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  1. Article ; Online: Bilateral carotid artery dissection in a SARS-CoV-2 infected patient: causality or coincidence?

    Morassi, Mauro / Bigni, Barbara / Cobelli, Milena / Giudice, Lodoviga / Bnà, Claudio / Vogrig, Alberto

    Journal of neurology

    2020  Volume 267, Issue 10, Page(s) 2812–2814

    MeSH term(s) Betacoronavirus ; Brain Neoplasms/complications ; COVID-19 ; Carotid Artery, Internal, Dissection/complications ; Coronavirus Infections/complications ; Humans ; Male ; Middle Aged ; Oligodendroglioma/complications ; Pandemics ; Pneumonia, Viral/complications ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-12
    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/s00415-020-09984-0
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  2. Article: Post Surgical Management of WHO Grade II Meningiomas: Our Experience, the Role of Gamma Knife and a Literature Review.

    Migliorati, Karol / Spatola, Giorgio / Giudice, Lodoviga / de Graaf, Nine / Bassetti, Chiara / Giorgi, Cesare / Fontanella, Marco / Vivaldi, Oscar / Bignardi, Mario / Franzin, Alberto

    Life (Basel, Switzerland)

    2022  Volume 13, Issue 1

    Abstract: Purpose: ...

    Abstract Purpose:
    Language English
    Publishing date 2022-12-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13010037
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  3. Article ; Online: Usefulness of Ultrasound-Guided Microsurgery in Cavernous Angioma Removal.

    Barzaghi, Lina Raffaella / Capitanio, Jody Filippo / Giudice, Lodoviga / Panni, Pietro / Acerno, Stefania / Mortini, Pietro

    World neurosurgery

    2018  Volume 116, Page(s) e414–e420

    Abstract: Background: Primary elements of surgical treatment of cavernous angiomas (CAs) are precise lesion identification and optimal trajectory determination. Navigation techniques allow for better results compared to microsurgery alone. In this study, we ... ...

    Abstract Background: Primary elements of surgical treatment of cavernous angiomas (CAs) are precise lesion identification and optimal trajectory determination. Navigation techniques allow for better results compared to microsurgery alone. In this study, we examined the benefits of intraoperative ultrasound (IOUS) use as an adjunct to standard localization systems.
    Methods: We retrospectively analyzed 59 CAs, comparing outcomes in 2 groups of patients: 34 who underwent frame-based or frameless navigation-assisted microsurgery (no-IOUS group) and 25 who underwent IOUS-guided microsurgery associated with these techniques (IOUS group).
    Results: The use of IOUS did not significantly increase the surgery time (mean, 172 ± 1.7 minutes in the IOUS group and 192.6 ± 11.5 in no-IOUS group; P = 0.08). In all 25 patients in the IOUS group, IOUS allowed for ready identification of CA as a hyperechoic mass. At the last follow-up (mean, 41.7 ± 3.5 months postsurgery), 95.2% of the IOUS group and 80.8% of the no-IOUS group had a modified Rankin Scale score of 0-1 and an Extended Glasgow Outcome Scale score of 7-8 (P = 0.2), with 100% and 64%, respectively, included in Engel outcome scale class IA (P = 0.006). Complete removal, as confirmed on postoperative magnetic resonance imaging, was achieved in all patients in the IOUS group and in almost all (97.1%; P = 0.4) patients in the no-IOUS group.
    Conclusions: IOUS is a valid tool for the intraoperative identification of CAs. Implementation of standard localization methods with IOUS guidance was associated with complete resection in all cases, without increasing surgical time. Compared with microsurgery without IOUS guidance, long-term functional outcomes showed better trends, and the epilepsy-free rate was significantly higher.
    MeSH term(s) Adolescent ; Adult ; Aged ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Female ; Follow-Up Studies ; Hemangioma, Cavernous/diagnostic imaging ; Hemangioma, Cavernous/surgery ; Humans ; Intraoperative Neurophysiological Monitoring/methods ; Intraoperative Neurophysiological Monitoring/utilization ; Male ; Microsurgery/methods ; Microsurgery/utilization ; Middle Aged ; Operative Time ; Retrospective Studies ; Ultrasonography, Interventional/methods ; Ultrasonography, Interventional/utilization ; Young Adult
    Language English
    Publishing date 2018-05-09
    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.2018.04.217
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  4. Article ; Online: Atlanto-occipital dislocation due to aneurysmal bone cyst of the occipital condyle.

