Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia最新文献

{"title":"Complex Regional Pain Syndrome: A Quantitative Review of Current Treatments","authors":"Fernando Furtado Santos, A. Takahashi, André Ponce, P. Franceschini, P. Aguiar","doi":"10.1055/s-0042-1743246","DOIUrl":"https://doi.org/10.1055/s-0042-1743246","url":null,"abstract":"\u0000 Introduction Complex regional pain syndrome (CRPS) is a disease that causes intense pain mainly in the upper and lower limbs of the patients, impairing the quality of life of those affected by the syndrome. Its pathophysiology has not yet been fully discovered and described. Also, treatments need to advance in the search for pain relief in those affected by the disease. The present article aims to describe the pathophysiology of CRPS and, mainly, to quantitatively analyze the efficiency of new treatments against pain caused by the disease.\u0000 Methods Several articles on clinical trials described in a table were included in the present study, and a systematic review of the effectiveness of current treatments was performed.\u0000 Results A total of 29 articles from clinical trials were selected using the preselection criteria. Surgical treatments against CRPS had a 56.9% efficiency in reducing painful sensation, and conservative treatments against CRPS had a 40.82% efficiency in reducing pain sensation.\u0000 Conclusion Complex regional pain syndrome is a disease that causes pain in patients and worsens the quality of life of those affected by it. The treatments are diverse, and their efficiencies vary from bad to excellent.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"5 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75716710","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}

{"title":"Dealing with a Pediatric Posterior Fossa Tumor after COVID-19 Infection: Report of One Case","authors":"M. Masoudi, R. Taheri, Alireza Liaghat","doi":"10.1055/s-0042-1742430","DOIUrl":"https://doi.org/10.1055/s-0042-1742430","url":null,"abstract":"Having the issue of coronavirus disease 2019 (COVID-19) in mind, there is always a dilemma surrounding elective and non-urgent neurosurgical operations. The unanswered question is regarding whether there is any post-COVID-19 complications that hinder a patient from becoming a candidate for a neurosurgical operation. If that is the case, what should we do?In the present article, we report our single-center experience with an unusual bleeding during the operation of a huge cerebellar tumor in a girl previously infected with COVID-19. In the end, we recommend our experience to our colleagues.\u0000 Abstract\u0000 There are still some conditions that pediatric neurosurgeons may face in the context of coronavirus disease 2019 (COVID-19) which have not been fully addressed so far. Authors have postulated an ongoing inflammatory myocardial status in a significant proportion of patients who have recovered from COVID-19. We report our experience with a 10-month-old girl who had recovered form COVID-19 and had a case of fourth-ventricle mass in the midline of the posterior fossa. She was scheduled for microneurosurgical resection of the mass following the insertion of a ventriculoperitoneal shunt. There were no significant issues regarding the induction of anesthesia. A midline suboccipital approach was chosen, and the patient was fully prepared and draped. Suboccipital soft tissues and muscles were dissected layer by layer through the midline avascular line. A marked gush of blood off the midline was observed during the opening in Y of the dura mater. Then, we started to approach the occipital sinus. However, there was an unusual loss of ∼ 200 mL of blood lost from this area. Despite the proper packed-cell transfusion, the patient developed bradycardia and a sudden rhythm of asystole. The cardiopulmonary cerebral resuscitation (CPCR) was initiated immediately. Despite the maximal effort, the heart rate did not change and remained asystole. We recommend that pediatric neurosurgeons postpone the procedures to be performed in patients who have recovered from COVID-19 for more than one month after a thorough preoperative cardiac evaluation has been performed.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"41 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81013201","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}

