bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral vasospasm following subarachnoid hemorrhage (SAH):
Authors: De Aguiar Paulo Henrique Pires , De Araújo Júnior Antônio Santos , Fazzito Mirella Martins , Simms Renata , Melgar Miguel , Kleindienst Andrea 
Published: April 2019

Cerebral vasospasm and the delayed cerebral ischemia remain a source of substantial morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Hemodynamic manipulation better known as ‘triple H’ therapy is routinely used in the management of patients with acute vasospasmfollowing SAH. The rationale of inducing hypertension, hypervolemia and hemodilution is to improve blood flow to the injured brain and to prevent secondary ischemia. While the Ca2+ antagonist Nimodipine is still the only drug with proven benefit on neurologic outcome following SAH, several alternatives are under research. Tirilazad is not effective, and studies of hemodynamic maneuvers, magnesium, statin medications, endothelin antagonists, steroid drugs, anticoagulant/antiplatelet agents, and intrathecal fibrinolytic drugs have yielded inconclusive and controversial results. Steroids drugs and anticoagulant/antiplatelet agents have been abandoned so far, because of the lack of efficacy. The purpose of the present paper is to provide a systematic review of the existing literature on the treatment of cerebral vasospasm.
Clipping Versus Coil
Authors: Flores Camila , Figueiredo Eberval Gadelha , Teixeira Manoel Jacobsen 
Published: April 2019

Introduction: Currently, there are two available methods for aneurysms treatment, endovascular and microsurgery. The publication of ISAT has been producing a tendency towards coiling in spite of methodological mistakes and misinterpretation. The objective of this study is to discuss the current treatmentof the cerebral aneurysms , considering the conclusions of ISAT review and perhaps enhancing its influence in the contemporary treatment of intracranial aneurysms. Matherial and Methods: The authors carried out a review of theliterature.studying articles and discussing the results of ISAT aiming to perform a critical analysis of its methodology and practical interpretations of these results. Results: Due to the controversial methodology, incongruous criteria of selection, statistical faults, no quantification of the secondary outcome,ISAT review was not able to provide definitive answers about the ideal treatment to the intracranial aneurysms. Conclusions: No conclusions can be formulated confirming the superiority of coiling over clipping. Generalization and acceptance of ISAT conclusions are precocious and it is not in thebest interest of patients harboring intracranial aneurysms.
Tratamento Cirúrgico dos Meningiomas Espinhais
Authors: Filho Osvaldo Vilela 
Published: April 2019

Introdução: Os meningiomas espinhais são os tumores intradurais e extramedulares mais freqüentes, representando na literatura entre 20 e 46% do total de tumores da coluna. Tipicamente se situam na região torácica apresentando crescimento lento com tendência a se extender lateralmente peloespaço subaracnóideo. Objetivo: Neste artigo os autores realizam uma revisão da literatura sobre meningiomas espinhais, descrevem as características epidemiológicas, achados histopatológicos, evolução clínica e as técnicas cirúrgicas descritas. Métodos: Artigos elaborados no formato de revisãocom levantamento de trabalhos citados na base MEDLINE/ Index Medicus e LILACS, compreendendo período de 1953 a 2008. Resultados: Neste período verificamos 476 trabalhos, 431 escritos em português ou inglês, destes selecionados os 51 de maior impacto. Conclusões: Meningiomas espinhais sãocaracteristicamente tumores benignos. O aperfeiçoamento dos exames de imagem, das técnicas microcirúrgicas e do desenvolvimento de dispositivos cirúrgicos com alta tecnologia permitem que estas lesões tendam a ter uma evolução favorável.
Microsurgical clipping of the anterior circulation aneurysms
Authors: Da Silva Carlos Eduardo , De Freitas Paulo Eduardo Peixoto , Romero Alicia Del Carmen Becerra , Oliveira Fáberson João Mocelin , Rockenbach Márcio Aloisio Bezerra Cavalcanti , Pereyra Tâmen Moyses , Fonseca Vicente Faraon , Martins Willian Alves 
Published: April 2019

