Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia最新文献_第7页

Neonate Brain Abscess by Cronobacter spp: A Powdered Infant Formula's Opportunistic Pathogen 克罗诺杆菌引起的新生儿脑脓肿:一种婴幼儿配方奶粉的机会致病菌

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-09-01 DOI: 10.1055/s-0040-1716563

B. Morais, D. F. Menendez, Iuri Santana Neville Ribeiro, Cibeli Ribeiro Borsetto, Fernando De Sousa Nascimento, M. Teixeira

{"title":"Neonate Brain Abscess by Cronobacter spp: A Powdered Infant Formula's Opportunistic Pathogen","authors":"B. Morais, D. F. Menendez, Iuri Santana Neville Ribeiro, Cibeli Ribeiro Borsetto, Fernando De Sousa Nascimento, M. Teixeira","doi":"10.1055/s-0040-1716563","DOIUrl":"https://doi.org/10.1055/s-0040-1716563","url":null,"abstract":"\u0000 Cronobacter spp is an opportunistic pathogen that can cause severe neonatal infections, including septicemia, meningitis, and necrotizing enterocolitis. Over 90% of these infections outbreaks are associated with the increased consumption of powdered infant formula (PIF). We report the case of a male neonate born at term with adequate weight for gestational age, fed by breast milk and PIF. He was admitted to the ICU at 22 days old due to fever, irritability, impaired consciousness, and food intolerance. Investigation revealed an extensive abscess in the right frontoparietal region, that was surgically drained. The culture of the purulent material showed the growth of Cronobacter spp. Guided antibiotic was kept for 21 days. The patient presented a good clinical outcome, without neurological deficits. The microbiological powdered formula contamination by Enterobacter sakazakii (Cronobacter spp) can lead to a higher risk of severe infections in infants. Children may present sepsis, sensory alteration, and refractory seizures. An early brain image should be considered for symptomatic infants. The mortality rate ranges from 40 to 80%, and 74% of survivors have an adverse neurological outcome. From 1997–2013, there were reports of 6 outbreaks of E. sakazakii disease in Brazil. According to the World Health Organization (WHO), this disease is undernotified, and active foodborne surveillance systems are less than ideal. To better address this problem, in some countries, the notification is mandatory, and the adoption of stricter sanitary measures by regulatory agencies are proposed.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"44 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73883257","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

291 Internal Carotid Artery Aneurysms Treated with Fred, Silk, and Pipeline Stents: A Cross-Sectional Study 291 . Fred、Silk和管道支架治疗颈内动脉瘤的横断面研究

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-08-06 DOI: 10.1055/s-0043-1769781

Vinicius Fialho Teixeira, R. Santos, Gabrielly Ramalho Mendonça Alves, Alexandro Colins dos Santos, Albedy Moreira Bastos

{"title":"291 Internal Carotid Artery Aneurysms Treated with Fred, Silk, and Pipeline Stents: A Cross-Sectional Study","authors":"Vinicius Fialho Teixeira, R. Santos, Gabrielly Ramalho Mendonça Alves, Alexandro Colins dos Santos, Albedy Moreira Bastos","doi":"10.1055/s-0043-1769781","DOIUrl":"https://doi.org/10.1055/s-0043-1769781","url":null,"abstract":"Abstract Objective Intracranial aneurysms (IAs) are present in ∼ 2 to 5% of the population. Several treatments have been used, including endovascular options such as flow diverter devices (FDDs). The present study retrospectively analyzed the effectiveness of three FDDs in the treatment of 291 aneurysms in the internal carotid artery. The devices analyzed were the flow-redirection endoluminal device (FRED), the SILK Embolization Device and the PIPELINE Embolization Device (PED). Method This is a cross-sectional study which evaluates the outcome of control arteriography. The O'Kelly-Marotta (OKM) Scale was used to assess the degree of filling and flow stasis in the aneurysm 12 months after surgery. Results Conjoining the result of the three devices, most aneurysms (87.9%) were from the classification C-D, that is, they presented complete or almost complete aneurysmal occlusion. However, 6.6% did not obtain aneurysm occlusion, so they were classified as belonging to group A. In group B, a subocclusion was presented in 5.5%. In addition, by analyzing individually the result of each device, there was a bigger proportion of those classified in the group A among those who used SILK and in the group C-D among those who used FRED. Regarding complications, 10 cases were found, corresponding to 4.23% of all 236 patients. Therefore, four of these patients had complications when treated with PED; this proportion is higher than expected concerning the other groups. Conclusion The three devices are safe choices. Particularly, the FRED was found to be the most effective in treating internal carotid artery aneurysms.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"42 1","pages":"e127 - e133"},"PeriodicalIF":0.1,"publicationDate":"2022-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75729334","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}

