Roberto Altieri | University of torino (original) (raw)

Papers by Roberto Altieri

Research paper thumbnail of Molecular biology of gliomas: present and future challenges

Translational medicine @ UniSa, 2014

Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a w... more Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a wide range of individuals. Malignant glioma is the most common intra axial tumor in the adult. Many researches on this theme brought advances in the knowledge of gliomas biology and pathogenesis and to the development of new agents for targeted molecular therapy. Recent studies focused on either tumor metabolism analysis or epigenetic regulation in the pathogenesis or maintenance of brain tumors. This Review summarizes these developments analyzing molecular pathology and possible further developments for targeted therapies.

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Role of nitric oxide and mechanisms involved into cerebral injury after subarachnoid hemorrhage: is nitric oxide a possible answer to cerebral vasospasm?

Journal of neurosurgical sciences, Jan 20, 2015

Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrh... more Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrhage (SAH). Therapy is only partially effective because cerebral arterial constriction is not fully understood yet. One of the most important biological messenger associated to SAH is nitric oxide (NO), that is considered local regulator of cerebral blood flow. Different nitric oxide synthase (NOS) forms play a role in different biological processes, one of which is to link neuronal activity to blood flow in cerebral cortex. We performed a reassessment of the literature to summarize the role of NO as the main inflammatory pathway activated after SAH to clarify its importance for treatment of vasospasm.

Research paper thumbnail of Emorragia subaracnoidea: ischemia cerebrale precoce e tardiva dopo trattamento dell'aneurisma

OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorra... more OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorragia subaracnoidea (ESA) è l ' ischemia cerebrale ad insorgenza precoce (da ro-ura dell ' aneurisma o alla procedura scelta per il tra-amento) o tardiva. Al fine di valutare la relazione tra queste due Dpologie di ischemia e l ' outcome del paziente abbiamo analizzato la frequenza relaDva dell ' infarto precoce vs tardivo dopo ESA nei pazienD tra-aD con clipping o coiling. METODI E ' stata effe-uata un ' analisi retrospeFva dei pazienD con ESA afferiD dal 2003 al 2015. Sono staD raccolD i daD demografici , WFNS score al ricovero , Fisher grade , sede dell ' aneurisma , metodo di tra-amento (clipping o coiling) , vasospasmo ed outcome (GOS score) alla dimissione. TC encefalo a 24-­‐48 ore post-­‐tra-amento o TC encefalo eseguita alla comparsa di disturbi neurologici sono state confrontate con indagini strumentali finali al fine di definire la condizione di ische...

Research paper thumbnail of Are acute subdural hematomas possible without head trauma?

Asian journal of neurosurgery

Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to ... more Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs.

Research paper thumbnail of THE CHALLANGE OF VESTIBULAR SCHWANNOMA IN ELDERLY: WHY WE CHOOSE THE TRANSLABIRINTHINE APPROACH

Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling sym... more Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling symptoms mainly due to the compression of the vestibular nerves, the cochlear branch of VIII cranial nerve and the brainstem. Typical clinical presentation is hearing loss, tinnitus, vertigo and imbalance. Large tumors compressing the brainstem lead to a worsening of disequilibrium facial and trigeminal disfunction. Impairment of balance in the elderly (over 65 years old) can result from different pathologies affecting one or more postural regulation levels (sensory, central processing, and motor systems) in addition to normal age-related refractive changes and to orthopedic disorders. VS related hearing loss and disequilibrium reduce autonomy and performance status, causing or worsening pre existing disability in elderly. Microsurgical resection allows to decompress the brainstem and cranial nerve and vascular structures, thus reducing symptoms. For large and adherent tumors subtotal resec...

