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Letter to the Editor Regarding: "Is Antihelminthics Necessary in Postoperative Treatment of Intraventricular Neurocysticercosis? A Systematic Review". World Neurosurg 2024; 182:229. [PMID: 38390886 DOI: 10.1016/j.wneu.2023.11.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 02/24/2024]
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Sexual dimorphism in the murine model of extraparenchymal neurocysticercosis. Parasitol Res 2023; 122:2147-2154. [PMID: 37428312 DOI: 10.1007/s00436-023-07913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
Neurocysticercosis is a heterogeneous disease, and the patient's sex seems to play a role in this heterogeneity. Hosts' sexual dimorphism in cysticercosis has been largely explored in the murine model of intraperitoneal Taenia crassiceps cysticercosis. In this study, we investigated the sexual dimorphism of inflammatory responses in a rat model of extraparenchymal neurocysticercosis caused by T. crassiceps. T. crassiceps cysticerci were inoculated in the subarachnoid space of Wistar rats (25 females, 22 males). Ninety days later, the rats were euthanized for histologic, immunohistochemistry, and cytokines studies. Ten animals also underwent a 7-T magnetic resonance imaging (MRI). Female rats presented a higher concentration of immune cells in the arachnoid-brain interface, reactive astrogliosis in the periventricular region, in situ pro-inflammatory cytokine (interleukin [IL]-6) and anti-inflammatory cytokine (IL-10), and more intense hydrocephalus on MRI than males. Intracranial hypertension signals were not observed during the observational period. Overall, these results suggest sexual dimorphism in the intracranial inflammatory response that accompanied T. crassiceps extraparenchymal neurocysticercosis.
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Survival in patients undergoing surgical resection for brain metastasis from lung cancer and utility of different prognostic scales. Neurosurg Rev 2023; 46:184. [PMID: 37493965 DOI: 10.1007/s10143-023-02092-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 07/27/2023]
Abstract
Brain metastases (BM) from lung cancer are among the most common intracranial tumors. Several studies have published scales to estimate the survival of patients with BM. Routine access to molecular diagnostics and modern oncologic treatments, including targeted therapy and immunotherapy, is limited in low- and middle-income countries (LMICs); therefore, incorporating them into recent prognostic scales may diminish the reliability of the scales in LMICs. This retrospective study aimed to determine the survival of 55 patients who were surgically treated for BM from lung cancer at a Brazilian public tertiary teaching hospital between 2012 and 2022. We determined clinical factors associated with survival, and compared observed survival rates with the estimated survival on prognostic scales. The mean overall survival (OS) was 9.3 months (range:0.2-76.5). At univariate analysis, female sex and improved postoperative Karnofsky performance status (KPS) score were associated with longer survival. The median survival did not differ between groups when classified using the Graded Prognostic Assessment (GPA)-2008, Lung-molecular GPA-2017, and Lung-GPA-2021 scales. According to the Diagnosis-Specific (DS)-GPA-2012 scale, there was a significant difference between the groups. In the multivariate Cox regression survival analysis, a higher DS-GPA-2012 and improved postoperative KPS score remained significantly associated with longer survival. In conclusion, this cohort showed a mean OS of < 1 year. Improved KPS score after surgery was associated with increased survival. This cohort DS-GPA scale demonstrated the highest concordance with observed survival, indicating its potential as a valuable tool for patient stratification in surgical treatment decision-making in LMICs.
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Contralateral Anterior Interhemispheric–Transcallosal–Transrostral Approach for the Resection of a Subcallosal Cavernous Malformation: A Case Report and an Operative Video. Front Surg 2022; 9:902242. [PMID: 35756470 PMCID: PMC9226553 DOI: 10.3389/fsurg.2022.902242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
This case report demonstrates the surgical resection of a cerebral cavernous malformation located in the subcallosal region. The authors present a detailed operative video explaining the steps to successfully remove the lesion through a contralateral interhemispheric–transcallosal–transrostral approach with the patient in lateral decubitus. The surgical procedure was uneventful, and the patient had no postoperative deficits and no residual lesions in a three-month follow-up.