Introduction: The authors present the analysis of the microsurgical clipping of 100 cerebral aneurysms of the anterior circulation and compare the series data with the literature. Methods: Eighty-eight patients presenting with 100 anterior circulation aneurysms operated on microsurgical techniques between 2002 and 2008 by the first author (CES) were retrospectively reviewed. Results: A total of 88 patients with 100 aneurysms of the anterior circulation were treated in a six years period. Fifty eight female (66%) and thirty male (34%) with nine patients (10.2%) presenting with multiple aneurysms. The mean age was 52 years (range from 26 to 76 years). Eighty five percent of the cases were ruptured aneurysms. The mean follow-up was 52.4 months (range from 5 to 76 months). The topography of the aneurysms was distributed as it follows: Anterior communicating artery (ACoA) 25%; posterior communicating artery (p-comm) 29%; middle cerebral artery (MCA) 27%; paraclinoidal aneurysms 8%; pericallosal artery 6% and internal carotid artery (ICA) tip 5%. The mortality was 7.9%, and such cases presenting with Hunt Hess graduation 3 and 4. The permanent morbidity was 4.5%, cases with Hunt Hess graduation 3 and 4. Perioperative rupture occurred in 17% of the cases, only in previous ruptured aneurysms. There was no clinical evidence of rebleeding during the follow-up period of the series. Conclusions: The microsurgical clipping of cerebral aneurysms of the anterior circulation is a safe and curative treatment for most of such lesions. At present, studies suggest evidences of superior results of surgery compared to the endovascular techniques in the rates of total occlusion of the aneurysms, lesser rates of rebleeding of the treated cases. The results of the present series are similar to the rates of the most relevant literature.
Mecânica e pragmática do funcionamento intelectual
Authors: Júnior Aluízio Silva , Serrao Valéria Trunkl , Jungerman Flávia Serebrenic , De Lúcia Maria Cristina Souza , Scaff Milberto , Miotto Eliane Correa 
Published: April 2019

Introdução: Mecânica cognitiva (inteligência fluida) declina com a idade devido às mudanças neurológicas e sensoriais típicas do envelhecimento, as quais afetam a velocidade de processamento. Pragmática cognitiva (inteligência cristalizada) é de base educacional e experiencial, permanecendo preservada durante a maior parte da vida adulta. Objetivo: Investigar o funcionamento intelectual em idosos saudáveis com 65 anos ou mais. Método: 15 idosos submeteram-se a testes neuropsicológicos. Resultados: Observou-se desempenho relativamente melhor em inteligência cristalizada. A totalidade apresentou-se preservada. Na inteligência cristalizada, 5 sujeitos situaram-se na faixa média, 7 na faixa média-superior e 3 na faixa superior. Na inteligência fluida, 10 encontram-se na faixa média, 1 na faixa média-superior e 4 na faixa muito superior. Concernente ao Q.I. estimado, 9 situaram-se na faixa média, 3 na faixa média-superior e 3 na faixa superior. Analisando as coortes, o grupo com idade entre 65 e 70 anos obteve desempenho relativamente melhor no que tange à pragmática cognitiva e ao Q.I. estimado do que o grupo com idade entre 71 e 75 anos. Esta diferença acentuase ainda mais quanto à mecânica cognitiva. Conclusão: Os resultados corroboram com dados da literatura, indicando que as capacidades fluidas declinam mais cedo e mais depressa do que as cristalizadas.
Implementing “Free-Hand” Technique Training for Pedicle Screw Instrumentation in Neurosurgical Residency
Authors: Mattei Tobias Alécio , De Meneses Murilo Sousa , Milano Jerônimo Buzetti , Ramina Ricardo , Borges Conrado Regis 
Published: April 2019

Introduction: The anatomical studies conducted in recent decades made possible the emergence of “free-hand” technique for pedicle screw instrumentation of the thoracic-lumbar spine based solely on anatomical parameters. However, the potential risks associated with such technique revealed the immediate need to create educational models for surgical training. Methods: After an interdisciplinary partnership, two anatomicspecimens were submitted to instrumentation of the thoracolumbar spine. In the sequence they were submitted to fine-slice CT-scan, and, finally, to the decompression of the lumbar spinal canal in order to verify the accuracy pedicle screw placement both on the anatomical and radiological level. Results: Overall, 28 intact vertebral bodies were instrumented (T5-S1) in two specimens (a total amount of 62 pedicle screws). Overall, there were only four critical perforations. Considering the accuracy rates for each specimen separately, the number of violations decreased from the first (32% of misplaced screws) to the second instrumented specimens (25%). A more surprising learning curve was noted when considering the lower thoracic spine separately (37,5% versus 12,5%). Conclusions: The authors demonstrate that incorporating the training of pedicle screw instrumentation in routine neurosurgical residency is a cost-effective educational method, which enables young neurosurgeons to practice these skills in the laboratory before proceeding to the operating room.
Differential Diagnosis and Surgical Management of Cerebellopontine Angle Cystic Lesions
Authors: Mattei Tobias Alécio , Goulart Carlos R. , De Lima Julia Schemes , Ramina Ricardo 
Published: April 2019

