bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutrição e Neurocirurgia
Authors: Riboldi Bárbara Pelicioli , Contini Betânia , Dos Santos Fernanda Trespach , Da Silva Laís Souza , De Oliveira Vanessa Rossoni , Da Cunha Fernanda Monte , Santis-isolan Paola Maria Brolin , Isolan Gustavo Rassier 
Published: April 2019

As alterações metabólicas e da composição corporal em decorrência da injúria cirúrgica resultam em necessidades nutricionais especiais para pacientes neurocirúrgicos. Estas alterações têm como características a instalação de um estado hipermetabólico e hipercatabólico, observando-se uma redução nas reservas corporais de lipídeos e proteínas, resultando na dificuldade de cicatrização e risco aumentado de infecção. Além disso, com um aporte nutricional inadequado, os pacientes podem evoluir para um estado de desnutrição. Na ausência de diretrizes específicas de como o suporte nutricional deve suceder em traumas neurológicos , verificou-se a importância da realização de um artigo de revisão a respeito do suporte nutricional utilizado em pacientes neurocirúrgicos. A partir da pesquisa realizada no banco de dados MEDLINE (1976 – 2010), observou-se que a estimativa energética é um fator decisivo no prognóstico do paciente, a suplementação de aminoácidos não se mostra necessária e que, além dos exames de rotina, deve-se realizar exames de eletrólitos e osmolalidade urinários e plasmáticos. O suporte nutricional ideal parece ser uma administração conjunta de nutrição enteral e parenteral e, quanto mais precocemente esta alimentação é iniciada, melhores são os desfechos clínicos. Considerando que é de competência do nutricionista a prescrição dietética da nutrição enteral, sua presença é essencial na equipe multiprofissional de suporte nutricional.
Anatomia Microcirúrgica do Segmento Clinóide da Artéria Carótida Interna e do Cavo Carotídeo
Authors: De Moraes Karina Ruiz , De Aguiar Paulo Henrique Pires , Tahara Adriana , Matsushige Toshinori , Eguchi Kuniki , Neves Maick Fernandes , Joseph Murilo , Zicarelli Carlos Alexandre , Isolan Gustavo Rassier , Serra Marcus Vinicius F. B. V. F. 
Published: April 2019

Embora a região clinóide seja comumente abordada pelos neurocirurgiões em várias afecções, sua anatomia e extremamente complexa e variável. O segmento clinóide da artéria carótida interna (ACI) se encontra na transição entre o seio cavernoso e o espaço subaracnóide, limitado pelos dois anéis durais. O segmento posteromedial do anel dural distal não tem contato com nenhuma estrutura óssea, esta peculiaridade anatômica facilita a formação do cavo carotídeo. Os anéis proximal e distal tornam-se relevantes por serem os limitesanatômicos. O entendimento do segmento clinóide é importante para o correto diagnóstico e abordagem dos aneurismas desta região. Controle proximal, clinoidectomia anterior, opções de clips fenestrados e auxílio do endoscópio são detalhes técnicos de grande utilidade no manejo dos aneurismas do cavo carotídeo.
Meningeomas da Base do Crânio
Authors: Da Silva Carlos Eduardo , Romero Alicia Del Carmen Becerra , De Freitas Paulo Eduardo Peixoto 
Published: April 2019

