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GIACOMO PAVESI

Professore Associato
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze sede ex-Neuroscienze


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Pubblicazioni

2022 - Delayed Effect of Dendritic Cells Vaccination on Survival in Glioblastoma: A Systematic Review and Meta‐Analysis [Articolo su rivista]
Cozzi, S.; Najafi, M.; Gomar, M.; Ciammella, P.; Iotti, C.; Iaccarino, C.; Dominici, M.; Pavesi, G.; Chiavelli, C.; Kazemian, A.; Jahanbakhshi, A.
abstract

Background: Dendritic cell vaccination (DCV) strategies, thanks to a complex immune response, may flare tumor regression and improve patients’ long‐term survival. This meta‐analysis aims to assess the efficacy of DCV for newly diagnosed glioblastoma patients in clinical trials. Meth-ods: The study databases, including PubMed, Web of Knowledge, Google Scholar, Scopus, and Cochrane, were searched by two blinded investigators considering eligible studies based on the following keywords: “glioblastoma multiforme”, “dendritic cell”, “vaccination”, “immunother-apy”, “immune system”, “immune response”, “chemotherapy”, “recurrence”, and “te-mozolomide”. Among the 157 screened, only 15 articles were eligible for the final analysis. Results: Regimens including DCV showed no effect on 6‐month progression‐free survival (PFS, HR = 1.385, 95% CI: 0.822–2.335, p = 0.673) or on 6‐month overall survival (OS, HR = 1.408, 95% CI: 0.882–2.248, p = 0.754). In contrast, DCV led to significantly longer 1‐year OS (HR = 1.936, 95% CI: 1.396–2.85, p = 0.001) and longer 2‐year OS (HR = 3.670, 95% CI: 2.291–5.879, p = 0.001) versus control groups. Hence, introducing DCV could lead to increased 1 and 2‐year survival of patients by 1.9 and 3.6 times, respectively. Conclusion: Antitumor regimens including DCV can effectively improve mid-term survival in patients suffering glioblastoma multiforme (GBM), but its impact emerges only after one year from vaccination. These data indicate the need for more time to achieve an anti‐GBM immune response and suggest additional therapeutics, such as checkpoint inhibitors, to empower an earlier DCV action in patients affected by a very poor prognosis.


2022 - Freezing of gait in Parkinson’s disease patients treated with bilateral subthalamic nucleus deep brain stimulation: A long-term overview [Articolo su rivista]
DI RAUSO, Giulia; Cavallieri, Francesco; Campanini, Isabella; Gessani, Annalisa; Fioravanti, Valentina; Feletti, Alberto; Damiano, Benedetta; Scaltriti, Sara; Bardi, Elisa; Corni, MARIA GIULIA; Antonelli, Francesca; Rispoli, Vittorio; Cavalleri, Francesca; Molinari, MARIA ANGELA; Contardi, Sara; Menozzi, Elisa; Puzzolante, Annette; Rossi, Jessica; Meletti, Stefano; Biagini, Giuseppe; Pavesi, Giacomo; Fraix, Valerie; Lusuardi, Mirco; Fraternali, Alessandro; Versari, Annibale; Budriesi, Carla; Moro, Elena; Merlo, Andrea; Valzania, Franco
abstract

Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment in advanced Parkinson’s Disease (PD). However, the effects of STN-DBS on freezing of gait (FOG) are still debated, particularly in the long-term follow-up (>/=5-years). The main aim of the current study is to evaluate the long-term effects of STN-DBS on FOG. Twenty STN-DBS treated PD patients were included. Each patient was assessed before surgery through a detailed neurological evaluation, including FOG score, and reevaluated in the long-term (median follow-up: 5-years) in different stimulation and drug conditions. In the long term follow-up, FOG score significantly worsened in the off-stimulation/off-medication condition compared with the preoperative off-medication assessment (z = -1.930; p = 0.05) but not in the on-stimulation/off-medication (z = -0.357; p = 0.721). There was also a significant improvement of FOG at long-term assessment by comparing on-stimulation/off-medication and off-stimulation/off-medication conditions (z = -2.944; p = 0.003). These results highlight the possible beneficial long-term effects of STN-DBS on FOG.


2022 - Management and safety of intraoperative ventriculostomy during early surgery for ruptured intracranial aneurysms [Articolo su rivista]
Pavesi, Giacomo; Nasi, Davide; Moriconi, Elisa; Stanzani, Riccardo; Puzzolante, Annette; Lucchesi, Lucio; Cavallo, Selene Marika; Iaccarino, Corrado
abstract

Brain edema and/or acute hydrocephalus are common features that limit working space during early surgery of aneurysmal subarachnoid hemorrhage (aSAH). Intraoperative ventriculostomy offers an immediate brain relaxation. However, management and complications related to the routine use of intraoperative external ventricular drainage (iEVD) are not well investigated.


2022 - Middle meningeal artery embolization for chronic subdural hematomas. A systematic review of the literature focused on indications, technical aspects, and future possible perspectives [Articolo su rivista]
Di Cristofori, A.; Remida, P.; Patassini, M.; Piergallini, L.; Buonanno, R.; Bruno, R.; Carrabba, G.; Pavesi, G.; Iaccarino, C.; Giussani, C. G.
abstract

Background: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical diseases that affect elderly and fragile patients and as a consequence, management can be challenging. Surgery represents the standard treatment; however, alternative options are under investigation. Middle meningeal artery (MMA) embolization is considered a minimally invasive treatment although with poor evidence. In this review, we tried to summarize the findings about MMA embolization as a treatment for a CSDH to provide a useful guidance for clinical practice and for future speculative aspects. Methods: Literature review on PubMed until March 2021 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We conducted a research on PubMed with a various combinations of the keywords "CSDH"and "middle meningeal artery"and "embolization,""refractory subdural hematoma,"and then we reviewed the references of the relevant studies as additional source of eligible articles. Results: Among the 35 studies eligible for this review, 22 were case series, 11 were case reports, one was a technical note, and 1 was a randomized trial. A total of 746 patients were found in the literature. Failure rate of MMA embolization was between 3.9 and 8.9% of the cases according the indication to treat CSDH (upfront vs. after surgery). Conclusion: The global impression deriving from the data available and the literature is that MMA embolization is a safe procedure with very low complications and with a low failure rate, both when associated with surgery or in case of a standalone treatment.


2022 - Remodulation of neurosurgical activities in an Italian region (Emilia-Romagna) under COVID-19 emergency: maintaining the standard of care during the crisis [Articolo su rivista]
Mazzatenta, Diego; Zoli, Matteo; Cavallo, Michele A; Ferro, Salvatore; Giombelli, Ermanno; Pavesi, Giacomo; Sturiale, Carmelo; Tosatto, Luigino; Zucchelli, Mino
abstract


2021 - A light on the dark side: in vivo endoscopic anatomy of the posterior third ventricle and its variations in hydrocephalus [Articolo su rivista]
Feletti, Alberto; Fiorindi, Alessandro; Lavecchia, Vincenzo; Boscolo-Berto, Rafael; Marton, Elisabetta; Macchi, Veronica; De Caro, Raffaele; Longatti, Pierluigi; Porzionato, Andrea; Pavesi, Giacomo
abstract

Despite the technological advancements of neurosurgery, the posterior part of the third ventricle has always been the "dark side" of the ventricle. However, flexible endoscopy offers the opportunity for a direct, in vivo inspection and detailed description of the posterior third ventricle in physiological and pathological conditions. The purposes of this study were to describe the posterior wall of the third ventricle, detailing its normal anatomy and surgical landmarks, and to assess the effect of chronic hydrocephalus on the anatomy of this hidden region.


2021 - Clipping of unruptured middle cerebral artery aneurysms in an average caseload center: a sustainable procedure? [Articolo su rivista]
Pavesi, G.; Nasi, D.
abstract


2021 - Endoscopic-assisted removal of ventricular catheter in high-risk patients [Articolo su rivista]
Puzzolante, A.; Pavesi, G.; Feletti, A.
abstract

Introduction. Ventriculoperitoneal shunt carries a non-negligible failure rate often requiring multiple surgical procedures during patient-s lifetime. The most common cause is obstruction of the ventricular catheter that can be embedded in adhesions with choroid plexus, ependymal tissue, and fibrous material. In such cases, or when an intraventricular tumor is present, particular attention must be paid when removal of the ventricular catheter is required. The potential adhesions with the tip of the ventricular catheter results in an increased risk of life-threatening hemorrhage. Materials and methods. We present the case of a ventriculoperitoneal shunt proximal revision in a von Hippel-Lindau affected patient. The neuroendoscopic exploration to restore the patency of the ventricular system made it possible to notice a fibrous adhesion between the tip of the catheter and a pituitary hemangioblastoma abutting into the third ventricle. Discussion. Pituitary stalk hemangioblastoma is an infrequent localization, although it represents the most common supratentorial site of hemangioblastoma in patients affected by von Hippel-Lindau syndrome. In this and in similar cases, endoscopic-assisted shunt revision allows visualizing the tip of the ventricular catheter and eventual adhesions that can be coagulated and cut by simple maneuvers, without any morbidity for patients. Conclusion. In a ventriculoperitoneal shunt revision with the concomitant presence of an intraventricular tumor or lesion at risk of bleeding, the surgical procedure should be performed under neuroendoscopic observation to reduce the risk of intraventricular hemorrhage.