Cerebellopontine angle (CPA) tumors in adults are mainly benign and extra-axial. Although the most common CPA lesion (vestibular schwannoma) is familiar to most neurosurgeons, cystic lesions of the CPA do pose an important diagnostic challenge demanding a careful consideration of a wide range of differential diagnosis including: epidermoid cysts, arachnoid cysts, cystic schwannomas, cystic meningiomas as well as other rare entities such as vascular and malignant tumoral lesions. The authors present a critical review of the current literature on cystic CPA lesions, providing an overview about possible differentials as well as guidelines for preoperative imaging evaluation of a cystic CPA lesion.
Occipito - C2 laminar screws fixation for treatment of chronic C1-2 instability
Authors: Joaquim Andrei F. , Cavalcante Rodrigo A. , Rodrigues Izair J. , Mudo Marcelo L. 
Published: April 2019

Introduction: Anomalies of the craniovertebral junction (CVJ) include a wide range of conditions, such as C1-2 chronic instability. Surgery is generally indicated in the context of neurological deficits, although the best surgical option to be chosen is controversy. Method: A 12-year-old girl with severe neurological deficits due to a chronic fixed C1-2 subluxation underwent to an occipito-C2 laminar screws fusion and posterior decompression, with significant neurological improvement after three months follow-up. Discussion: Treatment of cranio-cervical junction anomalies is challenging. An extensive knowledge of all the fixation techniques available for occipito-C1-2 fusion is needed due to frequent anatomical variations, to achieve good surgical results.
Costs of epilepsy
Authors: Lins Catarina Couras , Adry Rodrigo Antonio Rocha da Cruz , Marques Lucia Helena Neves , Andrade Filho Antonio De Souza 
Published: April 2019

Introduction: An epileptic disorder is defined as an intermittent disturbance of the nervous system and due to an excessive, sudden and disordered discharge of cerebral neurons. Recently, the cost of medical treatments, in general and in particular of the anti-epileptic drugs, have been discussed in many countries. The objective is to evaluate the cost of epilepsy treatment in Brazil. Materials And Methods: Eighty-seven epilepsy diagnosed patients with average age of 38,5 years old were studied . Results: The total cost for an annual treatment of all the 87 patients was of R$ 62.462,45. The costs with head computerized tomography, encephalic magnetic resonance, yearly electroencephalogram, yearly laboratory exams and medical consultations, were of R$8.477,28, R$3.493,75, R$986,58, R$5.649,78, R$ 3.480, respectively, with a total of R$84.549,84. The indirect costs could not be summed up because of the difficulty in obtaining retrospective information. Discussion: Drug treatment isresponsible for the higher cost of the treatment of epileptic patients, associated to the indirect costs that could be reduced with better access of the population to health services.
Diffuse Meningeal Tuberculosis
Authors: Giacomini Leonardo , Yacoub Alexandre , Mathias Roger Neves , Guizoni Enrico , Joaquim Andrei , Tedeschi Helder 
Published: April 2019

A central nervous system infection by Mycobacterium tuberculosis (MT), uncommonly seen in immunocompetent patients, brings a diagnose challenge in the modern medicine. Subdural space involvement of MT may simulate neoplastic or inflammatory diseases, bringing a direct influence in the therapeutics. We present a case report of a tetraparetic middleage woman with an atypical subdural space involvement by MT. Biopsy was done and the standard treatment for central nervous system MT was instituted, with a significant improvement in the motor function. In countries where MTinfection has high prevalence and incidence, an atypical intracranial mass should be always suspected for central nervous system involvement by MT.
Indirect Revascularization by Pial Synangiosis in Cerebrovascular Occlusive Disease in Adults
Authors: Crosa Roberto , Romani Rossana , Hernesniemi Juha 
Published: April 2019

Objective: Demonstrate the successful application of indirect revascularization techniques in an adult patient with a suspected cerebral circulatory insufficiency. Methods: A pial synangiosis procedure was performed according to the technique described by Adelson and Scott. Results: A total relief of the neurological deficits, with the disappearance of the arterio-arterial anastomosis and improvement of the parenchyma filling phase. Conclusion: The use of Pial synangiosis for treating cerebrovascular occlusive disorders remains under controversy, but it becomes an attractive option in adults due to the simplicity of the method.
Spinal Pedicle Screw Insertion
Authors: Tacla Rafaella Do Rosario , Guedes Murilo Henrique , Oliveira Lize Mattiello , Aguiar Luiz Roberto 
Published: April 2019