Objetivos: Os meningeomas da base do crânio representam um grande desafio neurocirúrgico. No presente estudo, pretende-se avaliar os resultados do tratamento cirúrgico dos meningeomas da base do crânio e revisar aspectos epidemiológicos, clínicos e cirúrgicos destes tumores. Pacientes e métodos: Foram avaliados retrospectivamente 40 pacientes com meningeomas da base do crânio, das fossas anterior, média e posterior, submetidos à tratamento neurocirúrgico entre janeiro de 2004 e maio de 2011, pelo primeiro autor (CES). Resultados: A série foi composta pela seguinte distribuição tumoral: goteira olfatória 21,4%, tubérculo da sela 11,9%, clinóide anterior 4,7%, asa do esfenóide 14,2%, seio cavernoso 7,1%, fossa temporal 7,1%, petroclivais 23,8%, tentório7,1%, forame magno 2,4%. O follow up médio foi de 42 meses. O grau de ressecção utilizando a escala de Simpson foi: Simpson 1- 54,7%, Simpson 2 - 21,4%, Simpson 3 - 9,5%, Simpson 4 - 14,2%. A morbidade observada foi: novos déficits de parescranianos 14,2%, déficits transitórios de nervos cranianos 11,9%, fístula de líquor 11,9%, infecção: 9,5%, hidrocefalia: 2,4%, mortalidade 9,5%. Conclusões: O tratamento cirúrgico dos meningeomas da base do crânio é considerado de primeira escolha para a maioria destas lesões. O planejamento deve considerar a possibilidadede ressecção radical, incluindo o envolvimento ósseo, com o intuito de diminuir os índices de recidiva tumoral. Os resultados do tratamento cirúrgico apresentam elevados índices de ressecção completa e subtotal, com riscos aceitáveis de morbimortalidade.
Ventriculoperitoneal Shunt assisted by Neuroendoscopy
Authors: Romero Flávio Ramalho 
Published: April 2019

Object. We present our experience in ventriculoperitoneal shunt assisted by neuroendoscopy. Methods. Thirty-six patients with new communicating hydrocephalus were selected to VP shunt placement assisted by neuroendoscopy. Postoperative computerized tomography (CT) was performed in the first day in all patients and ventricular catheter location was analysed. A follow up of 12 months was performed and results showed. Results. Mean patient age at implantation was 57 ± 13.59 years (range, 16-77). There was a slight preponderance of males (22 patients, 61%). The most common cause for shunt surgery was hemorrhage (20 patients, 55%), including subarachnoid hemorrhage (14 patients, 39%), and intracerebral hemorrhage (ICH) or intraventricular hemorrhage (IVH) (5 patients, 16%). Posttraumatic hydrocephalus followed as a secondary cause (11 patients 31.5%). During the period covered by thestudy, 8 valves were revised, thereby meeting the criteria for shunt failure endpoint. The most common cause for shunt revision was underdrainage in 5 patients, followed by infection in 2 patients, and overdrainage in 1 patient. None of them had proximal obstruction and in all cases, the ventricular catheter was well located. Conclusions. Endoscopic view can be used to place the ventricular catheter in a good position inside the ventricular system.
Critical Review of Clinical Aspects and Treatment Strategies of Cranial Dural Arteriovenous Malformations
Authors: Stefani Marco Antônio , Antunes Apio Claudio Martins 
Published: April 2019

The authors discuss the treatment strategies for dural arteriovenous fistulas, considering anatomical features such as the presence of cortical venous reflux (CVR) and patterns of cerebral venous drainage. Illustrative cases are presented with the different clinical and angiographic features, focusing on patterns of arterial and venous anatomy, normal cerebral venous drainage and the presence of cortical venous reflux. A review of the pathophysiology and current classifications are presented. The treatment strategies are discussed, focusing on the endovascular procedures available. Dural arteriovenous fistulas should be treated considering the significant risks of hemorrhage related to the presence of CVR. Treatment strategies should aim angiographic and clinical cure, achieved with low risk of complications when using a multidisciplinar approach, after carefull understanding of the venous drainage, respecting the anatomy of the lesion and the normal cerebral venous drainage.
Neuronavigation for Intracranial Meningiomas
Authors: Da Silva Erasmo Barros , Aurich Lucas Alves , Da Silva Junior Luis Fernando Moura , Milano Jerônimo Buzetti , Ramina Ricardo 
Published: April 2019

