bluuebunny/crossref_metadata_2025_split huggingface dataset:
Entubulation of sciatic nerve of rats with poly-l lactide-co p-lactide
Authors: Lacanna Santino N. , Prandini Mirto N. , Pereiro João Roberto , De Moraes Rodrigo Fagundes , Shoji Edílson Toshio 
Published: April 2019

Introduction: Axonal regeneration after a sectioning lesion is variable and depends on the environmental conditions of the two end points. An important enzymatic action and an immune response occur at this point. The Schwann cell at the end of the proximal segment starts a rapid mitotic division in an attemptto locate the target tissue for the severed neuron. The capacity for axonal regeneration after a sectioning lesion is variable and depends on the environmental conditions of the two end points. Objective: To insulate the region of nerve regeneration from biological activities coming from foreign tissues, reducing the immune and enzymatic response and improving the healing conditions of the two end points. Methods: The sciatic nerves of the right paw of twenty WISTAR EPM rats were sectioned, with a gap of 5 to 8mm.In ten animals a 20mm Poly-L Lactide-Co P-Lactide tube involved both sectioned extremities,without nerve suture. After 6 months the animals were sacrificed, the nerve was dissected and photographed. The distal muscles of the paw were sent to histological examination. Results: All animals in which entubulation with Poly-L Lactide- Co P-Lactide was performed demonstrated an excellent nerveregeneration. Histological examination demonstrated complete muscle regeneration. In the animals not submitted to nerve entubulation no nerve regeneration was demonstrated and histological examination demonstrated severe muscle atrophy. Conclusions: Poly-L Lactide-Co P-Lactide entubulationdemonstrated satisfactory nerve regeneration without nerve suture after six months spam. Paw innervated muscles did not show any histological atrophic characteristics.
Afundamentos cranianos na infância
Authors: Pereira Carlos Umberto , Santos Marcelo Bravo de Oliveira 
Published: April 2019

Introdução: As fraturas com afundamento craniano são relativamentefreqüentes na infância. As principais causas são quedas acidentais e acidentes de trânsito. A característica do afundamento craniano depende da superfície do objeto e da força de sua energia cinética. Metodologia: Foram estudados artigos científicos concernente a afundamentos cranianos na infância na literatura médica e analisados as principais causas, meios de diagnóstico,tratamento e prognóstico. Conclusão: A maioria das crianças com afundamentos cranianos, quando corretamente avaliadas e tratadas, apresentam boa recuperação.
Delayed facial nerve palsy after vestibular schwannoma surgery
Authors: Pereyra Walter J. Fagundes , De Sousa Alonso Luis , Nunes Karlo Faria , De Angeli Deborah Nunes 
Published: April 2019

Background: Facial nerve dysfunction may occur immediately after vestibular schwanoma surgery. Electromyographyc monitoring of motor cranial nerves during cerebellopontine angle surgery has become an essential tool. Although delayed onset of facial nerve dysfunction hours to months following vestibular schwanoma surgery are rare. Case description: We describe the case of a 70-years-old male who was admitted with a left side tinnitus and hearing loss of the last 3 years. Magnetic resonance imaging (MRI) T1-weighted demonstrated an isointensity lesion, 30mm in diameter, at the left cerebello-pontine angle with a small portion in the internal auditory canal. The patient was surgically treated by means of a standart suboccipital retrosigmoid approach. The facial nerve was monitored by continuously during surgery. Surgical removal was macroscopically complete. The facial nerve was well-preserved during surgery and showed at the end of the procedure normal electromyographic activity. The patient did well postoperatively and was discharged at the 4th postoperative day and facial function was normal (House-Brackmann grade I). On the 10th postoperative day he notices difficult closing his left eye that progressed to complete facial nerve palsy (House-Brackmann grade III). Steroid therapy was performed for five days associated with physical therapy. One month later his facial nerve function had completely recovered. After six months, the patient remains asymptomatic and neurologically intact. MRI obtained at the 16th postoperative day showed intense enhancement of the intracranial facial nerve segment and also demonstrated no residual tumor. Immunological study at the time of onset showed herpes simplex virus antibody titer normal as well as those for herpes zoster virus. Conclusions: Delayed facial nerve palsy remains an under reported and consequently not very known phenomenon in the neurosurgical practice and literature. Because of the 2009favorable rate of recovery, patients should be reassured in the interim and should not undergo any corrective surgical procedures to improve facial nerve function. Delayed facial nerve palsy is uncommon after vestibular schwannoma surgery. Excellent recovery of facial nerve function to the original postoperative status nearly always occurs in those circumstances.
Stereotactic radiosurgery for secreting pituitary tumors
Authors: Benabou Salomon , De Melo Suely Maymone , Mario Susana Dias 
Published: April 2019

Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) is a standard procedure as second-line treatment in patients with pituitary adenoma, when cure with the initial surgical and/or hormonal treatment is not possible. When compared to conventional Radiotherapy (RT), the stereotactic procedure shows a reduction of risks especially in visual and pituitary alterations. The prognosis of this type of intervention in the long-term control of tumor growth is excellent in 95 to 100% of the cases. In patients who have secreting tumors, reduction or normalization of elevated hormone levels are observed (40 to 92%). In general, the latency time is more than16 months and is dependent on the dose and the number of fractions. The best results are observed in Acromegaly, followed by Cushing`s Disease and Prolactinoma.
Stereotactic radiosurgery in the management of brain metastases
Authors: Aoyama Hidefumi 
Published: April 2019

A treatment relying solely on stereotactic radiosurgery (SRS), with the omission of whole brain radiotherapy (WBRT), is now increasingly applied to the patients with brain metastases that are limited in number, however, it has not been reached a general agreement if patients really receive benefit from this strategy. In response to this situation, we, Japanese Radiation Oncology Study Group (JROSG), carried out a prospective randomized control trial in which SRS-alone approach was compared with WBRT+SRS for patients with 1-4 brain metastases. This study proved that there was no significant difference in survival, mode of death (neurologic versus systemic), and functional preservation rate between two treatment arms. However, the omission of WBRT significantly increased the frequency of brain tumor recurrence, and as a result, salvages brain treatments were more frequently required among patients allocated to SRS-alone arm. In the analyses of neurocognitive function, it was shown that the brain tumor recurrence as well as late radiation toxicities could be a cause of the deterioration of neurocognitive function. Those results indicate that SRS-alone treatment can be a treatment option for 1-4 brain metastases, however frequent monitoring of the brain tumor status should be warranted in order to detect recurrence of brain metastases before they became symptomatic.
Cavernous sinus meningiomas
Authors: Spiegelmann Roberto , Cohen Zvi R. , Nissim Uzi 
Published: April 2019

Introduction: Tumors of the cranial base arising from or partially involving the cavernous sinus have represented a formidable challenge to neurosurgeons. Stereotactic radiosurgery represents an alternative to microsurgery for the management of cavernous sinus meningiomas. The present study aims to evaluate the results of radiosurgery in a large series of patients treated with a linear accelerator with a long-term follow-up. Patients and Methods: From 1993 through 2007, 462 patients with meningiomas underwent radiosurgery at the Chaim Sheba Medical Center LINAC radiosurgery unit. Of those, 117 had tumors involving predominantly the cavernous sinus. A mean follow-up of 67 months was obtained in 102 patients (range:12 to 180 months). Patients’ age ranged from 31 to 86 years (mean 57). Seventy two (70%) were females. Thirty five patients (34.3%) were initially submitted to microsurgery and 67 (65.6%) underwent stereotactic radiosurgery as the first treatment option. Patients were treated using a linear accelerator with cylindrical collimators in 44 patients (43.1%) and a minimultileaf collimator in 58 patients (56.8%). The prescription dose was delivered to the 60 to 80% isodose line (mean, 68%) in patients treated with cylindrical collimators, and to the 80% in those treated with a single conformal isocenter. Doses ranged between 12 and 17.5 Gy (mean, 13.5 Gy). Median tumor volume was 7.2 cm3 (range 0.61–23 cm3). Results: All patients were available for follow-up at 12 to 180 months after treatment (mean, 68 months; median, 60 months). The actuarial control rate was 98%. Fifty nine patients (58%) had a volume reduction and forty one (40%) had stable tumor volumes at the end of follow-up. Two tumors grew. Overall, 4 patients had a new lasting neurological deficit (facial hypesthesia or pain in two, trochlear neuropathy in two, and visual defect in one), for an incidence of 4% in persistent neurological complications. Conclusions: This series of linear accelerator radiosurgery confirms that in the short and long term, radiosurgery affords excellent control for cavernous sinus meningiomas with a very low incidence of complications. Radiosurgery can thus be regarded as the treatment of choice for cavernous sinus meningiomas.
A construção do conhecimento pelo jovem neurocirurgião
Authors: Isolan Gustavo Rassier 
Published: April 2019