We aimed to verify the reproducibility of the results obtained from previous systematic reviews and meta-analyses, focusing specifically on methodological and technical aspects, such as navigation method, screw insertion technique and spinal region involved to provide a more homogenous analysis. The PubMed database was searched using three terms: “stereotaxic techniques”, “neuronavigation”, and “image-guided surgery,” each associated with other two terms, “pedicle” and “screw”. Data were transferred to Comprehensive Meta-Analysis software, v.3, for statistical analysis. The significance of the pooled odds ratio was determined by the Z test, along with95% confidence intervals. A funnel plot was used to assess publication bias. The statistical significance was defined as p ≤ 0.05. The meta-analysis yielded an overall odds ratio of 2.9 favouring navigation. The average correct positioning of the screws was 91.8% for navigation, while 82.2% of screws were deemed appropriate in fluoroscopy. The odds ratio obtained for the thoracic and lumbar spines separately was 3.1 and 2.7, respectively. Among the fluoroscopy guided surgeries, 53 complications occurred, whereas only eleven complications were observed among those guided by neuronavigation. This meta-analysis suggests that compared with conventionalfluoroscopy technique, neuronavigation allows for more accurate pedicle screw placement.
Importância do Diagnóstico de Glioma Cístico Cerebral para Determinação da Tática Neurocirúrgica
Authors: De Andrade Francisco E. P. Doutel , De Souza Hugo , Câmara Lygia , Maurício Almir Salgado , Soeiro Sérgio P. G. , Oliveira Júnior Walter , De Araújo Iogo H. O. , Da Silva Fellip Dutra , B. Neves Francisco Weldes , Miorin Maria Izabel , Nakajima Marcos , Sampaio Rosana M. , Pinheiro José Álvaro B. 
Published: April 2019

Os autores, através da apresentação de um caso de Glioblastoma (GBM) temporal direito e de um caso de Xantoastrocitoma Pleomórfico (XAP) temporal esquerdo, ambos com degeneração cística, realizaram um estudo bibliográfico retrospectivo, com o intuito de estabelecer parâmetros fidedignos para a decisão da tática cirúrgica a ser empregada. A Ressonância Magnética, nas sequências T2 e FLAIR (Fluid Attenuated Invertion Recovery), no GBM demonstrou a diferença entre a necrose dita pastosa e aquela com verdadeira liquefação, essa última permitindo determinar uma tática neurocirúrgica menos invasiva (esvaziamento do cisto com biopsia do tumor), com igual ou superior eficácia prognóstica em curto prazo. Essa diferenciação morfológica, a Tomografia Computadorizada (TC) não foi capaz de determinar. No segundo caso, a TC também apenas demonstrou a diferenciaçãosólida para não-sólida da massa, mas não foi suficiente para a escolha da abordagem emergencial, tática decidida em campo.
Suprapraorbital “key-hole” Approach for Surgical Treatment of Middle Cerebral Artery Aneurysms
Authors: De Souza Alexandre Haddad , Flores Juan Antonio Castro , Roelke Carlos Eduardo , Vera Felipe Romero , Veiga José Carlos Esteves 
Published: April 2019

Objective. To describe details and technical difficulties observed in the use of this access for the treatment of middle cerebral artery aneurysms. Methods. This is a retrospective study including 15 patients with middle cerebral artery aneurysm operated on using this technique (two ruptured aneurysms and 13 incidental aneurysms). We considered age, gender, laterality of the aneurysm, and whether it was ruptured. We evaluated the surgical corridor (surgical field exposure and ease of handling of the surgical instruments), surgery time, complications, functional and cosmetic results. Results. This access provides adequate exposure of the surgical field, but the restricted working angle makes it difficult to dissect the aneurysm and, especially, to place the definitive clip. Conclusion. The restriction of the working angle may compromise the safety of the surgery. It is important to determine the specific indications for this access, particularly in cases of incidental aneurysms.
Caso Raro de Trauma Penetrante Transnasal com Lesão Direta e Isolada do Nervo Oculomotor
Authors: Silveira Giuliano Schmidt Bertazzo , Dalla Vechia Beatriz Manzan , Silveira Leonardo Schmidt Bertazzo , Eismann Marcos Rodrigo Pereira , Linhares Marcelo Neves , Mussi Antônio Cesar De Melo 
Published: April 2019

