Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 13 de 13
Filter
1.
Arq. bras. neurocir ; 43(3): 226-236, 2024.
Article in English | LILACS-Express | LILACS | ID: biblio-1571496

ABSTRACT

Objective To describe a tubular retractor technique for brain lesions through a series of cases and to conduct a literature review on intracranial tubular retractors with emphasis on the syringe port system. Materials and Methods We described four cases of lesions with an intraventricular component and different pathological patterns. The surgeries were performed between April, 2021 and July, 2022. The images were acquired through computed tomography (CT) and magnetic resonance imaging (MRI) scans and transferred to the Horos software, version 1.1.7. To make the tubular retractor, a 20-mL syringe and a 14-Fr/Ch, 30-mL/cc Foley probe were used. The syringe was sectioned according to the planned depth based on preoperative imaging. The syringe was the retractor itself, while the probe served as a means of dilating the path to the lesion. Results Gross total resection was achieved in all cases, and the samples collected were satisfactory regarding the results of the anatomopathological study. All patients evolved without any additional deficits and with adequate postoperative image control. Conclusion The syringe as a tubular retractor associated with the Foley probe as a surgical port dilator was useful, and it enabled the radical resection of intracranial tumors related to the lateral ventricle, not limiting the use of auxiliary instruments, neither of microsurgical instruments; therefore, it is an affordable, secure, and inexpensive method.


Objetivo Descrever uma técnica de retração tubular para lesões cerebrais por meio de uma série de casos e realizar uma revisão bibliográfica sobre retratores tubulares intracranianos com ênfase no sistema dilatador-seringa. Materiais e Métodos Foram descritos quatro casos de lesões com componente intraventricular, com diferentes padrões patológicos. As cirurgias foram realizadas entre abril de 2021 e julho de 2022. As imagens foram adquiridas por tomografia computorizada (TC) e ressonância magnética (RM), e transferidas para o programa Horos, versão 1.1.7. Para fabricar o retrator tubular, foram utilizadas uma seringa de 20 mL e uma sonda Foley de 14Fr/Ch, 30mL/cc. A seringa foi seccionada de acordo com a profundidade planejada e com base na imagem pré-operatória. A seringa era o retrator em si, ao passo que a sonda servia como meio de dilatar o caminho para a lesão. Resultados A ressecção total bruta foi alcançada em todos os casos, e as amostras recolhidas foram satisfatórias com relação aos resultados do estudo anatomopatológico. Todos os pacientes evoluíram sem quaisquer déficits adicionais e com controle de imagem pós-operatório adequado. Conclusão A seringa como retrator tubular associado à sonda de Foley como dilatador cirúrgico foi útil e permitiu a ressecção radical de tumores intracranianos relacionados com o ventrículo lateral, e não limitou a utilização de instrumentos auxiliares, nem dos instrumentos microcirúrgicos, sendo assim um método acessível, seguro e pouco dispendioso.

2.
Rev. argent. dermatol ; Rev. argent. dermatol;99(3): 51-60, set. 2018.
Article in Spanish | LILACS | ID: biblio-977221

ABSTRACT

RESUMEN El síndrome de Schimmelpenning es un desorden neurocutáneo sistémico raro caracterizado por nevo sebáceo extendido, de ubicación primordialmente craneofacial, y compromiso de diferentes órganos neuroectodérmicos. Los principales desórdenes del sistema nervioso central (SNC) comprenden retraso mental, convulsiones y hemimegalencefalia. Otras anomalías asociadas incluyen oculares, osteoesqueléticas, cardiovasculares y genitourinarias. Reportamos el caso de una paciente femenina de 4 meses de edad con lesiones cutáneas y sistémicas compatibles con Syndrome de Schimmelpenning - Feuerstein - Mims y RMN que muestra compromiso del SNC.


