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Article ; Online: Surgical management of skull base meningiomas and vestibular schwannomas.

Gambacciani, Carlo / Grimod, Gianluca / Sameshima, Tetsuro / Santonocito, Orazio S

2022 Volume 34, Issue 6, Page(s) 713–722

Abstract: Purpose of review: The aim of this study is to discuss surgical management of meningiomas and schwannomas of skull base.: Recent findings: Meningiomas and schwannomas are typically benign neoplasm with a good prognosis after surgery. Patients should ... ...

Abstract	Purpose of review: The aim of this study is to discuss surgical management of meningiomas and schwannomas of skull base. Recent findings: Meningiomas and schwannomas are typically benign neoplasm with a good prognosis after surgery. Patients should be treated individually related to several features: size and localization of tumor and its proximity with deep critical neurovascular structures, neurological status, age and comorbidity. Also, the widespread use of neuroimaging and the progressive and constant aging of the populations inevitably result in the increase of detection rate of incidental (asymptomatic) neoplasm.Nowadays, there are still controversies about the correct management strategy. Summary: Surgery represents the gold standard treatment, with the objective of gross total resection; however, it is not always feasible due to localization, encasement of neuro-vascular structure, invasion of cranial nerve and brain parenchyma. Stereotactic radiosurgery and radiation therapy are important to achieve a satisfactory functional outcome and tumor control in case of residue or recurrence. A multidisciplinary approach is pivotal.
MeSH term(s)	Humans ; Meningeal Neoplasms/diagnostic imaging ; Meningeal Neoplasms/surgery ; Meningioma/diagnostic imaging ; Meningioma/surgery ; Neuroma, Acoustic/surgery ; Radiosurgery/methods ; Retrospective Studies ; Skull Base/pathology ; Skull Base Neoplasms/diagnostic imaging ; Skull Base Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2022-09-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049384-0
ISSN	1531-703X ; 1040-8746
ISSN (online)	1531-703X
ISSN	1040-8746
DOI	10.1097/CCO.0000000000000904
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Article ; Online: Exploring Regorafenib Responsiveness and Uncovering Molecular Mechanisms in Recurrent Glioblastoma Tumors through Longitudinal In Vitro Sampling.

Morelli, Mariangela / Lessi, Francesca / Franceschi, Sara / Ferri, Gianmarco / Giacomarra, Manuel / Menicagli, Michele / Gambacciani, Carlo / Pieri, Francesco / Pasqualetti, Francesco / Montemurro, Nicola / Aretini, Paolo / Santonocito, Orazio Santo / Di Stefano, Anna Luisa / Mazzanti, Chiara Maria

Cells

2024 Volume 13, Issue 6

Abstract: Glioblastoma, a deadly brain tumor, shows limited response to standard therapies like temozolomide (TMZ). Recent findings from the REGOMA trial underscore a significant survival improvement offered by Regorafenib (REGO) in recurrent glioblastoma. Our ... ...

Abstract	Glioblastoma, a deadly brain tumor, shows limited response to standard therapies like temozolomide (TMZ). Recent findings from the REGOMA trial underscore a significant survival improvement offered by Regorafenib (REGO) in recurrent glioblastoma. Our study aimed to propose a 3D ex vivo drug response precision medicine approach to investigate recurrent glioblastoma sensitivity to REGO and elucidate the underlying molecular mechanisms involved in tumor resistance or responsiveness to treatment. Three-dimensional glioblastoma organoids (GB-EXPs) obtained from 18 patients' resected recurrent glioblastoma tumors were treated with TMZ and REGO. Drug responses were evaluated using NAD(P)H FLIM, stratifying tumors as responders (Resp) or non-responders (NRs). Whole-exome sequencing was performed on 16 tissue samples, and whole-transcriptome analysis on 13 GB-EXPs treated and untreated. We found 35% (n = 9) and 77% (n = 20) of tumors responded to TMZ and REGO, respectively, with no instances of TMZ-Resp being REGO-NRs. Exome analysis revealed a unique mutational profile in REGO-Resp tumors compared to NR tumors. Transcriptome analysis identified distinct expression patterns in Resp and NR tumors, impacting Rho GTPase and NOTCH signaling, known to be involved in drug response. In conclusion, recurrent glioblastoma tumors were more responsive to REGO compared to TMZ treatment. Importantly, our approach enables a comprehensive longitudinal exploration of the molecular changes induced by treatment, unveiling promising biomarkers indicative of drug response.
MeSH term(s)	Humans ; Antineoplastic Agents, Alkylating/pharmacology ; Glioblastoma/drug therapy ; Glioblastoma/pathology ; Neoplasm Recurrence, Local/pathology ; Phenylurea Compounds ; Pyridines ; Temozolomide/pharmacology
Chemical Substances	Antineoplastic Agents, Alkylating ; Phenylurea Compounds ; Pyridines ; regorafenib (24T2A1DOYB) ; Temozolomide (YF1K15M17Y)
Language	English
Publishing date	2024-03-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells13060487
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Article ; Online: O-(2-18F-ﬂuoroethyl)-L-tyrosine (18F-FET) PET as a potential selection tool for second surgery in glioblastoma patients.