2021 - fMRI-Based Effective Connectivity in Surgical Remediable Epilepsies: A Pilot Study [Articolo su rivista]
Vaudano, A. E.; Mirandola, L.; Talami, F.; Giovannini, G.; Monti, G.; Riguzzi, P.; Volpi, L.; Michelucci, R.; Bisulli, F.; Pasini, E.; Tinuper, P.; Di Vito, L.; Gessaroli, G.; Malagoli, M.; Pavesi, G.; Cardinale, F.; Tassi, L.; Lemieux, L.; Meletti, S.
abstract

Simultaneous EEG-fMRI can contribute to identify the epileptogenic zone (EZ) in focal epilepsies. However, fMRI maps related to Interictal Epileptiform Discharges (IED) commonly show multiple regions of signal change rather than focal ones. Dynamic causal modeling (DCM) can estimate effective connectivity, i.e. the causal effects exerted by one brain region over another, based on fMRI data. Here, we employed DCM on fMRI data in 10 focal epilepsy patients with multiple IED-related regions of BOLD signal change, to test whether this approach can help the localization process of EZ. For each subject, a family of competing deterministic, plausible DCM models were constructed using IED as autonomous input at each node, one at time. The DCM findings were compared to the presurgical evaluation results and classified as: "Concordant" if the node identified by DCM matches the presumed focus, "Discordant" if the node is distant from the presumed focus, or "Inconclusive" (no statistically significant result). Furthermore, patients who subsequently underwent intracranial EEG recordings or surgery were considered as having an independent validation of DCM results. The effective connectivity focus identified using DCM was Concordant in 7 patients, Discordant in two cases and Inconclusive in one. In four of the 6 patients operated, the DCM findings were validated. Notably, the two Discordant and Invalidated results were found in patients with poor surgical outcome. Our findings provide preliminary evidence to support the applicability of DCM on fMRI data to investigate the epileptic networks in focal epilepsy and, particularly, to identify the EZ in complex cases.


2021 - GD2 CAR T cells against human glioblastoma [Articolo su rivista]
Prapa, M.; Chiavelli, C.; Golinelli, G.; Grisendi, G.; Bestagno, M.; Di Tinco, R.; Dall'Ora, M.; Neri, G.; Candini, O.; Spano, C.; Petrachi, T.; Bertoni, L.; Carnevale, G.; Pugliese, G.; Depenni, R.; Feletti, A.; Iaccarino, C.; Pavesi, G.; Dominici, M.
abstract

Glioblastoma is the most malignant primary brain tumor and is still in need of effective medical treatment. We isolated patient-derived glioblastoma cells showing high GD2 antigen expression representing a potential target for CAR T strategy. Data highlighted a robust GD2 CAR antitumor potential in 2D and 3D glioblastoma models associated with a significant and CAR T-restricted increase of selected cytokines. Interestingly, immunosuppressant TGF β1, expressed in all co-cultures, did not influence antitumor activity. The orthotopic NOD/SCID models using primary glioblastoma cells reproduced human histopathological features. Considering still-conflicting data on the delivery route for targeting brain tumors, we compared intracerebral versus intravenous CAR T injections. We report that the intracerebral route significantly increased the length of survival time in a dose-dependent manner, without any side effects. Collectively, the proposed anti-GD2 CAR can counteract human glioblastoma potentially opening a new therapeutic option for a still incurable cancer.


2021 - Management of intracranial hypertension following traumatic brain injury: A best clinical practice adoption proposal for intracranial pressure monitoring and decompressive craniectomy: Joint statements by the Traumatic Brain Injury Section of the Italian Society of Neurosurgery (SINch) and the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) [Articolo su rivista]
Iaccarino, C.; Lippa, L.; Munari, M.; Castioni, C. A.; Robba, C.; Caricato, A.; Pompucci, A.; Signoretti, S.; Zona, G.; Rasulo, F. A.; Aimar, E.; Amato, S.; Angileri, F. F.; Anile, C.; Assietti, R.; Baratto, V.; Barbanera, A.; Basile, L.; Battaglia, R.; Bellocchi, S.; Bertuccio, A.; Blanco, S.; Bolognini, A.; Boniferro, B.; Bordi, L.; Bortolotti, C.; Brandini, V.; Broger, M.; Brollo, M.; Caffarella, D. D.; Caggiano, C.; Cantisani, P. L.; Capone, C.; Cappelletto, B.; Capuano, C.; Carangelo, B.; Caruselli, G.; Chessa, M. A.; Chiara, M.; Chibbaro, S.; Cioffi, V.; Ciprianocecchi, P.; Colistra, D.; Conti, C.; Contratti, F.; Costella, G. B.; Cuoci, A.; D'Avella, D.; D'Ercole, M.; Deangelis, M.; Defalco, R.; de Luca, G.; de Marinis, P.; Del Vecchio, C.; Delfinis, C.; Denaro, L.; Deodato, F.; Desogus, N.; Disomma, A.; Domenicucci, M.; Dones, F.; Fina, M.; Fiori, L.; Fricia, M.; Gaetani, P.; Gazzeri, R.; Gentile, M.; Germano, A.; Ghadirpour, R.; Gianfreda, C. D.; Gigante, N.; Gigli, R.; Giorgetti, J.; Giusa, M.; Gravina, U. G.; Grippi, L.; Guida, F.; Guizzardi, G.; Iannuzzo, G.; Kropp, M.; Lattanzi, L.; Lucantoni, D.; Maffei, L.; Magliulo, M.; Marconi, F.; Marruzzo, D.; Martellotta, N.; Marton, E.; Maugeri, R.; Mauro, G.; Meli, F.; Menniti, A.; Merciadri, P.; Milanese, L.; Nardacci, B.; Nasi, D.; Orvieto, P.; Pacca, P.; Pansini, G.; Panzarasa, G.; Passanisi, M.; Pavesi, G.; Pizzoni, C.; Pulera, F.; Rapana, A.; Ricci, A.; Rispoli, R.; Rotondo, M.; Russo, N.; Santilli, S.; Scarano, E.; Schwarz, A.; Servadei, F.; Simonetti, G.; Stefini, R.; Talamonti, G.; Turrisi, A.; Valente, V. M.; Villa, A.; Vindigni, M.; Visocchi, M.; Vitali, M.; Wierzbicki, V.; Zambon, G.; Zanotti, B.; Zenga, F.; Alampi, D.; Alessandri, F.; Aloj, F.; Amigoni, A.; Aspide, R.; Bertuetti, R.; Betti, V.; Bilotta, F.; Bonato, V.; Bosco, E.; Brita, M.; Buscema, G.; Cafiero, T.; Cappuccio, D.; Caradonna, M.; Caria, C. G.; Casartelliliviero, M.; Ciritella, P.; Cirrincione, S.; Citerio, G.; Colelli, S.; Coletta, F.; Concordia, L.; Congedo, E.; Covotta, M.; Crimella, F.; Dall'Acqua, G.; De Cassai, A.; Defulviis, S.; Deperi, E.; Deana, C.; Delgaudio, A.; Denittis, N.; Dicolandrea, S.; Divezza, F.; Ferri, F.; Flocco, R.; Fontana, C.; Forastierimolinari, A.; Frangiosa, A.; Fumagalli, P.; Fuselli, E.; Garbarino, M. M.; Gelormini, D.; Geraci, C.; Geraldini, F.; Giacomucci, A.; Giampaoli, V.; Giorgetti, D.; Gritti, P.; Gualdani, S.; Iacovazzo, C.; Iermano, C.; Latronico, N.; Lugari, S.; Lusenti, F.; Maglione, C.; Magnoni, S.; Maiarota, F.; Malla, M.; Marchesi, M.; Martino, C.; Matteotti, I.; Mazzeo, A. T.; Morello, G.; Nardiello, I.; Paticchio, F.; Pegoli, M.; Perotti, V.; Piazzolla, M.; Picciafuochi, F.; Rachedi, N.; Radolovich, D. K.; Recchia, A.; Riccardi, S.; Romagnoli, S.; Sala, S.; Scafuro, M. A.; Sgarlata, P.; Soragni, A.; Stefani, F.; Stival, E.; Stofella, G.; Terranova, F.; Tinturini, R.; Togni, T.; Toto, R.; Trapani, D.; Tringali, E.; Tullo, L.; Valente, A.; Valeo, T.; Varelli, G.; Villani, R.; Zamacavicchi, F.; Zanello, M.; Zarrillo, N.; Zugni, N.
abstract

No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified. However, RCTs in severe TBI have failed to establish intervention effectiveness, arising the need to make greater use of tools such as Consensus Conferences between experts, which have the advantage of providing recommendations based on experience, on the analysis of updated literature data and on the direct comparison of different logistic realities. The Italian scientific societies should provide guidelines following the national laws ruling the best medical practice. However, many limitations do not allow the collection of data supporting high levels of evidence for intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in patients with severe TBI. This intersociety document proposes best practice guidelines for this subsetting of patients to be adopted on a national Italian level, along with joint statements from “TBI Section” of the Italian Society of Neurosurgery (SINch) endorsed by the Neuroanesthesia and Neurocritical Care Study Group of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI). Presented here is a recap of recommendations on management of ICP and DC supported a high level of available evidence and rate of agreement expressed by the assemblies during the more recent consensus conferences, where members of both groups have had a role of active participants and supporters. The listed recommendations have been sent to a panel of experts consisting of the 107 members of the “TBISection” of the SINch and the 111 members of the Neuroanesthesia and Neurocritical Care Study Group of the SIAARTI. The aim of the survey was to test a preliminary evaluation of the grade of predictable future adherence of the recommendations following this intersociety proposal. The following recommendations are suggested as representing best clinical practice, nevertheless, adoption of local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management and perioperative care of decompressed patients is strongly recommended to improve treatment efficiency, to increase the quality of data collection and to provide more powerful evidence with future studies. Thus, for this future perspective a rapid overview of the role of the multimodal neuromonitoring in the optimal severe TB Imanagement is also provided in this document. It is reasonable to assume that the recommendations reported in this paper will in future be updated by new observations arising from future trials. They are not binding, and this document should be offered as a guidance for clinical practice through an intersociety agreement, taking in consideration the low level of evidence.


