Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia最新文献_第2页

The Importance of Orthostatic Radiography in the Management of Thoracolumbar Fractures: Case Report 体位摄影在胸腰椎骨折治疗中的重要性:病例报告

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-27 DOI: 10.1055/s-0043-1776276

Pedro Neves Fortunato, Yvens Barbosa Fernandes, Andrei Fernandes Joaquim

引用次数: 0

Microsurgical Treatment of Anterior Communicating Artery Aneurysms: An Analysis of 74 Consecutive Cases. Approach Side Choice and Outcome Considerations 显微外科治疗前交通动脉瘤74例临床分析。方法选择和结果考虑

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-27 DOI: 10.1055/s-0043-1776269

Leon Cleres Penido Pinheiro, Mario Wolak Junior, Joao Lucas Salgado, Francisco L. de A. Moura Neto, Pedro Tadao Hamamoto Filho, Marco Antonio Zanini, Adriano Yacubian Fernandes

{"title":"Microsurgical Treatment of Anterior Communicating Artery Aneurysms: An Analysis of 74 Consecutive Cases. Approach Side Choice and Outcome Considerations","authors":"Leon Cleres Penido Pinheiro, Mario Wolak Junior, Joao Lucas Salgado, Francisco L. de A. Moura Neto, Pedro Tadao Hamamoto Filho, Marco Antonio Zanini, Adriano Yacubian Fernandes","doi":"10.1055/s-0043-1776269","DOIUrl":"https://doi.org/10.1055/s-0043-1776269","url":null,"abstract":"Abstract Introduction Anterior communicating artery aneurysms (ACoAAs) are intracranial aneurysms whose treatment is still considered a challenging task. Materials and Methods Altogether, 74 patients were included in this study. The variables included age, sex, comorbidities, incidence of subarachnoid hemorrhage (SAH), the Fisher, Hunt-Hess, and WFNS scores, approach side, length of hospital stay, and mortality. We also investigate A1/A2 dimensions, association with approach side choice and the influence of surgeon's experience on the outcome. Results There were 61 patients (82.2%) admitted with SAH and 13 were treated for unruptured aneurysms. The A1 and A2 branches were larger ipsilaterally to the selected approach side (p < 0,001). No deaths occurred in the unruptured aneurysm group. In the SAH group, mortality was strongly correlated with the Hunt-Hess score (p < 0.001), Fisher grade (p < 0.001), and WFNS score (p < 0.001). No significant difference was found in mortality between the right-side and the left-side approaches (p = 0.253). A significant survival difference was identified on the group operated by the senior surgeon versus the non-senior group (p = 0.048). Discussion and Conclusion A1 dominance was identified as a factor associated to the approach side for SAH cases at our center. Understanding the factors involved in brain aneurysm surgery remains a relevant and underexplored subject. Further studies involving larger case series and multicenter collaborations are necessary to elucidate these factors and to determine the external validity of our findings.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Related to the Recurrence of Low-grade Gliomas 低级别胶质瘤复发的相关因素

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-27 DOI: 10.1055/s-0043-1776283

David Ilun Tseng Lin, Lindson Muhlmann, Fábio Pires Botta, Pedro Tadao Hamamoto Filho, Marco Antonio Zanini, Adriano Yacubian Fernandes

{"title":"Factors Related to the Recurrence of Low-grade Gliomas","authors":"David Ilun Tseng Lin, Lindson Muhlmann, Fábio Pires Botta, Pedro Tadao Hamamoto Filho, Marco Antonio Zanini, Adriano Yacubian Fernandes","doi":"10.1055/s-0043-1776283","DOIUrl":"https://doi.org/10.1055/s-0043-1776283","url":null,"abstract":"Abstract Objective To identify the determining factors for reoperation in patients with low-grade gliomas, taking into account the degree of resection, and to analyze the histological aspects, observing possible transformations with signs of malignancy in the tissue samples. Materials and Methods The sample consisted of 40 cases of low-grade glioma that were operated on at Hospital das Clínicas de Botucatu between 2013 and 2019. Results The mean follow-up was of 37 months, and the sample was composed of 28 men and 12 women with a mean age at the first surgery of 43.1 ± 15.6 years. Epileptic seizures were observed in 31 (77.5%) patients. According to the histological classification, half of the patients presented oligodendroglioma (50%), of grade II in most cases (97.5%). Total or subtotal resection was achieved in 22 (55%) patients. Only one patient underwent radiotherapy, and two underwent chemotherapy. Reoperation was performed in 20 (50%) patients. The median interval between the first surgery and the reapproach was of 16 (range: 0–77) months. In the second approach, the histological classification was of astrocytoma in 4 (20%) cases, oligoastrocytoma in another 4 (20%), oligodendroglioma in 7 (35%), and glioblastoma in 5 (25%) cases. The only variable associated with the need for reoperation was the degree of resection after the first surgery (p = 0.013). Conclusions Total resection of low-grade gliomas, when feasible, should be performed to avoid recurrence.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"14 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136317598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interventional Neuroradiology: Why Don't Brazilian Female Physicians Like It? 介入神经放射学:为什么巴西女医生不喜欢?