Santonocito, Orazio S / Grimod, Gianluca / DI Stefano, Anna L / Pieri, Francesco / Nizzola, Mariagrazia / Mazzuca, Nicola / Pasqualetti, Francesco / Morganti, Riccardo / Zucchi, Vanna / Gambacciani, Carlo

Journal of neurosurgical sciences

2023

Abstract: Background: Treatment-related changes still represent a diagnostic challenge in the management of patients with suspect of recurrent glioblastoma. The specificity of conventional MRI in detecting recurrence remains limited. Brain PET imaging provides ... ...

Abstract	Background: Treatment-related changes still represent a diagnostic challenge in the management of patients with suspect of recurrent glioblastoma. The specificity of conventional MRI in detecting recurrence remains limited. Brain PET imaging provides information on tumor metabolism and can contribute to improving the diagnostic accuracy of cerebral neoplasms. We performed a retrospective analysis to evaluate the clinical value of O-(2- Methods: A retrospective analysis on patients considered suitable for salvage surgery for recurrence glioblastoma was performed. Results: Forty-two of the 51 patients who underwent Conclusions: 18
Language	English
Publishing date	2023-12-21
Publishing country	Italy
Document type	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/S0390-5616.23.06019-8
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Article ; Online: Intracranial aneurysms in patients with autosomal dominant polycystic kidney disease: prevalence, risk of rupture, and management. A systematic review.

Cagnazzo, Federico / Gambacciani, Carlo / Morganti, Riccardo / Perrini, Paolo

Acta neurochirurgica

2017 Volume 159, Issue 5, Page(s) 811–821

Abstract: Background: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder associated with high incidences of intracranial aneurysms. We performed a systematic review with the purpose of clarifying the prevalence, risk of rupture, and ... ...

Abstract	Background: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder associated with high incidences of intracranial aneurysms. We performed a systematic review with the purpose of clarifying the prevalence, risk of rupture, and appropriate management of intracranial aneurysms in the ADPKD population. Method: PRISMA guidelines were followed. We conducted a comprehensive literature search of three databases (PubMed, Ovid MEDLINE, and Ovid EMBASE) on all series reporting ADPKD patients with intracranial aneurysms. Results: Our systematic review included 16 articles with a total of 563 patients with ADPKD and intracranial aneurysms. The prevalence of unruptured aneurysms was 11.5% (95% CI = 10.1-13%), whereas 1.9% (95% CI = 1.3-2.6%) of aneurysms were ruptured. Hypertension was present in 79.3% of patients with ADPKD and renal impairment in 65%. The mean size of ruptured aneurysms was slightly higher than unruptured (6 mm vs. 4.4 mm). The most common locations of unruptured and ruptured aneurysms were the ICA (40.5%) and MCA (45%), respectively. Asymptomatic patients studied with four-vessel angiography experienced 25% transient complications. Overall, 74% unruptured aneurysms were surgically treated with lower complication rates compared to endovascular treatment (11% vs. 27.7%). Among conservatively treated aneurysms, 2.9% ruptured at follow-up (rupture rate 0.4%/patient-year). Finally, the growth rate was 0.4% per patient-year, and the incidence of de novo aneurysm formation was 1.4% per patient-year. Conclusions: The prevalence of unruptured intracranial aneurysms in the ADPKD population is approximately 11%. Given the non-negligible rate of procedural complications, the management of these patients must be cautious and individualised. The rupture rate appears comparable to that of the general population. On the other hand, the 1.4% rate per patient-year of de novo aneurysms is non-negligible. These findings should be considered when counselling ADPKD patients regarding the appropriate management of intracranial aneurysms.
MeSH term(s)	Aneurysm, Ruptured/epidemiology ; Aneurysm, Ruptured/etiology ; Aneurysm, Ruptured/therapy ; Humans ; Intracranial Aneurysm/epidemiology ; Intracranial Aneurysm/etiology ; Intracranial Aneurysm/therapy ; Polycystic Kidney, Autosomal Dominant/complications ; Polycystic Kidney, Autosomal Dominant/epidemiology
Language	English
Publishing date	2017-03-10
Publishing country	Austria
Document type	Journal Article ; Review
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-017-3142-z
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Article ; Online: Aneurysm rebleeding after placement of external ventricular drainage: a systematic review and meta-analysis.

