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Article ; Online: An understimated maneuver for oculomotor nerve palsy due to posterior communicating artery aneurysm: the opening of the anterior petroclinoid ligament. A technical note.

LA Pira, Biagia / Picotti, Veronica / Frati, Alessandro / Pesce, Alessandro / D'Andrea, Giancarlo

2023

Abstract: Posterior communicating artery aneurysms (PcomAs) present with oculomotor nerve (OMN) palsy in 20-30% of cases, and the sudden onset of OMN palsy has to raise the suspicion of rupture, until proven otherwise. The surgical technique is described in a ... ...

Abstract	Posterior communicating artery aneurysms (PcomAs) present with oculomotor nerve (OMN) palsy in 20-30% of cases, and the sudden onset of OMN palsy has to raise the suspicion of rupture, until proven otherwise. The surgical technique is described in a stepwise fashion. An illustrative case is reported: a 57-year-old female was admitted to our department with the diagnosis of a right sided-PcomA. Three months before the admission, when she harbored with the acute onset of complete ptosis, diplopia, orbital pain, impairment of the medial, upward, and downward gaze, with no pupil dysfunction. The origin of the Pcom and the neck of the aneurysm were easily identified and the aneurysm was clipped. Then, we followed the OMN and cut for less than 4 mm the above-lying anterior petroclinoid ligament (APL) to obtain nerve release. Although few cases are described in the literature, and ours represents a single case, we support that this maneuver should be introduced in the clinical practice of expert neurosurgeons dealing with vascular pathologies, such as the opening of the falciform ligament occurs for the decompression of the optical nerve.
Language	English
Publishing date	2023-05-15
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/S0390-5616.23.06020-4
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Article ; Online: Controls on Physical and Chemical Denudation in a Mixed Carbonate‐Siliciclastic Orogen

Erlanger, E. / Rugenstein, J. / Bufe, A. / Picotti, V. / Willett, S.

Journal of Geophysical Research: Earth Surface

2021

Abstract: Mixed siliciclastic-carbonate active orogens are common on Earth’s surface, yet most studies have focused on erosion and weathering in silicate-rich landscapes. Relative to purely siliciclastic landscapes, the response of erosion and weathering to uplift ...

Abstract	Mixed siliciclastic-carbonate active orogens are common on Earth’s surface, yet most studies have focused on erosion and weathering in silicate-rich landscapes. Relative to purely siliciclastic landscapes, the response of erosion and weathering to uplift may differ in mixed-lithology regions. However, our knowledge of weathering and erosion in mixed carbonate-silicate lithologies is limited and, thus, so is our understanding of the mechanistic coupling between uplift, weathering, and the carbon cycle. Here, we partition denudation fluxes into erosion and weathering fluxes of carbonates and silicates in the Northern Apennines—a mixed carbonate-siliciclastic active orogen—using dissolved solutes, the carbonate sand fraction, and existing 10Be denudation rates. Erosion generally dominates total denudation fluxes relative to weathering by an order of magnitude. Carbonate and silicate contributions to erosion vary between lithologic units, but weathering fluxes are systematically dominated by carbonates. Silicate weathering may be kinetically limited, whereas carbonate weathering may be limited by acid supply. Carbonate re-precipitation estimated by comparing ion ratios (Sr, Ca, Na) from rivers and bedrock suggests that up to 90% of dissolved Ca2+ is lost from carbonate-rich catchments. Corresponding [Ca2+] estimates for the weathering zone are high, likely driven by high soil pCO2; however, re-equilibration with atmospheric pCO2 in rivers converts solutes back into grains that become part of the physical denudation flux. Weathering limits in this landscape therefore differ between the subsurface weathering zone and riverine exports, and our findings suggest that carbon cycle models may overestimate the sensitivity to erosion of solute exports (Ca2+ and HCO3-) derived from carbonate weathering.
Subject code	550
Publishing date	2021-08-06
Publishing country	de
Document type	Article ; Online
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Article ; Online: Neogene kinematics of the Giudicarie Belt and eastern Southern Alpine orogenic front (northern Italy)

Verwater, V. / Le Breton, E. / Handy, M. / Picotti, V. / Jozi Najafabadi, A. / Haberland, C.