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-27 DOI: 10.1055/s-0043-1776268

Luana Antunes Maranha Gatto, Marina Anita Martins, Elora Sampaio Lourenço

{"title":"Interventional Neuroradiology: Why Don't Brazilian Female Physicians Like It?","authors":"Luana Antunes Maranha Gatto, Marina Anita Martins, Elora Sampaio Lourenço","doi":"10.1055/s-0043-1776268","DOIUrl":"https://doi.org/10.1055/s-0043-1776268","url":null,"abstract":"Abstract Objective Much has been discussed about gender diversity in all professional fields, particularly in medicine. Recent studies showing that there are fewer than ten female professionals in interventional neuroradiology (INR) in a continental country like Brazil, and less than thirty in all of Latin America, have prompted an investigation into the causes of the low numbers of women choosing to follow this medical specialty. This project intended to reveal the reasons through an anonymous form applied to women in the final year of the three medical residencies considered prerequisites for INR in Brazil: neurology, radiology and neurosurgery. Materials and Methods The questionnaire addressed to each of the three fields contemplated the professionals' preference to follow their respective subspecialties, in addition to common considerations that could be deemed barriers to INR. Results Surprisingly, the weak link in the chain was demonstrated to be radiology, which is the exclusive prerequisite residency for training in INR in many countries. However, in Brazil, most doctors who graduate in INR come from Neurosurgery and, secondly, from neurology. These two specialties together account for less than half of the female residents compared to radiology alone. Conclusion All of the following items were already expected: difficulty in reconciling a double shift; employment opportunity; long training time; the lack of female leaders inspiring new generations of doctors; issues involving radiation and motherhood; and still the barriers of misogyny and machismo. But specific studies need to be conducted to find out why very few radiology residents follow INR training in Brazil.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Hoffmann-Tinel sign: Historical Background and Clinical Significance Hoffmann-Tinel征的历史背景及临床意义

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-27 DOI: 10.1055/s-0043-1776273

Mario Gilberto Siqueira, Roberto Sergio Martins

引用次数: 0

Intraoperative Ultrasonography in Neurosurgery: Experience of an Institution 术中超声检查在神经外科中的应用:一个机构的经验

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-20 DOI: 10.1055/s-0042-1756209

Robinson Antonio Menegotto Marques, Adriana Hernandez Marques, Amanda Hernandez Marques

{"title":"Intraoperative Ultrasonography in Neurosurgery: Experience of an Institution","authors":"Robinson Antonio Menegotto Marques, Adriana Hernandez Marques, Amanda Hernandez Marques","doi":"10.1055/s-0042-1756209","DOIUrl":"https://doi.org/10.1055/s-0042-1756209","url":null,"abstract":"Abstract Objective Intraoperative ultrasound (IOUS) is an imaging method that can be used in various neurosurgical procedures. It assists in the removal of brain tumors, hematomas, in the insertion of ventricular catheters, and in spinal and peripheral nerve surgeries. The original studies using IOUS were performed with devices that produced lower-quality images, generating little interest in their use. The introduction of ultrasound devices that yielded higher-quality images associated with a relative low cost and ease of use rendered IOUS attractive. Thus, we started using it in multiple neurosurgical procedures, studying its practicality, efficacy and limitations. Materials and methods A retrospective case study on the use of IOUS in neurosurgery from August 2014 to December 2020 at a single institution, evaluating its practicality, efficacy and limitations. Results A total of 127 IOUS scans were performed in 112 patients aged 19 to 83 (mean: 53.8) years: 106 scans of the brain, 4 of the spinal cord, and 2 of the peripheral nerves. Brain tumors were the majority, with 86 cases (67.8%). The IOUS was unsatisfactory in 9 cases (7.1%), and there were no cases of infection related to the IOUS. Conclusion The IOUS is a dynamic, safe, and practical exam. It can be performed in a few minutes and repeated several times during the surgical procedure. It enables surgeons to observe the pulsation of tissues and vessels, the displacement of lumps in liquid collections, and to monitor the drainage of cysts and collections, in vivid, interactive and real-time images.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135568178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Traumatic Carotid Artery Dissection — A Case Report 外伤性颈动脉夹层1例报告

