Giuliano Faccani - Academia.edu (original) (raw)
Uploads
Papers by Giuliano Faccani
Acta neurologica, 1993
First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury i... more First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury is characterized by disproportionately greater motor impairment in the upper compared to the lower extremities, bladder dysfunction and a variable degree of sensory loss below the level of injury. The syndrome has a good prognosis for neurologic and functional recovery. Spontaneous improvement of function is typical. Ten cases are reported. Clinical features, diagnosis and management are discussed.
The Neuroradiology Journal, 1989
Descriviamo 3 casi di tumore epidermoide del IV ventricolo, rara localizzazione di una neoplasia ... more Descriviamo 3 casi di tumore epidermoide del IV ventricolo, rara localizzazione di una neoplasia congenita the rappresenta circa l'1% di tutti i tumori cerebrali. Dopo alcuni cenni clinici viene trattata la diagnostica strumentale con tomografia computerizzata e tomografia a risonanza magnetica, sottolineando il ruolo di quest'ultima nella diagnosi differenziale con altre patologie della fossa cranica posteriore e la sua superiorità nella diagnosi di natura. I tumori epidermoidi presentano alla RM: 1) un segnale di intensity ridotta rispetto al parenchima nervoso nelle sequenze pesate in T1 ed in densità protonica ed un segnale di intensità aumentata nelle sequenze pesate in T2; 2) un segnale di intensità aumentata rispetto al liquor del IV ventricolo in tutte le sequenze usate, con la possibilità di ben delimitare l'estensione intraventricolare del tumore; 3) una disomogeneità dell'intensità del segnale nell'interno della massa tumorale, elemento utile nella dia...
Archimedica Editori, 1999
Clinical Neurophysiology, 2016
Journal of neurosurgical sciences, 2006
Treatment of unruptured cerebral aneurysms still represents an unsettled question in neurosurgica... more Treatment of unruptured cerebral aneurysms still represents an unsettled question in neurosurgical and neuroradiological communities. Although nowadays the indication for treatment have become relatively clear, indeed uncertainity remains for what concerns the proper treatment modality (surgical or endovascular)in terms of both the risk and the mid and long-term efficacy of the two procedures. The ''Unruptured Aneurysms Italian Study'' is a cooperative prospective study which aims to delineate the ''State of the Art'' in a nation based population. It has been designed: 1) to depict the nationwide modality of treatment of Unruptured Aneurysms, 2) to assess in the most objective way the overall treatment-related mortality and morbidity as well as the surgical and endovascular risk in the respective patient populations (it is not a surgical versus endovascular study) and 3) to asses the efficacy of the different procedures in the mid and long term period...
Clinical Neurophysiology, 2013
Persistent neurologic sequelae may be the consequences of brain aneurysms surgery. Aim of this st... more Persistent neurologic sequelae may be the consequences of brain aneurysms surgery. Aim of this study is to test the role of intraoperative neurophysiology in the prevention of postoperative deficits. Combined monitoring of combined m-MEPs and SEPs was attempted in 164 consecutive surgeries on 158 patients undergoing surgery for the treatment of 173 aneurisms. In 90 surgeries (54.9%) patients have suffered for SAH; 74 (54.1%) surgeries were performed for unrupted aneurysms. In 12 cases (7.3%), all of them affected by SAH, intraoperative neurophysiology documented a severe damage to motor or sensory/motor pathways: the overall monitorability was 92.7% (152 surgeries). Intraoperative modifications of neurophysiologic parameters were observed in 28 (18.4%) of the remaining 124 cases, transient in 17 (11.2%) and persistent in 11 (7.2%). Combined modifications of SEPs and m-MEPs (a pattern of cortical ischemia) were observed in 10 cases (reversible in 4, persistent in 6), isolated modifications of m-MEPs in 16 cases (11 transient, 5 persistent). In 2 cases a transient reduction in amplitude of SEPs was seen. All but one of cases with persistent modifications were followed by postoperative deficits. Intraoperative neurophysiology may detect an impending injury particularly on motor pathways and provide relevant information about sensory/motor outcome.
Clinical Neurophysiology, 2016
Change in somato-sensory evoked potentials (SSEP) or motor evoked potentials (MEPs) are variably ... more Change in somato-sensory evoked potentials (SSEP) or motor evoked potentials (MEPs) are variably associated with clinical modifications. This study aimed to investigate if neurophysiological changes during IOM are related with clinical modifications in patients underwent spinal surgery. 71 patients that presented neurophysiological changes in somato-sensory evoked potentials (SEPs) or motor evoked potentials (MEPs) during spinal surgery were considered. The pathologies included in the study were: cervical/thoracic myelopathy (27 pts, 38%), spinal cord tumours (31 pts, 44%), scoliosis correction (3 pts, 4%), trauma (7 pts, 10%) and spinal vascular malformations (3 pts, 4%). Clinical outcome, estimated with McCormick scale, was evaluated in the immediate postoperative period and at one month follow-up. Neurophysiological changes were associated to clinical modifications at one month follow-up in 36 patients (51%). When a clinical improvement was observed (19 pts), the percentage of SEPs or MEPs reappearance from basal absence was 42% (8 pts). Contrariwise, evoked potentials disappeared in 65% (11 pts) of observed clinical worsening (17 pts). Neurophysiological modifications in SEPs or MEPS seem to be associated clinical changes in patients submitted spinal surgery.