Cagnazzo, Federico / Gambacciani, Carlo / Morganti, Riccardo / Perrini, Paolo

Acta neurochirurgica

2017 Volume 159, Issue 4, Page(s) 695–704

Abstract: Background: The association between external ventricular drainage (EVD) and aneurysm rerupture is still a controversial issue. We performed a systematic review and meta-analysis of published series reporting data of EVD placement in aneurysmal ... ...

Abstract	Background: The association between external ventricular drainage (EVD) and aneurysm rerupture is still a controversial issue. We performed a systematic review and meta-analysis of published series reporting data of EVD placement in aneurysmal subarachnoid hemorrhage (SAH) with the aim to evaluate the relationship between ventricular drainage and aneurysm rebleeding. Method: PRISMA/MOOSE guidelines were followed. The Newcastle-Ottawa Scale was used to assess the quality of the studies. We conducted a comprehensive literature search of three databases (PubMed, Ovid MEDLINE, and Ovid EMBASE) on series reporting patients with EVD placement and aneurysmal SAH. The reported studies were analyzed with a primary aim to calculate the strength of the association (odds ratio) between rebleeding and EVD placement in patients with SAH. Results: Our systematic review included 16 articles with a total of 6804 patients with SAH of which 595 (8.7%) had aneurysmal rebleeding. Ventricular drainage was inserted in 19% of patients. Rebleeding occurred in 18.8% (95% CI = 16.4-20.6%) of patients requiring EVD and in 6.4% (95% CI = 5.8-7.1%) of patients who did not require EVD (OR = 3.92, p < 0.0001). The mean time between EVD placement and rebleeding was 1 h (range, 0-8 h). The maximal aneurysm diameter of patients with rerupture was larger when compared with patients without rerupture (9.9 mm vs. 7.5 mm; p < 0.04). High Fisher grades (III-IV) were present in 75% of patients with rerupture and in 60% of patients without aneurysmal rerupture (p < 0.0001). Conclusions: Our study conclusively defined an association between EVD and rebleeding. However, the effective role of EVD in aneurysm rebleeding is insufficiently investigated in the literature. Other significant factors of rebleeding are usually observed in patients requiring ventricular drainage. According to our findings, a causal relationship between EVD and aneurysm rebleeding could be a plausible hypothesis, at least in certain cases.
MeSH term(s)	Aged ; Aneurysm, Ruptured/surgery ; Drainage/adverse effects ; Female ; Humans ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects ; Postoperative Complications/etiology ; Subarachnoid Hemorrhage/etiology
Language	English
Publishing date	2017-02-27
Publishing country	Austria
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-017-3124-1
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Article ; Online: Subdural fluid collection and hydrocephalus following cervical schwannoma resection: hydrocephalus resolution after spinal pseudomeningocele repair: case report.

Benedetto, Nicola / Cagnazzo, Federico / Gambacciani, Carlo / Perrini, Paolo

Journal of neurosurgery. Spine

2016 Volume 25, Issue 6, Page(s) 762–765

Abstract: The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus ... ...

Abstract	The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus associated with cervical pseudomeningocele. The clinical symptoms, subdural fluid collections, and ventricular dilation resolved after surgical correction of the pseudomeningocele. This report emphasizes that hydrocephalus may be related to disorders of cerebrospinal fluid flow dynamics induced by cervical pseudomeningocele. In these rare cases, both the hydrocephalus and the symptoms are resolved by the simple correction of the pseudomeningocele.
MeSH term(s)	Adult ; Cerebrospinal Fluid Leak/diagnostic imaging ; Cerebrospinal Fluid Leak/etiology ; Cerebrospinal Fluid Leak/surgery ; Cervical Vertebrae ; Humans ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/surgery ; Male ; Neurilemmoma/complications ; Neurilemmoma/diagnostic imaging ; Neurilemmoma/surgery ; Neurosurgical Procedures/adverse effects ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/surgery ; Spinal Cord Neoplasms/complications ; Spinal Cord Neoplasms/diagnostic imaging ; Spinal Cord Neoplasms/surgery
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2016.5.SPINE16153
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Article ; Online: Innovative Approach to Isolate and Characterize Glioblastoma Circulating Tumor Cells and Correlation with Tumor Mutational Status.

