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Francesco Tognetti, Massimo Poppi, Giulio Gaist, and Franco Servadei

✓ An unusual case of pudendal neuralgia due to a solitary neurofibroma of the perineal region is described. The authors outline the long clinical history. There was complete pain relief after removal of the lesion.

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Eugenio Pozzati, Leo Fagioli, Franco Servadei, and Giulio Gaist

✓ The effects of common carotid artery ligation on five giant aneurysms (greater than 2.5 cm in diameter) of the internal carotid artery were studied by computerized tomography (CT). Four aneurysms thrombosed completely and one partially. The CT image of the thrombosed part in giant aneurysms is protean, varying from hyperdensity in the immediate postoperative period to isodensity and finally to inhomogeneously increased or decreased density, the attenuation values depending on the different stages of organization of the thrombus and on calcium deposition.

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Eugenio Pozzati, Giulio Gaist, and Franco Servadei

✓ This paper describes two patients with traumatic aneurysms of the supraclinoid internal carotid artery, which occurred after a closed-head injury and without demonstrable basal skull fracture. In the first case, the traumatic origin of the aneurysm was demonstrated by repeat angiograms. The second case documents the formation of a giant, traumatic, true aneurysm of the supraclinoid carotid artery over a period of less than 2 months; there was an associated traumatic partial occlusion of the vessel proximal to the aneurysm. The mechanisms of injury of the supraclinoid carotid artery are discussed.

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Alex B. Valadka, Andrew I. R. Maas, and Franco Servadei

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Marco Cenzato, Francesco DiMeco, Marco Fontanella, Davide Locatelli, and Franco Servadei

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Franco Servadei, Katharine J. Drummond, Ann Stroink, and Jamie J. Van Gompel

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Andrea Franzini, Zefferino Rossini, Maria Pia Tropeano, Piero Picozzi, Franco Servadei, and Federico Pessina

During the Greco-Italian War (World War II [WWII], 1940–1941), an Italian field hospital was set up in Sinanaj, Albania. The hospital’s military surgeons carefully collected information about the characteristics and management of patients with war-related injuries. In 1942, they published a detailed report, with a section dedicated to the management of war-related head injuries. The aim of this report is to analyze that section, to describe the characteristics and neurosurgical management of war-related head injuries, and to depict the status of war neurosurgery in the Royal Italian Army during WWII. The analysis revealed that, during the Greco-Italian War (November 1940–April 1941), 149 patients with war-related head injuries were admitted to the Sinanaj hospital, and 48 patients underwent surgery. Head injuries were caused by bomb fragments in 126 patients, bullets in 5 patients, and other causes (falls from height, vehicle accidents, or rock fragments) in 18 patients. Six patients (12.5%) died after surgery. Before surgery, patients underwent resuscitation with blood transfusions and fluid. Preoperatively, a plain head radiograph was usually acquired to locate metallic and bone fragments. The surgical technique consisted of craniotomy or craniectomy, aggressive debridement of metallic and bone fragments, and watertight dural closure. Surgical drainage, overall aseptic technique, serial spinal taps, and perioperative antibiotics were used to prevent infections. The surgical aims and technique used by the Italian surgeons for the management of head injuries were similar to those of the Allied surgeons during WWII. Operative mortality was also comparable. Although the surgical technique for war-related head injuries has evolved since WWII, many aspects of the technique used by the Italian and Allied surgeons during WWII are still in the standard of care today.