Casos graves de Traumatismos Cranioencefálicos (TCEs) podem ocasionar paralisia do nervo oculomotor por lesões diretas ou indiretas. Paralisias traumáticas isoladas do terceiro nervo craniano (NCIII) são incomuns. Neste estudo é apresentado um caso de lesão isolada e direta do nervo oculomotor devido a traumatismo penetrante transnasal. Em 65% dos casos de paralisia traumática do nervo oculomotor foi descrita ocorrência de regeneração aberrante e em casos persistentes de paralisia pode ser necessária uma cirurgia da musculatura extraocular.
Pneumoencéfalo Hipertensivo Secundário a Traumatismo Penetrante da Região Orbitária
Authors: Teixeira Marcos Paulo Dos Santos , Pereira Carlos Umberto 
Published: April 2019

O pneumoencéfalo geralmente é decorrente de lesão traumática craniofacial. Quando é decorrente de lesão penetrante na região da órbita, tem sido considerado raro. O pneumoencéfalo hipertensivo é considerado uma emergência neurocirúrgica. Os autores relatam um caso de pneumoencéfalo hipertensivo em um paciente vitima de acidente doméstico por chave de fenda na região orbitária direita. Foram discutidos a fisiopatologia, o tratamento e o prognóstico.
Aneurisma gigante da carótida interna na porção petrosa
Authors: Rogano Luís Augusto Carvalho , Cavalheiro Sergio , De Tella Júnior Oswaldo Inácio , Braga Fernando Menezes 
Published: April 2019

Os autores relatam um caso de aneurisma gigante da carótida interna, porção petrosa, com expansão intracraniana, em paciente de 55 anos com hipoestesia tátil e dolorosa no território de V2 e V3, paralisia completa do VI nervo e hipoacusia acentuada, todos à esquerda. Foi feita abordagem direta, com ressecção total do aneurisma, fechamento da carótida interna no pescoço, ligadura, tamponamento e extirpação do aneurisma na região petrosa, com evolução satisfatória. A revisão da literatura pertinente ao assunto mostrou tratar-se de patologia rara.
Jenis – jenis tumbuhan paku (Pteridofita) dari Hutan Universitas Riau, Provinsi Riaudan Pola Pita DNA berdasarkan Penanda DNA M13Primer
Authors: Sofiyanti Nery , Isda Mayta Novaliza 
Published: April 2019

Kawasan hutan di Universitas Riau, Provinsi Riau merupakan salah satu daerah distribusi tumbuhan paku (Pteridofita). Kajian ini bertujuan mengidentifikasi jenis-jenis tumbuhan paku di Hutan Universitas Riau dan mengetahui pola pita DNA menggunakan penanda DNA universal M13. Sampel dikoleksi dari lapangan menggunakan metode eksplorasi dan kemudian diidentifikasi. Isolasi DNA menggunakan DNeasy Plant Mini Kit (Qiagen), dan diamplifikasi berdasarkan metode PCR menggunakan DreamTaq Green PCR Master Mix (2X) (Thermo Scientific) denganpenanda DNA M13 (GAGGGTGGCGGTTCT),. Hasil inventarisasi menunjukan 26 jenis paku dari 8 famili telah diidentifikasi pada kajian ini. Hasilelektroforesis PCR menunjukanbahwa pola pita DNA yang dihasilkan bervariasi dengan ukuran berkisar antara 200 bp sampai 2000 bp. Pola pita DNA menggunakan penanda universal M13 dapat dijadikan data pendukung dalam taksonomi tumbuhan paku.
RANCANG BANGUN SISTEM KONTROL PADA MEJA MESIN PLANER KAYU OTOMATIS DENGAN MENGGUNAKAN MOTOR STEPPER BERBASIS ARDUINO UNO
Authors: Septiawan Muhammad Raffi , Winarso Rochmad , Qomaruddin Qomaruddin 
Published: April 2019

Permintaan akan teknologi terutama kebutuhan akan adanya mesin sekala kecil untuk menunjang kebutuhan industri rumahan yang membutuhkan mesin dengan desain simpel dan praktis dalam pengunaan maupun pengoprasian mesin. Dalam pengembangan mesin plener yang telah dibuat sebelumnya di perlukan penambahan sistem kontrol yang digunakan untuk mengatur naik maupun turun pada ketinggian meja mesin planer kayu. Metode yang digunakan meliputi studi literatur, studi lapangan, proses perancangan dan proses perakitan. Pada hasil penelitian telah dibuat sistem kontrol untuk mengontrol naik maupun turun pada ketinggian meja mesin plener dengan pengerak motor stepper yang telah dikontrol mengunakan mikrokontroler berupa arduino uno didapatkan hasil keakuratan untuk naik maupun turun dengan minimal 1mm dan maksimal 10cm didapat nilai error sebesar 0,8% Kata kunci :mesin planer, motor stepper, sistem kontrol, arduino,