Solid Earth

2021

Abstract: Neogene indentation of the Adriatic plate into Europe led to major modifications of the Alpine orogenic structures and style of deformation in the Eastern and Southern Alps. The Giudicarie Belt is a prime example of this, as it offsets the entire Alpine ... ...

Abstract	Neogene indentation of the Adriatic plate into Europe led to major modifications of the Alpine orogenic structures and style of deformation in the Eastern and Southern Alps. The Giudicarie Belt is a prime example of this, as it offsets the entire Alpine orogenic edifice; its activity has been kinematically linked to strike-slip faulting and lateral extrusion of the Eastern Alps. Remaining questions on the exact role of this fold-and-thrust belt in the structure of the Alpine orogen at depth necessitate a quantitative analysis of the shortening, kinematics, and depth of decoupling beneath the Giudicarie Belt and adjacent parts of the Southern Alps. Tectonic balancing of a network of seven cross sections through the Giudicarie Belt parallel to the local NNW–SSE shortening direction reveals that this belt comprises two kinematic domains that accommodated different amounts of shortening during overlapping times. These two domains are separated by the NW–SE-oriented strike-slip Trento-Cles–Schio-Vicenza fault system, which offsets the Southern Alpine orogenic front in the south and merges with the Northern Giudicarie Fault in the north. The SW kinematic domain (Val Trompia sector) accommodated at least ∼ 18 km of Late Oligocene to Early Miocene shortening. Since the Middle Miocene, this domain experienced at least ∼ 12–22 km shortening, whereas the NE kinematic domain accommodated at least ∼ 25–35 km shortening. Together, these domains contributed an estimated minimum of ∼ 40–47 km of sinistral strike-slip motion along the Northern Giudicarie Fault, implying that most offset of the Periadriatic Fault is due to Late Oligocene to Neogene indentation of the Adriatic plate into the Eastern Alps. Moreover, the faults linking the Giudicarie Belt with the Northern Giudicarie Fault reach ∼ 15–20 km depth, indicating a thick-skinned tectonic style of deformation. These fault detachments may also connect at depth with a lower crustal Adriatic wedge that protruded north of the Periadriatic Fault and are responsible for N–S shortening and eastward, orogen-parallel escape of deeply exhumed units in the Tauern Window. Finally, the E–W lateral variation of shortening across the Giudicarie Belt indicates internal deformation and lateral variation in strength of the Adriatic indenter related to Permian–Mesozoic tectonic structures and paleogeographic zones.
Subject code	550
Language	English
Publishing country	de
Document type	Article ; Online
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Book ; Online: Sliceable Monolith

Montesi, Fabrizio / Peressotti, Marco / Picotti, Valentino

Monolith First, Microservices Later

2021

Abstract: We propose Sliceable Monolith, a new methodology for developing microservice architectures and perform their integration testing by leveraging most of the simplicity of a monolith: a single codebase and a local execution environment that simulates ... ...

Abstract	We propose Sliceable Monolith, a new methodology for developing microservice architectures and perform their integration testing by leveraging most of the simplicity of a monolith: a single codebase and a local execution environment that simulates distribution. Then, a tool compiles a codebase for each microservice and a cloud deployment configuration. The key enabler of our approach is the technology-agnostic service definition language offered by Jolie.
Keywords	Computer Science - Programming Languages ; Computer Science - Software Engineering
Publishing date	2021-03-17
Publishing country	us
Document type	Book ; Online
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Article: Controls on Physical and Chemical Denudation in a Mixed Carbonate‐Siliciclastic Orogen

Erlanger, E. D. / Rugenstein, J. K. C. / Bufe, A. / Picotti, V. / Willett, S. D.

Journal of geophysical research. 2021 Aug., v. 126, no. 8

2021

Abstract: Mixed siliciclastic‐carbonate active orogens are common on Earth's surface, yet most studies have focused on erosion and weathering in silicate‐rich landscapes. Relative to purely siliciclastic landscapes, the response of erosion and weathering to uplift ...