O autor discute os aspectos relativos à curva de aprendizado em neurocirurgia relevantes para o jovem neurocirurgião. Os tópicos abordados são os seguintes: a construção do conhecimento ocidental, os padrões de curva de aprendizado, medicina baseada em evidências e neurocirurgia, treinamento em laboratório de microcirurgia, aspectos cognitivos e afetivos na formação neurocirúrgica.
Risk indicators for the development of pressure ulcers in spine surgery
Authors: Prandini Mirto N. , Martinez Andrea S. 
Published: April 2019

Introduction: According to literature review, pressure ulcers (PU) are a very concerning problem in cases where the time of surgery is superior to 4 hours. A better knowledge of PU incidence and the necessity of its prevention have demonstrated to be very important in the surgical practice. Material and methods: A brief description of PU as well as its classification and socioeconomic importance is presented. Results: Pressure ulcers may be considered an important and in some cases one undisclosed early complication in the post operative period, mainly in spine surgery. Conclusion: Diagnosis and prevention of pressure ulcers are mandatory in patients considered at increased risk to develop PU. Further studies should be carried out in order to investigate factors associated with PU development and prevention among surgical patients.
Traumatic injury of the transverse atlantal ligament
Authors: Scardino Fabrizio Borges , Botelho Ricardo Vieira 
Published: April 2019

Introduction. In some cases C2 may suffer only rotational dislocation around its own axis (dens), causing no increase in the atlantodental interval (ADI), making it difficult to diagnose the instability in static radiographies. Objective. To report a case of atlanto-axial traumatic subluxation, without bony injury or displacement, in which the diagnosis cannot be achieved through conventional radiology and computed tomography, and discuss the types of transverse ligament injuries, its diagnosis, the instability and their treatment. Methods.A 61-year-old man, victim of head (occipital), complaining neck. Static radiographies and CT scan of cervical spine were performed, demonstrating no abnormalities. Flexion and extension cervical radiography revealed an increase of ADI in flexion, indicating instability and damage to the transverse atlantal ligament (TAL). The MRI of the cervical spine demonstrated the discontinuity of the TAL, configuring an injury to the structure of the ligament. The patient underwent to early surgery with C1-C2 fixation using the Goel-Harms’technique. Results. The diagnosis could be revealed only in dynamic radiographs or MRI study. The patient presented complete improvement of symptoms. Conclusions. The use of cervical dynamic radiography and / or magnetic resonance imaging allowed the diagnosis of instability and visualization of the TAL injury, avoiding the lack of diagnosis with its consequences. The MRI allows a direct view of the ligament injury, their classification and the prognostic evaluation of the injury, guiding the therapy, surgical or conservative.
AICA Intrameatal Aneurysm
Authors: Vidal Claudio Henrique Fernandes , Guedes Germano Ferreira , Da Silva Joacil Carlos , Filho Hildo Rocha Cirne de Azevedo 
Published: April 2019

Introduction: The distal aneurysms of the anterior inferior cerebellar artery (AICA) are found in 0.1% of the patients with intracranial aneurysms (3% of the posterior fossa aneurysms). Methods: We report a case successfully treated of this rare kind of lesion, and review some available literature. Conclusion: The management requires a detailed knowledge of the local anatomy, relying on the lesion exclusion with the integrity of the local vascular structure, as the most suitable therapeutic pattern.
Trigeminal ganglion involvement in sarcoidosis
Authors: Dos Ângelos Jairo Silva , De Aguiar Guilherme Brasileiro , Fariña Edgar Manuel Garcete , Parise Maud , Cunha Alexandre Martins , Simões Elington Lannes , Nigri Flávio , Telles Carlos 
Published: April 2019

Sarcoidosis is a disease of unknown etiology presenting as noncaseating granulomatous infiltration in tissues. Central Nervous system is rarely affected , usually as dissemination from other organs, mainly lungs. We report on a case in which the patient had only central nervous system involvement, presenting with a mass in the right gasserian ganglion and another lesion in right parietal cortex, observed in magnetic resonance. Diagnosis was given by histopathological study of the lesion and the patient improved with corticosteroid treatment.
Infectious process and torticollis, is there something to worry about?
Authors: Alves Raphael Vicente , De Andrade Emerson Magno F. , Fiore Mariano Ebran , De Araújo Airton Batista , Souza Anderson Rodrigo 
Published: April 2019

