Publications by authors named "Giovanni di Pietro"

7 Publications

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Myelodysplasia presenting as thoracic spinal epidural extramedullary hematopoiesis: a rare treatable cause of spinal cord myelopathy.

Skeletal Radiol 2012 May 13;41(5):611-4. Epub 2011 Sep 13.

Unit NINT Neuroimaging and Neurointervention, Department of Neurological and Sensorial Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Viale Mario Bracci 16, 53100 Siena, Italy.

We present clinical, magnetic resonance imaging, and pathological findings of a 61-year-old patient with an otherwise asymptomatic myelodysplastic syndrome presenting with progressive paraparesis from epidural thoracic spinal extramedullary hematopoiesis. Surgical spinal cord decompression resulted in complete clinical remission.
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http://dx.doi.org/10.1007/s00256-011-1268-2DOI Listing
May 2012

Neuroradiological follow-up of the growth of papillary tumor of the pineal region: a case report.

J Neurooncol 2009 Dec 11;95(3):433-435. Epub 2009 Jun 11.

Unit of Neuroimaging and Neurointervention, Azienda Ospedaliera Universitaria Senese, "Santa Maria alle Scotte" General Hospital, Viale Mario Bracci, 16-53100, Siena, Italy.

Papillary tumor of the pineal region (PTPR) is a recently described distinct clinicopathological entity. The purpose of this case report is to increase the knowledge of its neuroradiological findings and natural history by describing the long-term clinical and neuroradiological follow-up of a PTPR occurring in a 56-year-old Italian male patient. At magnetic resonance imaging (MRI) obtained at diagnosis, the lesion showed a subtle high signal intensity on T1-weighted imaging. Twenty-nine months later, MRI showed clearcut enlargement of the lesion, which had only a small area of high signal intensity on T1-weighted images, and a minimum apparent diffusion coefficient of 0.854 x 10(-3) mm(2)/s. Treatment included surgery followed by irradiation. Three-month MRI follow-up did not show disease relapse.
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http://dx.doi.org/10.1007/s11060-009-9931-3DOI Listing
December 2009

Surgical treatment of central nervous system malformations.

Handb Clin Neurol 2008 ;87:569-90

Department of Neurosurgery, Ospedale Pediatrico Meyer, Via Luca Giordano 13, Florence, Italy.

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http://dx.doi.org/10.1016/S0072-9752(07)87031-XDOI Listing
December 2010

Maximizing results in craniofacial surgery with bioresorbable fixation devices.

J Craniofac Surg 2007 Jul;18(4):926-30

Wake Forest University Baptist Medical Center, Plastic and Reconstructive Surgery Department, Winston-Salem, North Carolina, USA.

The resorbable plating system allows the infant's skull to grow once the system is resorbed, thus not inhibiting the necessary developmental growth seen with the titanium system. Despite marked improvements in long-term outcomes, there are still technical points that can be followed to maximize outcome while reducing and possibly eliminating minor complications such as plate palpability and visibility through the skin as well as skin breakdown over the plate. A retrospective electronic chart review was performed on the pediatric patient population who underwent craniofacial surgery with the use of resorbable fixation devices by the senior author (LG). Fifty-two patients underwent surgical correction for craniosynostosis with resorbable material (Craniosorb, Lactosorb, or Biosorb PDX). This series included patients with brachycephaly (17), anterior plagiocephaly (unilateral coronal synostosis; 16), trigonocephaly (11), multisuture craniosynostosis (7), and Cohen's craniotelencephalic dysplasia (1). The mean age at the time of the operation was 8 months and the mean follow up was 17 months. Eight patients experienced complications related to the resorbable material. Seven of the eight had complete resolution of symptoms after conservative treatment and one patient had complete resolution of the skin infection after plate removal. The purpose of this study was to evaluate the risks and complications with the use of resorbable material to establish guidelines for avoidance of surgical pitfalls that lead to increased risk of morbidity with the use of this material, particularly as it relates to plate visibility under the skin, plate palpability, skin breakdown, and skin infections over the plating system.
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http://dx.doi.org/10.1097/scs.0b013e3180a771e9DOI Listing
July 2007

Focal cortical dysplasia type 1b as a cause of severe epilepsy with multiple independent spike foci.

Brain Dev 2008 Jan 20;30(1):53-8. Epub 2007 Jun 20.

Department of Pediatrics, Section of Pediatric Neurology, Policlinico Le Scotte, University of Siena, Siena, Italy.

To investigate the clinical picture, the neurophysiological pattern, and neuropathological features of a young woman with severe drug-resistant epilepsy of unknown cause. We used the patient's clinical records from the age of 2 to 20years including neurophysiological patterns recorded via both scalp and cortex electrodes and results of studies conducted on the brain neuropathological specimen. The patient, with severe mental/psychomotor retardation, suffered from severe epilepsy from an early age, characterized by daily seizures of multiple types (atypical absences, tonic, and complex partial seizures), high frequency, and intractability. The neurophysiological pattern indicated multiple independent spike foci (SE-MISF). When she was 16, a vagal nerve stimulator was implanted without success. Neither neuroimaging (brain MRI and ictal SPECT) nor surface EEGs identified unique loci of seizure onset, establishing her as a candidate for a complete callosotomy. When the patient was 19, before the callosotomy, invasive EEG (i.e., electrocorticography) using just a few electrodes in different lobes showed the presence of a distinctive pattern. The surgical specimen, taken very close to one of the activity sites, showed architectural abnormalities and neurons that were giant or immature but not dysmorphic, indicative of focal cortical dysplasia (FCD) type 1b. Twelve months after the callosotomy, according to the Engel score, the patient exhibited a large improvement in quality of life, without permanent complications from the interhemispheric disconnection. (1) Hidden FCD type 1b could represent a missing diagnosis in patients with SE-MISF in the absence of other causes for their seizures. (2) Complete callosotomy can be efficacious in patients with SE-MISF with hidden FCD type 1b.
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http://dx.doi.org/10.1016/j.braindev.2007.05.010DOI Listing
January 2008