    Spina, Alfio / Boari, Nicola / Gagliardi, Filippo / Giudice, Lodoviga / Mortini, Pietro

    Acta neurochirurgica

    2016  Volume 158, Issue 8, Page(s) 1637–1638

    Language English
    Publishing date 2016-08
    Publishing country Austria
    Document type Letter
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-016-2880-7
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  5. Article: Bilateral carotid artery dissection in a SARS-CoV-2 infected patient: causality or coincidence?

    Morassi, Mauro / Bigni, Barbara / Cobelli, Milena / Giudice, Lodoviga / Bnà, Claudio / Vogrig, Alberto

    J Neurol

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #596745
    Database COVID19

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  6. Article ; Online: Bilateral carotid artery dissection in a SARS-CoV-2 infected patient

    Morassi, Mauro / Bigni, Barbara / Cobelli, Milena / Giudice, Lodoviga / Bnà, Claudio / Vogrig, Alberto

    Journal of Neurology

    causality or coincidence?

    2020  Volume 267, Issue 10, Page(s) 2812–2814

    Keywords Neurology ; Clinical Neurology ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    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/s00415-020-09984-0
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Bone resorption in autologous cryopreserved cranioplasty: quantitative evaluation, semiquantitative score and clinical significance.

    Barzaghi, Lina Raffaella / Parisi, Veronica / Gigliotti, Carmen Rosaria / Giudice, Lodoviga / Snider, Silvia / Dell'Acqua, Antonio / Del Vecchio, Antonella / Mortini, Pietro

    Acta neurochirurgica

    2019  Volume 161, Issue 3, Page(s) 483–491

    Abstract: Background: Changes after reimplantation of the autologous bone have been largely described. However, the rate and the extent of resorption in cranial grafts have not been clearly defined. Aim of our study is to evaluate the bone flap resorption (BFR) ... ...

    Abstract Background: Changes after reimplantation of the autologous bone have been largely described. However, the rate and the extent of resorption in cranial grafts have not been clearly defined. Aim of our study is to evaluate the bone flap resorption (BFR) after cryopreservation.
    Methods: We retrospectively reviewed 27 patients, aged 18 years or older, subjected to cranioplasty (CP) adopting autologous cryopreserved flap. The BFR was derived from the percentage of decrease in flap volume (BFR%), comparing the first post-operative computed tomography (CT) and the last one available (performed at least 1 year after surgery). We also proposed a semiquantitative scoring system, based on CT, to define a clinically workable BFR classification.
    Results: After a mean ± SE follow-up of 32.5 ± 2.4 months, the bone flap volume decreased significantly (p < 0.0001). The mean BFR% was 31.7 ± 3.8% and correlated with CT-score (p < 0.001). Three BFR classes were described: mild (14.8% of cases) consisting in minimal bone remodelling, CT-score ≤ 6, mean BFR% = 3.5 ± 0.7%; moderate (51.9% of cases) corresponding to satisfactory cerebral protection, CT-score < 13, mean BFR% = 25.6 ± 2.2%; severe (33.3% of cases) consisting in loss of cerebral protection, CT-score ≥ 13, mean BFR% = 54.2 ± 3.9%. Females had higher BFR% than males (p = 0.022). BFR classes and new reconstructive surgery were not related (p = 0.58).
    Conclusions: BFR was moderate or severe in 85.2% of re-implanted cryopreserved flaps. The proposed CT-score is an easy and reproducible tool to define resorption extent.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bone Resorption/classification ; Bone Resorption/diagnostic imaging ; Bone Resorption/surgery ; Cryopreservation ; Decompressive Craniectomy/adverse effects ; Decompressive Craniectomy/methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/classification ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/surgery ; Reconstructive Surgical Procedures/methods ; Skull/surgery ; Surgical Flaps/pathology ; Surgical Flaps/surgery ; Tomography, X-Ray Computed ; Transplantation, Autologous
    Language English
    Publishing date 2019-01-07
    Publishing country Austria
    Document type Journal Article
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-018-03789-x
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  8. Article ; Online: Safety of transsphenoidal microsurgical approach in patients with an ACTH-secreting pituitary adenoma.