Rivista di Neuroradiologia, 2002
In the evaluation of poor grade patients with subarachnoid haemorrhage, different clinical aspect... more In the evaluation of poor grade patients with subarachnoid haemorrhage, different clinical aspects have to be considered involving many specialists. The occlusion of aneurysm in the acute phase allows a more aggressive treatment of the complications related to haemorrhage. In this context, whenever possible, the endovascular exclusion of the aneurysm as a less invasive method can be very useful to improve the prognosis of these critical patients.
Journal of the Peripheral Nervous System, 2010
The objectives of this study were (1) epidemiological analysis of traumatic peripheral nerve inju... more The objectives of this study were (1) epidemiological analysis of traumatic peripheral nerve injuries; (2) assessment of neuropathic pain and quality of life in patients affected by traumatic neuropathies. All consecutive patients with a diagnosis of traumatic neuropathies from four Italian centres were enrolled. Electromyography confirmed clinical level and site diagnosis of peripheral nerve injury. All patients were evaluated by disability scales, pain screening tools, and quality of life tests. 158 consecutive patients for a total of 211 traumatic neuropathies were analysed. The brachial plexus was a frequent site of traumatic injury (36%) and the radial, ulnar, and peroneal were the most commonly involved nerves with 15% of iatrogenic injuries. Seventy-two percent of the traumatic neuropathies were painful. Pain was present in 66% and neuropathic pain in 50% of all patients. Patients had worse quality of life scores than did the healthy Italian population. Moreover, there was a strong correlation between the quality of life and the severity of the pain, particularly neuropathic pain (Short Form-36 [SF-36] p < 0.005; Beck Depression Inventory [BDI] p < 0.0001). Traumatic neuropathies were more frequent in young males after road accidents, mainly in the upper limbs. Severe neuropathic pain and not only disability contributed to worsening the quality of life in patients with traumatic neuropathies.
Clinical Neurophysiology, 2013
Clinical Neurophysiology, 2016
Acta neurologica, 1993
First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury i... more First described by Schneider in 1954, the syndrome of acute central cervical spinal cord injury is characterized by disproportionately greater motor impairment in the upper compared to the lower extremities, bladder dysfunction and a variable degree of sensory loss below the level of injury. The syndrome has a good prognosis for neurologic and functional recovery. Spontaneous improvement of function is typical. Ten cases are reported. Clinical features, diagnosis and management are discussed.
The Neuroradiology Journal, 1989
Descriviamo 3 casi di tumore epidermoide del IV ventricolo, rara localizzazione di una neoplasia ... more Descriviamo 3 casi di tumore epidermoide del IV ventricolo, rara localizzazione di una neoplasia congenita the rappresenta circa l'1% di tutti i tumori cerebrali. Dopo alcuni cenni clinici viene trattata la diagnostica strumentale con tomografia computerizzata e tomografia a risonanza magnetica, sottolineando il ruolo di quest'ultima nella diagnosi differenziale con altre patologie della fossa cranica posteriore e la sua superiorità nella diagnosi di natura. I tumori epidermoidi presentano alla RM: 1) un segnale di intensity ridotta rispetto al parenchima nervoso nelle sequenze pesate in T1 ed in densità protonica ed un segnale di intensità aumentata nelle sequenze pesate in T2; 2) un segnale di intensità aumentata rispetto al liquor del IV ventricolo in tutte le sequenze usate, con la possibilità di ben delimitare l'estensione intraventricolare del tumore; 3) una disomogeneità dell'intensità del segnale nell'interno della massa tumorale, elemento utile nella dia...
Archimedica Editori, 1999
Clinical Neurophysiology, 2016
Journal of neurosurgical sciences, 2006
Treatment of unruptured cerebral aneurysms still represents an unsettled question in neurosurgica... more Treatment of unruptured cerebral aneurysms still represents an unsettled question in neurosurgical and neuroradiological communities. Although nowadays the indication for treatment have become relatively clear, indeed uncertainity remains for what concerns the proper treatment modality (surgical or endovascular)in terms of both the risk and the mid and long-term efficacy of the two procedures. The ''Unruptured Aneurysms Italian Study'' is a cooperative prospective study which aims to delineate the ''State of the Art'' in a nation based population. It has been designed: 1) to depict the nationwide modality of treatment of Unruptured Aneurysms, 2) to assess in the most objective way the overall treatment-related mortality and morbidity as well as the surgical and endovascular risk in the respective patient populations (it is not a surgical versus endovascular study) and 3) to asses the efficacy of the different procedures in the mid and long term period...