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Emorragia subaracnoidea: ischemia cerebrale precoce e tardiva dopo trattamento dell'aneurisma

OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorra... more OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorragia subaracnoidea (ESA) è l ' ischemia cerebrale ad insorgenza precoce (da ro-ura dell ' aneurisma o alla procedura scelta per il tra-amento) o tardiva. Al fine di valutare la relazione tra queste due Dpologie di ischemia e l ' outcome del paziente abbiamo analizzato la frequenza relaDva dell ' infarto precoce vs tardivo dopo ESA nei pazienD tra-aD con clipping o coiling. METODI E ' stata effe-uata un ' analisi retrospeFva dei pazienD con ESA afferiD dal 2003 al 2015. Sono staD raccolD i daD demografici , WFNS score al ricovero , Fisher grade , sede dell ' aneurisma , metodo di tra-amento (clipping o coiling) , vasospasmo ed outcome (GOS score) alla dimissione. TC encefalo a 24-­‐48 ore post-­‐tra-amento o TC encefalo eseguita alla comparsa di disturbi neurologici sono state confrontate con indagini strumentali finali al fine di definire la condizione di ische...

Research paper thumbnail of CHIRURGIA DEI MENINGIOMI: ESPERIENZA DI UN SINGOLO CENTRO

Research paper thumbnail of STIMOLAZIONE DEL NERVO VAGO NELL’EPILESSIA FARMACO RESISTENTE: LA NOSTRA ESPERIENZA E REVISIONE DELLA LETTERATURA

INTRODUZIONE: Il tasso di incidenza dell'epilessia nella popolazione generale italiana è di circa... more INTRODUZIONE: Il tasso di incidenza dell'epilessia nella popolazione generale italiana è di circa 1%, con tassi di farmaco resistenza riportati di circa il 30-40% degli epilettici. Di questi, circa il 15-30% è suscettibile di utile trattamento chirurgico (ablativo/neuromodulativo). Nel 1997 l'FDA ha approvato l'utilizzo di impianti di stimolatori del nervo vago sinistro per modulare, tramite l'attivazione intermittente di fibre di piccolo diametro con proiezioni diffuse, l'attività del tronco e della corteccia encefalica. Tra i principali effetti collaterali della procedura si riportano raucedine (20-30%), tosse (7-30%), dispnea (6-25%), nausea (7-15%). Tasso di mortalità: 10 morti improvvise in 2017 procedure. OBIETTIVI: Obiettivi dell'analisi erano la valutazione sia della tollerabilità che dell'efficacia clinica con controllo EEG e variazioni nel Qualitiy of Life index.

Research paper thumbnail of DCC

Research paper thumbnail of THE CHALLANGE OF VESTIBULAR SCHWANNOMA IN ELDERLY: WHY WE CHOOSE THE TRANSLABIRINTHINE APPROACH

Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling sym... more Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling symptoms mainly due to the compression of the vestibular nerves, the cochlear branch of VIII cranial nerve and the brainstem. Typical clinical presentation is hearing loss, tinnitus, vertigo and imbalance. Large tumors compressing the brainstem lead to a worsening of disequilibrium facial and trigeminal disfunction. Impairment of balance in the elderly (over 65 years old) can result from different pathologies affecting one or more postural regulation levels (sensory, central processing, and motor systems) in addition to normal age-related refractive changes and to orthopedic disorders. VS related hearing loss and disequilibrium reduce autonomy and performance status, causing or worsening pre existing disability in elderly. Microsurgical resection allows to decompress the brainstem and cranial nerve and vascular structures, thus reducing symptoms. For large and adherent tumors subtotal resec...

Research paper thumbnail of Molecular biology of gliomas: present and future challenges

Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a w... more Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a wide range of individuals. Malignant glioma is the most common intra axial tumor in the adult. Many researches on this theme brought advances in the knowledge of gliomas biology and pathogenesis and to the development of new agents for targeted molecular therapy. Recent studies focused on either tumor metabolism analysis or epigenetic regulation in the pathogenesis or maintenance of brain tumors. This Review summarizes these developments analyzing molecular pathology and possible further developments for targeted therapies.

Research paper thumbnail of Are acute subdural hematomas possible without head trauma?

Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to ... more Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs.

Research paper thumbnail of Double concentric craniotomy: Safe and effective technique to achieve an en bloc resection of tumor involving both skull and duraa

International Journal of Surgery Case Reports, 2015

Please cite this article in press as: R. Fornaro, et al., Double concentric craniotomy: Safe and ... more Please cite this article in press as: R. Fornaro, et al., Double concentric craniotomy: Safe and effective technique to achieve an en bloc resection of tumor involving both skull and duraa, Int J Surg Case Rep (2015), http://dx.

Research paper thumbnail of Spinal deformity: how to extend the fusion to the sacro-pelvis?

Research paper thumbnail of P17.26 * IS NICU MANDATORY AFTER SURGERY IN ADULT HGG? A SINGLE CENTER EXPERIENCE

Neuro-Oncology, 2014

Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may re... more Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may require neurocritical intensive care unit (NICU) admittance. Actually there is no consensus whether there is real need for NICU for this patients; often the possibility is related to surgeon preferences. In literature there are still little data on clinical parameters associated with long-term outcome after neurocritical care. We retrospectively analyzed 175 patients, that underwent surgical resection for HGG in our division; 15 of which needed NICU admittance after surgery. We compare this group with a homogeneous control group of 15 patients that did not need NICU after surgery. Statistical analysis (p value set at 0.05) did not show any statistical difference between the two groups and we suggest that NICU should not always be used after craniotomy for supratentorial HGG.

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Role of nitric oxide and mechanisms involved into cerebral injury after subarachnoid hemorrhage: is nitric oxide a possible answer to cerebral vasospasm?

Journal of neurosurgical sciences, Jan 20, 2015

Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrh... more Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrhage (SAH). Therapy is only partially effective because cerebral arterial constriction is not fully understood yet. One of the most important biological messenger associated to SAH is nitric oxide (NO), that is considered local regulator of cerebral blood flow. Different nitric oxide synthase (NOS) forms play a role in different biological processes, one of which is to link neuronal activity to blood flow in cerebral cortex. We performed a reassessment of the literature to summarize the role of NO as the main inflammatory pathway activated after SAH to clarify its importance for treatment of vasospasm.

Research paper thumbnail of A bone fide atypical fibroxanthoma of penis

Urology annals, 2014

Malignant mesenchymal tumors of the penis are very rare and they have vascular origin. We present... more Malignant mesenchymal tumors of the penis are very rare and they have vascular origin. We present a case of a 71-year-old man with a painless nodule of 2.0 cm in diameter located in the penile foreskin. There was no history of urinary or sexually transmitted disease. An excisional biopsy revealed a markedly pleomorphic sarcoma resembling atypical fibroxanthoma (AFX) associated with a squamous cell carcinoma in situ. The patient refused a wide re-excision and was free of disease after 36 months. Because the different therapeutic management and prognosis, differential diagnosis should be made with sarcomatoid squamous cell carcinoma and melanoma: A diagnosis of AFX or malignant fibrous histiocytoma may be considered only after the complete exclusion of these two entities.

Research paper thumbnail of Molecular biology of gliomas: present and future challenges

Translational medicine @ UniSa, 2014

Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a w... more Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a wide range of individuals. Malignant glioma is the most common intra axial tumor in the adult. Many researches on this theme brought advances in the knowledge of gliomas biology and pathogenesis and to the development of new agents for targeted molecular therapy. Recent studies focused on either tumor metabolism analysis or epigenetic regulation in the pathogenesis or maintenance of brain tumors. This Review summarizes these developments analyzing molecular pathology and possible further developments for targeted therapies.

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Role of nitric oxide and mechanisms involved into cerebral injury after subarachnoid hemorrhage: is nitric oxide a possible answer to cerebral vasospasm?