According to its location, the surgical treatment of intracranial meningioma can be of considerable challenge for the neurosurgeon. The aplication of neuronavigation for meningioma surgery is commonly related to tumor localization. However, this concept is applied only to convexity located lesions. Its usage can range from a simple craniotomy flap localization to a deep brain tumor resection respecting tract fibers, eloquent areas and neurovascular structures. In some cases, neuronavigation may not be necessary, but, ifavaliable, it should promotes a safer surgery, as it has yet to become an integral part of intracranial procedures. The aim of this article is show how to enhance the neuronavigation usage for meningioma surgery.
Percutaneous Vertebroplasty
Authors: Aguiar Luiz Roberto , Martins Carolina , Farinã Edgar Garcete , Neto Heraldo Mello , Bichinho Gerson Link , Gariba Munir Antonio 
Published: April 2019

Percutaneous Vertebroplasty is a minimally invasive procedure initially developed to treat aggressive hemangiomas, which was then further extended to vertebral tumors - especially aggressive osteolytic metastasis and myeloma - and is currently largely applied in osteoporotic compression fractures that are refractory to medical therapy. In this article we formulate and answer questions reviewing the current technique, its indications and potential complications. This paper summarizes the experience of the Department of Neurosurgery at Hospital Santa Cruz in Curitiba (PR) and aims at providing a source of reference to neurosurgeons interested in this procedure.
Uso de anticonvulsivantes profiláticos no traumatismo cranioencefálico severo
Authors: Pereira Carlos Umberto , De Almeida Annie Marielle Gomes , Dantas Rafaela Nunes 
Published: April 2019

Introdução: Epilepsia pós-traumática é uma complicação comum do traumatismo cranioencefálico (TCE), ocorrendo em 15-20% dos pacientes com lesão severa. Objetivos: Identificar os casos de TCE severo, caracterizando-o epidemiologicamente, e avaliar o uso de anticonvulsivante em vítimas de TCE grave. Métodos: Estudo prospectivo, descritivo e observacional, com pacientes vítimas de TCE severo admitidos em um hospital referência em Sergipe, de janeiro a dezembro de 2009. Resultados: O trabalho constou com 135 pacientes. A média de idades foi 32 ± 19 anos. O gênero masculino foi o mais acometido (93%). A principal causa de TCE severo foi o acidente de trânsito (78%). A maioria dos pacientes foi vítima de politrauma (62%). A profilaxia para convulsão pós-traumática foi realizada em 87% dos pacientes, sendo a fenitoína utilizada em 100% dos casos. A dose média do anticonvulsivante foi de290 ± 111 mg/dia, com tempo médio de uso de 21 ± 8 dias. O exame de escolha foi a TC (61%) e 100% dos seus resultados apresentaram alterações.Conclusão: A falta de padronização do uso de anticonvulsivantes profilático torna necessária a realização de um protocolo cabível ao hospital estudado e aos tipos de pacientes nele atendidos.
Inflammatory Reaction After Cranioplasty Using Bovine Pericardium as a Dural Substitute
Authors: Stochero Luciele , Alberton Luciele Zibetti , Bezerra Sofia , D'Ávila Rui , Teixeira Alice Becker , Romero Alicia Del Carmen Becerra , De Freitas Paulo Eduardo Peixoto , Da Silva Carlos Eduardo 
Published: April 2019

Dura mater grafts are commonly applied in neurosurgery. The bovine pericardium is safe and associated with rare complications. We report a case of a patient presenting with tuberculum sellae meningioma and unusual complication after frontotemporal duroplasty using bovine pericardium. After two days of good postoperative evolution, the patient presents with neurological worsening and CT scan shows intraparenchymal hematoma on the right, with perilesional edema, requiring surgery to drain and replace the pericardium of a fascia lata graft. with good postoperative evolution. Pediculated pericranium, temporal fascia and fascia lata are the most effective and safe choice to replace the dura mater. Among heterologous grafts, bovine pericardium is associated with few complications. However, complications such as inflammationand infection are related to the substance glutaraldehyde, present in such graft.
Spontaneous Subarachnoid Hemorrhage Induced by Warfarin Use
Authors: Campos Ricardo Rezende , Cunha Alexandre Martins , Dos Santos Marcelo Eduardo Sette , De Aguiar Guilherme Brasileiro 
Published: April 2019

