasive than other treatments.
MeSH term(s)	Adult ; Aged ; Biopsy/methods ; Brain Neoplasms/diagnosis ; Cerebral Ventricle Neoplasms/diagnosis ; Female ; Humans ; Male ; Middle Aged ; Neuroendoscopy/methods ; Ventriculostomy/methods
Language	English
Publishing date	2020-02-27
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-020-01299-1
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Article ; Online: A rare case of Meckel's cave primary lymphoma: a case report and elaboration of the diagnostic algorithm.

Paglia, Francesco / di Norcia, Valerio / D'Angelo, Luca / Berra, Luigi Valentino / Santoro, Antonio

Acta neurologica Belgica

2020 Volume 121, Issue 4, Page(s) 907–914

Abstract: Management of lesions involving Meckel's cave can represent a challenge for neurosurgeons, because of the deep-seated location and the surrounding complex neurovascular structures. Very small lesions arising from MC are generally asymptomatic and ... ...

Abstract	Management of lesions involving Meckel's cave can represent a challenge for neurosurgeons, because of the deep-seated location and the surrounding complex neurovascular structures. Very small lesions arising from MC are generally asymptomatic and radiological follow-up with head MRI and PET-CT is sufficient to control these lesions. In rare cases, the rapid increase in the size of lesions and the alteration of the neurologic status make early histological characterization mandatory in the plethora of lesions arising from Meckel's cave; a very small percentage is represented by central nervous system lymphomas. Primary diffuse large B-cell lymphoma is the most commonly found. Aggressive surgery, in case of suspicious Meckel's cave lesions, is strongly discouraged, because this procedure may increase the risk of postoperative deficit and provides no survival benefit compared with biopsy alone. The aim of the present paper is to report a very rare case of primary Meckel's cave diffuse large B-cell lymphoma (only seven cases were described in literature) and standardize an operative algorithm to avoid the risks of an incorrect surgical conduct.
MeSH term(s)	Algorithms ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Cranial Fossa, Middle/diagnostic imaging ; Humans ; Lymphoma/diagnostic imaging ; Lymphoma/drug therapy ; Male ; Middle Aged ; Skull Base Neoplasms/diagnostic imaging ; Skull Base Neoplasms/drug therapy
Language	English
Publishing date	2020-01-25
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-020-01281-x
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Article ; Online: Intracranial capillary hemangiomas: literature review in pediatric and adult population.

Santoro, Giorgio / Piccirilli, Manolo / Chiarella, Vito / Greco, Nicoletta / Berra, Luigi Valentino / Santoro, Antonio

Neurosurgical review

2020 Volume 44, Issue 4, Page(s) 1977–1985

Abstract: Capillary hemangiomas (CHs) of the central nervous system represent a rare diagnosed pathology. CHs are benign vascular tumors whose most common manifestations are dermal and mucous and mainly occur during childhood or adolescence, while the involvement ... ...

Abstract	Capillary hemangiomas (CHs) of the central nervous system represent a rare diagnosed pathology. CHs are benign vascular tumors whose most common manifestations are dermal and mucous and mainly occur during childhood or adolescence, while the involvement of the central nervous system can occur in a wider age range. We conducted a PubMed research on literature published until March 2020. We only enrolled cases with histological documented presence of intracranial CH. For every case collected, we analyzed age, sex, localization, neuroimaging studies performed, the presence of extracranial CHs, symptoms, neurological deficits, extent of surgical resection (biopsy, partial or gross total), adjunct treatment received (radiotherapy, chemotherapy, Trans-Arterial Embolization TAE), and outcome. Up to March 2020, the literature review identified 52 cases to which we added the case of our personal experience. The mean age was 26 with slightly female prevalence (28 F, 25 M). The most common presenting symptom was headache (21 cases, 40%). The surgical treatment consisted of biopsy in 7 cases (13%), partial resection in 10 cases (19%), gross total resection in 31 cases (58.5%), biopsy followed by total resection in 2 cases (3%), and partial resection followed by total resection in 1 case (1.5%), and the diagnosis was obtained from an autopsy sample in 1 case (1.5%). For symptomatic lesions, surgery is a valid option to obtain histological characterization, neurological improvement, and where possible a total resection. Stereotactic radiotherapy can be used if the lesion is not surgically approachable or as an adjuvant treatment in case of partial resection, having shown good results in terms of long-term disease control.
MeSH term(s)	Adolescent ; Adult ; Biopsy ; Brain Neoplasms/diagnosis ; Brain Neoplasms/epidemiology ; Brain Neoplasms/therapy ; Child ; Female ; Hemangioma ; Hemangioma, Capillary/diagnosis ; Hemangioma, Capillary/epidemiology ; Hemangioma, Capillary/surgery ; Humans ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-10-20
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-020-01419-8
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Article: Far lateral lumbar disc herniation part 1: Imaging, neurophysiology and clinical features.

Berra, Luigi Valentino / Di Rita, Andrea / Longhitano, Federico / Mailland, Enrico / Reganati, Paolo / Frati, Alessandro / Santoro, Antonio

World journal of orthopedics

2021 Volume 12, Issue 12, Page(s) 961–969

Abstract: Far lateral lumbar disc herniations (FLLDH) represent a separate category of disc pathology which includes both intraforaminal and extraforaminal lumbar disc herniations, that are characterized by a peculiar clinical presentation, diagnostic and ... ...

Abstract	Far lateral lumbar disc herniations (FLLDH) represent a separate category of disc pathology which includes both intraforaminal and extraforaminal lumbar disc herniations, that are characterized by a peculiar clinical presentation, diagnostic and treatment modalities as compared to the more frequent median and paramedian disc hernias. Surgical treatment often represents the only effective weapon for the cure of this disease and over the years different approaches have been developed that can reach the region of the foramen or external to it, with different degrees of invasiveness. The diagnosis is more demanding and still underestimated as it requires a more detailed knowledge in the spine anatomy and dedicated radiological studies. Computerized tomography and in particular magnetic resonance imaging are the appropriate tools for the diagnosis of FLLDH. Despite the widespread use of these diagnostic tests, many cases of FLLDH are overlooked due to insufficiently detailed radiological examinations or due to the execution of exams not focused to the foraminal or the extraforaminal region. Neurophysiological studies represent a valid aid in the diagnostic classification of this pathology and in some cases they can facilitate the differential diagnosis with other types of radiculopathies. In the present study, a comprehensive review of the clinical presentation, epidemiology, radiological study and the neurophysiological aspects is presented.
Language	English
Publishing date	2021-12-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v12.i12.961
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