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Insulectomy for Refractory Epilepsy: Case Series and Literature Review 顽固性癫痫的脑岛切除术:病例系列和文献回顾

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-08-02 DOI: 10.1055/s-0042-1749072

Adriano de Medeiros Barbosa Rodrigues, Henrique Nicola Santo Antonio Bernardo, M. Seba, Carlos Alberto Cavalcante Junior, P. Franceschini, P. Aguiar

{"title":"Insulectomy for Refractory Epilepsy: Case Series and Literature Review","authors":"Adriano de Medeiros Barbosa Rodrigues, Henrique Nicola Santo Antonio Bernardo, M. Seba, Carlos Alberto Cavalcante Junior, P. Franceschini, P. Aguiar","doi":"10.1055/s-0042-1749072","DOIUrl":"https://doi.org/10.1055/s-0042-1749072","url":null,"abstract":"Surgical resection of the insula (insulectomy) is a procedure used for brain lesions and for refractory epilepsy. It has a difficult surgical access and the need of a wide anatomical knowledge and preoperative planning. There are two types of surgical approaches aiming the exposure of the insular cortex: transsylvian and transcortical. The importance of insulectomies is the efficacy in providing a remarkable decrease in seizures. The objective of the present article is to document the results of a series of 10 patients submitted to insulectomies for refractory epilepsies and compare them with the results of other studies reported in the literature, as well as to describe the main nuances of the surgical approaches and their associated risks. In the new case series, all patients corresponded to preoperative Engel classification IV for; after a mean 2-year follow-up period, they corresponded to Engel classification II. A subtotal resection was performed in six patients, and the remaining four underwent a partial resection, most of them leading to temporary complications. The literature review endorsed the good outcomes of the casuistry. A critical analysis of the presented data reiterates the opinion of several authors that insulectomies are beneficial and safe for the patients. A broad anatomical knowledge of the insular region, preoperative planning (limits of resections), and the use of modern microsurgical techniques must be considered as basic principles by neurosurgeons for the prevention of perioperative morbidities. Insulectomies are safe and effective, although they result in temporary postoperative complications, and provide highly satisfactory results in terms of seizure control.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"13 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73712182","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

Treatment of Cluster Headache by Occipital Nerve Stimulation: Case Report 枕神经刺激治疗丛集性头痛1例

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-08-01 DOI: 10.1055/s-0042-1743104

Andressa Lima Oliveira, Vitória Harumi Rodrigues Takahashi Monteiro, L. Silva

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Brain Metastasis is Associated with Tumor Size, Nodal Status, and c-erbB-2 Expression in Invasive Breast Carcinoma 浸润性乳腺癌脑转移与肿瘤大小、淋巴结状态和c-erbB-2表达相关

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-07-30 DOI: 10.1055/s-0043-1769779

E. Cambruzzi, N. Zandoná, José Nathan Andrade Müller da Silva, Gabriella Bezerra Cortês Nascimento, M. Medeiros

{"title":"Brain Metastasis is Associated with Tumor Size, Nodal Status, and c-erbB-2 Expression in Invasive Breast Carcinoma","authors":"E. Cambruzzi, N. Zandoná, José Nathan Andrade Müller da Silva, Gabriella Bezerra Cortês Nascimento, M. Medeiros","doi":"10.1055/s-0043-1769779","DOIUrl":"https://doi.org/10.1055/s-0043-1769779","url":null,"abstract":"Abstract Introduction According to the World Health Organization (WHO) classification, invasive breast carcinoma (IBC) of no special type (IBC-NST) is the second most common primary site of central nervous system metastases, affecting 15% to 30% of patients. Brain metastasis originating from IBC is associated with patient age, tumor size, and axillary lymph node status. Loss of expression of hormone receptors and c-erbB-2 amplification are frequent findings in patients who develop brain metastasis. Radiological studies of the central nervous system are carried out only in patients presenting with neurological signs or symptoms during the clinical follow-up. Objective To evaluate the associations of clinical and pathological findings with brain metastasis in breast cancer. Materials and Methods The sample comprised 73 patients with breast cancer who underwent mastectomy with lymph node resection. The following variables were evaluated: tumor size, histological grade, nodal state, expression of estrogen and progesterone receptors and c-erbB-2, and presence of brain metastasis. Results The histopathological findings associated with brain metastasis in patients with IBC were tumor size ( p = 0.03), presence of nodal metastasis ( p = 0.045), and c-erbB-2 expression ( p = 0.012). Conclusion The assessment of specific pathological findings in breast carcinoma can help identify risk factors and/or clinical parameters associated with the development of brain metastasis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"112 1","pages":"e121 - e126"},"PeriodicalIF":0.1,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87712421","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}