{"title":"Primary Extraskeletal Ewing Sarcoma of the Thoracolumbar Epidural Space: Rare Case Report in a Child","authors":"A. F. D. Silva, Ana Carolina de Carvalho Ruela Pires, A. D. P. V. Costa, Fabiana Lopes Amaral, R. Bomfim, Ângelo M. S. Bomfim Filho, Alessandra Lamenha Feitosa, I. Buarque","doi":"10.1055/s-0042-1742710","DOIUrl":"https://doi.org/10.1055/s-0042-1742710","url":null,"abstract":"\u0000 Introduction Ewing sarcomas are a family of tumors that can be of skeletal or extraskeletal origin. We report a rare case of a child with extraskeletal Ewing sarcoma in the thoracolumbar epidural space.\u0000 Case Report The patient was a 1-year-old female child with sphincter alteration, flaccid paraplegia, and areflexia. A magnetic resonance imaging (MRI) scan showed a large extensive epidural lesion with compression of the dural sac in the D6–L2 segment, and a left paravertebral extension through the L1–L2 foramen. Laminotomy was performed, with subtotal resection of the lesion. The histopathological and immunohistochemical analyses indicated Ewing sarcoma. Due to the child's age, radiotherapy was not performed, only chemotherapy, due to the aggressiveness of the neoplasm. The patient showed rapid tumor recurrence and ended up dying.\u0000 Discussion Extraskeletal Ewing sarcoma can appear in different locations in the body. They are aggressive tumors with local recurrence and distant metastases. In our case, a combination of MRI and positron-emission tomography–computed tomography scan presented a clearer result, especially in the presence of metastasis. In the histopathological analysis, small blue cells with a clear cytoplasm and indistinct nucleoli were observed. In the immunohistochemical analysis, CD99 (MIC2) expression is highlighted. The best treatment outcome would have been surgical resection with chemotherapy and radiotherapy.\u0000 Conclusion We reported a rare case of thoracolumbar epidural Ewing sarcoma in which, despite surgery and chemotherapy, the tumor behaved very aggressively, leading to an unfavorable prognosis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"3 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82159315","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}

{"title":"Multi-Level Cervical Disc Degeneration and Vertigo","authors":"S. Ercan, M. Baloglu","doi":"10.1055/s-0042-1749369","DOIUrl":"https://doi.org/10.1055/s-0042-1749369","url":null,"abstract":"Abstract Objective  While complaints of pain, loss of strength, and numbness radiating to the neck and arm are common in patients due to cervical disc degeneration, vertigo is a rare symptom. The articles previously published on the subject focus on single-level disk degeneration and its correlation with vertigo. However, in the case of multilevel cervical discopathy, its effect on the severity of vertigo and its response to surgical treatment has not been clarified. Therefore, the objective of the present study is to shed light on the topic. Methods  Patients with vertigo complaints in whom all known etiological causes of vertigo had been excluded, but with cervical disc degeneration, were included in the study. The scores on the Visual Analog Scale (VAS) and Cervical Vertigo Evaluation Scale (CVES) were analyzed in terms of numbers of discopathy, spine levels, and differences regarding the preoperative and postoperative status. Results  A total of 24 patients (14 with single-level and 10 with multi-level disc degeneration) underwent anterior cervical discectomy. The preoperative CVES score was significantly decreased after surgery. Multi-level disc degeneration causes fewer vertigo symptoms than the single-level kind. No significant correlation between the severity of pain and vertigo was observed. Conclusion  Multi-level disc degeneration causes fewer vertigo symptoms. These symptoms decreased after anterior cervical discectomy in cases of single-level disk herniation at upper segments. The surgical intervention could be a favorable choice of treatment. However, the mechanism and treatment approach to cervical vertigo is still a controversial issue.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"1 1","pages":"e311 - e315"},"PeriodicalIF":0.1,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86524489","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}

{"title":"Enterogenous Cyst and Glioblastoma: A Brief Histopathological Review of Two Uncommon Cystic Lesions of the Central Nervous System","authors":"E. Cambruzzi, N. Ferreira, M. Ferreira, Guilherme Gago, João Pedro Pattussi Bertinatti","doi":"10.1055/s-0042-1744112","DOIUrl":"https://doi.org/10.1055/s-0042-1744112","url":null,"abstract":"Intracranial cystic lesions are common findings in cerebral imaging and might represent a broad spectrum of conditions. These entities can be divided into nonneoplastic lesions, comprising Rathke cleft cyst, arachnoid cyst, and colloid cyst, as well as neoplastic lesions, including benign and malignant components of neoplasms such as pilocytic astrocytoma, hemangioblastoma, and ganglioglioma. Surgical resection and histological evaluation are currently the most effective methods to classify cysts of the central nervous system. The authors report two uncommon cases presenting as cystic lesions of the encephalic parenchyma—a enterogenous cyst and a glioblastoma—and discuss typical histological findings and differential diagnosis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82420066","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}