Journal of neurosurgical sciences, Jan 20, 2015

Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrh... more Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrhage (SAH). Therapy is only partially effective because cerebral arterial constriction is not fully understood yet. One of the most important biological messenger associated to SAH is nitric oxide (NO), that is considered local regulator of cerebral blood flow. Different nitric oxide synthase (NOS) forms play a role in different biological processes, one of which is to link neuronal activity to blood flow in cerebral cortex. We performed a reassessment of the literature to summarize the role of NO as the main inflammatory pathway activated after SAH to clarify its importance for treatment of vasospasm.

Research paper thumbnail of Emorragia subaracnoidea: ischemia cerebrale precoce e tardiva dopo trattamento dell'aneurisma

OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorra... more OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorragia subaracnoidea (ESA) è l ' ischemia cerebrale ad insorgenza precoce (da ro-ura dell ' aneurisma o alla procedura scelta per il tra-amento) o tardiva. Al fine di valutare la relazione tra queste due Dpologie di ischemia e l ' outcome del paziente abbiamo analizzato la frequenza relaDva dell ' infarto precoce vs tardivo dopo ESA nei pazienD tra-aD con clipping o coiling. METODI E ' stata effe-uata un ' analisi retrospeFva dei pazienD con ESA afferiD dal 2003 al 2015. Sono staD raccolD i daD demografici , WFNS score al ricovero , Fisher grade , sede dell ' aneurisma , metodo di tra-amento (clipping o coiling) , vasospasmo ed outcome (GOS score) alla dimissione. TC encefalo a 24-­‐48 ore post-­‐tra-amento o TC encefalo eseguita alla comparsa di disturbi neurologici sono state confrontate con indagini strumentali finali al fine di definire la condizione di ische...

Research paper thumbnail of Are acute subdural hematomas possible without head trauma?

Asian journal of neurosurgery

Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to ... more Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs.

Research paper thumbnail of THE CHALLANGE OF VESTIBULAR SCHWANNOMA IN ELDERLY: WHY WE CHOOSE THE TRANSLABIRINTHINE APPROACH

Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling sym... more Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling symptoms mainly due to the compression of the vestibular nerves, the cochlear branch of VIII cranial nerve and the brainstem. Typical clinical presentation is hearing loss, tinnitus, vertigo and imbalance. Large tumors compressing the brainstem lead to a worsening of disequilibrium facial and trigeminal disfunction. Impairment of balance in the elderly (over 65 years old) can result from different pathologies affecting one or more postural regulation levels (sensory, central processing, and motor systems) in addition to normal age-related refractive changes and to orthopedic disorders. VS related hearing loss and disequilibrium reduce autonomy and performance status, causing or worsening pre existing disability in elderly. Microsurgical resection allows to decompress the brainstem and cranial nerve and vascular structures, thus reducing symptoms. For large and adherent tumors subtotal resec...

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Emorragia subaracnoidea: ischemia cerebrale precoce e tardiva dopo trattamento dell'aneurisma

OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorra... more OBIETTIVO Uno dei maggiori fa-ori che contribuiscono ad un " poor " outcome dopo emorragia subaracnoidea (ESA) è l ' ischemia cerebrale ad insorgenza precoce (da ro-ura dell ' aneurisma o alla procedura scelta per il tra-amento) o tardiva. Al fine di valutare la relazione tra queste due Dpologie di ischemia e l ' outcome del paziente abbiamo analizzato la frequenza relaDva dell ' infarto precoce vs tardivo dopo ESA nei pazienD tra-aD con clipping o coiling. METODI E ' stata effe-uata un ' analisi retrospeFva dei pazienD con ESA afferiD dal 2003 al 2015. Sono staD raccolD i daD demografici , WFNS score al ricovero , Fisher grade , sede dell ' aneurisma , metodo di tra-amento (clipping o coiling) , vasospasmo ed outcome (GOS score) alla dimissione. TC encefalo a 24-­‐48 ore post-­‐tra-amento o TC encefalo eseguita alla comparsa di disturbi neurologici sono state confrontate con indagini strumentali finali al fine di definire la condizione di ische...