2021 - Spinal hemangioblastomas: analysis of surgical outcome and prognostic factors [Articolo su rivista]
Feletti, A.; Boaro, A.; Giampiccolo, D.; Casoli, G.; Moscolo, F.; Ferrara, M.; Sala, F.; Pavesi, G.
abstract

The prognostic factors for surgically removed spinal hemangioblastomas, the impact of VHL disease on outcome, and the role of intraoperative neuromonitoring are still not completely clear. The aim of this study was to review our experience with spinal hemangioblastomas in order to assess potential predictors of neurological outcome after surgery. All cases of spinal hemangioblastomas removed at two Italian academic institutions from 1985 to 2020 were reviewed. Data about clinical presentation and symptom duration, diagnosis of VHL, surgical approach, use of IONM, duration of hospital stay, follow-up, and modified McCormick grade before and after surgery were extracted. Sixty-one patients (31 F, 30 M) underwent 69 surgeries to remove 74 spinal hemangioblastomas (37 cervical, 32 thoracic, 5 lumbar). Improvement was found in 32.3% of cases, neurological condition remained stable in 51.6% of cases, and deteriorated in 16.1% of patients. A worsening trend in VHL patients and an improvement trend in non-VHL patients were detected, despite the lack of statistical significance. Laminotomy and use of IONM were found to be associated with better outcome, although no association was found between surgery without IONM and worse outcome. In most cases, patients affected by spinal hemangioblastomas can expect a good long-term outcome. In our experience, laminotomy seems to be associated with better outcome compared to laminectomy. While its absence is not associated with worse outcome, IONM seems to be associated with a better neurological outcome. Our study suggests that the more impaired the preoperative neurological condition, the worse the outcome.


2021 - Temporal Lobe Spikes Affect Distant Intrinsic Connectivity Networks [Articolo su rivista]
Mirandola, L.; Ballotta, D.; Talami, F.; Giovannini, G.; Pavesi, G.; Vaudano, A. E.; Meletti, S.
abstract

Objective: To evaluate local and distant blood oxygen level dependent (BOLD) signal changes related to interictal epileptiform discharges (IED) in drug-resistant temporal lobe epilepsy (TLE). Methods: Thirty-three TLE patients undergoing EEG–functional Magnetic Resonance Imaging (fMRI) as part of the presurgical workup were consecutively enrolled. First, a single-subject spike-related analysis was performed: (a) to verify the BOLD concordance with the presumed Epileptogenic Zone (EZ); and (b) to investigate the Intrinsic Connectivity Networks (ICN) involvement. Then, a group analysis was performed to search for common BOLD changes in TLE. Results: Interictal epileptiform discharges were recorded in 25 patients and in 19 (58%), a BOLD response was obtained at the single-subject level. In 42% of the cases, BOLD changes were observed in the temporal lobe, although only one patient had a pure concordant finding, with a single fMRI cluster overlapping (and limited to) the EZ identified by anatomo-electro-clinical correlations. In the remaining 58% of the cases, BOLD responses were localized outside the temporal lobe and the presumed EZ. In every patient, with a spike-related fMRI map, at least one ICN appeared to be involved. Four main ICNs were preferentially involved, namely, motor, visual, auditory/motor speech, and the default mode network. At the single-subject level, EEG–fMRI proved to have high specificity (above 65%) in detecting engagement of an ICN and the corresponding ictal/postictal symptom, and good positive predictive value (above 67%) in all networks except the visual one. Finally, in the group analysis of BOLD changes related to IED revealed common activations at the right precentral gyrus, supplementary motor area, and middle cingulate gyrus. Significance: Interictal temporal spikes affect several distant extra-temporal areas, and specifically the motor/premotor cortex. EEG–fMRI in patients with TLE eligible for surgery is recommended not for strictly localizing purposes rather it might be useful to investigate ICNs alterations at the single-subject level.


2021 - Use of Foley catheter in control of internal carotid hemorrhage during endoscopic endonasal surgery [Articolo su rivista]
Alicandri-Ciufelli, M.; Maccarrone, F.; Botti, C.; Pavesi, G.; Presutti, L.
abstract

Internal carotid artery (ICA) injuries during endoscopic endonasal surgery (EES) are rare life-threatening events. We describe a technique to manage ICA injuries based on the use of Foley catheters.A 26-year-old female underwent endoscopic transnasal trans-sphenoidal removal of pituitary adenoma. Cerebrospinal fluid leak occurred 4 days postoperatively. During repair procedure, accidental injury of ICA occurred. Emergency nasal packing through positioning of four Foley urologic catheters was successfully performed to stop bleeding. The patient did not report neurologic deficits.In author's opinion, Foley catheters are suitable to obtain immediate bleeding control since they are rapidly available and easily usable.


2021 - Von Hippel-Lindau disease and multispecialist team [Articolo su rivista]
Pavesi, G.; Feletti, A.; Ferrara, A. M.; Anglani, M.; Scarpa, B.; Schiavi, F.; Boaretto, F.; Zovato, S.; Taschin, E.; Gardi, M.; Zanoletti, E.; Piermarocchi, S.; Murgia, A.; Opocher, G.
abstract


2020 - A metabolomic data fusion approach to support gliomas grading [Articolo su rivista]
Righi, V.; Cavallini, N.; Valentini, A.; Pinna, G.; Pavesi, G.; Rossi, M. C.; Puzzolante, A.; Mucci, A.; Cocchi, M.
abstract

Magnetic resonance imaging (MRI) is the current gold standard for the diagnosis of brain tumors. However, despite the development of MRI techniques, the differential diagnosis of central nervous system (CNS) primary pathologies, such as lymphoma and glioblastoma or tumor-like brain lesions and glioma, is often challenging. MRI can be supported by in vivo magnetic resonance spectroscopy (MRS) to enhance its diagnostic power and multiproject-multicenter evaluations of classification of brain tumors have shown that an accuracy around 90% can be achieved for most of the pairwise discrimination problems. However, the survival rate for patients affected by gliomas is still low. The High-Resolution Magic-Angle-Spinning Nuclear Magnetic Resonance (HR-MAS NMR) metabolomics studies may be helpful for the discrimination of gliomas grades and the development of new strategies for clinical intervention. Here, we propose to use T2-filtered, diffusion-filtered and conventional water-presaturated spectra to try to extract as much information as possible, fusing the data gathered by these different NMR experiments and applying a chemometric approach based on Multivariate Curve Resolution (MCR). Biomarkers important for glioma's discrimination were found. In particular, we focused our attention on cystathionine (Cyst) that shows promise as a biomarker for the better prognosis of glioma tumors.


2020 - Anatomic and radiologic relationships of neck structures to cervical spine: Implications for anterior surgical approaches [Articolo su rivista]
Alicandri-Ciufelli, M.; Fermi, M.; Molinari, G.; Cavazza, E. A.; Billi, A. M.; Giliberto, G.; Cavalleri, F.; Pavesi, G.; Presutti, L.
abstract

The position of the pharyngolaryngeal framework is very important in choosing the best surgical approach for cervical spine disease. The aim of the present paper is to investigate the position of the hyoid bone and cricoid cartilage in relation to the cervical spine. Moreover, the surgical implications for anterior transcervical approaches to the upper spine and the prevertebral space are discussed. To minimise complication rates and increase surgical effectiveness, the location and extent of the cervical spine disease should be evaluated in the context of the patient’s specific anatomy. A retrospective analysis of 100 cervical spine MRIs was conducted. Patients with diseases that could alter anatomic relationships of cervical structures were excluded. The mid-sagittal view of the hyoid and the inferior margin of the cricoid cartilage were projected perpendicularly to the anterior surface of the cervical vertebrae. The distance between these two landmarks was measured on the same view. The distribution of hyoid projections ranged between C2-C3 and C4-C5 intervertebral space, while the cricoid cartilage ranged between C4-C5 and C7-T1 intervertebral spaces. The mean distance between these two landmarks was 49.1 ± 7.7 mm, with statistically significant differences between males and females. The position of the cricoid cartilage significantly influenced the length of the pharyngolaryngeal framework, while the position of hyoid did not. A wide range of variability in the position of the hyoid bone and the cricoid cartilage in relation to cervical levels exists. This implies that an a priori association of a cervical level to neck structures at risk might be inaccurate. The use of these easily identifiable landmarks on pre-operative imaging may help to guide the choice among different anterior surgical approaches to cervical spine and reduce the risk of surgical complications.


2020 - Cutaneous Metastasis from Cervical Spinal Chordoma: Case Report and Literature Review [Articolo su rivista]
Berlucchi, Silvia; Nasi, Davide; Zunarelli, Elena; Valluzzi, Adelaide; ALICANDRI CIUFELLI, Matteo; Presutti, Livio; Pavesi, Giacomo
abstract

Chordomas are rare primary tumors of the bone that arise from embryonic notochord. They are locally aggressive tumors with high tendency for post-surgical recurrence. On the contrary, distant metastases are rare. When occurring, they involve lungs, liver, lymph nodes, and bones. Skin and subcutaneous tissue involvement is even rarer and usually occurs by direct extension of the primary tumor or by local recurrence. Then, distant cutaneous metastasis from chordoma is an exceptional finding, with less than 20 cases reported in the literature. All the cutaneous metastases described derive from sacral chordomas, except for two cases in which the source of metastasis are skull-base chordomas.