    Donofrio, Carmine Antonio / Losa, Marco / Gemma, Marco / Giudice, Lodoviga / Barzaghi, Lina Raffaella / Mortini, Pietro

    Endocrine

    2017  Volume 58, Issue 2, Page(s) 303–311

    Abstract: Purpose: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as ... ...

    Abstract Purpose: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as compared with patients with nonfunctioning pituitary adenoma.
    Methods: We have retrospectively analyzed 142 patients with Cushing's disease and 299 patients with nonfunctioning pituitary adenoma who underwent transsphenoidal surgery performed by a single experienced neurosurgeon between September 2007 and December 2014. For all of them, an intraoperative computerized anesthetic record for the automatic storage of data was available.
    Results: The intraoperative vital parameters and the frequency of drugs administered during anesthesia were comparable between Cushing's disease and nonfunctioning pituitary adenoma groups. The duration of surgery was similar between the two groups (41.2 ± 11.8 vs. 42.9 ± 15.6 min), while the duration of anesthesia was slightly shorter in Cushing's disease patients (97.6 ± 18.1 min) than in nonfunctioning pituitary adenoma patients (101.6 ± 20.6 min, p = 0.04). The total perioperative mortality rate was 0.2% (0% in Cushing's disease vs. 0.3% in nonfunctioning pituitary adenoma). Cushing's disease patients had surgical and medical complication rates of 3.5% each, not different from those occurring in nonfunctioning pituitary adenoma. The postoperative incidence of diabetes insipidus (10.6%) and isolated hyponatremia (10.6%) in Cushing's disease patients was significantly higher than in nonfunctioning pituitary adenoma patients (4.4 and 4.1%; p = 0.02 and p = 0.01, respectively).
    Conclusions: In a large series of unselected and consecutive patients with Cushing's disease, transsphenoidal surgery performed by one dedicated experienced neurosurgeon had a reasonably low risk of complications. In particular, despite the higher burden of comorbidities typically associated with hypercortisolism, medical complications are rare and no more frequent than in patients with nonfunctioning pituitary adenoma.
    MeSH term(s) ACTH-Secreting Pituitary Adenoma/surgery ; Adenoma/surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Pituitary ACTH Hypersecretion/surgery ; Postoperative Complications/etiology ; Retrospective Studies ; Sphenoid Sinus/surgery ; Transanal Endoscopic Microsurgery/adverse effects ; Transanal Endoscopic Microsurgery/methods ; Young Adult
    Language English
    Publishing date 2017-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1194484-5
    ISSN 1559-0100 ; 1355-008X ; 0969-711X
    ISSN (online) 1559-0100
    ISSN 1355-008X ; 0969-711X
    DOI 10.1007/s12020-016-1214-0
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  9. Article ; Online: Fronto-orbitozygomatic approach: functional and cosmetic outcomes in a series of 169 patients.

    Boari, Nicola / Spina, Alfio / Giudice, Lodoviga / Gorgoni, Francesca / Bailo, Michele / Mortini, Pietro

    Journal of neurosurgery

    2017  Volume 128, Issue 2, Page(s) 466–474

    Abstract: OBJECTIVE Advantages of the fronto-orbitozygomatic (FOZ) approach have been reported extensively in the literature; nevertheless, restoration of normal anatomy and the esthetic impact of surgery are increasingly important issues for patients and ... ...