Abstract	Mixed siliciclastic‐carbonate active orogens are common on Earth's surface, yet most studies have focused on erosion and weathering in silicate‐rich landscapes. Relative to purely siliciclastic landscapes, the response of erosion and weathering to uplift may differ in mixed‐lithology regions. However, our knowledge of weathering and erosion in mixed carbonate‐silicate lithologies is limited and, thus, so is our understanding of the mechanistic coupling between uplift, weathering, and the carbon cycle. Here, we partition denudation fluxes into erosion and weathering fluxes of carbonates and silicates in the Northern Apennines—a mixed carbonate‐siliciclastic active orogen—using dissolved solutes, the carbonate sand fraction, and existing ¹⁰Be denudation rates. Erosion generally dominates total denudation fluxes relative to weathering by an order of magnitude. Carbonate and silicate contributions to erosion vary between lithologic units, but weathering fluxes are systematically dominated by carbonates. Silicate weathering may be kinetically limited, whereas carbonate weathering may be limited by acid supply. Carbonate re‐precipitation estimated by comparing ion ratios (Sr, Ca, Na) from rivers and bedrock suggests that up to 90% of dissolved Ca²⁺ is lost from carbonate‐rich catchments. Corresponding [Ca²⁺] estimates for the weathering zone are high, likely driven by high soil CO₂ partial pressures (pCO₂); however, re‐equilibration with atmospheric pCO₂ in rivers converts solutes back into grains that become part of the physical denudation flux. Weathering limits in this landscape therefore differ between the subsurface weathering zone and riverine exports, and our findings suggest that carbon cycle models may overestimate the sensitivity to erosion of solute exports (Ca²⁺ and HCO₃⁻) derived from carbonate weathering.
Keywords	bedrock ; calcium ; carbon cycle ; carbon dioxide ; carbonates ; geophysics ; landscapes ; lithology ; research ; riparian areas ; sand fraction ; silicates ; solutes
Language	English
Dates of publication	2021-08
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ISSN	2169-9003
DOI	10.1029/2021JF006064
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Impact of early surgery of ruptured cerebral aneurysms on vasospasm and hydrocephalus after SAH: Our preliminary results.

D'Andrea, Giancarlo / Picotti, Veronica / Familiari, Pietro / Barbaranelli, Claudio / Frati, Alessandro / Raco, Antonino

Clinical neurology and neurosurgery

2020 Volume 192, Page(s) 105714

Abstract: Objective: Timing of surgical treatment of ruptured intracranial aneurysms has undergone a drastic change in the last few decades with preference for early surgery Our paper focuses specifically on the prognostic importance of timing of surgery, since ... ...

Abstract	Objective: Timing of surgical treatment of ruptured intracranial aneurysms has undergone a drastic change in the last few decades with preference for early surgery Our paper focuses specifically on the prognostic importance of timing of surgery, since early surgery of ruptured aneurysms provides immediately good clinical results. We present a series of cases operated in early and ultra early surgery, evaluating the technical aspects, the efficacy, the safety and the clinical results. Patients and methods: We retrospectively reviewed the clinical records and radiological imaging of patients treated for ruptured intracranial aneurysms who underwent early and ultra early clipping between January 2011 and April 2017 at our Institution. We included patients treated within the first 12 h and subsequently we divided our series in two subgroups based on the timing of surgery comparing the "early surgery" group (within 12 h) with the "ultra early surgery" group (within 6 h). Results: Seventy-six (76) patients undergoing either early or ultra-early surgery for ruptured intracranial aneurysms have been reported Either early or ultra-early surgery showed a statistically favorable impact on reducing the incidence of both postoperative vasospasm and hydrocephalus. Ultra-early surgery group had the best outcome at the statistical analyses. (good postoperative 1Y GOSE.) CONCLUSIONS: We strongly believe that patients affected by ruptured intracranial aneurysms excluding Hunt and Hess grade V patients) should be treated as soon as possible and hence it should be considered as an emergency surgery. This approach prevents immediately a second bleeding of the aneurysm, allows to treat any associated condition of intracranial hypertension including hematomas and hydrocephalus and to use safely aggressive medical therapy such as hypertension.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Aneurysm, Ruptured/complications ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/physiopathology ; Aneurysm, Ruptured/surgery ; Computed Tomography Angiography ; Early Medical Intervention ; Female ; Functional Status ; Humans ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/physiopathology ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/physiopathology ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Prognosis ; Retrospective Studies ; Subarachnoid Hemorrhage/complications ; Subarachnoid Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/physiopathology ; Subarachnoid Hemorrhage/surgery ; Time-to-Treatment/statistics & numerical data ; Treatment Outcome ; Ultrasonography, Doppler, Transcranial ; Vasospasm, Intracranial/diagnostic imaging ; Vasospasm, Intracranial/etiology ; Vasospasm, Intracranial/physiopathology
Language	English
Publishing date	2020-02-03
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.2020.105714
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Article ; Online: Microsurgical clipping of unruptured intracranial aneurysms by a single surgeon's experience: why should we preserve the neurosurgical skills in our health areas?