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The Learning Curve in Skullbase Surgery Part 2–From the Microsurgical Lab Training to the Operative Room 颅底外科的学习曲线第2部分——从显微外科实验室训练到手术室

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-07-29 DOI: 10.1055/s-0042-1758221

G. Isolan, J. Monteiro, M. A. S. Vaz, J. Lavinsky, R. Araújo, E. Figueiredo, Samir Aler Bark, J. Polanski, Carmem Austrália Paredes Ribas Filho, J. M. Ribas Filho, O. Malafaia

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The Learning Curve in Skull Base Surgery Part 1–From Historical-Philosophical Concepts to Microsurgical Lab Training 颅底外科的学习曲线第一部分-从历史哲学概念到显微外科实验室训练

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-07-29 DOI: 10.1055/s-0042-1758220

G. Isolan, J. Monteiro, M. A. S. Vaz, J. Lavinsky, R. L. D. de Araújo, G. Santis, E. Figueiredo, V. Buffon, Carmem Austrália Paredes Ribas Filho, J. M. Ribas Filho, O. Malafaia

{"title":"The Learning Curve in Skull Base Surgery Part 1–From Historical-Philosophical Concepts to Microsurgical Lab Training","authors":"G. Isolan, J. Monteiro, M. A. S. Vaz, J. Lavinsky, R. L. D. de Araújo, G. Santis, E. Figueiredo, V. Buffon, Carmem Austrália Paredes Ribas Filho, J. M. Ribas Filho, O. Malafaia","doi":"10.1055/s-0042-1758220","DOIUrl":"https://doi.org/10.1055/s-0042-1758220","url":null,"abstract":"Abstract The learning curve reflects surgeons' experience in managing several patients with the same disease. In skull base surgery, the professional's place on the curve could be related to the number of times the same procedure was performed. Where does curve begin? What amount of training is necessary prior to its application in surgical settings? What were the results of the first few skull base tumor surgeries performed by a surgeon who goes on to produce excellent results, and how is reflected in the start of their learning curve? The only way for neurosurgeons to improve their results from the start is with prior training in the microsurgery laboratory. This learning technique is essential to maximize the chance of success of a neurosurgical procedures, minimizing the morbidity rate to which patients are subjected by less experienced neurosurgeons. This article is divided in two parts, and its purpose is to show how training in the microsurgical laboratory fits into the construction of knowledge about skull base surgery, based on authors' experience and reflections. This first part discusses the technical, psychological, and philosophical aspects of medical knowledge, primarily addressing those training in skull base surgery, the principles of some selected philosophical currents, and their influence on the development of current medical knowledge.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"5 1","pages":"e340 - e347"},"PeriodicalIF":0.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90651741","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}

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Sectioning of the Filum Terminale in Patients with Chiari Malformation Type 1 Associated with Occult Tethered Cord Syndrome: Literature Review 1型Chiari畸形合并隐蔽性脊髓栓系综合征患者的终丝切片:文献综述

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-07-29 DOI: 10.1055/s-0043-1769780

José Nazareno Pearce de Oliveira Brito, Patryck Araújo Dantas, Pedro Borges Bomfim, C. B. Tavares, Leonardo Augusto Martins, E. B. Sousa, Michele Medeiros da Cunha

