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1.
J Neurol Surg Rep ; 83(2): e39-e43, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35837503

RESUMO

Craniopharyngioma is a rare embryonic malformation, usually benign, of the sellar or parasellar regions. In this study, an uncommon case of third ventricle craniopharyngioma and a succinct review of its prevalence are presented. Even with low mortality rates, these injuries involve a high degree of endocrinological, visual, and neuropsychological morbidities, which have a huge impact on the patient's quality of life. Thus, surgical resection is the preferred therapy for tumors that compromise the flow of cerebrospinal fluid. However, due to the location of the craniopharyngioma, surgical management is accompanied by the risk of injury to important adjacent areas with postoperative repercussions. Therefore, the neurosurgeon's experience and the choice of the best surgical approach, are crucial for increasing prognosis.

2.
World Neurosurg ; 161: e580-e586, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35202880

RESUMO

BACKGROUND: Malignant ischemic stroke (MIS) occurs in a subgroup of patients with cerebrovascular accident who sustain massive or significant cerebral infarction. It is characterized by neurological deterioration owing to progressive edema, raised intracranial pressure, and cerebral herniation. Decompressive craniectomy (DC) is a surgical technique that can be used to treat select cases of this condition in the presence of medically refractory intracranial hypertension. This study aimed to identify prognostic factors associated with clinical outcome, including timing of the procedure, and postoperative mortality. METHODS: We analyzed surgical characteristics associated with prognosis in 145 patients who underwent DC secondary to MIS between 2013 and 2018, assessing clinical outcome at discharge and 6 and 12 months after discharge. Our inclusion criteria were DC secondary to MIS in adult patients with raised intracranial pressure signs. RESULTS: Our analysis showed that although patients from cities >100 km from the neurosurgical center had a worse prognosis, only the surgical head side (left vs. right, P = 0.001), hospitalization length (P < 0.001), and earlier timing of procedure (P < 0.001) were statistically relevant in having worse outcomes. CONCLUSIONS: Patients in whom more time passed from presentation to the neurosurgical procedure, owing to living in a distant city or taking more time to be seen by a specialist, tended to have a worse prognosis. The timing of procedure, surgical side, and hospitalization length were independent predictors in determining the prognosis of patients who underwent DC after an MIS.


Assuntos
Craniectomia Descompressiva , Hipertensão Intracraniana , AVC Isquêmico , Acidente Vascular Cerebral , Adulto , Brasil/epidemiologia , Hospitais , Humanos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/cirurgia , Acidente Vascular Cerebral/cirurgia
3.
Interdiscip Neurosurg ; 28: 101485, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35018284

RESUMO

Background and purpose: The novel coronavirus, SARS-CoV-2, which was identified after the outbreak in Wuhan, China, in December 2019, has kept the whole world in tenterhooks due to its severe life-threatening nature of the infection. The World Health Organization (WHO) declared coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 a pandemic in 2020, an unprecedented challenge, having a high contagious life-threatening condition with unprecedented impacts for worldwide societies and health care systems. Neurologic symptoms related to SARS-CoV-2 have been described recently in the literature, and acute cerebrovascular disease is one of the most serious complications. The occurrence of large-vessel occlusion in young patients with COVID-19 infection has been exceedingly rare. In this article, we describe the profile of patients undergoing decompressive craniectomy for the treatment of intracranial hypertension by stroke associated with COVID-19 published so far. A narrative review of the central issue in focus was designed: decompressive craniectomy in a pandemic time.

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