LA Pira, Biagia / Picotti, Veronica / Zappalà, Marta / Maiola, Vincenza / Pesce, Alessandro / Frati, Alessandro / Santoro, Antonio / D'Andrea, Giancarlo

Journal of neurosurgical sciences

2021 Volume 68, Issue 2, Page(s) 157–163

Abstract: Background: The long-standing comparison between the endovascular and microsurgical treatment is still ongoing. While not any center avails of a neuroendovascular service, and not every aneurysm is suitable for endovascular treatment, the neurovascular ... ...

Abstract	Background: The long-standing comparison between the endovascular and microsurgical treatment is still ongoing. While not any center avails of a neuroendovascular service, and not every aneurysm is suitable for endovascular treatment, the neurovascular technique is slowly disappearing from our territories, whereas in the current literature, the role of the neurosurgical treatment is being re-appreciated. The aim of this paper was to discuss a single surgeon's clinical and radiological results with the microsurgical management of unruptured intracranial aneurysms (UIA). Methods: We retrospectively reviewed the clinical and radiological records of patients treated for UIA, by a single surgeon, in the period ranging between 2015 and 2019. We recorded all the relevant anatomic features of the aneurysm, saliencies of the surgical treatment, such as the need for temporary clipping, intraoperative rupture, or postoperative complications. The results of the clinical and radiological follow-up examinations were recorded either. Results: Fifty-eight patient undergoing microsurgical clipping were included, harboring a total of 65 UIAs. CTA with 3D reconstructions was sufficient to reach a reliable preoperative planning in 46 patients (76%). A total of 94% of the cases were unchanged or neurologically unremarkable at follow-up. The presence of postoperative complications was associated to the neck size and predictor of a longer hospitalizations, as well as longer hospitalizations are associated to the patients' age, size of the aneurysms and surgical times. Conclusions: According to our experience, we believe that microsurgical clipping plays a critical role in the management of UIA, also on the ground of the encouraging results of the relevant literature.
MeSH term(s)	Humans ; Intracranial Aneurysm/therapy ; Retrospective Studies ; Treatment Outcome ; Neurosurgical Procedures/methods ; Microsurgery/methods ; Postoperative Complications/etiology ; Surgeons
Language	English
Publishing date	2021-08-03
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/S0390-5616.21.05366-2
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Article ; Online: Role of 1p/19q Codeletion in Diffuse Low-grade Glioma Tumour Prognosis.

Familiari, Pietro / Lapolla, Pierfrancesco / Picotti, Veronica / Palmieri, Mauro / Pesce, Alessandro / Carosi, Giulia / Relucenti, Michela / Nottola, Stefania / Gianno, Francesca / Minasi, Simone / Antonelli, Manila / Frati, Alessandro / Santoro, Antonio / D'Andrea, Giancarlo / Bruzzaniti, Placido / LA Pira, Biagia

Anticancer research

2023 Volume 43, Issue 6, Page(s) 2659–2670

Abstract: Background/aim: In the latest 2021 WHO classification of central nervous system tumours (CNS), gliomas that present isocitrate dehydrogenase (IDH) mutations are defined as diffuse low-grade gliomas (DLGGs). IDH mutations are commonly observed in this ... ...