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Microscopic resection of a giant epidermoid tumor of the pineal region via supracerebellar infra and transtentorial approach with endoscope assistance. NEUROSURGICAL FOCUS: VIDEO 2021; 5:V7. [PMID: 36284911 PMCID: PMC9549989 DOI: 10.3171/2021.4.focvid2128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022]
Abstract
The authors present a case of a 22-year-old male who developed hydrocephalus symptoms related to a giant epidermoid tumor at the pineal region. The surgical approach and technique for a large epidermoid tumor in this area are extensively discussed. A paramedian contralateral supracerebellar infratentorial and transtentorial approach was performed, with the patient in a semisitting position. The tumor was removed using a microscopic technique, and endoscope assistance was used in order to reach the areas unable to be visualized under the microscope. The patient was neurologically intact at his 2-year follow-up, and postoperative MRI showed a significant decrease in the tumoral volume. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2128.
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Thrombectomy for Stroke in Brazil-Late Evidence or Promising Future? Front Surg 2021; 8:651183. [PMID: 33996885 PMCID: PMC8113624 DOI: 10.3389/fsurg.2021.651183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/15/2021] [Indexed: 11/26/2022] Open
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Long-term follow-up of patients undergoing decompressive hemicraniectomy for malignant stroke: Quality of life and caregiver's burden in a real-world setting. Clin Neurol Neurosurg 2020; 197:106168. [PMID: 32861040 DOI: 10.1016/j.clineuro.2020.106168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND PURPOSE Decompressive hemicraniectomy is a life-saving procedure for the treatment of space-occupying middle cerebral artery infarctions (malignant stroke); however, patients may survive severely disabled. Comprehensive data on long-term sequelae outside randomized controlled trials are scarce. METHODS We retrospectively evaluated the survival rates, quality of life, ability to perform activities of daily living, and caregiver burden of 61 patients (aged from 37 to 83) who had previously undergone decompressive hemicraniectomy for malignant stroke between 2012 and 2017. RESULTS The mortality rate was higher among patients older than 60 years than among younger patients (71.0 % vs 36.7 %, p = 0.007; odds ratio 4.222, 95 % confidence interval 1.443-12.355). The mean survival time was 37.9 ± 6.0 months for 19 survivors of the younger group and 22.6 ± 5.7 months for 9 survivors of the older group. Among the 28 surviving patients, 22 (78.6 %) were interviewed, and we found that age was a determining factor for functional outcome (Barthel indices of 65.7 ± 10.6 for younger patients vs 48.0 ± 9.3 for older patients, p < 0.001), but not for quality of life. The caregiver burden was significantly correlated (R = -0.53, p < 0.01) with the severity of disability and age (R = 0.544, p = 0.011) of the patients. CONCLUSION Our findings show that the degree of impairment, as well as caregiver burden, is higher in patients older than 60 years than in younger patients.
