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1.
J Clin Neurosci ; 107: 1-7, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36442337

RESUMO

PURPOSE: We aim to identify specific parameters that will allow identification of those patients at greater risk of vision loss, specifically variables such as geometry, volume and size of the pituitary tumour. METHODOLOGY: Volume measurements were made with both manual (using the formula width × height × length × 0.5) and video size, sub-voxel interpolation using Brainlab software. The shape of the tumour was divided into four categories, ovoid, dumbbell, pyramidal and other. Chiasmal compression was divided into central and lateral compression and the chiasm location was classified based on pre/post and normal fixed chiasm in relation to the tuberculum sella. We used a visual impairment score ranging from (0-100), which was then further subdivided in to four grades: Grade I - 0-25 (mild); Grade II - 26-50 (moderate); Grade III - 51-75 (severe); Grade IV - 76-100 (subtotal or complete). RESULTS: Univariate analysis of variables related to vision loss found tumour volume, suprasellar growth and lateral chiasmal compression related to pre-operative vision loss. On multivariate regression analysis tumour volume and lateral chiasmal compression remained significant (p < 0.008). In relation to post-operative vision, univariate analysis indicated that variables such as giant macroadenoma, pre-operative visual impairment score and suprasellar growth were significant. Multivariate analysis showed pre-operative visual impairment and suprasellar growth as the only statistically significant variables. CONCLUSION: Our ROC analysis suggests tumours with suprasellar extension 16 mm (sensitivity 85 %, specificity 67 %) in sagittal plane are more likely to result in moderate to severe grade vision loss (VIS grade ≥ 2).


Assuntos
Adenoma , Neoplasias Hipofisárias , Humanos , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Estudos Retrospectivos , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Visão Ocular , Transtornos da Visão/etiologia , Imageamento por Ressonância Magnética
2.
Cell Rep ; 41(3): 111500, 2022 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-36260998

RESUMO

Dendritic spikes function as cardinal components of rodent neocortical circuit computations. Recently, the biophysical properties of human pyramidal neurons (PNs) have been reported to be divergent, raising the question of whether dendritic spikes have homologous roles in the human neocortex. To directly address this, we made electrical recordings from the soma and apical dendrites of human and rat layer 2/3 PNs of the temporal cortex. In both species, dendritic excitatory input led to the initiation of sodium-channel-mediated dendritic spikes. Dendritic sodium spikes could be generated across a wide input range, exhibited a similar frequency range of activation, and forward-propagated with high-fidelity to implement stereotyped computations in human and rat PNs. However, the physical expansion and complexification of the apical dendritic trees of human PNs allowed the enriched expression of dendritic spike generation. The computational capacity of human PNs is therefore enhanced by the widespread implementation of a conserved dendritic integration mechanism.


Assuntos
Neocórtex , Humanos , Ratos , Animais , Neocórtex/fisiologia , Técnicas de Patch-Clamp , Potenciais de Ação/fisiologia , Ratos Wistar , Células Piramidais/fisiologia , Dendritos/fisiologia , Sódio
3.
World Neurosurg ; 153: 79-83, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34229102

RESUMO

The use of intraoperative ultrasound in emergency cranial neurosurgical procedures is not well described. It may improve surgical outcomes and is useful when other neuro-navigation systems are not readily available. We provide a practical guide for neurosurgical trainees to utilize ultrasound for various emergency cranial neurosurgical procedures, including lesion localization, insertion of an external ventricular drain, and shunt revision surgery. Intraoperative ultrasound is a useful modality for urgent neurosurgical procedures.


Assuntos
Neurorradiografia/métodos , Neurocirurgia/métodos , Procedimentos Neurocirúrgicos/métodos , Ultrassonografia/métodos , Humanos , Apoio ao Desenvolvimento de Recursos Humanos
4.
J Neurosurg Pediatr ; 22(5): 523-527, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30052117

RESUMO

The fossa navicularis is an anatomical variant of the skull base thought to be a rare finding. It represents a bony depression in the skull base. The authors here report the case of a fossa navicularis magna in a 9-year-old female who had been treated for recurrent episodes of meningitis.A literature review was also done to highlight the unique features and clinical importance of this distinctive radiological skull base finding. The literature search covered papers from the 19th century up to 2018. Earlier authors described "fossa navicularis" as a very rare skull base finding. So far, only three cases of fossa navicularis with associated clival or intracranial infection have been reported in the literature. This is the fourth reported case, and the defect was closed endoscopically via a transnasal route. This morphological skull base anomaly should be considered in the differential diagnoses for an unexplained skull base infective pathology.Skull base surgeons should be aware of the existence of the fossa navicularis because of its clinical importance in rendering a prompt diagnosis and appropriate treatment.


Assuntos
Meningite/diagnóstico por imagem , Base do Crânio/anormalidades , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Base do Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X
6.
Br J Neurosurg ; 30(1): 101-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26311311

RESUMO

Remote cerebellar haemorrhage (RCH) is a rare complication of neurosurgical procedures seldom requiring intervention. We report two cases of RCH. The first unilateral RCH is asymptomatic, the other is bilateral and associated with supratentorial haemorrhage and hydrocephalus requiring intervention. We propose multiple foci of haemorrhage as an adverse prognostic marker in RCH.


Assuntos
Doenças Cerebelares/cirurgia , Hemorragia Cerebral/cirurgia , Craniotomia , Hemorragias Intracranianas/cirurgia , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/cirurgia , Doenças Cerebelares/diagnóstico , Hemorragia Cerebral/diagnóstico , Craniotomia/métodos , Feminino , Humanos , Aneurisma Intracraniano/cirurgia , Hemorragias Intracranianas/diagnóstico , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico
7.
J Clin Neurosci ; 15(6): 609-12, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18395452

RESUMO

Traumatic intracranial aneurysms are uncommon and represent fewer than 1% of all cerebral aneurysms. They may develop after blunt or penetrating head injuries and can present both diagnostic challenges and surgical difficulties. Because traumatic aneurysms are fragile and prone to rupture, early diagnosis with cerebral angiography and prompt treatment are essential. We present two patients with traumatic aneurysms and discuss their aetiology, classification, clinical presentations, diagnosis, and treatment options.


Assuntos
Traumatismos Craniocerebrais/complicações , Aneurisma Intracraniano/etiologia , Adolescente , Adulto , Angiografia Cerebral/métodos , Feminino , Humanos , Aneurisma Intracraniano/patologia , Masculino , Tomografia Computadorizada por Raios X/métodos
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