Lessi, Francesca / Morelli, Mariangela / Franceschi, Sara / Aretini, Paolo / Menicagli, Michele / Marranci, Andrea / Pasqualetti, Francesco / Gambacciani, Carlo / Pieri, Francesco / Grimod, Gianluca / Zucchi, Vanna / Cupini, Samanta / Di Stefano, Anna Luisa / Santonocito, Orazio Santo / Mazzanti, Chiara Maria

International journal of molecular sciences

2023 Volume 24, Issue 12

Abstract: Circulating tumor cells (CTCs) are one of the most important causes of tumor recurrence and distant metastases. Glioblastoma (GBM) has been considered restricted to the brain for many years. Nevertheless, in the past years, several pieces of evidence ... ...

Abstract	Circulating tumor cells (CTCs) are one of the most important causes of tumor recurrence and distant metastases. Glioblastoma (GBM) has been considered restricted to the brain for many years. Nevertheless, in the past years, several pieces of evidence indicate that hematogenous dissemination is a reality, and this is also in the caseof GBM. Our aim was to optimize CTCs' detection in GBM and define the genetic background of single CTCs compared to the primary GBM tumor and its recurrence to demonstrate that CTCs are indeed derived from the parental tumor. We collected blood samples from a recurrent IDH wt GBM patient. We genotyped the parental recurrent tumor tissue and the respective primary GBM tissue. CTCs were analyzed using the DEPArray system. CTCs Copy Number Alterations (CNAs) and sequencing analyses were performed to compare CTCs' genetic background with the same patient's primary and recurrent GBM tissues. We identified 210 common mutations in the primary and recurrent tumors. Among these, three somatic high-frequency mutations (in
MeSH term(s)	Humans ; Neoplastic Cells, Circulating/pathology ; Glioblastoma/genetics ; Glioblastoma/pathology ; Neoplasm Recurrence, Local/genetics ; Mutation ; Genotype
Language	English
Publishing date	2023-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms241210147
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Article ; Online: Surgical management of acute subdural haematomas in elderly: report of a single center experience.

Benedetto, Nicola / Gambacciani, Carlo / Montemurro, Nicola / Morganti, Riccardo / Perrini, Paolo

British journal of neurosurgery

2017 Volume 31, Issue 2, Page(s) 244–248

Abstract: Objective: To evaluate the clinical outcome of patients over 70 years old who have received surgical treatment for traumatic acute subdural haematoma (aSDH) in our Neurosurgical Department. We also disclose related surgical and medical costs.: Methods! ...

Abstract	Objective: To evaluate the clinical outcome of patients over 70 years old who have received surgical treatment for traumatic acute subdural haematoma (aSDH) in our Neurosurgical Department. We also disclose related surgical and medical costs. Methods: A retrospective analysis was performed by analyzing the medical records of patients older than 70 who had undergone surgery for evacuation of traumatic aSDH between June 2011 and December 2014. Through univariate and multivariate analyses, we correlated clinical and radiological pre-operatory features with outcome at one and six months after surgery. Overall costs for each patient were recorded. Results: We observed 67 patients, 36 male and 31 female, with a median age of 80.5 years old (range 71-94). The mortality rate at one month and six months after surgery was respectively 55.1% and 67.2% while functional recovery was respectively 10.4% and 13.4%. Multivariate analysis age and Glasgow Coma Score (GCS) are the most significant parameters in relation to clinical outcome. Age greater than 90, shift midline >20 mm and volume of the haematoma >200 cu cm were independent parameters to predict mortality within 10 days of surgery. Conclusion: Our study confirms a poor outcome for patients of 70 years and over who received surgical treatment for traumatic aSDH.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma, Subdural, Acute/economics ; Hematoma, Subdural, Acute/mortality ; Hematoma, Subdural, Acute/surgery ; Humans ; Neurosurgical Procedures/economics ; Neurosurgical Procedures/methods ; Neurosurgical Procedures/mortality ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Wounds and Injuries/complications
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Journal Article
ZDB-ID	639029-8
ISSN	1360-046X ; 0268-8697
ISSN (online)	1360-046X
ISSN	0268-8697
DOI	10.1080/02688697.2016.1244249
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Article ; Online: Cage with anterior plating is advantageous over the stand-alone cage for segmental lordosis in the treatment of two-level cervical degenerative spondylopathy: A retrospective study.