SUMMARY Schimmelpenning syndrome is a rare congenital neurocutaneous disorder characterized by extensive nevus sebaceous, mainly craniofacial, and abnormalities in different neuroectodermal organ systems. The most common central nervous system disorders are intellectual disability, seizures and hemimegalencephaly. Other associated anomalies include ocular, skeletal, cardiovascular and genitourinary. We report a four month old female patient with cutaneous and systemic lesions compatible with Schimmelpenning - Feuerstein - Mims syndrome and MRI showing central nervous system compromise. system compromise include seizures, mental retardation and anatomic alterations that include cranial asymmetry, hemimegalencephaly with asymmetric and dilated ventricles, and calcium deposit. We report the case of a four month old female patient with skin and systemic lesions compatible with Schimmelpenning syndrome and MRI showing its central nervous system compromise.

3.
Journal of Stroke ; : 38-49, 2016.
Article in English | WPRIM | ID: wpr-135888

ABSTRACT

With the advances in magnetic resonance imaging, previously unrecognized small brain lesions, which are mostly asymptomatic, have been increasingly detected. Diffusion-weighted imaging can identify small ischemic strokes, while gradient echo T2* imaging and susceptibility-weighted imaging can reveal tiny hemorrhagic strokes (microbleeds). In this article, we review silent brain lesions appearing soon after acute stroke events, including silent new ischemic lesions and microbleeds appearing 1) after acute ischemic stroke and 2) after acute intracerebral hemorrhage. Moreover, we briefly discuss the clinical implications of these silent new brain lesions.


Subject(s)
Brain , Cerebral Hemorrhage , Magnetic Resonance Imaging , Stroke
4.
Journal of Stroke ; : 38-49, 2016.
Article in English | WPRIM | ID: wpr-135893

ABSTRACT

With the advances in magnetic resonance imaging, previously unrecognized small brain lesions, which are mostly asymptomatic, have been increasingly detected. Diffusion-weighted imaging can identify small ischemic strokes, while gradient echo T2* imaging and susceptibility-weighted imaging can reveal tiny hemorrhagic strokes (microbleeds). In this article, we review silent brain lesions appearing soon after acute stroke events, including silent new ischemic lesions and microbleeds appearing 1) after acute ischemic stroke and 2) after acute intracerebral hemorrhage. Moreover, we briefly discuss the clinical implications of these silent new brain lesions.


Subject(s)
Brain , Cerebral Hemorrhage , Magnetic Resonance Imaging , Stroke
5.
Article in English | WPRIM | ID: wpr-111664

ABSTRACT

PURPOSE: Carotid endarterectomy (CEA) is the standard treatment for carotid artery stenosis. New brain ischemia is a major concern associated with CEA and diffusion weighted imaging (DWI) is a good imaging modality for detecting early ischemic brain lesions. We aimed to investigate the surgical complications and identify the potential risk factors for the incidence of new brain lesions (NBL) on DWI after CEA. METHODS: From January 2006 to November 2011, 94 patients who had been studied by magnetic resonance imaging including DWI within 1 week after CEA were included in this study. Data were retrospectively investigated by review of vascular registry protocol. Seven clinical variables and three procedural variables were analyzed as risk factors for NBL after CEA. RESULTS: The incidence of periprocedural NBL on DWI was 27.7%. There were no fatal complications, such as ipsilateral disabling stroke, myocardial infarction or mortality. A significantly higher incidence of NBL was found in ulcer positive patients as opposed to ulcer negative patients (P = 0.029). The incidence of NBL after operation was significantly higher in patients treated with conventional technique than with eversion technique (P = 0.042). CONCLUSION: Our data shows CEA has acceptable periprocedural complication rates and the existence of ulcerative plaque and conventional technique of endarterectomy are high risk factors for NBL development after CEA.