Research paper thumbnail of CHIRURGIA DEI MENINGIOMI: ESPERIENZA DI UN SINGOLO CENTRO

Research paper thumbnail of STIMOLAZIONE DEL NERVO VAGO NELL’EPILESSIA FARMACO RESISTENTE: LA NOSTRA ESPERIENZA E REVISIONE DELLA LETTERATURA

INTRODUZIONE: Il tasso di incidenza dell'epilessia nella popolazione generale italiana è di circa... more INTRODUZIONE: Il tasso di incidenza dell'epilessia nella popolazione generale italiana è di circa 1%, con tassi di farmaco resistenza riportati di circa il 30-40% degli epilettici. Di questi, circa il 15-30% è suscettibile di utile trattamento chirurgico (ablativo/neuromodulativo). Nel 1997 l'FDA ha approvato l'utilizzo di impianti di stimolatori del nervo vago sinistro per modulare, tramite l'attivazione intermittente di fibre di piccolo diametro con proiezioni diffuse, l'attività del tronco e della corteccia encefalica. Tra i principali effetti collaterali della procedura si riportano raucedine (20-30%), tosse (7-30%), dispnea (6-25%), nausea (7-15%). Tasso di mortalità: 10 morti improvvise in 2017 procedure. OBIETTIVI: Obiettivi dell'analisi erano la valutazione sia della tollerabilità che dell'efficacia clinica con controllo EEG e variazioni nel Qualitiy of Life index.

Research paper thumbnail of DCC

Research paper thumbnail of THE CHALLANGE OF VESTIBULAR SCHWANNOMA IN ELDERLY: WHY WE CHOOSE THE TRANSLABIRINTHINE APPROACH

Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling sym... more Vestibular Schwannoma (VS) is an histologically benign tumor that causes severe and disabling symptoms mainly due to the compression of the vestibular nerves, the cochlear branch of VIII cranial nerve and the brainstem. Typical clinical presentation is hearing loss, tinnitus, vertigo and imbalance. Large tumors compressing the brainstem lead to a worsening of disequilibrium facial and trigeminal disfunction. Impairment of balance in the elderly (over 65 years old) can result from different pathologies affecting one or more postural regulation levels (sensory, central processing, and motor systems) in addition to normal age-related refractive changes and to orthopedic disorders. VS related hearing loss and disequilibrium reduce autonomy and performance status, causing or worsening pre existing disability in elderly. Microsurgical resection allows to decompress the brainstem and cranial nerve and vascular structures, thus reducing symptoms. For large and adherent tumors subtotal resec...

Research paper thumbnail of Molecular biology of gliomas: present and future challenges

Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a w... more Malignant brain tumours are one of the most relevant causes of morbidity and mortality across a wide range of individuals. Malignant glioma is the most common intra axial tumor in the adult. Many researches on this theme brought advances in the knowledge of gliomas biology and pathogenesis and to the development of new agents for targeted molecular therapy. Recent studies focused on either tumor metabolism analysis or epigenetic regulation in the pathogenesis or maintenance of brain tumors. This Review summarizes these developments analyzing molecular pathology and possible further developments for targeted therapies.

Research paper thumbnail of Are acute subdural hematomas possible without head trauma?

Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to ... more Acute subdural hematomas (ASDHs) are rarely reported in the literature. In general, it is due to head trauma, but if the traumatic event is very mild, it is inadequate to explain the ASDH occurrence. Risk factors for the development of spontaneous ASDH include hypertension, vascular abnormalities and deficit of coagulation. We present two cases of ASDH in patients with the coagulation deficit and review of the literature to understand the coagulation factors role and platelet role in the management of ASDHs.

