Hernia de disco toracica operada por toracoscopia videoassistida / Herniated thoracic disc operated through video-assisted thoracoscopy

A detailed description of the surgical steps od the first five patients with herniated thoracic disc operated on through videoendoscopic technique at our institution are described below: This is an optimal approach to the spine through a ventral route with minimally ivasive technique. This surgical modality allows for superb illumination, visualization and magnification and permits relatively easy manipulation and dissection of delicate amatomic structures through small openings and with the use of high resolution endoscopes. Fast recovery is usual and the patients were discharged on the 3rd ou 4th postoperative day, some of them claiming of intercostal pain for more 24 to 48 hours. No cases of infection were observed.

[Auditory evoked potentials in the monitoring of 15 laser microsurgeries of the brain stem]. / Potencial evocado auditivo na monitorização de 15 microlaser cirurgias do tronco cerebral.

Based upon the results observed in 15 patients submitted to tumor resection by the CO2 microlaser technique and submitted to brain stem auditive evoked potential (BAEP) intraoperative determination, the authors emphasize the importance of the technique. BAEP during the intraoperative period and the ultrasonic control of removal of tumors proved useful in the 15 cases of brain stem tumors or tumor adherent to it. Morbidity and mortality are described, and the important changes in BAEP that precede bradycardia are detailed. The importance of advances obtained through BAEP in peroperative control in such surgeries is stressed.

CO2 laser in brain stem gliomas.

The author presents his experience with the use of carbon dioxide laser surgery on five patients with brain stem gliomas. Such problematically located tumors, when removed by this freehand, secure, and efficient technique, were completely evaporated with minimum trauma to neighboring tissue. This method represents new hope for these unfortunate patients. Additional time is needed before we can draw the conclusions regarding long-term results of the treatment described.

Epidemiologia das lesoes cirurgicas raque-medulares. I. Frequencia dos processos expansivos neoplasicos. / Epidemiology of surgical spinal-medullary injuries. I. Frequency of neoplastic expansive process

Os autores apresentam a frequencia dos processos expansivos neoplasicos raque-medulares em numero de 700 casos entre 4.090 casos de processos cirurgicos coletados ate 1980. Sao analisados apenas 579, pois 121 nao tem informacoes histologicas.O material focaliza o enorme numero dos metastaticos e mostra que sem eles a grande maioria dos processos sao benignos

Abscesso intra-raqueano epidural. Levantamento de 23 casos. / Spinal epidural abscess. Report of 23 cases

Os autores apresentam um levantamento de 23 casos de abscessos intra-raqueanos epidurais da Disciplina de Nerocirurgia da Escola Paulista de Medicina, entre 1947-1981, sendo analizados 14 casos

Pontine haematoma: successful removal of two cases with review of 22 cases previously described in accessible literature.

Two cases of operative evacuation of pontine haematomas are described in addition to 22 cases reported in the literature. Clinical and neuroradiological findings indicate a brain stem lesion sometimes considered as an inoperable brain stem glioma. Computer assisted tomography todate easily reveals such hematomas. Successful operative results are generally obtained. This diagnosis must be considered when the onset of symptoms is progressive and young people are affected. We describe two young patients with rapidly progressive symptoms. In one case (case 2) the symptoms started after a bee sting but we were unable to find any real correlation. Surgical removal of blood clot was followed by progressive improvement in the patients who were able to return to normal active life.

The use of the CO2-laser for the removal of awkwardly situated meningiomas.

The surgical CO2-laser knife is now a safe and well-proven instrument, which is being used more and more in neurosurgical practice. The particular advantages are its accuracy and the fact that much less handling of the tissue is necessary (4, 5, 6, 7, 9, 11). We are reporting its use in eight cases of supratentorial meningiomas, six of which were in situations not easily accessible. The operations would have been very risky using normal technique because the tumours were very large and were also extremely vascular. The technical and clinical advantages of the CO2-La-ser are presented.