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-20 DOI: 10.1055/s-0042-1755453

Taís Otilia Berres, Wagner Lazaretto Padua, Artur Eduardo Martio, Yasmynni Escher, Luciano Bambini Manzato, José Ricardo Vanzin, Octávio Ruschel Karam, Paulo Moacir Mesquita Filho

{"title":"Traumatic Carotid Artery Dissection — A Case Report","authors":"Taís Otilia Berres, Wagner Lazaretto Padua, Artur Eduardo Martio, Yasmynni Escher, Luciano Bambini Manzato, José Ricardo Vanzin, Octávio Ruschel Karam, Paulo Moacir Mesquita Filho","doi":"10.1055/s-0042-1755453","DOIUrl":"https://doi.org/10.1055/s-0042-1755453","url":null,"abstract":"Abstract Traumatic carotid artery dissection (TCAD) usually occurs after a direct cervical trauma or blunt trauma that causes hyperextension and excessive rotation of the neck. The most frequent presentation of TCAD is stroke, with 80% of patients developing a stroke in the first week after the trauma. Recent data indicate that symptoms start later in non-survivors (19.5 hours after trauma) compared with survivors (12.5 hours). In this case report, a young boy, 14 years-old, developed TCAD after he fell from his bike. He developed ischemic stroke symptomatology in the eighth day of hospitalization, with full recovery of symtoms after acetylsalicylic acid (AAS) administration. The use of antithrombotic medication is recommended, aiming for better neurological outcomes and prevention of stroke in TCAD patients, as highlighted by our case. However, the treatment recommendations are based on observational studies and expert opinion, owing to the lack of concrete data on the treatment of carotid artery blunt trauma. New studies and data are required to improve diagnosis and treatment of TCAD.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"38 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135568029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Protocol of a Nerve Neurotmesis Sciatic Repair using Polyvinyl Alcohol Biofilm in Wistar Rats 聚乙烯醇生物膜修复Wistar大鼠坐骨神经损伤的实验研究

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-18 DOI: 10.1055/s-0042-1742297

Ana Camila Nobre de Lacerda Brito, Maria Danielly Lima de Oliveira, César Augusto Souza de Andrade, Hélida Cristina Cirilo da Silva, Paulo César da Silva Queiroz, Sara Emanuely Veríssimo Santos, Wilayane Alves Martins, Estela Batista Santos, Romero Andion de Medeiros Sobrinho, Kalline Lourenço Ribeiro, Alberto Galdino da Silva Júnior, Sílvia Regina Arruda de Moraes

{"title":"Protocol of a Nerve Neurotmesis Sciatic Repair using Polyvinyl Alcohol Biofilm in Wistar Rats","authors":"Ana Camila Nobre de Lacerda Brito, Maria Danielly Lima de Oliveira, César Augusto Souza de Andrade, Hélida Cristina Cirilo da Silva, Paulo César da Silva Queiroz, Sara Emanuely Veríssimo Santos, Wilayane Alves Martins, Estela Batista Santos, Romero Andion de Medeiros Sobrinho, Kalline Lourenço Ribeiro, Alberto Galdino da Silva Júnior, Sílvia Regina Arruda de Moraes","doi":"10.1055/s-0042-1742297","DOIUrl":"https://doi.org/10.1055/s-0042-1742297","url":null,"abstract":"Abstract Background Animal models are commonly used to assess the efficacy of new materials to be employed in the surgical repair of a nerve injury. However, there is no published surgical repair protocol for sciatic nerve neurotmesis in rats. Objective To produce and evaluate a protocol for the tubing technique using a polyvinyl alcohol biofilm after sciatic nerve neurotmesis. Methods Eighteen rats were randomized into 3 groups ( n = 6 per group): control group - CG, neurotmesis group - NG, and neurotmesis biofilm group - NBG. The NG and NBG animals were submitted to neurotmesis of the sciatic nerve at 60 days of life, followed by suture of the nerve stumps; in the NBG, the animals had the suture involved by polyvinyl alcohol biofilm. A descriptive evaluation of the surgical technique was performed after the experimental period. The Shapiro-Wilk normality test was used for body weight, and analysis of variance (ANOVA) with Bonferroni posthoc ( p < 0.05) was applied. Results All groups showed good repair of the skin and muscle sutures; however, 33.30% of the CG presented disruption of skin points. Furthermore, 16.70% of the stumps were not structurally aligned and 33.30% had neuromas in the NG, while in the NBG, all stumps were aligned and none of them had neuroma . Conclusions The present study was able to produce a protocol with high reproducibility in view of the mechanical stability, targeting of the nerve stumps, muscle healing, the low frequency of skin breakage and the low complexity level of the technique, and it can be used in future studies that aim to evaluate other biomaterials for nerve repair in rats.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thermocoagulation in Multiple Targets to Treat Obsessive-Compulsive Disorder Associated with Drug Addiction: Case Report 多靶点热凝治疗与药物成瘾相关的强迫症:病例报告