{"title":"Cervical Primitive Neuroectodermal Tumor in an Adult: Case Report and Literature Review","authors":"Guilherme dos Santos de Alencar, Maria Eduarda Turczyn de Lucca, Felipe Antonio Torres Mazzo, Milena Massumi Konozoe, Eduardo Talib Bacchi Jaouhari, R. Morais, Carlos Eliseu Barcelos, R. S. Torres","doi":"10.1055/s-0042-1742709","DOIUrl":"https://doi.org/10.1055/s-0042-1742709","url":null,"abstract":"\u0000 Introduction Primitive neuroectodermal tumors are rare neoplasms of the central nervous system that occur in children, with few reports in adults. These tumors are found most often in the cerebral hemispheres, with spinal cord disorders being rare.\u0000 Case Report A 71-year-old man with motor and sensory deficits in the upper limbs, cervical pain, and urinary incontinence presented to the Neurosurgery Service. The physical examination revealed grade-III motor strength on the right side, grade IV- on the left upper limb, and grade IV+ on the left lower limb. A magnetic resonance imaging scan showed an expansive intramedullary lesion with a C3-C4 epicenter. Spinal decompression, lesional biopsy, and adjuvant radiotherapy were performed. The anatomopathological report showed a primitive neuroectodermal tumor. After a new treatment with adjuvant radiotherapy (20 × 1.8 Gy in the skull and neuroaxis and 5 × 1.8 Gy in tumor boost), the patient progressed without recurrence.\u0000 Conclusion Since the characteristics of the tumor are similar to those of medulloblastoma, it is necessary to expand the studies on these lesions, to better understand their pathophysiology and list better diagnostic and therapeutic methods, in addition to those already available.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"77 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77524564","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}

{"title":"Surgical Treatment Compared to Conservative Treatment in Remission of Pain and Hyposthesia in Tarsal Tunnel Syndrome – Systematic Review","authors":"M. Magalhães, I. Ribeiro, Márcio de Mendonça Cardoso, R. Gepp","doi":"10.1055/s-0042-1742425","DOIUrl":"https://doi.org/10.1055/s-0042-1742425","url":null,"abstract":"\u0000 Introduction Tarsal tunnel syndrome (TTS) is caused by compression of the posterior tibial nerve.\u0000 Objective To evaluate the effectiveness of surgical treatments compared to conservative treatments in reducing the symptoms of the syndrome.\u0000 Methods The PubMed, Lilacs, Cochrane Library, and PEDro databases were used for this review.\u0000 Results Only 11 articles were selected.\u0000 Conclusion The most common causes of TTS identified were presence of ganglia, bone prominence causing a talocalcaneal collision, trauma, varicose and idiopathic veins. The main symptom was pain in the medial plantar region and paresthesia that can radiate to the fingers or to the calf. Most patients have a positive Tinel sign upon physical examination. Electrodiagnostic test usually shows the presence of latency in sensory nerve conduction. There is no consensus suggesting that a longer time between diagnosis and surgical treatment leads to worse prognosis. In the group of operated patients, the ones who benefited most from the procedure were those who had a structure such as ganglion, cysts, or varicosities causing compression. The most cited surgical complications were postsurgical wound infection, wound dehiscence, and calcaneus hypoesthesia. Regarding surgical techniques, the release of the posterior tibial nerve via endoscopy had a favorable outcome in relation to the symptoms of pain and hypoesthesia, with no reports of infection of the operative site in the articles identified in this review. We observed a rate of good or excellent pain control of 68% (n = 204) for open surgery (n = 299), 100% (n = 8) for endoscopic surgery (n = 8), and 7% (n = 2) for conservative treatment (n = 28).","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"8 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79922012","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}