2020 - Early life-threating enlargement of a vestibular schwannoma after gamma knife radiosurgery [Articolo su rivista]
Nasi, D.; Zunarelli, E.; Puzzolante, A.; Moriconi, E.; Pavesi, G.
abstract

Stereotactic gamma knife radiosurgery (GKS) may induce a transient enlargement of vestibular schwannomas (VS). This phenomenon, known as pseudoprogression or swelling, starts at about 3 months following GKS, peaks at about 6 months, and typically subsides thereafter, usually without significant neurological deterioration. We describe a 34-year-old female who developed an aggressive enlargement of a VS 1 month after GKS. The patient was treated with an immediate external ventricular drainage and surgical resection via retrosigmoid approach for an acute neurological deterioration due to hydrocephalus and brainstem compression. Histopathological examination revealed a VS with abundant intratumoral thrombosis and necrosis, suggesting that its rapid expansion could be related to massive radiation-induced tumor necrosis. The present case indicated that rapid life-threating enlargement of a VS may occur as an early complication following GKS.


2020 - Intraoperative neurophysiological monitoring in aneurysm clipping: Does it make a difference? A systematic review and meta-analysis [Articolo su rivista]
Nasi, Davide; Meletti, Stefano; Tramontano, Vincenzo; Pavesi, Giacomo
abstract


2020 - Myelomeningocele Repair Combining a Double Cryopreserved Amniotic Membrane Homograft and the Keystone Flap in a 3-Year-Old Child: A Case Report [Articolo su rivista]
Pignatti, Marco; Feletti, Alberto; Sapino, Gianluca; Marotti, Francesca; Pavesi, Giacomo; De Santis, Giorgio
abstract

Early repair in patients affected by myelomeningocele (MMC) is of paramount importance in order to prevent infection, minimize neural tissue damage, and reduce mortality. Treatment must include duraplasty and possibly an adequate soft tissue coverage. Delayed surgery in MMC patients can be more tedious due to the less clear borders between the placode and the skin. Moreover, the risks of wound infection and breakdown increase significantly.


2020 - Osteoid Osteoma of the Atlas in a Boy: Clinical and Imaging Features-A Case Report and Review of the Literature [Articolo su rivista]
Valluzzi, A.; Donatiello, S.; Gallo, G.; Cellini, M.; Maiorana, A.; Spina, V.; Pavesi, G.
abstract

Osteoid osteoma is a benign osteoblastic tumor, quite uncommon in the spine. We report a case of an osteoid osteoma involving the atlas in a 6-year-old boy, who presented with suboccipital pain and torticollis. Initial radiological findings were ambiguous as magnetic resonance imaging showed mainly edema of upper cervical soft tissues. The subsequent computed tomography depicted a lesion of left lamina of C1. As conservative treatment failed, the lesion was surgically resected and the patient became pain free. To our knowledge, this is the first case of osteoid osteoma involving the atlas associated with abnormal soft tissue reaction reported in literature.


2020 - Spontaneous Regression of a Giant Traumatic Herniated Thoracic Disk: A Case Report and Review of the Literature [Articolo su rivista]
Valluzzi, A.; Sorenson, T.; Nasi, D.; Acciarri, N.; Palandri, G.; Pavesi, G.
abstract

Thoracic disk herniation (TDH) after traumatic injury is a relatively uncommon disease with few cases reported in the literature. Herniated disks in this location typically may result in progressive myelopathy and refractory pain. In the presence of these symptoms, surgical treatment may be indicated since spontaneous regression in this area is less common than that of disk herniations in the cervical or lumbar spine. Herein, we present the case of giant traumatic TDH that occurred at the T9-T10 level and spontaneously resolved after 5 months. We highlight the fact that regression of a herniated disk at the thoracic level may occur even in the absence of treatment. When considering this phenomenon, conservative management of these cases with clinical and radiological monitoring may be an appropriate first-line management for patients without signs of progressive myelopathy or severe refractory pain.


2020 - Targeting GD2-positive glioblastoma by chimeric antigen receptor empowered mesenchymal progenitors [Articolo su rivista]
Golinelli, Giulia; Grisendi, Giulia; Prapa, Malvina; Bestagno, Marco; Spano, Carlotta; Rossignoli, Filippo; Bambi, Franco; Sardi, Iacopo; Cellini, Monica; Horwitz, Edwin M.; Feletti, Alberto; Pavesi, Giacomo; Dominici, Massimo
abstract

Tumor targeting by genetically modified mesenchymal stromal/stem cells (MSCs) carrying anti-cancer molecules represents a promising cell-based strategy. We previously showed that the pro-apoptotic agent tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can be successfully delivered by MSCs to cancer sites. While the interaction between TRAIL and its receptors is clear, more obscure is the way in which MSCs can selectively target tumors and their antigens. Several neuroectoderm-derived neoplasms, including glioblastoma (GBM), sarcomas, and neuroblastoma, express high levels of the tumor-associated antigen GD2. We have already challenged this cell surface disialoganglioside by a chimeric antigen receptor (CAR)-T cell approach against neuroblastoma. With the intent to maximize the therapeutic profile of MSCs delivering TRAIL, we here originally developed a bi-functional strategy where TRAIL is delivered by MSCs that are also gene modified with the truncated form of the anti-GD2 CAR (GD2 tCAR) to mediate an immunoselective recognition of GD2-positive tumors. These bi-functional MSCs expressed high levels of TRAIL and GD2 tCAR associated with a robust anti-tumor activity against GD2-positive GBM cells. Most importantly, the anti-cancer action was reinforced by the enhanced targeting potential of such bi-functional cells. Collectively, our results suggest that a truncated anti-GD2 CAR might be a powerful new tool to redirect MSCs carrying TRAIL against GD2-expressing tumors. This affinity-based dual targeting holds the promise to combine site-specific and prolonged retention of MSCs in GD2-expressing tumors, thereby providing a more effective delivery of TRAIL for still incurable cancers.


2020 - The efficacy of postoperative bracing after spine surgery for lumbar degenerative diseases: a systematic review [Articolo su rivista]
Nasi, D.; Dobran, M.; Pavesi, G.
abstract

Purpose: Postoperative bracing treatment is widely used after surgery for lumbar degenerative diseases. However, the guidelines are lacking in this regard, and its use is mainly driven by individual surgeon preferences. The objective of the current review was to evaluate the available evidence on the use of postoperative bracing after surgery for degenerative disease of the lumbar spine. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed while conducting a systematic search of the PubMed/Medline, Scopus, and Cochrane databases from January 1990 to January 2019. High-quality studies were included that evaluated disability, pain, quality of life, the rate of fusion, complications, and rate of reoperations in patients who had surgery for lumbar degenerative disease, with and without postoperative bracing. The overall strength of evidence across the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Results: Of the 391 citations screened, four randomized controlled trials met the inclusion criteria and were included in the review. Based on low- to moderate-quality evidence, postoperative bracing in patients with lumbar degenerative disease does not result in improved disability, pain, and quality of life compared to no bracing patients. Low-quality evidence suggests that there was no significant difference between the two groups in terms of the rate of fusion, complications, and the need for reoperation. Conclusions: To date, there is not a medical evidence to support the use of bracing after surgery for lumbar degenerative disease. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].


2019 - Expert Consensus on the Management of Brain Arteriovenous Malformations [Articolo su rivista]
Kato, Yoko; He Dong, Van; Chaddad, Feres; Takizawa, Katsumi; Izumo, Tsuyoshi; Fukuda, Hitoshi; Hara, Takayuki; Kikuta, Kenichiro; Nakai, Yasunobu; Endo, Toshiki; Kurita, Hiroki; Xu, Bin; Beneš, Vladimír; Christian, Raftopoulos; Pavesi, Giacomo; Hodaie, Mojgan; Kumar Sharma, Rajan; Agarwal, Harshal; Mohan, Krishna; Seng Liew, Boon
abstract


2019 - Neuroendoscopic Aspiration of Blood Clots in the Cerebral Aqueduct and Third Ventricle During Posterior Fossa Surgery in the Prone Position [Articolo su rivista]
Feletti, Alberto; Stanzani, Riccardo; Alicandri-Ciufelli, Matteo; Giliberto, Giuliano; Martinoni, Matteo; Pavesi, Giacomo
abstract

During surgery in the posterior fossa in the prone position, blood can sometimes fill the surgical field, due both to the less efficient venous drainage compared to the sitting position and the horizontally positioned surgical field itself. In some cases, blood clots can wedge into the cerebral aqueduct and the third ventricle, and potentially cause acute hydrocephalus during the postoperative course.


2019 - Pineoblastoma in Adults: A Rare Case Successfully Treated with Multimodal Approach Including Craniospinal Irradiation Using Helical Tomotherapy [Articolo su rivista]
Gaito, Simona; Malagoli, Marcella; Depenni, Roberta; Pavesi, Giacomo; Bruni, Alessio
abstract

Pineoblastomas (PBs) are rare and aggressive malignancies of the pineal gland. They are more commonly diagnosed in children between 1-12 years old, and are very rarely diagnosed in adults. For this reason, evidence in literature for adults is scarce and mainly derives from the paediatric practice. For their clinical behaviour and embryonal histology, PBs are often grouped together with medulloblastomas in clinical trials. In this report, we describe an adult PB case who was treated at our institution. We reference the literature to explain the clinical reasoning behind our decision-making process. A 46-year-old male patient was referred to our institution in November 2015 with three months history of headache. Imaging confirmed localised disease of the pineal gland. He underwent surgery which was radical and clinically uncomplicated. Histology showed PB. He then received adjuvant craniospinal radiotherapy with a boost to the tumour bed followed by consolidation chemotherapy. After 36 months follow-up, he remains disease-free without significant toxicities. Surgery followed by craniospinal irradiation and consolidation chemotherapy can be a safe and effective treatment option in adult PBs.


