Craniocerebral gunshot injury in newborn.

Head wounds caused by firearms in newborns are an under-studied phenomenon in Latin America due to either the low frequency of such events or inadequate documentation. Nonetheless, a progressive increase is noted, with different frequencies reported for different geographic areas. We present the case of a 28-day-old newborn who suffered traumatic brain injury from a gunshot wound stemming from urban violence. This is one of the youngest patients reported with this type of head trauma in the literature.

[Vasculitic neuropathy in Wegener granulomatosis: case report]. / Neuropatia vasculítica na granulomatose de Wegener: relato de caso.

The neurologic involvement during Wegener granulomatosis reaches 15-50% of patients, however as initial symptomatology is not commented in the literature. We describe a patient with Wegener's granulomatosis and mononeuritis multiplex, emphasizing the fact that neurologic manifestations anticipated systemic symptoms, and also focusing on the diagnostic contribution of sural biopsy and the good outcome of neurologic disease.

[Saphenous vein graft bypass from the external carotid artery to the supraclinoid internal carotid artery to treat a giant aneurysm of the cavernous internal carotid: case report]. / Anastomose entre a artéria carótida externa e a artéria carótida interna supraclinóidea utilizando enxerto de veia safena para tratamento de aneurisma gigante do segmento cavernoso da carótida interna: relato de caso.

Alternative surgical procedures to treat unclippable aneurysms of the intracavernous carotid artery include proximal vessel occlusion and trapping. Those techniques, even in patients with rich collateral vessels, are associated with risk of hemodynamic compromise and ischemic complications. Therefore, a safe treatment requires revascularization to maintain blood flow to the involved territories. We report the case of a 47-year-old female, with ischemic signs and symptoms and a right third nerve palsy caused by a giant aneurysm, partially trombosed, of the intracavernous carotid artery. The patient was submitted to trapping after a saphenous vein graft bypass from the external carotid artery to the supraclinoid internal carotid artery. The surgical result was good without complications.

Oclusao gradual da arteria carotida no pescoco. Nota tecnica. / Gradual occlusion of the carotid artery at the neck. Technical note

A oclusao gradual da carotida no pescoco e ainda um procedimento terapeutico utilizado no manuseio de determinadas malformacoes vasculares do encefalo. O autor relata modificacao processada nos "clamps" ate entao descritos para esse fim. As alteracoes facilitam os atos de colocar e remover o "clamp", diminuindo dessa forma o tempo operatorio

Uso de barbituricos em afeccoes do sistema nervoso central. / Barbiturate use in affections of the central nervous system

O autor faz uma revisao das consequencias da isquemia cerebral e analisa os possiveis efeitos beneficos do uso de barbituricos no edema cerebral e na hipertensao intracraniana

Tratamento cirurgico da disostose craniofacial. Relato de um caso de Sindrome de Pfeiffer. / Surgical treatment of craniofacial dysostosis.Report of a case of Pfeiffer' syndrome

Um caso de disostose craniofacial e descrito, bem como as suas outras anomalias que permitiram rotula-lo como sindrome de Pfeiffer. O tratamento cirurgico compreendeu uma serie de osteotomias que resultaram em um avanco fronto-orbitario de 10mm.Os bons resultados pos-operatorios sao enfatizados

"Impressao basilar associada a malformacao de Arnold-Chiari e luxacao congenita da apofise odontoide. Relato de um caso. / Basilar impression associated with Arnold-Chiari malformation and congenital dislocation of the odontoid. A case report

E descrito o caso de um paciente com impressao basilar associada a malformacao de Arnold-Chiari e luxacao posterior da apofise odontoide com sintomatologia iniciada aos 12 anos. O quadro clinico-radiologico e analisado bem como as alternativas terapeuticas, que devido a certas peculiaridades do caso sofreram algumas modificacoes de ordem tecnica

Hematoma extradural (consideracoes sobre 66 casos). / Epidural hematoma (considerations on 66 cases)

Durante o periodo de 1972 a 1977 foram diagnosticados 66 casos de hematoma extradural (HED) entre 2930 pacientes com traumatismo craniencefalico (2,5%). Considerou-se que 21% dos casos seguiram o curso clinico classico dos HED e que apenas 41% dos pacientes eram portadores de hematoma extradural sem lesao intradural associada.Verificou-se mortalidade de 45% em relacao ao total de HED e de 34% quando consideramos apenas pacientes sem lesao intradural associada. Concluimos que esses indices elevados se devem principalmente a 2 fatores: existencia de lesoes intradurais associadas e atraso no atendimento dos pacientes

Fisiopatologia e tratamento das fraturas toraco-lombares. / Physiopathology and treatment of thoracic and lumbar spinal injuries

O autor tece consideracoes sobre alguns aspectos historicos dessa patologia e apos abordar alguns topicos no que concerne a fisiopatologia externa sua visao no que tange alternativas terapeuticas

Neuralgia do ganglio geniculado.Estudo de um caso. / Neuralgia of the geniculate ganglion. Study of a case

Sao relatados os aspectos clinicos e o tratamento cirurgico, de um caso de neuralgia do ganglio geniculado. E feita uma revisao de alguns casos descritos na literatura

Hematoma extradural cronico sem sinais de fraturas cranianas. Registro de um caso. / Chronic extradural hematoma without signs of cranial fractures. Report of a case

E descrito um caso de hematoma extradural cronico em um paciente de 17 anos, decorrente de contusao craniana sem sinais de fraturas cranianas. O diagnostico foi baseado na evolucao clinica, exames radiologicos e na cirurgia

Intracranial compliance during the post-operative period after surgery for intracranial aneurysms.

Generalised post-operative cerebral vasospasm is a major factor in delineating poor operative results following direct ruptured intracranial aneurysms. Continuous monitoring of intracranial pressure seems to be particularly helpful on such occasions, and intracranial compliance determination as well. High intracranial compliance values suggest that even small intracranial volume increases may induce rapid intracranial pressure and situations likely to produce neurological deterioration.

Some observations on the microneurosurgical treatment of intracranial aneurysms.

This paper reports a retrospective study of the microneurosurgical management of intracranial aneurysm in 133 patients. Good or fair results were obtained in 76%, 12% of patients had a poor result and the mortality was 12%. Major factors which were found to influence the outcome of surgery were: pre-operatively, the Botterell grade of the patient, pre-existing systemic hypertension and the time interval between the last subarachnoid haemorrhage and surgery. Post-operatively, the development of cerebral vasospasm was associated with a poor outcome from surgery. Better results might be obtained from the surgery of intracranial aneurysm by delaying operation to the second week after subarachnoid haemorrhage and by better management of hypertensive patients pre-operatively and patients who develop cerebral vasospasm post-operatively.

Disturbances of sexual potency in patients with basilar impression and Arnold-Chiari malformation.

Sexual impotence is common in patients with basilar impression and/or Arnold-Chiari malformation. There is no evidence of hypogonadism and testicular biopsy is usually normal. An autonomic disturbance is postulated.