{"title":"Peculiarities of Atypical Meningiomas: Literature Review","authors":"R. Santos, Ana Carla Mondek Rampazzo, C. A. Zicarelli, L. V. D. Camargo","doi":"10.1055/s-0042-1742427","DOIUrl":"https://doi.org/10.1055/s-0042-1742427","url":null,"abstract":"\u0000 Introduction Meningiomas are common tumors of the central nervous system that represent around 30% of primary tumors. However, the incidence of atypical meningiomas (AMs) is lower, of approximately 15% of all meningiomas, and they present high rates of relapse and mortality.\u0000 Aim To review peculiarities of AMs.\u0000 Methodology A literature review of articles published in English between 2009 and 2020 on the PubMed and Biblioteca Virtual em Saúde (BVS) databases using the terms meningioma and atypical.\u0000 Results Atypical meningiomas are rare and more prevalent in older males. The clinical condition depends on the site of the tumor, and a definitive diagnosis of AM is only possible via anatomical pathology. Moreover, prominent studies have indicated a relationship between the presence of the anti-Ki67 antibody/mindbomb (Ki-67/MIB1) marker as an aid in the definition of AM and one of the determinants of tumor aggressiveness. Imaging studies have also advanced in terms of seeking criteria using magnetic resonance that may suggest the malignancy of a lesion. As far as treatment is concerned, total resection remains the main therapeutic option, and it has a direct relationship with survival and time until disease progression. Lastly, there are many factors involved in the prognosis of AM.\u0000 Conclusion Atypical meningiomas continue to be a challenge, requiring further and more specific studies to provide a better understanding of it.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"54 5 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83413566","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}

{"title":"Um cirurgião sob o olhar de Deus","authors":"E. Figueiredo, M. Teixeira","doi":"10.1055/s-0042-1743468","DOIUrl":"https://doi.org/10.1055/s-0042-1743468","url":null,"abstract":"","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"92 4 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83454889","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}

{"title":"Predictive Mortality Factors after Decompressive Craniectomy in Ischemic Stroke","authors":"Maria Luísa Brito Almino Leite, Matheus Silva Leite, Fernando Diogo Barbosa, I. Kessler","doi":"10.1055/s-0042-1743106","DOIUrl":"https://doi.org/10.1055/s-0042-1743106","url":null,"abstract":"\u0000 Background Decompressive craniectomy is a consolidated method for the treatment of malignant ischemic stroke (iS) in the territory of the middle cerebral artery. Thus, factors contributing to mortality constitute an important area of investigation.\u0000 Objective To evaluate the epidemiological clinical profile and predictors of mortality in a single-center population of patients undergoing decompressive craniectomy for the treatment of malignant iS.\u0000 Methods A single-center retrospective study was performed in 87 patients with malignant iS subjected to emergency decompressive craniectomy from January 2014 to December 2017. Age, gender, laterality, aphasia, time interval between disease onset and treatment, and clinical and neurological outcomes using the Glasgow coma scale were assessed. The patients were stratified by age: a group of participants 60 years old or younger, and a group of participants older than 60 years old for assessment of survival and mortality by the Kaplan-Meier test and log-rank comparison. The intensity of the association between demographic and clinical variables was evaluated by multivariate Cox regression.\u0000 Results Ischemic stroke was prevalent in patients with hypertension (63.29%). Seventy-seven (84%) patients had some type of postoperative complication, mostly pneumonia (42.8%). The risk of death was 2.71 (p = 0.0041) and 1.93 (p = 0.0411) times higher in patients older than 60 and with less than 8 points on the Glasgow coma scale, respectively.\u0000 Conclusion Malignant iS has a significant mortality rate. Age above 60 years and Glasgow coma scale values below 8 were statistically correlated with unfavorable prognosis.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"58 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76916472","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}