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Experimental neurocysticercosis and demyelination. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:528-529. [PMID: 32725050 DOI: 10.1590/0004-282x20200034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
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Letter to the Editor Regarding "Decompressive Craniectomy: A Preliminary Study of Comparative Radiographic Characteristics Predicting Outcome in Malignant Ischemic Stroke". World Neurosurg 2019; 133:452. [PMID: 31881575 DOI: 10.1016/j.wneu.2019.09.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/21/2019] [Indexed: 11/24/2022]
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A Rat Model of Neurocysticercosis-Induced Hydrocephalus: Chronic Progressive Hydrocephalus with Mild Clinical Impairment. World Neurosurg 2019; 132:e535-e544. [PMID: 31470163 DOI: 10.1016/j.wneu.2019.08.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Hydrocephalus is the most common complication of extraparenchymal neurocysticercosis, combining obstructive and inflammatory mechanisms that impair cerebrospinal fluid circulation. METHODS We studied the long-term progression of neurocysticercosis-induced hydrocephalus in a rat model. We generated an experimental rat model of neurocysticercosis-induced hydrocephalus by cisternal inoculation of cysts or antigens of Taenia crassiceps and compared it with the classic model of kaolin-induced hydrocephalus. We used 52 animals divided into 4 groups: 1) control, 2) neurocysticercosis-induced hydrocephalus by cysts or 3) by antigens, and 4) kaolin-induced hydrocephalus. We studied behavioral, radiologic, and morphologic alterations at 1 and 6 months after inoculation by open field test, magnetic resonance imaging, and immunohistochemical localization of aquaporin-4 (AQP-4). RESULTS Behavioral changes were observed later in neurocysticercosis-induced than in kaolin-induced hydrocephalic rats (P = 0.023). The ventricular volume of hydrocephalus induced by experimental neurocysticercosis progressively evolved, with the magnetic resonance imaging changes being similar to those observed in humans. Periventricular inflammatory and astrocytic reactions were also observed. AQP-4 expression was higher in the sixth than in the first month after inoculation (P = 0.016) and also occurred in animals that received antigen inoculation but did not develop hydrocephalus, suggesting that AQP-4 may constitute an alternative route of cerebrospinal fluid absorption under inflammatory conditions. CONCLUSIONS Our neurocysticercosis-induced hydrocephalus model allows for the long-term maintenance of hydrocephalic animals, involving mild clinical performance impairments, including body weight and behavioral changes.
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Hypermethylation of BRCA1 Gene in Meningioma in Elderly Males. Anticancer Res 2018; 38:2819-2822. [PMID: 29715104 DOI: 10.21873/anticanres.12526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/28/2018] [Accepted: 04/02/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Breast cancer 1, early onset (BRCA1) gene is expressed in the cells of the breast and other tissues, where it plays a role in cell-cycle regulation, transcription, repair of DNA double-stranded breaks, ubiquitination, transcriptional regulation as well as other functions, such as cell response regulation to mitogenic signals triggered by estrogens. Considering that meningioma shows greater tumor growth during pregnancy, can express estrogen receptors and proliferate in response to estrogenic stimulation, the hypothesis that this type of tumor may share molecular mechanisms that involve exposure to estrogen should be investigated. Therefore, the aim of the present study was to investigate the BRCA1 gene methylation profile in meningioma. MATERIALS AND METHODS Methylation-specific polymerase chain reaction (PCR) assay was performed on 50 meningioma samples from male and female patients. Statistical analysis was carried out using Fisher's exact test. RESULTS The most important finding of this study was that 100% of the male patients over 55 years with meningioma showed BRCA1 methylated in their tumor cells. CONCLUSION The silencing of BRCA1 through hypermethylation seems to play an important role in meningioma.
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Decompressive craniectomy for stroke in Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:838. [PMID: 29236834 DOI: 10.1590/0004-282x20170135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/08/2017] [Indexed: 11/21/2022]
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Taenia crassiceps injection into the subarachnoid space of rats simulates radiological and morphological features of racemose neurocysticercosis. Childs Nerv Syst 2017; 33:119-123. [PMID: 27613638 DOI: 10.1007/s00381-016-3239-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Neurocysticercosis is a major public health concern. Although its eradication appears feasible, the disease remains endemic in developing countries and has emerged again in Europe and in the USA. Basic studies on neurocysticercosis are needed to better understand the pathophysiologic mechanisms and, consequently, to improve treatment perspectives. Much has been published on experimental parenchymal neurocysticercosis, but there are no experimental models of racemose neurocysticercosis. METHODS Cysts of Taenia crassiceps were injected into the subarachnoid space of 11 rats. After 4 months, magnetic resonance imaging (MRI) was performed to verify the occurrence of ventricular dilatation and the distribution of cysts in the cerebrospinal fluid compartments. The histologic assessment was done focusing on changes in the ependyma, choroid plexus, and brain parenchyma. RESULTS MRI and histologic assessment confirmed the findings similar to those seen in human racemose neurocysticercosis including enlargement of the basal cisterns, hydrocephalus, and inflammatory infiltration through the ependyma and choroid plexus into cerebrospinal fluid spaces. CONCLUSIONS We developed a simple model of racemose neurocysticercosis by injecting cysts of T. crassiceps into the subarachnoid space of rats. This model can help understand the pathophysiologic mechanisms of the disease.
