ABSTRACT
Stereotactic surgery for ParkinsonÝs disease can be performed using different neuroimaging methods. Ventriculography has been used to locate the coordinates of the structures close to the third ventricle. Although it has several potential disadvantages related to the intraventricular injection of iodine contrast, it is considered a precise method. Computed tomography and magnetic resonance imaging have been used in some centers. In order to compare their efficacy, 50 stereotactic thalamotomies for ParkinsonÝs disease were performed using either ventriculography (VE) (25) or magnetic resonance imaging (MRI) (25). In 14 out of 25 VE procedures, computed tomography (CT-scan) was also used and showed a significant mean difference of coordinate Y and Z. The clinical results employing either VE or MRI were similar, with 80 percent abolition of tremor in the VE group, and 84 percent in the MRI group, after a follow up period of at least 3 months. Another 12 percent of VE and 16 percent of MRI group showed significant improvement of tremor. Complication rate was 4 percent in both groups. MRI-guided stereotactic thalamotomy in Parkinson's disease has shown good clinical results, comparable to VE-guided stereotaxis.
Subject(s)
Female , Humans , Cerebral Ventriculography , Magnetic Resonance Spectroscopy , Parkinson Disease/surgery , Stereotaxic Techniques , Evaluation Study , Follow-Up Studies , Thalamus/surgeryABSTRACT
In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.
Subject(s)
Humans , Cerebral Arteries/anatomy & histology , Cerebral Arteries/surgery , Cerebral Revascularization , Anastomosis, Surgical , Carotid Arteries/surgeryABSTRACT
Intramedullary lesions caused by Paracoccidioides brasiliensis have been rarely described. Its diagnosis may be challenging and surgical approach is indicated for diagnostic and therapeutic purposes. We hereby report a case with MRI and surgical findings in a 45 year-old woman with intramedullary paracoccidioidomycosis, and make a review of other cases presented in the literature.
Subject(s)
Humans , Female , Middle Aged , Thoracic Diseases/diagnosis , Granuloma/diagnosis , Paracoccidioidomycosis/diagnosis , Spinal Cord , Thoracic Diseases/surgery , Thoracic Diseases/pathology , Granuloma/pathology , Granuloma/surgery , Paracoccidioidomycosis/pathology , Paracoccidioidomycosis/surgery , Spinal Cord/surgeryABSTRACT
Os autores apresentam série 50 pacientes submetidos a cirurgia estereotáctica para processos expansivos intracranianos. Em 12 casos realizou-se um procedimento terapêutico: ressecçao tumoral guiada em 5 pacientes e aspiraçao do conteúdo da lesao nos outros 7. Neste estudo confirmam-se a grande precisao e a baixa morbidade relacionadas com as técnicas estereotáctica. A tomografia computadorizada e a ressonância magnética determinam com acurácia as coordenadas estereotácticas, mas em certos casos a estereo-angiografia cerebral deve ser realizada. As ressecçoes tumorais guiadas por estereotaxia permitem o tratamento de lesoes cerebrais profundas ou em áreas funcionais anteriormente consideradas como inoperáveis. A literatura pertinente é discutida.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Brain Neoplasms/surgery , Stereotaxic Techniques , Brain Neoplasms/diagnosis , Magnetic Resonance Imaging , Microsurgery , Magnetic Resonance Spectroscopy , Tomography, X-Ray ComputedABSTRACT
Acometimento do sistema nervoso central por actinomicetos é extremamente raro. Os autores descrevem um caso de actinomicose de cerebelo, com diagnóstico estabelecido após remoçäo cirúrgica da lesäo e tratamento com sucesso com penicilina endovenosa e oral. Breve revisäo da literatura sobre o envolvimento do sistema nervoso na actinomicose é apresentada
Subject(s)
Humans , Male , Adult , Actinomycosis , Brain Abscess , Cerebellar Diseases , Actinomycosis/drug therapy , Actinomycosis/pathology , Actinomycosis/surgery , Brain Abscess/drug therapy , Brain Abscess/pathology , Brain Abscess/surgery , Cerebellar Diseases/surgery , Cerebellar Diseases/pathology , Cerebellar Diseases/drug therapy , Penicillins/therapeutic use , Tomography, X-Ray ComputedABSTRACT
Revisäo da literatura do tratamento cirúrgico da doença de Parkinson. O advento da tomografia computadorizada e da ressonância magnética, e o desenvolvimento da eletroneurofisiologia aplicada à esterotaxia, tornaram procedimentos como a talamotomia estereotáxica muito mais seguros e precisos. Ao mesmo tempo, os transplantes autólogos de medula de suprarenal e heterólogos de tecido nervoso estäo sendo realizados com bons resultados na doença de Parkinson, em vários centros
Subject(s)
Adrenal Medulla/transplantation , Nerve Tissue/transplantation , Parkinson Disease/surgery , Stereotaxic Techniques , Transplantation, Autologous , Transplantation, HeterologousABSTRACT
Os autores apresentam um caso de hemorragia subaracnóidea perimesencefálica näo aneurismática em um paciente masculino de 42 anos, com excelente evoluçäo clínica. É realizada revisäo da literatura, sendo apresentados aspectos clínicos e neurrradiológicos desta entidade benigna
Subject(s)
Humans , Male , Adult , Mesencephalon , Subarachnoid Hemorrhage , Cerebral Angiography , Prognosis , Tomography, X-Ray ComputedABSTRACT
Os autores apresentam estudo de 35 casos de microcirurgia de descompressäo neuro-vascular na neuralgia do trigêmeo. A ausência de mortalidade e a morbidade muito baixa permitem a indicaçäo deste procedimento, realizado atualmente como uma cirurgia de rotina. A escolha do tratamento e as vantagens de cada método säo discutidas