2018 - Acquisition of surgical skills for endoscopic ear and lateral skull base surgery: A staged training programme [Articolo su rivista]
Alicandri-Ciufelli, M.; Marchioni, D.; Pavesi, G.; Canzano, Federica; Feletti, A.; Presutti, L.
abstract

Endoscopic ear surgery is radically changing the treatment of several middle and inner ear pathology, but its learning presents well-known manual and technical difficulties. The aim of this paper is be to present a training programme based on a modular model of increased difficulties. The experience from 2007 to 2016 at the University Hospital of Modena and University Hospital of Verona was reviewed and analysed for further considerations and to establish stages of training. The increasing experience of expert surgeons who deal with this kind of surgery represented the main guide to establish the steps and progression of training. In addition, the potential risk of damage of vascular structures or nerves represents fundamental criteria for progression toward higher levels. Some not-mandatory skills were also suggested for stage of difficulty. Five stages of training were deemed appropriate for progressive learning of endoscopic ear and lateral skull base surgery, ranging from simple middle and external ear procedures to surgery of inner ear and internal auditory canal. Mastering of each level is suggested before attempting procedures at a higher level, in particular for procedures involving lateral skull base. Standardisation and adoption of modular incremental training are expected to facilitate improvement of otolaryngologists and neurosurgeons starting with endoscopic middle ear and lateral skull base surgery. Adherence to such a programme during the growth phase may potentially decrease the rate of complications, making the training programme safer.


2018 - Congenital Arteriovenous Malformation of the Scalp Involving the Orbit [Articolo su rivista]
Feletti, Alberto; Dimitriadis, Stavros; Vallone, Stefano; Pavesi, Giacomo
abstract

Background Arteriovenous malformations (AVMs) of the scalp are rare and infrequently encountered by the neurosurgeon. Case Description We report a unique case of a 42-year-old patient who presented with a progressive worsening of visual acuity in the right eye (lower quadrantanopia) and palpebral ptosis. Physical examination revealed a right exophthalmos and a right frontoparietal scalp soft swelling when the patient was in the supine position. Neurologic work-up showed a scalp AVM extending into the orbit and connected to an intraorbital cavernous angioma. The patient was treated with a frontotemporal craniotomy and decompression of the orbit. Conclusions In the rare case of intraorbital extension of a scalp AVM, neurologic symptoms may appear when the size of the vascular malformation increases with age. The aims of surgery should be decompression of the orbit and aesthetic preservation, rather than complete excision. A review of the literature is also provided.


2018 - Correction to: Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study (Journal of Neuro-Oncology, (2016), 128, 1, (157-162), 10.1007/s11060-016-2093-1) [Articolo su rivista]
Franceschi, Enrico; Depenni, Roberta; Paccapelo, Alexandro; Ermani, Mario; Faedi, Marina; Sturiale, Carmelo; Michiara, Maria; Servadei, Franco; Pavesi, Giacomo; Urbini, Benedetta; Pisanello, Anna; Crisi, Girolamo; Cavallo, Michele A.; Dazzi, Claudio; Biasini, Claudia; Bertolini, Federica; Mucciarini, Claudia; Pasini, Giuseppe; Baruzzi, Agostino; Brandes, Alba A.; Baruzzi, A.; Albani, F.; Calbucci, F.; D’Alessandro, R.; Michelucci, R.; Brandes, A.; Eusebi, V.; Ceruti, S.; Fainardi, E.; Tamarozzi, R.; Emiliani, E.; Cavallo, M.; Franceschi, E.; Tosoni, A.; Cavallo, Marino; Fiorica, F.; Valentini, A.; Depenni, R.; Mucciarini, C.; Crisi, G.; Sasso, Enrico; Biasini, C.; Cavanna, L.; Guidetti, D.; Marcello, Norina; Pisanello, A.; Cremonini, A. M.; Guiducci, G.; de Pasqua, S.; Testoni, S.; Agati, R.; Ambrosetto, G.; Bacci, A.; Baldin, E.; Baldrati, A.; Barbieri, E.; Bartolini, Stefano; Bellavista, E.; Bisulli, F.; Bonora, E.; Bunkheila, F.; Carelli, V.; Crisci, M.; Dall’Occa, P.; de Biase, D.; Ferro, S.; Franceschi, C.; Frezza, G.; Grasso, Vincenzo; Leonardi, M.; Marucci, G.; Morandi, L.; Mostacci, B.; Palandri, G.; Pasini, E.; Pastore Trossello, M.; Pession, A.; Poggi, R.; Riguzzi, P.; Rinaldi, R.; Rizzi, S.; Romeo, G.; Spagnolli, F.; Tinuper, P.; Trocino, C.; Dall’Agata, M.; Frattarelli, M.; Gentili, G.; Giovannini, A.; Iorio, P.; Pasquini, U.; Galletti, G.; Guidi, C.; Neri, W.; Patuelli, A.; Strumia, S.; Faedi, M.; Casmiro, M.; Gamboni, A.; Rasi, F.; Cruciani, Giuseppe; Cenni, P.; Dazzi, C.; Guidi, A. R.; Zumaglini, F.; Amadori, A.; Pasini, G.; Pasquinelli, Mario; Pasquini, Elena; Polselli, A.; Ravasio, A.; Viti, B.; Sintini, M.; Ariatti, A.; Bertolini, F.; Bigliardi, G.; Carpeggiani, P.; Cavalleri, F.; Meletti, S.; Nichelli, P.; Pettorelli, E.; Pinna, Greta; Zunarelli, E.; Artioli, F.; Bernardini, I.; Costa, M.; Greco, G.; Guerzoni, R.; Stucchi, C.; Iaccarino, Corrado; Ragazzi, M.; Rizzi, R.; Zuccoli, G.; Api, P.; Cartei, F.; Colella, Margherita; Fallica, E.; Farneti, M.; Frassoldati, A.; Granieri, E.; Latini, F.; Monetti, C.; Saletti, A.; Schivalocchi, R.; Sarubbo, S.; Seraceni, S.; Tola, M. R.; Urbini, B.; Zini, G.; Giorgi, C.; Montanari, E.; Cerasti, D.; Crafa, P.; Dascola, I.; Florindo, I.; Giombelli, E.; Mazza, S.; Ramponi, V.; Servadei, F.; Silini, E. M.; Torelli, P.; Immovilli, P.; Morelli, N.; Vanzo, C.; Nobile, C.
abstract

The members of the PERNO Study Group were not individually captured in the metadata of the original publication. They are included in the metadata of this publication.


2018 - High speed flow cytometry allows the detection of circulating endothelial cells in hemangioblastoma patients [Articolo su rivista]
De Biasi, Sara; Gibellini, Lara; Feletti, Alberto; Pavesi, Giacomo; Bianchini, Elena; Lo Tartaro, Domenico; Pecorini, Simone; De Gaetano, Anna; Pullano, Rosalberta; Nasi, Milena; Pinti, Marcello; Cossarizza, Andrea; Boraldi, Federica
abstract

Circulating endothelial cells (CECs) detach from the intima monolayer after endothelial damages. Their circulating endothelial progenitors (CEPs) represent less than 0.01% of nucleated blood cells. Increased levels of CECs and CEPs have been detected in patients with several types of cancer, suggesting that they could be a useful blood-based marker for detecting a tumor, or for monitoring its clinical course. However, their routine monitoring is time consuming and technically challenging. Here, we present a flow cytometry method for quantifying such cells in a cohort of patients with hemangioblastoma (HB). HB is a rare benign tumor, responsible for 1-2.5% of primary intracranial tumors and up to 10% of spinal cord tumors, and for which no tools are available to predict the onset or recurrence in patients undergoing surgical removal of tumor mass. This method allowed us to accurately quantifying CEC and CEP before and after surgery. CEPs are present at high levels in HB patients than control before intervention, and decrease after tumor removal, suggesting that their percentage could represent a valid tool to monitor the disease onset and recurrence.


2018 - Intraoperative measurement of arterial blood flow in aneurysm surgery [Capitolo/Saggio]
Pasqualin, Alberto; Meneghelli, Pietro; Musumeci, Angelo; Della Puppa, Alessandro; Pavesi, Giacomo; Pinna, Giampietro; Scienza, Renato
abstract

Intraoperative flowmetry (IF) has been recently introduced during cerebral aneurysm surgery in order to obtain a safer surgical exclusion of the aneurysm. This study evaluates the usefulness of IF during surgery for cerebral aneurysms and compares the results obtained in the joined surgical series of Verona and Padua to the more recent results obtained at the neurosurgical department of Verona. In the first surgical series, between 2001 and 2010, a total of 312 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical departments of Verona and Padua: 162 patients presented with subarachnoid hemorrhage (SAH) whereas 150 patients harbored unruptured aneurysms. In the second series, between 2011 and 2016, 112 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical department of Verona; 24 patients were admitted for SAH, whereas 88 patients were operated on for unruptured aneurysms. Comparison of the baseline values in the two surgical series and the baseline values between unruptured and ruptured aneurysms showed no statistical differences between the two clinical series. Analysis of flowmetry measurements showed three types of loco-regional flow derangements: hyperemia after temporary arterial occlusion, redistribution of flow in efferent vessels after clipping, and low flow in patients with SAH-related vasospasm. IF provides real-time data about flow derangements caused by surgical clipping of cerebral aneurysm, thus enabling the surgeon to obtain a safer exclusion; furthermore, it permits the evaluation of other effects of clipping on the loco-regional blood flow. It is suggested that—in contribution with intraoperative neurophysiological monitoring—IF may now constitute the most reliable tool for increasing safety in aneurysm surgery.