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Spontaneous resolution of traumatic acute subdural haematomas: A systematic review. Neurocirugia (Astur) 2016; 27:129-35. [DOI: 10.1016/j.neucir.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/06/2015] [Accepted: 05/10/2015] [Indexed: 12/09/2022]
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Development of an experimental model of neurocysticercosis-induced hydrocephalus. Pilot study. Acta Cir Bras 2016; 30:819-23. [PMID: 26735053 DOI: 10.1590/s0102-865020150120000005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/13/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To develop an experimental model of neurocysticercosis-induced hydrocephalus METHODS There were used 17 rats. Ten animals were inoculated with Taenia crassiceps cysts into the subarachnoid. Five animals were injected with 0. ml of 25% kaolin (a standard solution for the development of experimental hydrocephalus) and two animals were injected with saline. Magnetic resonance imaging (MRI) was used to evaluate enlargement of the ventricles after one or three months of inoculation. Volumetric study was used to quantify the ventricle enlargement. RESULTS Seven of the 10 animals in the cyst group developed hydrocephalus, two of them within one month and five within three months after inoculation. Three of the five animals in the kaolin group had hydrocephalus and none in the saline group. Ventricle volumes were significantly higher in the 3-months MRI cyst subgroup than in the 1-month cyst subgroup. Differences between cyst subgroups and kaolin group did not reach statistical significance. CONCLUSION The developed model may reproduce the human condition of neurocysticercosis-related hydrocephalus, which exhibits a slowly progressive chronic course.
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Unusual Painful Trigeminal Neuropathy Caused by Racemose Neurocysticercosis. PAIN MEDICINE 2016; 17:992-994. [DOI: 10.1093/pm/pnv081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Traumatic brain injury presenting with bilateral basal ganglia hemorrhage. Neurol Neurochir Pol 2015; 49:456-9. [PMID: 26652883 DOI: 10.1016/j.pjnns.2015.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/26/2015] [Accepted: 09/03/2015] [Indexed: 11/28/2022]
Abstract
CONTEXT Traumatic basal ganglia hemorrhage (TBGH) is a rare presentation of traumatic brain injury. Bilateral lesions are even rarer. Only twelve similar cases were previously published. CASE REPORT We report the case of a patient with bilateral TBGH. He was managed conservatively. Long-term follow-up disclosed a cognitive dysfunctions attributed to associated diffuse axonal injury. Acceleration and deceleration forces may have torn pallidum arterial branches determining hemorrhage. CONCLUSION Bilateral TBGH is an uncommon presentation of traumatic brain injury. Associated diffuse axonal injury worsens the outcome.
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Critical analysis of diagnostic criteria (ICHD-3 beta) about migraine in childhood and adolescence. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:1005-8. [DOI: 10.1590/0004-282x20150162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 08/05/2015] [Indexed: 01/03/2023]
Abstract
Objective The objective of this study was to prospectively evaluate the International Classification of Headache Disorders I (ICHD-I) diagnostic criteria for migraine in children and adolescents. Methods 150 pain diaries were analyzed during an initial consultation. The duration of migraine headache attacks were divided into 2 groups: Group I, for attacks lasting > 2 hours, and Group II, for attacks lasting < 2 hours.The two groups were statistically compared using Fisher’s exact test (p < 0.05). Results In this study, 51(34%) subjects were male and 99 (66%) were female, aged 7–15 years. Fisher’s exact test demonstrated that the ICHD-3 beta had a 58% sensitivity for Group I diagnoses and a 94% sensitivity for Group II diagnoses (p < 0.001). Conclusion The current ICHD-3 beta classification improves and advances migraine diagnosis in children and adolescents; however, more research is needed to identify additional characteristics of headache in this age group.