Clinical Neurophysiology, 2013
Persistent neurologic sequelae may be the consequences of brain aneurysms surgery. Aim of this st... more Persistent neurologic sequelae may be the consequences of brain aneurysms surgery. Aim of this study is to test the role of intraoperative neurophysiology in the prevention of postoperative deficits. Combined monitoring of combined m-MEPs and SEPs was attempted in 164 consecutive surgeries on 158 patients undergoing surgery for the treatment of 173 aneurisms. In 90 surgeries (54.9%) patients have suffered for SAH; 74 (54.1%) surgeries were performed for unrupted aneurysms. In 12 cases (7.3%), all of them affected by SAH, intraoperative neurophysiology documented a severe damage to motor or sensory/motor pathways: the overall monitorability was 92.7% (152 surgeries). Intraoperative modifications of neurophysiologic parameters were observed in 28 (18.4%) of the remaining 124 cases, transient in 17 (11.2%) and persistent in 11 (7.2%). Combined modifications of SEPs and m-MEPs (a pattern of cortical ischemia) were observed in 10 cases (reversible in 4, persistent in 6), isolated modifications of m-MEPs in 16 cases (11 transient, 5 persistent). In 2 cases a transient reduction in amplitude of SEPs was seen. All but one of cases with persistent modifications were followed by postoperative deficits. Intraoperative neurophysiology may detect an impending injury particularly on motor pathways and provide relevant information about sensory/motor outcome.
Clinical Neurophysiology, 2016
Change in somato-sensory evoked potentials (SSEP) or motor evoked potentials (MEPs) are variably ... more Change in somato-sensory evoked potentials (SSEP) or motor evoked potentials (MEPs) are variably associated with clinical modifications. This study aimed to investigate if neurophysiological changes during IOM are related with clinical modifications in patients underwent spinal surgery. 71 patients that presented neurophysiological changes in somato-sensory evoked potentials (SEPs) or motor evoked potentials (MEPs) during spinal surgery were considered. The pathologies included in the study were: cervical/thoracic myelopathy (27 pts, 38%), spinal cord tumours (31 pts, 44%), scoliosis correction (3 pts, 4%), trauma (7 pts, 10%) and spinal vascular malformations (3 pts, 4%). Clinical outcome, estimated with McCormick scale, was evaluated in the immediate postoperative period and at one month follow-up. Neurophysiological changes were associated to clinical modifications at one month follow-up in 36 patients (51%). When a clinical improvement was observed (19 pts), the percentage of SEPs or MEPs reappearance from basal absence was 42% (8 pts). Contrariwise, evoked potentials disappeared in 65% (11 pts) of observed clinical worsening (17 pts). Neurophysiological modifications in SEPs or MEPS seem to be associated clinical changes in patients submitted spinal surgery.
Rivista di Neuroradiologia, 2002
In the evaluation of poor grade patients with subarachnoid haemorrhage, different clinical aspect... more In the evaluation of poor grade patients with subarachnoid haemorrhage, different clinical aspects have to be considered involving many specialists. The occlusion of aneurysm in the acute phase allows a more aggressive treatment of the complications related to haemorrhage. In this context, whenever possible, the endovascular exclusion of the aneurysm as a less invasive method can be very useful to improve the prognosis of these critical patients.
Journal of the Peripheral Nervous System, 2010
The objectives of this study were (1) epidemiological analysis of traumatic peripheral nerve inju... more The objectives of this study were (1) epidemiological analysis of traumatic peripheral nerve injuries; (2) assessment of neuropathic pain and quality of life in patients affected by traumatic neuropathies. All consecutive patients with a diagnosis of traumatic neuropathies from four Italian centres were enrolled. Electromyography confirmed clinical level and site diagnosis of peripheral nerve injury. All patients were evaluated by disability scales, pain screening tools, and quality of life tests. 158 consecutive patients for a total of 211 traumatic neuropathies were analysed. The brachial plexus was a frequent site of traumatic injury (36%) and the radial, ulnar, and peroneal were the most commonly involved nerves with 15% of iatrogenic injuries. Seventy-two percent of the traumatic neuropathies were painful. Pain was present in 66% and neuropathic pain in 50% of all patients. Patients had worse quality of life scores than did the healthy Italian population. Moreover, there was a strong correlation between the quality of life and the severity of the pain, particularly neuropathic pain (Short Form-36 [SF-36] p < 0.005; Beck Depression Inventory [BDI] p < 0.0001). Traumatic neuropathies were more frequent in young males after road accidents, mainly in the upper limbs. Severe neuropathic pain and not only disability contributed to worsening the quality of life in patients with traumatic neuropathies.
Clinical Neurophysiology, 2013
Clinical Neurophysiology, 2016