Subject(s)
Humans , Brain Ischemia , Brain , Carotid Stenosis , Diffusion , Endarterectomy , Endarterectomy, Carotid , Incidence , Magnetic Resonance Imaging , Mortality , Myocardial Infarction , Retrospective Studies , Risk Factors , Stroke , Ulcer
6.
Article in Chinese | WPRIM | ID: wpr-430469

ABSTRACT

Objective To evaluate the effect of neuromuscular electrical stimulation (NMES) on swallowing function in brain injury patients with dysphagia.Methods Sixty-four patients with dysphagia were divided into A group (n=21,stimulated with T =700 ms,R =2 s,frequency =0.19 Hz),B group (n =22,T =700 ms,R =1 s,frequency =0.29 Hz),and C group (n =21,T =340 ms,R =400 ms,frequency =0.68 Hz).One pair of electrodes was placed at the midline under the chin over the submental muscle group.The intensity of stimulation ranged from 5 to 11 mA.The treatments were once a day,5 times a week,with 20 times as one course.The results were assessed with Kubota's water swallowing test before and 4 weeks after treatment.Results The water swallowing test scores were significantly reduced after treatment in all 3 groups,with significantly greater reductions in A group compared with B and C group.The effectiveness rate was 81% in A group,73% in B group and 67% in C group,all statistically significant differences.Conclusion NMES can be an effective and safe treatment for dysphagia after brain injury.NMES appears to be most effective with T =700 ms,R =2 s,and a frequency of 0.19 Hz.

7.
Article in Chinese | WPRIM | ID: wpr-413398

ABSTRACT

Objective To probe deficits in visuospatial attention using an attention network test (ANT) in patients with frontoparietal network lesions. Methods The ANT was used to measure the alertness, orienting and executive control abilities of 25 patients with local brain lesions, including 13 with frontal and 12 with parietal damage. Their results were compared with those of health adults. Results During ANT tasks, the patients' responses were significantly slower on each cue and target condition than controls', and showed deficits in their alerting and orienting networks. The efficiency of executive control was impaired in patients with frontal lesions, but increased with parietal lesions. Conclusions These findings suggest that the frontoparietal network is involved in alerting and orienting, but the executive control function may be selectively associated with the frontal lobe. ANT is an efficienttool for studying visual attention and cognition.

8.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;67(1): 74-77, Mar. 2009. tab
Article in English | LILACS | ID: lil-509111

ABSTRACT

OBJECTIVE: In the majority of cases, the correct treatment of brain lesions is possible only when the histopathological diagnosis is made. Several deep-seated lesions near eloquent areas are not safely approached by the classical neurosurgical procedures. These patients can get benefit by a minimally invasive procedure. METHOD: We present a series of 176 consecutive patients submitted to stereotactic biopsies due to a great variety of brain lesions. RESULTS: Histological diagnosis found in this series: glioma in 40.1 percent of the patients, other neoplasms in 12.2 percent and infectious or inflammatory diseases in 29.1 percent. The result was inconclusive in 5.2 percent of the procedures. One patient died (0.6 percent) and two (1.2 percent) presented operative complications. The criteria, advantages and risks of the stereotactic biopsies are discussed. CONCLUSION: The efficacy of the method is adequate and morbid-mortality rates were low.


OBJETIVO: O diagnóstico anatomopatológico das lesões encefálicas é muitas vezes necessário para a instituição do tratamento adequado. Entretanto, muitas lesões localizadas profundamente no encéfalo ou em centros nervosos de grande importância funcional não podem ser acessadas sem riscos, com a aplicação dos procedimentos neurocirúrgicos habituais. MÉTODO: Apresentamos uma série de 176 doentes submetidos a biópsias estereotáxicas de lesões encefálicas. RESULTADOS: Em 40,1 por cento dos casos, o diagnóstico foi de glioma, em 12,2 por cento de outras neoplasias e em 29,1 por cento, de doenças infecciosas ou inflamatórias. O resultado foi inconclusivo em 5,2 por cento dos doentes. Um (0,6 por cento) doente faleceu e dois (1,2 por cento) apresentaram graves complicações operatórias. Os critérios de seleção, as vantagens e os riscos da biópsia estereotáxica são discutidos. CONCLUSÃO: A eficácia do método é boa e a morbimortalidade das biópsias estereotáxicas é baixa.