2018 - The Prognostic Roles of Gender and O6-Methylguanine-DNA Methyltransferase Methylation Status in Glioblastoma Patients: The Female Power [Articolo su rivista]
Franceschi, Enrico; Tosoni, Alicia; Minichillo, Santino; Depenni, Roberta; Paccapelo, Alexandro; Bartolini, Stefania; Michiara, Maria; Pavesi, Giacomo; Urbini, Benedetta; Crisi, Girolamo; Cavallo, Michele A.; Tosatto, Luigino; Dazzi, Claudio; Biasini, Claudia; Pasini, Giuseppe; Balestrini, Damiano; Zanelli, Francesca; Ramponi, Vania; Fioravanti, Antonio; Giombelli, Ermanno; De Biase, Dario; Baruzzi, Agostino; Brandes, ; Alba, A.; Iaccarino, Corrado
abstract

Background: Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. Methods: We performed a prospective evaluation of the Project of Emilia Romagna on Neuro-Oncology (PERNO) registry to identify prognostic factors in patients with GBM who received standard treatment. Results: A total of 169 patients (99 males [58.6%] and 70 females [41.4%]) were evaluated prospectively. MGMT methylation was evaluable in 140 patients. Among the male patients, 36 were MGMT methylated (25.7%) and 47 were unmethylated (33.6%); among the female patients, 32 were methylated (22.9%) and 25 were unmethylated (17.9%). Survival was longer in the methylated females compared with the methylated males (P = 0.028) but was not significantly different between the unmethylated females and the unmethylated males (P = 0.395). In multivariate analysis, gender and MGMT methylation status considered together (methylated females vs. methylated males; hazard ratio [HR], 0.459; 95% confidence interval [CI], 0.242-0.827; P = 0.017), age (HR, 1.025; 95% CI, 1.002-1.049; P = 0.032), and KPS (HR, 0.965; 95% CI, 0.948-0.982; P < 0.001) were significantly correlated with survival. Conclusions: Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.


2018 - Unruptured versus Ruptured AVMs: Outcome analysis from a multicentric consecutive series of 545 surgically treated cases [Articolo su rivista]
Cenzato, M; Tartara, F; D'Aliberti, G; Bortolotti, C; Cardinale, F; Ligarotti, G; Debernardi, A; Fratianni, A; Boccardi, E; Stefini, E; Zenga, F; Boccaletti, R; Lanterna, A; Pavesi, G; Ferroli, P; Sturiale, C; Ducati, A; Cardia, A; Piparo, M; Valvassori, L; Piano, M.
abstract

BACKGROUND: Recent literature strongly challenged indications to perform preventive surgery in unruptured arteriovenous malformation (AVM) claiming that invasive AVM treatment is associated with a significant risk of complications and thus conservative management may be a preferable alternative in many patients. On the other hand, the recent improvement of surgical instrumentation and treatment strategies (both surgical and interventional) yielded better outcomes than those achieved only a decade ago. Therefore, even among specialists, a wide variety of opinions, concerning the treatment of unruptured AVM, can be found. METHODS: This multicenter retrospective study analyzes a consecutive series of 545 surgically treated AVMs in 10 different hospitals in Italy. RESULTS: Patients with AVMs treated after hemorrhage had an unfavorable (modified Rankin Scale score >1) outcome in more than one third (37.69%) of the cases. Conversely, with proper indications, unruptured AVMs treated preventively have a good outcome in 93.8% of cases, increasing to 95.7%, with no death, if only Spetzler-Martin grades 1-3 are considered (P < 0.05). Outcomes on discharge significantly (P < 0.05) improve at 6 months with the disappearance of many of the initial neurologic deficits that turn out to be transient. CONCLUSIONS: In unruptured low-risk AVMs (Spetzler-Martin grades 1-3), over time, the risk of surgery-associated neurologic deficits becomes lower than that linked to spontaneous hemorrhage, with a crossover point at 6.5 years. Because the average bleeding age is less than 45 years, preventive surgery can be advocated to safeguard the patient and overcome the risks associated with the natural history of AVMs.


2017 - Awake craniotomy anesthetic management using dexmedetomidine, propofol, and remifentanil [Articolo su rivista]
Prontera, A; Baroni, S; Marudi, A; Valzania, F; Feletti, A; Benuzzi, F; Bertellini, E; Pavesi, G
abstract


2017 - Cavernous angioma of the cerebral aqueduct [Articolo su rivista]
Feletti, A; Dimitriadis, S; Pavesi, G
abstract


2017 - Complication avoidance during aneurysm clipping [Capitolo/Saggio]
Feletti, A; Pavesi, G
abstract


2017 - Exclusive endoscopic transcanal transpromontorial approach: a new perspective for internal auditory canal vestibular schwannoma treatment [Articolo su rivista]
Feborl-hns, ; Pavesi, G; Marchioni, D; Alicandri-Ciufelli, M; Rubini, A; Masotto, B; Presutti, L.
abstract


2017 - Expanded transcanal transpromontorial approach to the internal auditory canal and cerebellopontine angle: a cadaveric study [Articolo su rivista]
Presutti, Livio; Bonali, Marco; Marchioni, Daniele; Pavesi, G; Feletti, A; Anschuetz, L; Alicandri Ciufelli, M.
abstract

The aim of this paper is to describe and evaluate the feasibility of an expanded endoscopic transcanal transpromotorial approach (ExpTTA) to the internal auditory canal and the cerebellopontine angle. To this end, we performed a cadaveric dissection study in September 2015. In total, 2 heads (4 sides) were dissected focusing on anatomical landmarks and surgical feasibility. Data from dissections were reviewed and analysed for further consideration. In all 4 sides of the cadavers the procedure was feasible. In all cadavers, it was necessary to extensively drill the temporo-mandibular joint and to calibrate the external ear canal to allow adequate room to manoeuver the instruments and optics and to comfortably access the cerebellopontine angle. In addition, thorough skeletonisation of the carotid artery and the jugular bulb were necessary for the same purpose. In conclusion, ExpTTA appeared to be successful to access the internal auditory canal and cerebellopontine angle region. Potential extensive and routine application of this type of approach in lateral skull base surgery will depend on the development of technology and surgical refinements and on the diffusion of skull base endoscopic skills among otolaryngologists and neurosurgical community.


2017 - Expanded transcanal transpromontorial approach to the internal auditory canal: Pilot clinical experience [Articolo su rivista]
Presutti, Livio; Alicandri Ciufelli, Matteo; Bonali, Marco; Rubini, Alessia; Pavesi, Giacomo; Feletti, Alberto; Masotto, Barbara; Anschuetz, Lukas; Marchioni, Daniele
abstract

The aim of this study was to describe and evaluate the feasibility of an expanded transcanal transpromontorial approach, developed from the exclusive endoscopic transcanal transpromontorial approach.


2017 - Indocyanine green videoangiography: The thin border between a useful tool and an illusion of safety [Articolo su rivista]
Pavesi, G; Prontera, A; Feletti, A
abstract


2017 - Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Federici, Gaia; Anschuetz, Lukas; Pavesi, Giacomo; Todeschini, Alessandra; Presutti, Livio; Marchioni, Daniele
abstract

The most popular approaches for vestibular schwannoma (VS) removal are retrosigmoid, middle cranial fossa and translabyrinthine (TL). All require a certain degree of invasivity, bone removal, or brain manipulation. Recently, the authors described the transcanal transpromontorial approaches (TTA), which allow the inner ear to be accessed directly through the external auditory canal (EAC), either with a microscopic (Expanded TTA, or ExpTTA) or even an exclusive endoscopic technique (Endoscopic TTA, or EndoTTA). The advantages compared to traditional approaches are a direct view of the internal auditory canal (IAC) from lateral to medial, very little or no superficial tissue dissection and very little petrous bone drilling. In summary, from an anatomical point of view, they could be considered to be minimally invasive approaches. The radiologic outcome and the anatomical correspondence of these new approaches are described so as to share with the readers the possible radiologic findings and to compare and differentiate them from classic transpetrous approaches such as the TL approach.


2016 - If it can be done, it should be done,… or not? Response to Prof. Grotenhuis [Articolo su rivista]
Feletti, Alberto; Alicandri Ciufelli, Matteo; Pavesi, Giacomo
abstract

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2016 - Management of Subarachnoid Hemorrhage in Two Important Italian Political Leaders: A Paradigm of Ethical and Technological Evolution of Neurosurgery During the Past Half-Century [Articolo su rivista]
Longatti, P; Giombelli, E; Pavesi, G; Carteri, A; Feletti, A
abstract


2016 - Transaqueductal trans-Magendie fenestration of arachnoid cyst in the posterior fossa [Articolo su rivista]
Feletti, Alberto; Alicandri Ciufelli, Matteo; Pavesi, Giacomo
abstract

Neuroendoscopy is currently recommended as the first choice to treat posterior fossa arachnoid cysts. It has proven to be effective, providing improved outcome, and safe, having a low complication rate. Compared to craniotomy and shunt placement, it has lower surgical morbidity, minimizing or avoiding risks of subdural fluid collections, shunt infection, malfunction, overdrainage, and dependence. Usually, rigid scopes maneuvered through a suboccipital approach are used. When symptomatic obstructive hydrocephalus develops, CSF diversion is the first aim of surgery.