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Long-term follow-up in sacroiliac joint pain patients treated with radiofrequency ablative therapy. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:476-9. [DOI: 10.1590/0004-282x20150049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/19/2015] [Indexed: 01/22/2023]
Abstract
Sacroiliac joint (SIJ) pain is responsible for up to 40% of all cases of lumbar back pain.Objective Report the long-term efficacy of radiofrequency denervation for sacroiliac joint pain at six, twelve and eighteen months.Method Third-two adults’ patients with sacroiliac join pain diagnosis were included for a prospective study. Primary outcome measure was pain intensity on the Numeric Rating Scale (NRS). Secondary outcome measure was Patient Global Impression of Change Scale (PGIC).Results Short-term pain relief was observed, with the mean NRS pain score decreasing from 7.7 ± 1.8 at baseline to 2.8 ± 1.2 at one month and to 3.1 ± 1.9 at six months post-procedure (p < 0.001). Long-term pain relief was sustained at twelve and eighteen months post-procedure, with NRS pain remaining at 3.4 ± 2.1 and 4.0 ± 2.7, respectively.Conclusion Radiofrequency denervation of the SIJ can significantly reduce pain in selected patients with sacroiliac syndrome.
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Sinking skin flap syndrome with delayed dysautonomic syndrome-An atypical presentation. Int J Surg Case Rep 2013; 4:1007-9. [PMID: 24083997 PMCID: PMC3825975 DOI: 10.1016/j.ijscr.2013.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 08/26/2013] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Sinking skin flap syndrome or “syndrome of the trephined” is a rare complication after a large craniectomy, with a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. PRESENTATION OF CASE We report a case of 21 years old man with trefinated syndrome showing delayed dysautonomic changes. DISCUSSION Our patient had a large bone flap defect and a VP shunt that constitute risk factors to develop this syndrome. Also, there is reabsorption of bone tissue while it is placed in subcutaneous tissue. The principal symptoms of sinking skin flap syndrome are severe headache, mental changes, focal deficits, or seizures. Our patient presented with a delayed dysautonomic syndrome, with signs and symptoms very characteristics. Only few cases of this syndrome were related in literature and none were presented with dysautonomic syndrome. CONCLUSION We reported here a very uncommon case of sinking skill flap syndrome that causes a severe dysautonomic syndrome and worsening the patient condition.
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[Cerebral aneurysm and arachnoid cyst: about a case with intracystic hemorrhage]. ARQUIVOS DE NEURO-PSIQUIATRIA 2000; 58:330-5. [PMID: 10849636 DOI: 10.1590/s0004-282x2000000200021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report a case of a carotid artery bifurcation aneurysm which ruptured into a silvian fissure arachnoid cyst. In the review of the literature, only three cases were before reported. We discuss about uncommon clinical findings, the surgical aspects and the associations among the lesions.
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Immunological alterations in patients with primary tumors in central nervous system. ARQUIVOS DE NEURO-PSIQUIATRIA 1999; 57:539-46. [PMID: 10667274 DOI: 10.1590/s0004-282x1999000400001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Natural killer (NK) cells play an important role in immune surveillance against tumors. The present work aimed to study the cytotoxic activity of NK cells and T cell subsets in peripheral blood of 13 patients with primary tumors in central nervous system (CNS). As controls 29 healthy subjects with the age range equivalent to the patients were studied. The methods employed were: a) determination of cytotoxic activity of NK cells towards K562 target cells, evaluated by single cell-assay; b) enumeration of CD3+ lymphocytes and their CD4+ and CD8+ subsets defined by monoclonal antibodies; c) the identification of tumors were done by histologic and immunochemistry studies. The results indicated that adults and children with tumor in CNS display reduced percentage of total T cells, helper/inducer subset and low helper/suppressor ratio. The cytotoxic activity of NK cells was decreased in patients with CNS tumors due mainly to a decrease in the proportion of target-binding lymphocytes. These results suggest that cytotoxic activity of NK cells may be affected by the immunoregulatory disturbances observed in patients with primary tumors in CNS.