Introduction: The most frequent cause of spontaneous subarachnoid hemorrhage (SAH) is the rupture of a brain aneurysm. Approximately 5% of cases of spontaneous SAH did not show changes on magnetic resonance imaging (MRI) or angiography that explain such bleeding. The objective of this study was to report a case of spontaneous SAH induced by warfarin, where there was no evidence of any vascular malformation. Case Report: A 59 year-old male patient developed a sudden onset severe headache while in the shower. The patient had a history of mitral valve disease and valve replacement 23 years before and hypertension monitored by a cardiologist with 5 mg warfarin sodium daily. Computed tomography (CT) scan revealed a SAH. Laboratory tests showed an International Normalized Ratio (INR) of 2.22 (normal: 1 to 1.2). Cerebral angiography and neuraxis MRI were performed and showed no aneurysms or other vascular malformations. Conclusion: The occurrence of hemorrhageassociated with warfarin treatment is a well-documented event in the literature. However, the isolated occurrence of SAH in these patients is a rare event. To prove that SAH is indeed attributed to anticoagulation, it is necessary to excludethe presence of aneurysms and other vascular diseases by imaging techniques.
The variations in anatomy of the sphenoid sinus and sellar floor to perform transsphenoidal endoscopy in adult age
Authors: Romero Alicia Del Carmen Becerra , Barkhoudarian Garni , Da Silva Carlos Eduardo , De Aguiar Paulo Henrique Pires , Júnior Edward R. Laws 
Published: April 2019

Transsphenoidal surgery depends on the ability to visualize and identify key anatomical landmarks during each phase of the operation. A remarkable degree of anatomical variation exists in the sphenoid sinus, sella turcica, and surrounding skull base structures. Our purpose is to review the anatomical variations in sphenoid sinus and sellar floor that are important to performing safe and effective transsphenoidal endoscopic surgery in adult patients. Detailed information regarding the anatomy is the most reliable and effective way of avoiding complications of all kinds in transsphenoidal surgery.
Image Guided Intensity Modulated Helical Radiation (Tomotherapy) Used as a Radiosurgical Tool
Authors: Lovo Eduardo E. , Caceros Victor , Campos Fidel , Molina Emelda 
Published: April 2019

Introduction: Tomotherapy (HT) is a Linear accelerator mounted on a Computerized Tomography (CT), it is helical in nature, its application implies a megavoltage CT image acquisition which is fused daily to the radiosurgical plan that has been done previously (Image Guided Intensity Modulated Radiosurgery). This technology is new worldwide; to our knowledge this is the first report of intracranial radiosurgery in Latinamerica with HT. We describe dose distribution in a small target, as well as normal case flow and our initial intracranial experience. Methods: For the analysis of irradiation of a small target (PTV), one 10 mm spherical (0.51cc volume) target was elaborated. The PTVs where placed in the isocenter and 100 mm above the isocenter, the PTV received a 6 Gy prescription to the 85% isodose line, with a maximum dose of 9.0 Gy and a minimum of 4.7 Gy. We describe normal patient flow and retrospectively report our early experience from February 2011 to August 2011of intracranial radiosurgical cases. Results: The results of our Quality Assurance (DQA) on phantom studies show a very conformal (CI) 1.14, and homogeneous (HI) 1.51 dose behavior with a fall-off to 50% with regards to PTV of 4.6 mm, thirteen patients had been treated receiving 36 radiosurgical sessions. Conclusions: Radiosurgery with HT, it is a highly conformal,homogeneous with steep dose falloff, comparable to other stereotactic radiosurgical (SRS) tools, it is non invasive and it usually is a very low time consumption technique.
Tratamento endovascular de fístula arteriovenosa dural intracraniana através de punção direta do seio transverso
Authors: De Alcântara Eduardo André Goulart , Veiga José Carlos Esteves , De Aguiar Guilherme Brasileiro , Jory Maurício , Júnior Paulo Puglia , Conti Mario Luiz Marques 
Published: April 2019