Atlantoaxial rotatory subluxation in association with head and neck infectious process (Grisel’s syndrome) is a rare disease and poorly reported. The syndrome`s pathogenesis is unclear and several theories have been proposed to explain it. This paper report a 7 year old child with Grisel’s syndrome and the literature on this subject is briefly reviewed.
Neurogenic Pulmonary Edema
Authors: De Almeida Carlos Eduardo Romeu , Figueiredo Eberval Gadelha , De Monaco Bernardo Assumpção , Oliveira Arthur Maynart Pereira , Teixeira Manoel Jacobsen 
Published: April 2019

Neurogenic Pulmonary Edema (NPE) is defined as the acute onset of dyspnea or a decrease in PaO2/FiO2 ratio, following an acute central nervous system (CNS) insult, in the absence of other obvious causes of lung injury. The most important cause of NPE is subarachnoid hemorrhage (SAH), followed by cerebraltrauma and epilepsy. The incidence of NPE after SAH in the literature may vary from 4 to 23% in greater studies, with SAH accounting for 43-73% of cases of NPE. It is postulated that an excessive adrenergic discharge would lead to pulmonary vasoconstriction and a rapid increase in pulmonary capillaryhydrostatic pressure, thus promoting fluid leakage to the alveolar space. NPE is generally treated in a supportive and conservative fashion, and patient management should be focused in the primary insult.
Orbital Meningiomas
Authors: Da Silva Carlos Eduardo , Freitas Paulo Eduardo , Romero Alicia Del Carmen Becerra , Pereyra Tâmen Moyses , Fonseca Vicente Faraon , Martins Willian Alves , Rockenbach Márcio Aloisio Bezerra Cavalcanti , Oliveira Fáberson João Mocelin 
Published: April 2019

Orbital meningiomas usually invade the orbit as an extension of the sphenoid wing meningiomas, clinoidal meningiomas, cavernous sinus meningiomas and tuberculum sella tumors. They also arise into the orbit originating from the optic sheath or as ectopical lesions. The authors present a review of clinical aspects and surgical treatment of the orbital meningiomas. Material and methods: The authors present a literature review of the anatomical, clinical, and surgical aspects of the orbital meningiomas, add illustrative cases, pointing their principal concerns about the treatment of such tumors. Results: Exophthalmos and unilateral visual loss are the most common features of the orbital meningiomas. There are two important surgical routes to approach such tumors, which are extracranial (transorbital) and transcranial approaches. Recurrence is higher in sphenoorbital meningiomas and related to bone and neurovascular invasion. Conclusions: The anatomical structures involved by orbital meningiomas challenge the microsurgical resection. Total removal should be the goal at the first surgical approach. Orbital reconstruction should be performed in cases where the orbital floor is not preserved or in extensive lateral and roof removal with no preservation of the periorbit.
Estado de Mal Não-Convulsivo em UTI Neurológica
Authors: Furlan André Luiz Beer , Figueiredo Eberval Gadelha , Nogueira Adriano Barreto , Welling Leonardo , Teixeira Manoel Jacobsen 
Published: April 2019

Os tumores e cirurgias cerebrais são causas de convulsões e epilepsia. No estado de mal não-convulsivo as alterações eletroencefalográficas consistentes com atividade epileptiforme estão associadas ao coma e obnubilação com mínima ou nenhuma manifestação motora. Essa é responsável por aproximadamente 20% de todos os estados de mal e está cada vez maissendo reconhecida em pacientes comatosos. Nessa revisão os autores chamam a atenção para o diagnóstico precoce e tratamento dessa entidade até então negligenciada no passado.
Lesões císticas não tumorais intraselares
Authors: Araújo Leopoldo Prézia , Hueb Marcelo Miguel , Dezena Roberto , Rodrigues de Resende Elisabete Aparecida Mantovani , Delfino Vanessa , Ferreira Beatriz Pires , Lara Beatriz Hallal Jorge , Borges Maria de Fátima , Rojas Fonseca Elvi Cristina 
Published: April 2019

São discutidos os aspectos clínicos, endocrinológicos, radiológicos e cirúrgicos de dois pacientes: um portador de cisto de bolsa de Rathke e outro de cisto aracnóide, ambos em localização intraselar, de uma série de 123 pacientes portadores de lesão intra e supraselar abordados por via transesfenoidal. Lesões císticas puras são raras e as dificuldades diagnósticas pré-operatórias assim como os aspectos neurocirúrgicos relativos a estas patologias são destacados. É feita uma revisão da literatura.
Tratamento conservador das radiculopatias cervicais
Authors: Pereira Carlos Umberto , Santos Carlos Michell Torres , De Lima Pábula Thais Maurício Rodrigues , De Farias Neto  Jader Pereira 
Published: April 2019