Perrini, Paolo / Cagnazzo, Federico / Benedetto, Nicola / Morganti, Riccardo / Gambacciani, Carlo

Clinical neurology and neurosurgery

2017 Volume 163, Page(s) 27–32

Abstract: Objectives: To compare retrospectively the clinical and radiological outcomes in cervical spinal alignment after two consecutive levels PEEK cage-assisted ACDF when performed with or without plate fixation PATIENTS AND METHODS: Seventy-eight patients ... ...

Abstract	Objectives: To compare retrospectively the clinical and radiological outcomes in cervical spinal alignment after two consecutive levels PEEK cage-assisted ACDF when performed with or without plate fixation PATIENTS AND METHODS: Seventy-eight patients underwent two consecutive levels PEEK cage-assisted ACDF without plating (56 patients) or supplemented with plating (22 patients). The average clinical follow-up was 31.40±12.98months. The authors compared clinical parameters (Neck disability index and Robinson criteria), perioperative parameters (hospital stays, complications), and radiological parameters (global lordotic curvature, segmental lordosis, segmental height). Results: Demographic features, neurological presentation, preoperative sagittal alignment, postoperative complications, length of hospitalization and clinical improvement were not different between groups. At 12-months radiological follow-up, the global lordotic curvature was similar in both groups (P=0.02). However, the use of anterior plate fixation versus stand-alone cage was associated with greater segmental lordosis (-7.68±4.82° versus -0.02±8.44°, P<0.0001) and greater segmental height (39.51±3.50 versus 36.75±3.90, P=0.005). Conclusion: The clinical outcomes after two consecutive levels PEEK cage-assisted ACDF with and without plate fixation were similar, but the supplement of an anterior plate was advantageous for improving segmental alignment on long-term radiological follow-up.
MeSH term(s)	Adult ; Aged ; Bone Plates ; Cervical Vertebrae/surgery ; Diskectomy/methods ; Female ; Fracture Fixation, Internal/methods ; Humans ; Lordosis/diagnosis ; Lordosis/surgery ; Male ; Middle Aged ; Neck/surgery ; Postoperative Complications/surgery ; Radiography/methods ; Spinal Fusion/methods ; Treatment Outcome
Language	English
Publishing date	2017-10-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2017.10.014
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Article ; Online: Single-Cell Molecular Characterization to Partition the Human Glioblastoma Tumor Microenvironment Genetic Background.

Lessi, Francesca / Franceschi, Sara / Morelli, Mariangela / Menicagli, Michele / Pasqualetti, Francesco / Santonocito, Orazio / Gambacciani, Carlo / Pieri, Francesco / Aquila, Filippo / Aretini, Paolo / Mazzanti, Chiara Maria

Cells

2022 Volume 11, Issue 7

Abstract: Background: Glioblastoma (GB) is a devastating primary brain malignancy. The recurrence of GB is inevitable despite the standard treatment of surgery, chemotherapy, and radiation, and the median survival is limited to around 15 months. The barriers to ... ...

Abstract	Background: Glioblastoma (GB) is a devastating primary brain malignancy. The recurrence of GB is inevitable despite the standard treatment of surgery, chemotherapy, and radiation, and the median survival is limited to around 15 months. The barriers to treatment include the complex interactions among the different cellular components inhabiting the tumor microenvironment. The complex heterogeneous nature of GB cells is helped by the local inflammatory tumor microenvironment, which mostly induces tumor aggressiveness and drug resistance. Methods: By using fluorescent multiple labeling and a DEPArray cell separator, we recovered several single cells or groups of single cells from populations of different origins from IDH-WT GB samples. From each GB sample, we collected astrocytes-like (GFAP+), microglia-like (IBA1+), stem-like cells (CD133+), and endothelial-like cells (CD105+) and performed Copy Number Aberration (CNA) analysis with a low sequencing depth. The same tumors were subjected to a bulk CNA analysis. Results: The tumor partition in its single components allowed single-cell molecular subtyping which revealed new aspects of the GB altered genetic background. Conclusions: Nowadays, single-cell approaches are leading to a new understanding of GB physiology and disease. Moreover, single-cell CNAs resource will permit new insights into genome heterogeneity, mutational processes, and clonal evolution in malignant tissues.
MeSH term(s)	Brain Neoplasms/genetics ; Genetic Background ; Glioblastoma/pathology ; Humans ; Microglia/pathology ; Tumor Microenvironment/genetics
Language	English
Publishing date	2022-03-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells11071127
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