As lesões arteriovenosas que envolvem a dura máter e o espaço epidural são chamadas de shunts arteriovenosos durais. Elas representam comunicações diretas anormais, entre artérias durais e veias durais dilatadas, sem um leito capilar entre estas. A fístula arteriovenosa dural corresponde à cerca de 15% de todas as lesões arteriovenosas intracranianas. Apresentamos o caso de um paciente de 31 anos, apresentando crises epilépticas de início aos 14 anos, cuja investigação diagnóstica com exames de imagem mostrou fístula arteriovenosa dural da região da inserção da tenda drenando para os seios transverso e sigmóide direitos, nutrida pelas artérias occipitais, meníngea média direita e tronco meningohipofisário direito. Além das múltiplas aferências arteriais, também havia oclusão das veias jugulares, o que impedia o tratamento pela via venosa. Foi realizado tratamento combinado, com acesso cirúrgico através de trepanação na junção dos seios transverso-sigmoide direitos, com punção do seio transverso e embolização dos mesmos com espiras metálicas e adesivo tissular (cianoacrilato), com oclusão total da lesão. Descrevemos o procedimento e realizamos uma breve revisão da literatura sobre o tema.
Pyogenic brain abscess caused by Serratia marcescens in a Brazilian premature neonate
Authors: De Albuquerque Regina Célia Ajeje Pires , Beani Lilian , De Paula Raquel Siqueira Leonel , Meguins Lucas Crociati 
Published: April 2019

Bacterial brain abscess remain a serious central nervous system infectious disorder despite advances in neurosurgical, neuroimaging, clinical support on intensive care units, microbiological techniques and availability of new antibiotics. The successful treatment of brain abscess usually requires surgery, appropriate antibiotic therapy and eradication of the primary source. Although uncommon, brain abscesses are particularly important in the pediatric population due to its devastating potential to cause severe neurologic deficits, especially in preterm newborns. The purpose of the present report is to describe the case of a Brazilian premature neonate with pyogenic brain abscesses caused by Serratia marcescens and to discuss therapeutic and diagnostic approaches. The early suspicion, proper diagnostic measures and immediate neurosurgical consultation associated with aggressive antibiotic therapy seem to be the essentials steps on themanagement for those high-risk pediatric patients.
Sindrome de Eagle simulando neuralgia occipital
Authors: Albuquerque Antônio Carlos Moreira , Santos Francis Balduíno Guimarães , Barbosa Ramon Guerra , Lopes Matheus Felipe Borges , Figueiredo Isabella Drumond 
Published: April 2019

A Síndrome de Eagle caracteriza-se por sinais e sintomas faríngeos e cervicais associados ao alongamento do processo estilóide do osso temporal ou calcificação do ligamento estilo-hióideo. Apesar de ser rara, ela está bem documentada na literatura da otorrinolaringologia e da odontologia. Todavia, na literatura neurológica há poucos relatos. O objetivo desse trabalho é relatar um caso e fazer uma revisão de literatura sobre a Síndrome de Eagle. Pretende-se, dessa forma, familiarizar os neurologistas e neurocirurgiões com os sintomas, diagnóstico e o tratamento dessa afecção.
Spontaneous Spinal Epidural Hematoma
Authors: Grativvol Ronnyson Susano , Amaral Raquel Portugal Guimarães , Scardino Fabrizio Borges , Henrique Paulo César Mariano , Grativvol Tharson Susano 
Published: April 2019