Introdução: A radiculopatia cervical é um processo patológicoque envolve raízes nervosas cervicais, sendo resultado dacompressão e inflamação. O exame clínico, estudos radiográficose eletrodiagnósticos possibilitam uma localização acuradada patologia. O objetivo principal do seu tratamento conservadoré de eliminar os sintomas, por meio de métodos quevisam reduzir a dor e restaurar a força muscular. Materiais e Métodos: Artigo de revisão realizado com levantamento em base de dados Medline/Pubmed, SCIELO E LILACS, incluindoum período de 1960 a 2009, com prioridade para artigos com maior relevância. Resultados: Foram detectados artigos relacionados às radiculopatias cervicais, dos quais 108 foram revisados e resultaram no presente trabalho. Conclusões: O tratamento conservador desta afecção é multidisciplinar e apresenta bons resultados. Todavia, são necessários mais estudos a este respeito, em virtude de controvérsias observadas na literatura.
Spinal synovial cysts causing neurological deficit
Authors: De Andrade Emerson Magno F. , Alves Raphael Vicente , Fiore Mariano Ebran , De Araújo Jr Airton Batista , Montanaro Antônio Carlos , Godoy Roberto 
Published: April 2019

Synovial cysts of the spine are usually asymptomatic, rarely causing nerve root or spinal cord compression. The authors report on two cases of spinal synovial cysts. One patient harbored a cervical cyst causing myelophaty, and a secondpatient had a lumbar cyst with gradual development of radiculopathy. In both cases the patients had improvement of the symptoms and good outcome after surgical removal of the cysts. Synovial cysts should be considered in the differential diagnosis of any spinal extradural masses. The literature is reviewed and the etiological, clinical presentation, diagnosis and treatment are discussed.
Tuberculose vertebral
Authors: Kirchhoff Dierk F.B. , Kirchhoff Daniel De Carvalho , Monducci David , Alves Luiz Paulo , Pereira Lorenza , De Souza Renato Ângelo Ribeiro 
Published: April 2019

Objetivos: A tuberculose vertebral ou Mal de Pott é uma forma da tuberculose extrapulmonar, onde ocorre o comprometimento da coluna vertebral em até 50% dos casos de comprometimento ósseo. Temos como objetivo demonstrar a importância desta afecção em nosso meio e compartilhar a experiência de nosso serviço no tratamento da enfermidade. Métodos: Foram coletadas informações sobre os casos de tuberculose vertebral diagnosticados e tratados em nosso serviço, totalizando 23 pacientes em 30 anos, durante os quais foram acompanhados evolutivamente neste período, com follow up de até 6 anos. Observamos queixas iniciais, presença de déficit motor e de dor radicular; submetemos todos os pacientes a tratamento cirúrgico individualizado, sendointroduzido esquema tríplice, com avaliação da evolução dos pacientes. Resultados: Obtivemos melhora em 8 dos 9 pacientes com déficit neurológico, sendo que 6 (75%) pacientes obtiveram recuperação de 1 ou mais pontos na escala de força e 2 (25%) retornaram para força grau V. Conclusão: Atuberculose vertebral é uma afecção deformante com grande potencial de déficit neurológico, cujo diagnóstico é realizado com base em dados clínicos, reforçados pelos resultados de exames de imagem, e confirmados pelo resultado de anátomo-patológico e cultura. Normalmente, ocorre uma ótimaresposta a descompressão do canal medular e ao uso de antibióticos do esquema tríplice.
The Genesis of Intracranial Aneurysms
Authors: Flores Camila , Welling Leonardo C. , Figueiredo Eberval G. , Teixeira Manoel J. 
Published: April 2019

Introduction: The pathogenesis of intracranial aneurysms remains unclear in spite of its great importance. Besides the “classical” saccular aneurysms, there are other, such as the traumatic, infectious or fusiform ones. This study aims at reviewing the genesis of intracranial aneurysms. Method: This review was focused on the Medline/Pubmed data, with the keywords “intracranial” and “aneurysms” from 1990 to 2009. Conclusions: The epidemiological studies have identified the endogenous factors such as the elevated arterial blood pressureand the exogenous risk factors (cigarette smoking, heavy alcohol consumption or certain medications) that may lead to the formation, growth and rupture of the intracranial aneurysms. However, its etiology remains unclear and sometimes fatal to those who harbor an intracranial aneurysm. More evidence is needed to establish definitively what factors are responsible for causing intracranial aneurysms.