    Abstract OBJECTIVE Advantages of the fronto-orbitozygomatic (FOZ) approach have been reported extensively in the literature; nevertheless, restoration of normal anatomy and the esthetic impact of surgery are increasingly important issues for patients and neurosurgeons. The aim of this study was to analyze functional and cosmetic outcomes in a series of 169 patients with different pathologies who underwent surgery in which the FOZ approach was used. METHODS Between January 2000 and December 2014, 250 consecutive patients underwent surgery with an FOZ approach as the primary surgical treatment. Follow-up data were available for only 169 patients; 103 (60.9%) of these patients were female and 66 (39.1%) were male, and their ages ranged from 6 to 77 years (mean 46.9 years; SD 15.6 years). Mean follow-up time was 66 months (range 6-179 months; SD 49.5 months). Evaluation of clinical outcomes was performed with a focus on 4 main issues: surgical complications, functional outcome, cosmetic outcome, and patient satisfaction. The additional time needed to perform orbitotomy and orbital reconstruction was also evaluated. RESULTS The permanent postoperative complications included forehead hypesthesia (41.4%) and dysesthesia (15.3%), frontal muscle weakness (10.3%), exophthalmos (1.4%), enophthalmos (4.1%), diplopia (6.6%; 2% were related to surgical approach), and persistent periorbital and eyelid swelling (3%). Approximately 90% of the patients reported subjectively that surgery did not affect their quality of life or complained of only minor problems that did not influence their quality of life significantly. The mean time needed for orbitotomy and orbital reconstruction was approximately half an hour. CONCLUSIONS Comprehensive knowledge of the potential complications and overall clinical outcomes of the FOZ approach can be of great utility to neurosurgeons in balancing the well-known benefits of the approach with potential additional morbidities.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Craniotomy/methods ; Female ; Follow-Up Studies ; Frontal Bone/surgery ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/methods ; Operative Time ; Orbit/surgery ; Patient Satisfaction ; Postoperative Complications/epidemiology ; Quality of Life ; Retrospective Studies ; Skull Base/surgery ; Treatment Outcome ; Young Adult ; Zygoma/surgery
    Language English
    Publishing date 2017-02-03
    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 10.3171/2016.9.JNS16622
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  10. Article ; Online: Safety and feasibility of lumbar drainage in the management of poor grade aneurysmal subarachnoid hemorrhage.

    Panni, Pietro / Donofrio, Carmine Antonio / Barzaghi, Lina Raffaella / Giudice, Lodoviga / Albano, Luigi / Righi, Claudio / Simionato, Franco / Scomazzoni, Francesco / Cozzi, Silvano / Calvi, Maria Rosa / Beretta, Luigi / Falini, Andrea / Mortini, Pietro

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

    2019  Volume 64, Page(s) 64–70

    Abstract: The use of lumbar drain (LD) in the aneurysmal subarachnoid hemorrhage (aSAH) has been described to reduce cerebral vasospasm and delayed cerebral ischemia (DCI), with a lack of studies referring to high grade population. The purpose of our study is to ... ...

    Abstract The use of lumbar drain (LD) in the aneurysmal subarachnoid hemorrhage (aSAH) has been described to reduce cerebral vasospasm and delayed cerebral ischemia (DCI), with a lack of studies referring to high grade population. The purpose of our study is to assess safety and feasibility of LD in the poor grade aSAH population subjected to endovascular aneurysm occlusion. Twenty-four consecutive poor grade aSAH patients, defined as grade IV and V according to World Federation of Neurological Surgeons (WFNS) classification, subjected to endovascular aneurysm occlusion, were retrospectively reviewed. Details of CSF drainage via LD and related complications were analyzed. Ventriculo-lumbar pressure gradient (VLPG) lower than 6 mmHg was considered in order to start LD use. Good outcome was defined as modified Rankin Scale (mRS) 0-2. LD was started within 72 h since aSAH in 17 cases (70.8%), and in 7 cases (29.2%) it was delayed due to contraindications. The mean LD length was of 13.8 days. The median VLPG during drainage was 2 mmHg (IQR: 0-4). No cases of brain or spinal hemorrhage, permanent neurological worsening due to brain herniation were noted. Three cases (12.5%) of CSF infection and a related death (4.2%) were reported. The use of LD, in association with external ventricular drain (EVD), seems to be safe and feasible in the poor grade aSAH population. VLPG monitoring seems to play a key role in avoiding potentially severe complications.
    MeSH term(s) Adult ; Aged ; Cerebrospinal Fluid ; Drainage/methods ; Female ; Humans ; Intracranial Aneurysm/complications ; Middle Aged ; Retrospective Studies ; Subarachnoid Hemorrhage/cerebrospinal fluid ; Subarachnoid Hemorrhage/etiology ; Subarachnoid Hemorrhage/therapy
    Language English
    Publishing date 2019-04-22
    Publishing country Scotland
    Document type Case Reports ; Journal Article
    ZDB-ID 1193674-5
    ISSN 1532-2653 ; 0967-5868
    ISSN (online) 1532-2653
    ISSN 0967-5868
    DOI 10.1016/j.jocn.2019.04.010
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