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[Is the metabolic response self-limited in head trauma? Analysis of acute phase proteins and glycemia]. ARQUIVOS DE NEURO-PSIQUIATRIA 1998; 56:778-88. [PMID: 10029882 DOI: 10.1590/s0004-282x1998000500013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
There are many reports supporting a self-limitation mechanism involved with hypermetabolic response after severe cranial injury. It was proposed a study with severe head injury patients, in three stages of the evolution. The first 7 days after admission (moment 1-M1), the second three days latter (M2) and the last 7 days after the first (M3). Among male patients with severe head injury, attended between January 1992 and December 1993 in University Hospital of Botucatu, UNESP, were selected 28 male patients, with Glasgow severity scale between 4 and 6, with pO2 < 70 mm Hg, weighting 60 kg or more. Among these patients, 6 finished the study, including analysis of the excretion of N, acute phase proteins, glycemia, triglycerides and amine nitrogen. During the study there were no changes in nitrogen balance and there was a decrease in protein C-reative. Glycemia tends to fall within two weeks after injury. The authors make some considerations about possible mechanisms involved in brain modulation associated with the period of dependence of hypermetabolism and hypercatabolism after closed brain injury. There are some evidences that the brain responds to head trauma with a gobal non specific way, which tends to be reorganized beyond the first two weeks after lesion. The study does not show any influence of the type and severity of head trauma.
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[Intracranial pressure monitoring as a complementary tests for diagnosing brain death. Preliminary observation through the report of 2 cases]. ARQUIVOS DE NEURO-PSIQUIATRIA 1997; 55:310-4. [PMID: 9629393 DOI: 10.1590/s0004-282x1997000200021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The clinical evolution of two patients with continuous intracranial pressure (ICP) monitoring, admitted to the Intensive Care Unit of Neurology, University Hospital of Botucatu, and followed until irreversible cardiac failure (ICF) was studied retrospectively. The evolution of ICP showed that it reached a maximum 5 to 12 hours before a decrease in wave amplitude occurred (this was observed approximately 47 to 60 hours before ICF). The tracing became linear approximately 30 hours before ICF in both cases. The clinical diagnosis of brain death (BD) was obtained 3 to 28 hours after the tracing had become linear. The authors suggest that, in absence of sedation, the diagnosis of BD may be made early with the use of ICP monitoring even before the clinical diagnosis, and emphasize the need for more observations in a larger number of patients.
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Compression of the peripheral branches of the sciatic nerve by lipoma. ELECTROMYOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1997; 37:251-5. [PMID: 9208220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors report two female patients with chronic sensitive and motor findings in lower limbs caused by compression of distal branches of sciatic nerve by lipoma. Similar cases were not described on literature. Nerve conduction studies allowed to localize the exact site of compression. At surgery, lipomas compressing the deep peroneal nerve (case 1) and the posterior tibial nerve (case 2) were observed. Histologic studies of tumors confirmed the diagnoses.
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[Cystic oligodendroglioma and positivity of reactions for cysticercosis: report of a case]. ARQUIVOS DE NEURO-PSIQUIATRIA 1992; 50:234-8. [PMID: 1308398 DOI: 10.1590/s0004-282x1992000200020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A case of a 32-year old male patient with complaints of frontal headache progressive decrease in visual acuity, altered behaviour, and positive results of immunological tests for cysticercosis performed on the cystic and cerebrospinal fluids is presented. After several clinical and surgical proceedings, the frontal craniotomy was indicated and a multi-lobulated cystic tumor was excised. Biopsy material revealed an oligodendroglioma invading the degenerated membrane of cystic wall. Some aspects related to the possible mechanisms involved in the association of oligodendroglioma with neurocysticercosis in the presented case are discussed. Three different types of conclusions may be reached: (1) neurocysticercosis may have acted as an oncogenetic factor for the oligodendroglioma; (2) the glycoprotein nature of the antigens of gliomas and cysticercosis and the similarity in the molecular weight range of their polypeptides may be responsible for the positivity of the reactions for cysticercosis in the cystic fluid; or (3) the association of oligodendroglioma with cysticercosis may be a simple coincidence. The present study strengthens the opinion that other pathologies should be looked for when clinical treatment of cysticercosis does not follow the expected course.
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