Subject(s)
Adolescent , Adult , Aged, 80 and over , Child , Humans , Male , Middle Aged , Young Adult , Biopsy/methods , Brain Neoplasms/pathology , Brain/pathology , Glioma/pathology , Stereotaxic Techniques , Biopsy/adverse effects , Biopsy/mortality , Brain Neoplasms/surgery , Glioma/surgery , Stereotaxic Techniques/adverse effects , Stereotaxic Techniques/mortality , Young Adult
9.
Medicina (B.Aires) ; Medicina (B.Aires);68(4): 285-290, jul.-ago. 2008. tab
Article in Spanish | LILACS | ID: lil-633554

ABSTRACT

Las lesiones cerebrales focales constituyen una complicación frecuente en los pacientes con infección por el virus de la inmunodeficiencia humana (HIV) y síndrome de inmunodeficiencia adquirida (sida). Durante el período comprendido entre enero de 1999 y mayo de 2007 se realizaron un total de 83 biopsias en pacientes con sida y lesiones cerebrales. Se incluyeron aquellos pacientes que no hubiesen respondido al algoritmo habitual de enfoque diagnóstico-terapéutico de estas lesiones. Todas las muestras obtenidas fueron sometidas a evaluación intraoperatoria para asegurar la obtención de material patológico y posterior análisis histopatológico y exámenes microbiológicos. De los 41 pacientes con lesiones cerebrales múltiples, 62 tenían localización supratentorial, en 4 eran infratentoriales y 17 mostraron ambas localizaciones. Cincuenta y un lesiones seleccionadas como blanco estereotáctico tuvieron refuerzo periférico del contraste. Se obtuvo material histopatológico en el 100% de los procedimientos. El diagnóstico más frecuente fue el de leucoencefalopatía multifocal progresiva (LEMP) con 24 casos (29%), seguido del linfoma primario del sistema nervioso central (LPSNC) con 19 diagnósticos (23%) y de toxoplasmosis en 13 pacientes (15.7%). Se comprobó una relación significativa entre los diagnósticos histopatológicos y la localización de las lesiones y entre los diagnósticos histopatológicos y el comportamiento de las imágenes luego de la administración de la sustancia de contraste. El rédito diagnóstico alcanzó el 90.3% (75 biopsias). La morbiletalidad en esta serie fue de 2.4%. La biopsia cerebral estereotáctica permitió alcanzar el diagnóstico etiológico y adecuar el enfoque terapéutico en la mayoría de los pacientes de esta serie.


Focal brain lesions are frequent complications among HIV/AIDS patients. Between January 1999 and May 2007, 83 procedures of stereotactic brain biopsies in HIV/AIDS patients with focal cerebral lesions were carried out. The inclusion criteria were lack of response to current diagnostic and therapeutic guidelines for brain lesions. All the samples underwent microscopic evaluation during surgery to assert valid material and delayed histopathological and microbiological examination. Forty one patient images demonstrated multiple brain lesions. Sixty two cases had supratentorial localization, 4 lesions were located beneath the tentorium and 17 showed both settings. Fifty one lesions presented peripheral enhancement after contrast computed tomography (CT) or magnetic resonance imaging (MRI). A 100% of useful samples recovery was achieved. Progressive multifocal leucoencephalopathy (PML) was the most frequent diagnosis (29%), followed by primary central nervous system lymphoma (PCNSL) (23%), and toxoplasmosis (15.7%). Statistically significant association was observed between histopathological diagnosis and lesion location and between those and peripheral ring enhancement images. The positive diagnostic rate of the invasive procedure was 90.3%. The morbidity/mortality rate was 2.4% in this series. In conclusion, the stereotactic brain biopsy ordered early during the patient’s evolution showed a good performance in order to achieve a prompt and accurate diagnosis and to guide the therapeutic scheme in these AIDS patients with focal brain lesions.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , AIDS-Related Opportunistic Infections/pathology , Acquired Immunodeficiency Syndrome/pathology , Biopsy/methods , Brain Diseases/pathology , Brain/pathology , Central Nervous System Viral Diseases/pathology , AIDS-Related Opportunistic Infections/surgery , Biopsy/mortality , Central Nervous System Neoplasms/pathology , Leukoencephalopathy, Progressive Multifocal/pathology , Magnetic Resonance Imaging , Retrospective Studies , Stereotaxic Techniques/mortality , Stereotaxic Techniques/standards , Tomography, X-Ray Computed , Toxoplasmosis, Cerebral/pathology
10.
Article in Korean | WPRIM | ID: wpr-84265

