Falcotentorial Meningiomas: Optimal Surgical Planning and Intraoperative Challenges - Case Report and a Review

Meningiomas arising from the falcotentorial junction are rare, and the selection of the optimal surgical approach is essential. We report a falcotentorial meningioma (FTM) case approached by occipitotranstentorial resection and subtotal tumor resection presenting a satisfactory clinical outcome. The present review sought to reveal the current knowledge regarding the clinical presentation, radiological imaging, and the microsurgical anatomy of FTMs as a form of improving the surgical approach. The selection of the optimal surgical approach is essential for the safe and effective removal of an FTM. Preoperative imaging analysis should identify the anatomical relations of the tumor and guide toward the least disruptive route that preserves the neurovascular structures.

Hemotransfusion and mechanical ventilation time are associated with intra-hospital mortality in patients with traumatic brain injury admitted to intensive care unit / Hemotransfusão e tempo de ventilação mecânica estão associados à mortalidade intra-hospitalar em pacientes com lesão cerebral traumática, internados em unidade de terapia intensiva

ABSTRACT Objective To identify the factors associated with the intra-hospital mortality in patients with traumatic brain injury (TBI) admitted to intensive care unit (ICU). Methods The sample included patients with TBI admitted to the ICU consecutively in a period of one year. It was defined as variables the epidemiological characteristics, factors associated with trauma and variables arising from clinical management in the ICU. Results The sample included 87 TBI patients with a mean age of 28.93 ± 12.72 years, predominantly male (88.5%). The intra-hospital mortality rate was of 33.33%. The initial univariate analysis showed a significant correlation of intra-hospital death and the following variables: the reported use of alcohol (p = 0.016), hemotransfusion during hospitalization (p = 0.036), and mechanical ventilation time (p = 0.002). Conclusion After multivariate analysis, the factors associated with intra-hospital mortality in TBI patients admitted to the intensive care unit were the administration of hemocomponents and mechanical ventilation time.

RESUMO Objetivo Identificar os fatores associados à mortalidade intra-hospitalar em pacientes com TCE internados em unidade de terapia intensiva (UTI). Métodos A amostra incluiu pacientes com TCE internados na UTI em um período de um ano. Foi definido como variáveis as características epidemiológicas, os fatores associados ao trauma e variáveis decorrentes dos cuidados clínicos na UTI. Resultados A amostra incluiu 87 pacientes com TCE, com idade média de 28,93 ± 12,72 anos, predominantemente do sexo masculino (88,5%). A taxa de mortalidade intra-hospitalar foi de 33,33%. A análise univariada inicial mostrou uma correlação significativa de morte intra-hospitalar e as seguintes variáveis: relato de uso de álcool (p = 0,016), hemotransfusão durante a internação (p = 0,036) e tempo de ventilação mecânica (p = 0,002). Conclusão Após análise multivariada, os fatores associados à mortalidade intra-hospitalar em pacientes com TCE internados na unidade de cuidados intensivos foram a administração de hemocomponentes e tempo de ventilação mecânica.

Cervical Internal Carotid Artery Saccular Aneurysm Manifesting with Progressive Dysphonia / Aneurisma sacular da artéria carótida interna cervical manifestando-se por disfonia progressiva

Aneurysm of the cervical internal carotid artery is a rare condition, which can trigger severe neurologic complications. The authors report a case of a female patient of 54 years, presenting as a progressive dysphonia, which revealed it to be an aneurysmof the extracranial portion of the internal carotid artery. Endovascular treatment was used.

Aneurisma da artéria carótida interna cervical é uma patologia infrequente, podendo desencadear severas complicações neurológicas. Os autores relatam o caso de uma paciente feminina de 54 anos, apresentando-se por disfonia progressiva, que revelou tratar-se de um aneurisma da porção extracraniana da artéria carótida interna, tendo sido empregado o tratamento endovascular.