A case of spontaneous spinal epidural hematoma (SSEH) in the thoracic spine (T10-12) is reported. This is a rare cause of neurological deficit (represents 0,3-0,9% of the lesions that occupy epidural space in vertebral canal) requiring immediate diagnosis and treatment. Patients with SSEH typically present with acute onset of severe back pain and signs of neurological deficit. We report the case of a woman admitted to the emergency room with abdominal pain (radiating radicular pain) with signs and symptoms of spinal cord compression. A magnetic resonance imaging (MRI) of the thoracic spine showed expansive extramedullary formation located at T10-T12 level which pressed and displaced the spinal cord anterolaterally to the right. The patient underwent surgery on an emergency basis, and permanent neurological deficit was avoided.
Femoral nerve schwannoma
Authors: Leal-Filho Manoel Baldoino , Da Silva Júnior Raimundo Gerônimo , Pinheiro-Leal Luciana Maria , Montechi Lucas Nunes , Lima Iansey Willer Sousa 
Published: April 2019

Objective: The authors report a case of femoral nerve schwannoma by MR imaging findings. Case: A patient presenting with right inguinofemoral pain and swelling was submitted to a Gadolinium-enhanced Magnetic Resonance Imaging (MRI): a schwannoma arising from the femoral nerve in the right inguinofemoral area was disclosed. She underwent microsurgical procedure, with total removal of the lesion. Postoperatively, the inguinofemoral pain and swelling disappeared, with complete relief of symptoms. Conclusion: The authors stress that femoral nerve schwannoma in the inguinofemoral place should be considered according to MRI findings.
Multiresistant Acinetobacter baumannii ventriculitis
Authors: Brandão Rafael Augusto Castro Santiago , Braga Moises Heleno Vieira , De Albuquerque Lucas Alverne Freitas , Christo Paulo Pereira , Faria Marcello Penholate , Reis Baltazar Leão 
Published: April 2019

Among Gram-negative bacteria, Acinetobacter sp. has become an important nosocomial pathogen due to the increase in the number of multiresistant strains, and this species is responsible for a growing number of postoperative infections with a high mortality rate. The occurrence of multiresistant Gram-negative bacteria has led to an increase in the number of central nervous system infections and the occurrence of bacteria resistant to fourth-generation cephalosporins and carbapenems resulted in a significant reduction of therapeutic options for the treatment of these infections. Acinetobacter baumannii is an important nosocomial agent and its resistance to antibiotic has improved over the time and the occurrence of carbapenems and fourth generation cephalosporins resistant strains is a serious threaten to infected patients. We describe a case of a multi-resistant Acinetobacter baumannii resistant to fourth-generation cephalosporins and meropenem, after a neurosurgical procedure.
Balloon remodeling technique in endovascular treatment of intracranial aneurysms
Authors: Aurich Lucas Alves , Leal André Giacomelli , Ramina Ricardo , De Meneses Murilo Sousa 
Published: April 2019

Objectives: Endovascular treatment of intracranial aneurysms demonstrates low rates of morbidity and mortality. However, aneurysms with complex forms and wide neck remain a therapeutic challenge. The aim of this study is to evaluate the endovascular management of a series of intracranial aneurysms using the balloon remodeling technique. Method: A retrospective evaluation was performed on patients with intracranial aneurysms having undergone endovascular treatment with balloon remodeling technique at the Instituto de Neurologia de Curitiba (from October, 2006 to June, 2011). Results: Thirty-four patients were evaluated. The mean age was 55.12 years and 78.79% were female. Thirteen patients had ruptured aneurysms (38.24%) and 8 had vasospasm (23,53%). The majority of the aneurysms (61.76%) had domemeasurements between 5 to 15mm and 41.18% had a neck size of greater than or equal to 4mm. Total occlusion was obtained in 29 aneurysms (85,29%) and partial occlusion in 2 (5.88%). One patient died from a procedure-related hemorrhage. Conclusion: Endovascular treatment with balloon remodeling techniques seems to be a safe and effective treatment for intracranial aneurysms, especially those with complex formsand wide neck.