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-18 DOI: 10.1055/s-0043-1774747

Laryssa Simões de Lima Assis, Laura Araújo de Carvalho, Ledismar José da Silva

{"title":"Thermocoagulation in Multiple Targets to Treat Obsessive-Compulsive Disorder Associated with Drug Addiction: Case Report","authors":"Laryssa Simões de Lima Assis, Laura Araújo de Carvalho, Ledismar José da Silva","doi":"10.1055/s-0043-1774747","DOIUrl":"https://doi.org/10.1055/s-0043-1774747","url":null,"abstract":"Abstract Substance-related disorders are chronic psychiatric conditions defined by substance abuse, and they compromise patients both clinically and functionally. Currently, pharmacotherapy, behavioral therapy, or an association of both are the treatments of choice for obsessive-compulsive disorder associated with drug addiction. However, the refractoriness to treatment, as a result of the high failure rates of these approaches, has led to the need to develop surgical techniques to treat severe cases of substance-related disorders. In the present article, we report the case of a patient who underwent neurosurgery through the stereotactic technique after refractoriness to the conventional treatment for drug addiction. The patient showed sustained improvement in his addiction to drugs. Despite the numerous reports on the effectiveness and applicability of neurosurgery in psychiatric disorders, some concerns regarding stereotactic surgery as a treatment for drug addiction still remain, especially in relation to its efficacy, safety, and ethical implications.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral Cerebral Venous Thrombosis with a Rare Presentation in a COVID-19 Patient: A Case Report 新型冠状病毒肺炎患者双侧脑静脉血栓形成1例

Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2023-10-18 DOI: 10.1055/s-0042-1756458

Iman Ahrari, Arash Saffarian, Abbas Rakhsha, Mahsa Ghavipisheh, Mohamad Reza Gholami

{"title":"Bilateral Cerebral Venous Thrombosis with a Rare Presentation in a COVID-19 Patient: A Case Report","authors":"Iman Ahrari, Arash Saffarian, Abbas Rakhsha, Mahsa Ghavipisheh, Mohamad Reza Gholami","doi":"10.1055/s-0042-1756458","DOIUrl":"https://doi.org/10.1055/s-0042-1756458","url":null,"abstract":"Abstract Since the COVID-19 pandemic started, millions of peoples are involved. The presentation of the disease varies from mild respiratory symptoms and multiple organ failure to coma and death. Neurological symptoms such as headache or seizure are also coincident with COVID-19. Thromboembolic events increase in COVID-19 patients due to hypercoagulability and inflammation, particularly in severely ill patients. Thrombosis may cause venous thrombosis, pulmonary embolism, or cerebral sinus venous thrombosis (CSVT). Cerebral sinus venous thrombosis is a rare phenomenon that is usually found in critically ill patients with bad prognoses. In the present case report, we present a 40-year-old man with COVID-19 confirmed by real-time polymerase chain reaction (RT-PCR) who was admitted due to acute bilateral visual loss due to bilateral transverse sinus thrombosis. Pseudotumor cerebri disease was confirmed through high lumbar puncture. Early surgical intervention (optic nerve fenestration) was performed and, fortunately, his visual acuity improved. Cerebral sinus venous thrombosis is a rare incident in COVID-19 patients, but due to irreversible complications, an early diagnosis is fundamental. In any neurologic change in COVID-19 patients, CSVT must be considered. Also, prophylactic thrombolytic therapy should be kept in mind as the patient is admitted.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135825254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0