2016 - Von Hippel-Lindau disease: An evaluation of natural history and functional disability [Articolo su rivista]
Feletti, A; Anglani, M; Scarpa, B; Schiavi, F; Boaretto, F; Zovato, S; Taschin, E; Gardi, M; Zanoletti, E; Piermarocchi, S; Murgia, A; Pavesi, G; Opocher, G
abstract


2016 - Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study [Articolo su rivista]
Franceschi, Enrico; Depenni, R.; Paccapelo, Alexandro; Ermani, Mario; Faedi, M.; Sturiale, Carmelo; Michiara, Maria; Servadei, F.; Pavesi, Giacomo; Urbini, B.; Pisanello, A.; Crisi, G.; Cavallo, Michele A.; Dazzi, C.; Biasini, C.; Bertolini, F.; Mucciarini, C.; Pasini, G.; Baruzzi, Agostino; Brandes, Alba A; Albani, F.; Calbucci, F.; D’Alessandro, R.; Michelucci, R.; de Pasqua, S.; Testoni, S.; Brandes, A.; Franceschi, E.; Tosoni, A.; Eusebi, V.; Ceruti, S.; Fainardi, E.; Tamarozzi, R.; Emiliani, E.; Cavallo, M.; Fiorica, F.; Sasso, E.; Cavanna, L.; Guidetti, D.; Marcello, N.; Cremonini, A. M.; Guiducci, G.; Agati, R.; Ambrosetto, G.; Bacci, A.; Baldin, E.; Baldrati, A.; Barbieri, E.; Bartolini, S.; Bellavista, E.; Bisulli, F.; Bonora, E.; Bunkheila, F.; Carelli, V.; Crisci, M.; Dall’Occa, P.; de Biase, D.; Ferro, S.; Franceschi, C.; Frezza, G.; Grasso, V.; Leonardi, M.; Marucci, G.; Morandi, L.; Mostacci, B.; Palandri, G.; Pasini, E.; Pastore Trossello, M.; Pession, A.; Poggi, R.; Riguzzi, P.; Rinaldi, R.; Rizzi, S.; Romeo, G.; Spagnolli, F.; Tinuper, P.; Trocino, C.; Dall’Agata, M.; Frattarelli, M.; Gentili, G.; Giovannini, A.; Iorio, P.; Pasquini, U.; Galletti, G.; Guidi, C.; Neri, W.; Patuelli, A.; Strumia, S.; Casmiro, M.; Gamboni, A.; Rasi, F.; Cruciani, G.; Cenni, P.; Guidi, A. R.; Zumaglini, F.; Amadori, A.; Pasquinelli, M.; Pasquini, E.; Polselli, A.; Ravasio, A.; Viti, B.; Sintini, M.; Ariatti, A.; Bigliardi, G.; Carpeggiani, P.; Cavalleri, F.; Meletti, Stefano; Nichelli, Paolo Frigio; Pettorelli, E.; Pinna, G.; Zunarelli, E.; Artioli, F.; Bernardini, I.; Costa, M.; Greco, G.; Guerzoni, R.; Stucchi, C.; Iaccarino, C.; Ragazzi, M.; Rizzi, R.; Zuccoli, G.; Api, P.; Cartei, F.; Colella, M.; Fallica, E.; Farneti, M.; Frassoldati, A.; Granieri, E.; Latini, F.; Monetti, C.; Saletti, A.; Schivalocchi, R.; Sarubbo, S.; Seraceni, S.; Tola, M. R.; Zini, G.; Giorgi, C.; Montanari, E.; Cerasti, D.; Crafa, P.; Dascola, I.; Florindo, I.; Giombelli, E.; Mazza, S.; Ramponi, V.; Silini, E. M.; Torelli, P.; Immovilli, P.; Morelli, N.; Vanzo, C.; Nobile, C.
abstract

The role of temozolomide concurrent with and adjuvant to radiotherapy (RT/TMZ) in elderly patients with glioblastoma (GBM) remains unclear. We evaluated the outcome of patients >70 years in the context of the Project of Emilia-Romagna Region in Neuro-Oncology (PERNO), the first Italian prospective observational population-based study in neuro-oncology. For this analysis the criteria for selecting patients enrolled in the PERNO study were: age >70 years; PS 0–3; histologically confirmed GBM; postoperative radiotherapy (RT) after surgery with or without concomitant temozolomide (TMZ) or postsurgical TMZ alone. Between January 2009 and December 2010, 76 GBM elderly patients were identified in the prospective PERNO study. Twenty-three patients did not receive any treatment after surgery, and 53 patients received postsurgical treatments (25 patients received RT alone and 28 patients RT/TMZ). Median survival was 11.1 months (95 % CI 8.8–13.5), adding temozolomide concomitant and adjuvant to radiotherapy it was 11.6 months (95 % CI 8.6–14.6), and 9.3 months (95 % CI 8.1–10.6) in patients treated with RT alone (P = 0.164). However, patients with MGMT methylated treated with RT/TMZ obtained a better survival (17.2 months, 95 % CI 11.5–22.9) (P = 0.042). No difference in terms of survival were observed if patients with MGMT unmethylated tumor received RT alone, or RT/TMZ or, in MGMT methylated tumor, if patients received radiotherapy alone. In elderly patients RT/TMZ represent a widely used approach but it is effective with methylated MGMT tumors only.


2015 - Adult idiopathic occlusion of Monro foramina: Intraoperative endoscopic reinterpretation of radiological data and review of the literature [Articolo su rivista]
Prontera, A.; Feletti, A.; Chahine, R.; Pavesi, G.
abstract


2015 - Facial nerve grading scales: systematic review of the literature and suggestion for uniformity [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Pavesi, Giacomo; Presutti, Livio
abstract

N/D


2015 - Intraoperative Functional and Perfusion Monitoring During Surgery for Giant Serpentine Middle Cerebral Artery Aneurysms [Articolo su rivista]
Pavesi, G; Dimitriadis, S; Baroni, S; Vallone, S; Valzania, F; Costella, Gb; Feletti A,
abstract


2015 - Letter to the Editor: Gamma Knife radiosurgery for vestibular schwannoma [Articolo su rivista]
ALICANDRI CIUFELLI, Matteo; Pavesi, Giacomo; Presutti, Livio
abstract

N/D


2014 - Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis [Articolo su rivista]
Pavesi, G; Causin, F; Feletti, A
abstract


2014 - Combined approach for tegmen defects repair in patients with cerebrospinal fluid otorrhea or herniations: our experience [Articolo su rivista]
Marchioni, Daniele; Bonali, Marco; ALICANDRI CIUFELLI, Matteo; Rubini, Alessia; Pavesi, Giacomo; Presutti, Livio; Bonali, Marco
abstract

Objectives To describe our departmental experience in the surgical repair of tegmen tympani defects using a combined transmastoid/minicraniotomic approach. Design Retrospective review of videos from surgery and patients' charts. Setting Tertiary university referral center. Participants Twenty-two patients who underwent surgical repair of tegmen defects associated with cerebrospinal fluid (CSF) leakage and/or meningocele/meningoencephalocele by a combined transmastoid/minicraniotomic approach. Main Outcome Measures A retrospective review of videos of surgery and charts of patients with tegmen tympani or tegmen antri defects and CSF leakage, temporal lobe encephalocele, and/or meningoencephalocele. Results All patients underwent the combined approach and had their defects closed, without significant intraoperative or postoperative complications. Conclusions Mastoidectomy with temporal minicraniotomy represents an effective approach in patients with tegmen tympani dehiscence; the advantages of this technique are the control of the floor of the middle cranial fossa and the possibility to reach bony defects located anteriorly without manipulation of the ossicular chain and temporal lobe.


2014 - Combined endoscopic-microscopic approach for vestibular schwannoma removal: outcomes in a cohort of 81 patients [Articolo su rivista]
Presutti, L; Magnaguagno, F; Pavesi, G; Cunsolo, E; Pinna, G; Alicandri-Ciufelli, M; Marchioni, D; Prontera, A; Gioacchini, Fm
abstract

Patients affected by vestibular schwannomas typically report a number of symptoms and minor disabilities after surgery. Therefore, surgeons dealing with this pathology should also try to achieve a good QoL for patients who have undergone tumour removal. The aim of this study was to analyse QoL in subjects undergoing surgery for vestibular schwannomas and to try to establish a relationship with both the tumour size and post-surgical alterations (e.g. facial motor dysfunctions, difficulties in balance, persistence of headache and tinnitus). A retrospective analysis was performed on a consecutive series of 81 patients affected by vestibular schwannomas and treated by a combined microscopic-endoscopic approach. Three groups of patients were identified on the basis of tumour size. Group 1 (lesions < 25 mm) with 31 patients (38%); Group 2 (lesions > 26 mm and < 40 mm) with 39 patients (48%); Group 3 (lesions > 41 mm) with 11 patients (14%). Data obtained with the Short Form Questionnaire showed a statistically significant difference in QoL in those undergoing intervention compared with a control group of healthy subjects. The Glasgow Benefit Inventory Questionnaire showed that 25 (31%) patients felt better, 11 (14%) felt similarly, and 45 (55%) felt poorer health conditions in comparison to the pre-surgical period. Concerning the relationship between preservation of facial nerve function and QoL, using the Glasgow Health Status Inventory, it appeared that only 34% of subjects with good facial nerve function (RGS grade I-II) complained of worsening of QoL, while 45% of those with serious facial nerve injury (RGS grade IV-V) referred poorer QoL. Moreover, the possibility of recovery of facial nerve function during the months following surgery was clearly highlighted by our analysis. Our study confirmed the close relation between tumour size and post-surgical QoL, which is worse for patients affected by larger lesions.