ABSTRACT

It is well recognized that antiepileptic drugs (AEDs) can cause generalized or bilateral asterixis. However, the unilat-eral asterixis induced by AEDs has been rarely reported in patients with structural brain lesions. We report 2 patients who developed unilateral asterixis within therapeutic AEDs levels. In both patients, the unilateral asterixis disappeared when the daily dosage of AEDs was decreased. Our cases suggest that the cerebral hemisphere with structural lesions might be more vulnerable to the development of AEDs-induced asterixis.


Subject(s)
Humans , Anticonvulsants , Brain , Cerebrum , Dyskinesias
11.
Article in Korean | WPRIM | ID: wpr-724248

ABSTRACT

Visual perceptual dysfunction in stroke patients causes a failure in activties of daily living and learning. Therefore, the correct diagnosis and remediation of visual perceptual dysfunction are important. Since the mechanism of visual perception is not well studied, it is difficult to treat visual perceptual dysfunction effectively. In this study, we tried to correlate visual perceptual dysfunction with anatomical lesion of brain for the use of visual perceptual training. We assesed the visual perception and the brain lesions of fiftroke patients, with Motor-Free Visual Perception Test(MVPT), and brain computerized tommography respectively. The visual responses of contralateral side of the lesions were diminished. The raw score of MVPT was low in patients with lesions in both parietal and, right temporal lobes. The right parietal lobe lesions correlated with tests for figure-ground and visual closure, and the left parietal lobe lesions with visual processing time. The result suggests that the right parietal lobe has an important role in visual perceptions. The right temporal, and the left parietal lobes as well as the subcortex of both hemisphere also has significant roles in visual perceptions.


Subject(s)
Humans , Brain , Diagnosis , Equidae , Learning , Parietal Lobe , Rabeprazole , Stroke , Temporal Lobe , Visual Perception
12.
Article in Korean | WPRIM | ID: wpr-132205

ABSTRACT

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.


Subject(s)
Humans , Auditory Pathways , Brain Injuries , Brain Stem , Brain , Diencephalon , Electrodes , Electrophysiology , Evoked Potentials , Evoked Potentials, Auditory, Brain Stem , Mesencephalon , Permeability , Pons , Scalp , Thalamus
13.
Article in Korean | WPRIM | ID: wpr-132208

ABSTRACT

Brainstem auditory response abnormalities directly reflect disturbance of neural function rather than the underlying anatomic cause of that disturbance. The test has advantage in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity, displace surrounding structures or change vascular supply and permeability. A sequence of seven low-amplitude potentials that occur in the initial 10 msec following click signals can be recorded from scalp electrodes in 44 patient with focal brain lesions using computer averaging techniques. The potentials, termed auditory brainstem responses, are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brainstem. We have studied auditory brainstem evoked potential responses in a variety of focal brain lesions and found them to be of assistance in evaluating the localization of pontomedullary, pons, midbrain, thalamus, subcortical and functional recovery. 1) Distortion of early components (type I) was occured in the brainstem lesions. 2) Distortion of late components (type II) was developed in the diencephalon or subcortical lesions. 3) Distortion of all components (type III) was developed in the brainstem and diffuse brain contusions. 4) Serial recordings provided information about the evolution of brain stem lesions and good functional recovery marker.


Subject(s)
Humans , Auditory Pathways , Brain Injuries , Brain Stem , Brain , Diencephalon , Electrodes , Electrophysiology , Evoked Potentials , Evoked Potentials, Auditory, Brain Stem , Mesencephalon , Permeability , Pons , Scalp , Thalamus
SELECTION OF CITATIONS
SEARCH DETAIL