Abstract	Background/aim: In the latest 2021 WHO classification of central nervous system tumours (CNS), gliomas that present isocitrate dehydrogenase (IDH) mutations are defined as diffuse low-grade gliomas (DLGGs). IDH mutations are commonly observed in this tumour type. The Extent of Resection (EOR) positively influence survival; however, it is still debated whether the predictive value of EOR is independent of the 1p/19q co-deletion. We carried out a retrospective analysis on patients operated on for DLGG at the Sant'Andrea University Hospital Sapienza University of Rome, correlating the outcome with the presence of 1p/19q co-deletion and EOR. Patients and methods: The study examined 66 patients with DLGG who had undergone surgery for tumour resection between 2008 and 2018. Patients with DLGG were divided into two groups; diffuse astrocytoma (DA) in which 1p/19q codeletion is absent and oligodendroglioma (OG) in which 1p/19q codeletion is present. According to EOR, both groups were divided into two subgroups: subtotal resection (STR) and gross total resection (GTR). Three end-point variables were considered: overall survival (OS), progression-free survival (PFS) and time to malignant transformation (TMT). Results: In the DA group, the GTR subgroup had an average OS of 81.6 months, an average PFS of 45.9 months and an average TMT of 63.6 months. After surgery, these patients had an average Karnofsky Performance Score (KPS) of 83.4. The STR subgroup had an average OS of 60.4 months, PFS was 38.7 months, and TMT was 46.4 months, post-operative KPS was 83.4. In contrast, in the OG group, the GTR averagely had 101.7 months of OS, 64.9 months of PFS, 80.3 months of TMT and an average post-operative KPS of 84.2, and the STR subgroup had an average of OS of 73.3 months, PFS of 48.2 months, TMT of 57.3 and an average postoperative KPS of 96.2. Conclusion: In patients affected by DLGGs, 1p/19q codeletion is significantly associated with prolonged survival and longer time-to-malignant transformation (TMT) compared to the absence of 1p/19q codeletion. Also, the extent of surgical resection (EOR) in DLGG patients has been confirmed as one of the main prognostic factors. However, its predictive value is substantially influenced by the presence of the 1p/19q codeletion.
MeSH term(s)	Humans ; Brain Neoplasms/genetics ; Brain Neoplasms/surgery ; Brain Neoplasms/pathology ; Retrospective Studies ; Glioma/genetics ; Glioma/surgery ; Glioma/pathology ; Chromosome Aberrations ; Prognosis ; Mutation ; Oligodendroglioma ; Astrocytoma ; Isocitrate Dehydrogenase/genetics ; Chromosomes, Human, Pair 1/genetics ; Chromosomes, Human, Pair 19/genetics
Chemical Substances	Isocitrate Dehydrogenase (EC 1.1.1.41)
Language	English
Publishing date	2023-05-27
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.16432
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Article: Functional Magnetic Resonance Imaging (fMRI), Pre-intraoperative Tractography in Neurosurgery: The Experience of Sant' Andrea Rome University Hospital.

D'Andrea, Giancarlo / Trillo', Giuseppe / Picotti, Veronica / Raco, Antonino

Acta neurochirurgica. Supplement

2017 Volume 124, Page(s) 241–250

Abstract: Background: The goal of neurosurgery for cerebral intraparenchymal neoplasms of the eloquent areas is maximal resection with the preservation of normal functions, and minimizing operative risk and postoperative morbidity. Currently, modern technological ...