2014 - Hemangioblastoma of the Filum Terminale Resected with the Aid of Intraoperative Indocyanine Green Angiography in a Patient Affected by Von Hippel Lindau Disease [Articolo su rivista]
A, Puzzolante; A, Prontera; Pavesi, G
abstract


2014 - Hemifacial spasm:clinical features and management [Capitolo/Saggio]
Pavesi, G; Costella, Gb; Zara, G
abstract


2014 - Papillary glioneuronal tumor as a cause of superficial siderosis. A case report [Articolo su rivista]
A., Puzzolante; A., Prontera; S., Dimitriadis; Pavesi, G
abstract


2014 - Symptomatic Anterior Cerebral Artery Vasospasm after Brainstem Hemangioblastoma Resection: A Case Report [Articolo su rivista]
A, Prontera; A, Puzzolante; P, Carpeggiani; Pavesi, G
abstract


2013 - Intraventricular melanoma metastases [Articolo su rivista]
Feletti, A; Magrini, S; Manara, R; Orvieto, E; Pavesi, G
abstract


2012 - Ex vivo HR-MAS NMR, in vivo MRS-MRI and Multiivariate analysis to Highlight Biomarkers in Gliomas [Abstract in Atti di Convegno]
Righi, V.; Schenetti, Luisa; Valentini, A.; Nocetti, L.; Pavesi, G.; Tugnoli, V.; Mucci, Adele
abstract

Gliomas account for about 40% of total primitive brain tumors, and discrimination between high and low glioma grade remains a vital diagnostic decision, determining the most effective treatment and having an important impact on patient management and outcome. The in vivo MRS is considered a tool able to help the diagnosis based on MRI in the evaluation of several human pathologies, including cancer. In vivo MRS provides the spectra of living tissues, directly correlated to their chemical composition, but it can be used when the molecular markers of tissues are well established by means of a detailed biochemical picture. This last can be derived from the spectroscopic analysis of ex vivo biopsy samples using High Resolution Magic Angle Spinning (HR-MAS) NMR technique. The ex vivo HR-MAS NMR spectra provide more details about metabolites (aminoacids, carbohydrates, osmolites, organic acids, mobile lipids) than in vivo MRS and permits to produce a metabolic picture of the tissues. Accurate biochemical assignment of metabolites will improve our interpretation of HR-MAS data and the translation of NMR tumor biomarkers to in vivo studies. 1D and 2D HR-MAS NMR experiments were used to determine metabolites of brain tumor (astrocytoma grade II, grade III gliomas, glioblastomas). We developed this project on gliomas with the aim to gain a better insight into the discrimination among different grades and subtypes using ex vivo HR-MAS NMR, in vivo MRS, MRI, clinical data and statistical analysis. We report experiments performed on 15 specimen already collected from different grade glioma. Different amount of some small metabolites such as alanine, lactate, glutamine, glutamate, myo-inositol and glycine in two different ex vivo high grade glioma samples. The ex vivo spectra obtained on samples from different locations, line-broadened in order to be compared with the in vivo MR spectrum, obtained from the same selected voxel. A number of metabolites have been identified as potential biomarkers of tumor type; now we need to combine all the in vivo, ex vivo, histological and clinical data to obtain a unique tumor fingerprints. Results gathered from this study should lead to the development of tools that can facilitate the distinction of tumor types and grade that cannot be readily distinguished by histopathology or by routine neuroimaging.


2011 - Acute endovascular treatment (<48 hours) of uncoilable ruptured aneurysms at non-branching sites using silk flow-diverting devices [Articolo su rivista]
Causin, F; Pascarella, R; Pavesi, G; Marasco, R; Zambon, G; Battaglia, R; Munari, M
abstract


2011 - Increased Rate of Intracranial Saccular Aneurysms in Acromegaly: An MR Angiography Study and Review of the Literature [Articolo su rivista]
Manara, R; Maffei, P; Citton, V; Rizzati, S; Bommarito, G; Ermani, M; Albano, I; Della Puppa, A; Carollo, C; Pavesi, G; Scanarini, M; Ceccato, F; Sicolo, N; Mantero, F; Scaroni, C; Martini, C.
abstract


2010 - clinical and surgical features of lower brainstem hemangioblastomas in von hippel-Lindau disease [Articolo su rivista]
Pavesi, G; Berlucchi, S; Munari, M; Manara, R; Scienza, R; Opocher, G
abstract


2010 - Prevalence of asymptomatic cerebral aneurysms in acromegalic patients [Articolo su rivista]
Manara, R; Citton, V; Rizzati, S; Pavesi, G
abstract


2009 - acute surgical removal of low-grade (Spetzler-Martin I-II) bleeding arteriovenous malformations [Articolo su rivista]
Pavesi, G; Rustemi, O; Berlucchi, S; Frigo, Ac; Gerunda, V; Scienza, R
abstract


2009 - Aneurisma della vena di Galeno nell'adulto. Malformazione, dilatazione o fistola? [Abstract in Rivista]
Causin, F; Marasco, R; Calderone, M; Dal Pos, S; Manara, R; Rolma, G; Pavesi, G; De Caro, R; Faggi, G; Mangiafico, S
abstract


2009 - Trattamento chirurgico degli emangioblastomi del tronco encefalico nella sindrome di von Hippel-Lindau [Articolo su rivista]
Pavesi, G; Berlucchi, S; Scienza, R; Munari, M; Manara, R; Murgia, A; Opocher, G
abstract


2009 - Trattamento delle Mav cerebrali con colla acrilica. Quali indicazioni ancora? [Abstract in Rivista]
Causin, F; Marasco, R; Calderone, M; Dal Pos, S; Manara, R; Rolma, G; Pavesi, G; Carollo, C
abstract


2009 - Trattamento endovascolare degli aneurismi microbici: differenti opzioni [Abstract in Rivista]
Marasco, R; Calderone, M; Dal Pos, S; Manara, R; Rolma, G; Iannucci, G; Pavesi, G; Faggi, G; Causin, F
abstract


2008 - Intraventricular hemorrhage caused by peripheral anterior choroidal artery aneurysm rupture [Articolo su rivista]
Pavesi, G; Amistà, P; Munari, M; Gardiman, Mp; Scienza, R
abstract


2008 - Neurosurgical treatment of von Hippel-Lindau-associated hemangioblastomas: benefits, risks and outcome [Articolo su rivista]
Pavesi, G; Feletti, A; Berlucchi, S; Opocher, G; Martella, M; Murgia, A; Scienza, R
abstract


2007 - Digisonic SP auditory brainstem implant in NF2 patients [Articolo su rivista]
Trabalzini, F; Scienza, R; Pavesi, G
abstract


2007 - Intracranial stenting in four patients with acute ischemic stroke [Articolo su rivista]
Amistà, P; Munari, M; Sartori, Mt; Volipin, Sm; Pavesi, G; Basile, Am; Cavasin, N
abstract


2006 - Endothelial cells from human cerebral aneurysms and arteriovenous malformation release ET-1 in response to vessel rupture [Articolo su rivista]
Boscolo, E; Pavesi, G; Zampieri, P; Conconi, Mt; Calore, C; Scienza, R; Parnigotto, Pp; Folin, M
abstract


2006 - Hemangioblastoma of the obex mimicking anorexia nervosa [Articolo su rivista]
Pavesi, G; Berlucchi, S; Feletti, A; Opocher, G; Scienza, R
abstract


2006 - Unruptured aneurysm italian study (UAIS). Background and method [Articolo su rivista]
Versari, ; Tartara, F; Pavesi, G; Et, Al
abstract


2005 - Risk of hemorrhage in hemangioblastomas of the central nervous system: Comments [Articolo su rivista]
Schackert, G.; Niemela, M.; Hernesniemi, J.; Ishii, K.; Pavesi, G.; Awad, I. A.; Barrow, D. L.
abstract


2004 - Impairment of executive functions in a patient with a focal lesion in the anterior cingulate cortex. Evidence from neuropsychological assessment [Articolo su rivista]
Peru, A; Pavesi, G; Campello, M
abstract


2003 - Flowmetry-assisted aneurysm clipping. A cooperative study [Relazione in Atti di Convegno]
Scienza, R; Pavesi, G; Pasqualin, A; Benericetti, E; Boccaletti, R; Pinna, Gp; Profeta, G; Santoro, A
abstract


2003 - Intraoperative cerebral angiography: superficial temporal artery method and results [Articolo su rivista]
Lee, Mc; Macdonald, Rl; Niemela, M; Hernesniemi, J; Pavesi, G
abstract


2003 - Terapia chirurgica degli aneurismi cerebrali [Articolo su rivista]
Scienza, R; Pavesi, G
abstract


2002 - MAV cerebrali, la nostra esperienza chirurgica [Articolo su rivista]
Scienza, R; Pavesi, G
abstract


2001 - Aspetti clinici e chirurgici dei neurinomi del trigemino [Relazione in Atti di Convegno]
Della Puppa, A; Pavesi, G; Scienza, R
abstract


2000 - Trattamento dei meningiomi del seno cavernoso [Articolo su rivista]
Scienza, R; Pavesi, G; Berlucchi, S; Zampieri, P
abstract


1999 - Cerebral blood flow-guided phenylephrine-induced hypertensive therapy after subarachnoid hemorrhage [Articolo su rivista]
Karakus, A; Yonas, H; Pavesi, G; Jungreis, Ca; Kromer, Ha; Pentheny, Sl; Kassam, A
abstract


1994 - Intracranial ependymomas in children: long-term prognosis in relation to age [Articolo su rivista]
Sala, F; Mazza, C; Talacchi, A; Pavesi, G; Bricolo, A
abstract


1993 - The influence of various factors on transcranial Doppler flow velocity and resistance index after subarachnoid hemorrhage [Relazione in Atti di Convegno]
Pasqualin, A; Pavesi, G; Battaglia, R; Acerbi, G
abstract


1993 - The value of hemodynamic measurements in the early stage of subarachnoid hemorrhage [Capitolo/Saggio]
Pasqualin, A; Talacchi, A; Pavesi, G; Da Pian, R
abstract


1992 - Combined pterional-subtemporal approach to upper basilar artery aneurysms [Capitolo/Saggio]
Da Pian, R; Pasqualin, A; Scienza, R; Pavesi, G; Licata, C
abstract


1992 - Combined transcranial doppler sonography and rCBF measurements in the early stage of subarachnoid hemorrhage [Capitolo/Saggio]
Pasqualin, A; Talacchi, A; Chioffi, F; Pavesi, G; Da Pian, R
abstract


1992 - evaluation of cerebral perfusion after subarachnoid hemorrhage using transcranial doppler and rCBF measurements [Capitolo/Saggio]
Pasqualin, A; Talacchi, A; Pavesi, G; Da Pian, R
abstract


1992 - The importance of transcranial doppler sonography in the management of cerebral AVMs: pre-treatment evaluation and post-embolization changes [Capitolo/Saggio]
Chioffi, F; Pasqualin, A; Acerbi, G; Pavesi, G
abstract