Research paper thumbnail of Double concentric craniotomy: Safe and effective technique to achieve an en bloc resection of tumor involving both skull and duraa

International Journal of Surgery Case Reports, 2015

Please cite this article in press as: R. Fornaro, et al., Double concentric craniotomy: Safe and ... more Please cite this article in press as: R. Fornaro, et al., Double concentric craniotomy: Safe and effective technique to achieve an en bloc resection of tumor involving both skull and duraa, Int J Surg Case Rep (2015), http://dx.

Research paper thumbnail of Spinal deformity: how to extend the fusion to the sacro-pelvis?

Research paper thumbnail of P17.26 * IS NICU MANDATORY AFTER SURGERY IN ADULT HGG? A SINGLE CENTER EXPERIENCE

Neuro-Oncology, 2014

Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may re... more Surgery in high grade gliomas (HGG) is often related to peri-operative complications, that may require neurocritical intensive care unit (NICU) admittance. Actually there is no consensus whether there is real need for NICU for this patients; often the possibility is related to surgeon preferences. In literature there are still little data on clinical parameters associated with long-term outcome after neurocritical care. We retrospectively analyzed 175 patients, that underwent surgical resection for HGG in our division; 15 of which needed NICU admittance after surgery. We compare this group with a homogeneous control group of 15 patients that did not need NICU after surgery. Statistical analysis (p value set at 0.05) did not show any statistical difference between the two groups and we suggest that NICU should not always be used after craniotomy for supratentorial HGG.

Research paper thumbnail of Say “no” to spinal cord injury: is nitric oxide an option for therapeutic strategies?

International Journal of Neuroscience, 2015

a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, ... more a literature review was made to investigate the role of nitric oxide (NO) in spinal cord injury, a pathological condition that leads to motor, sensory, and autonomic deficit. Besides, we were interested in potential therapeutic strategies interfering with NO mechanism of secondary damage. A literature search using PubMed Medline database has been performed. excessive NO production after spinal cord injury promotes oxidative damage perpetuating the injury causing neuronal loss at the injured site and in the surrounding area. different therapeutic approaches for contrasting or avoiding NO secondary damage have been studied, these include nitric oxide synthase inhibitors, compounds that interfere with inducible NO synthase expression, and molecules working as antioxidant. Further studies are needed to explain the neuroprotective or cytotoxic role of the different isoforms of NO synthase and the other mediators that take part or influence the NO cascade. In this way, it would be possible to find new therapeutic targets and furthermore to extend the experimentation to humans.

Research paper thumbnail of Role of nitric oxide and mechanisms involved into cerebral injury after subarachnoid hemorrhage: is nitric oxide a possible answer to cerebral vasospasm?

Journal of neurosurgical sciences, Jan 20, 2015

Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrh... more Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrhage (SAH). Therapy is only partially effective because cerebral arterial constriction is not fully understood yet. One of the most important biological messenger associated to SAH is nitric oxide (NO), that is considered local regulator of cerebral blood flow. Different nitric oxide synthase (NOS) forms play a role in different biological processes, one of which is to link neuronal activity to blood flow in cerebral cortex. We performed a reassessment of the literature to summarize the role of NO as the main inflammatory pathway activated after SAH to clarify its importance for treatment of vasospasm.

Research paper thumbnail of A bone fide atypical fibroxanthoma of penis

Urology annals, 2014

Malignant mesenchymal tumors of the penis are very rare and they have vascular origin. We present... more Malignant mesenchymal tumors of the penis are very rare and they have vascular origin. We present a case of a 71-year-old man with a painless nodule of 2.0 cm in diameter located in the penile foreskin. There was no history of urinary or sexually transmitted disease. An excisional biopsy revealed a markedly pleomorphic sarcoma resembling atypical fibroxanthoma (AFX) associated with a squamous cell carcinoma in situ. The patient refused a wide re-excision and was free of disease after 36 months. Because the different therapeutic management and prognosis, differential diagnosis should be made with sarcomatoid squamous cell carcinoma and melanoma: A diagnosis of AFX or malignant fibrous histiocytoma may be considered only after the complete exclusion of these two entities.