Abstract	Background: The goal of neurosurgery for cerebral intraparenchymal neoplasms of the eloquent areas is maximal resection with the preservation of normal functions, and minimizing operative risk and postoperative morbidity. Currently, modern technological advances in neuroradiological tools, neuronavigation, and intraoperative magnetic resonance imaging (MRI) have produced great improvements in postoperative morbidity after the surgery of cerebral eloquent areas. The integration of preoperative functional MRI (fMRI), intraoperative MRI (volumetric and diffusion tensor imaging [DTI]), and neuronavigation, defined as "functional neuronavigation" has improved the intraoperative detection of the eloquent areas. Methods: We reviewed 142 patients operated between 2004 and 2010 for intraparenchymal neoplasms involving or close to one or more major white matter tracts (corticospinal tract [CST], arcuate fasciculus [AF], optic radiation). All the patients underwent neurosurgery in a BrainSUITE equipped with a 1.5 T MR scanner and were preoperatively studied with fMRI and DTI for tractography for surgical planning. The patients underwent MRI and DTI during surgery after dural opening, after the gross total resection close to the white matter tracts, and at the end of the procedure. We evaluated the impact of fMRI on surgical planning and on the selection of the entry point on the cortical surface. We also evaluated the impact of preoperative and intraoperative DTI, in order to modify the surgical approach, to define the borders of resection, and to correlate this modality with subcortical neurophysiological monitoring. We evaluated the impact of the preoperative fMRI by intraoperative neurophysiological monitoring, performing "neuronavigational" brain mapping, following its data to localize the previously elicited areas after brain shift correction by intraoperative MRI. Results: The mean age of the 142 patients (89 M/53 F) was 59.1 years and the lesion involved the CST in 66 patients (57 %), the language pathways in 24 (21 %), and the optic radiations in 25 (22 %). The integration of tractographic data into the volumetric dataset for neuronavigation was technically possible in all cases. In all patients intraoperative DTI demonstrated a shift of the bundle position caused by the surgical procedure; its dislocation was both outward and inward in the range of +6 mm and -2 mm. Conclusion: We found a high concordance between fMRI/DTI and intraoperative brain mapping; their combination improves the sensitivity of each technique, reducing pitfalls and so defining "functional neuronavigation", increasing the definition of eloquent areas and also reducing the time of surgery.
MeSH term(s)	Brain Mapping ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Diffusion Tensor Imaging ; Evoked Potentials, Motor ; Female ; Functional Neuroimaging ; Humans ; Intraoperative Care/methods ; Language ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neural Pathways/diagnostic imaging ; Neural Pathways/surgery ; Neuronavigation/methods ; Neurosurgical Procedures/methods ; Preoperative Care/methods ; Rome ; Sensorimotor Cortex/diagnostic imaging ; Sensorimotor Cortex/surgery ; Visual Pathways/diagnostic imaging ; Visual Pathways/surgery
Language	English
Publishing date	2017
Publishing country	Austria
Document type	Journal Article
ISSN	0065-1419
ISSN	0065-1419
DOI	10.1007/978-3-319-39546-3_36
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Article: Intracranial Meningioma in Elderly Patients. Retrospective Multicentric Risk and Surgical Factors Study of Morbidity and Mortality.

Armocida, Daniele / Arcidiacono, Umberto Aldo / Palmieri, Mauro / Pesce, Alessandro / Cofano, Fabio / Picotti, Veronica / Salvati, Maurizio / D'Andrea, Giancarlo / Garbossa, Diego / Santoro, Antonio / Frati, Alessandro

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 2

Abstract: With the increasing life expectancy, a large number of intracranial meningiomas (IM) have been identified in elderly patients. There is no general consensus regarding the management for IMs nor studies regarding the outcome of older patients undergoing ... ...

Abstract	With the increasing life expectancy, a large number of intracranial meningiomas (IM) have been identified in elderly patients. There is no general consensus regarding the management for IMs nor studies regarding the outcome of older patients undergoing meningioma surgery. We aimed to determine whether preoperative variables and postoperative clinical outcomes differ between age groups after meningioma surgery. We analyzed data from all patients who had undergone IM surgery from our departments. The final cohort consisted of 340 patients affected by IM with ASA class I-II: 188 in the young group (<65) and 152 in the elderly. The two subgroups did not present significant differences concerning biological characteristics of tumor, localization, diameters, lesion and edema volumes and surgical radicality. Despite these comparable data, elderly presented with a significantly lower Karnofsky Performance status value on admission and remained consistently lower during the follow-up. We establish instead that there is no intrinsic correlation to the presence of IM and no significant increased risk of complications or recurrence in elderly patients, but rather only an increased risk of reduced performance status with mortality related to the comorbidity of the patient, primarily cardiovascular disease, and an intrinsic frailty of the aged population.
Language	English
Publishing date	2022-01-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12020351
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