Introduction: Investigating on brain local connectivity changes following Carotid Endarterectomy (CEA) by connectometry. Methods: In this exploratory study, seventeen subjects (15 males and 2 females, mean age 74.1 years) who underwent CEA, were prospectively recruited. Within one week before the CEA, each patient performed, in the same day, a cognitive evaluation with a Mini Mental State Examination (MMSE) and a Magnetic Resonance (MR) exam that included a DTI sequence for the connectometry analysis. The same cognitive test and MR protocol were performed on follow-up in a period between 3-6 months after CEA. The MMSE scores were analyzed using T-Student test. The connectometry analysis was performed using a multiple regression model in order to consider the effect of CEA, choosing three different T-score threshold values (1, 2 and 3), and results were considered statistically valid when p-value adjusted for False Discovery Rate (p-FDR) < 0.05. Results: Comparison of pre-CEA and post-CEA MMSE scores showed improvement of MMSE scores after CEA (p-value = 0.0001). Connectometry analysis revealed no areas of statistically significant increased connectivity related to CEA for T-threshold value = 1 and 2, whereas for Tthreshold value = 3 the analysis revealed statistically significant increased connectivity after CEA (p-FDR = 0.0106667) in both cerebellar hemispheres and corpus callosum. Conclusion: The results suggest that CEA procedure is associated with both improvements of cognitive performances and changes in both interhemispheric local connectivity through corpus callosum and in cerebellum.

Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed. Some other similar but significantly smaller lesions were found. An en bloc resection of the mesenteric mass together with the corresponding intestinal loops, an appendicectomy, and some peritoneal biopsies were performed. The postoperative period was complicated by a peritonitis due to dehiscence of the intestinal anastomosis, which required another operation, and a delayed return of normal bowel function, which was resolved through prokinetic therapy. Through histological examination, a BMPM was diagnosed. At 8 months of follow-up, the patient is free of symptoms. BMPM exact etiopathogenesis still remains uncertain. Given his high recurrence rate, a long-term follow-up is recommended.

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