{"title":"Sectioning of the Filum Terminale in Patients with Chiari Malformation Type 1 Associated with Occult Tethered Cord Syndrome: Literature Review","authors":"José Nazareno Pearce de Oliveira Brito, Patryck Araújo Dantas, Pedro Borges Bomfim, C. B. Tavares, Leonardo Augusto Martins, E. B. Sousa, Michele Medeiros da Cunha","doi":"10.1055/s-0043-1769780","DOIUrl":"https://doi.org/10.1055/s-0043-1769780","url":null,"abstract":"Abstract Approximately 125 years ago, a group of pathologies now known as Chiari malformations was described for the first time. However, some mechanisms of its formation still remain unknown. A bibliographic survey was performed through a search in PubMed. In 1938, it was already theorized that an increase in spinal cord tension could be the cause of Chiari malformation type 1 (CM1) tonsillar herniation. In 1953, a condition known for the anchoring of the filum terminale to the vertebral canal was described for the first time and would later be known as tethered cord syndrome (TCS). Some studies have shown that it is associated with increased tension in the spinal cord, and this formed the basis for a possible pathophysiological explanation of tonsillar herniation. Case series emerged reporting that treatment for TCS with the sectioning of the filum terminale (SFT) could provide clinical improvement of patients with CM1. A new pathological entity emerged when it was realized that patients with the clinical picture of TCS could have the medullary cone in its normal position, differing from the caudal migration expected for the TCS. This condition became known as occult tethered cord syndrome (OTCS). Case series attempted to demonstrate its association with the origin of CM1, a non-intuitive association, since the cone in the normal position contradicts traction as a source of tonsillar herniation. To this day, the absence of randomized control trials limits any conclusions regarding the effectiveness of SFT for the treatment of patients with CM1.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"12 1","pages":"e114 - e120"},"PeriodicalIF":0.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85161460","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

Surgical Management of the Armored Brain: Case Report of the Treatment of a Chronic Calcified Subdural Hematoma 装甲脑的外科治疗:慢性钙化硬膜下血肿1例报告

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-07-01 DOI: 10.1055/s-0042-1758711

André Luiz Girotto, Guilherme Gago

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Ultrasound-Guided In-Plane Interlaminar Lumbar Endoscopic Approach with Smartphone and Portable Light Source: Description of a New Surgical Technique 智能手机和便携式光源下超声引导腰椎板间内窥镜入路:一种新手术技术的描述

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Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia Pub Date : 2022-05-30 DOI: 10.1055/s-0042-1756459

João Paulo Souza de Castro, R. Brock, M. Teixeira, E. Figueiredo

{"title":"Ultrasound-Guided In-Plane Interlaminar Lumbar Endoscopic Approach with Smartphone and Portable Light Source: Description of a New Surgical Technique","authors":"João Paulo Souza de Castro, R. Brock, M. Teixeira, E. Figueiredo","doi":"10.1055/s-0042-1756459","DOIUrl":"https://doi.org/10.1055/s-0042-1756459","url":null,"abstract":"Abstract Introduction Endoscopic spine surgery enables the minimally invasive treatment of pathologies affecting the spinal cord and roots. Herein we describe an unprecedented technique Ultrasound-Guided in-plane interlaminar lumbar endoscopic approach with a smartphone and portable light source. Methods The interlaminar approach was performed in a cadaveric specimen at L4 to 5 and L5 to S1 bilaterally. A curvilinear 2 to 5 MHz ultrasound probe was employed, the puncture was performed with the needle, a guide wire was inserted until the flavum ligament, followed by the dilator and working cannula. A 30° spinal endoscope, with an optical adapter of the endoscope camera for smartphone and portable endoscope lighting was inserted, the flavum ligament was visualized, and an opening in this site was performed with the scissors. Open dissection of the specimen was subsequently performed by identifying the puncture site in the interlaminar window. Results The four interlaminar punctures were successfully guided by ultrasound; the opening of the ligamentum flavum was performed in the most lateral part of the interlaminar space, near the junction of the superior and inferior articular processes of the corresponding vertebrae in all the punctures. Discussion The ultrasound makes possible to identify facets, foramina, transverse processes, and the interlaminar space. It is possible to minimize the use of radioscopy and its associated risks, both for patients and health professionals. Conclusions The ultrasound-guided, in-plane, interlaminar, lumbar endoscopic approach with smartphone-adapted endoscope and portable light source is feasible and practical, minimizing radiation risks and making it possible to perform endoscopic spinal surgery.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"13 1","pages":"e391 - e396"},"PeriodicalIF":0.1,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87537438","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