CT features of cellulosae and racemosus neurocysticercosis.

Of 210 cases of cerebral neurocysticercosis studied with CT since 1982, three cases proved to be due to the rare Cysticercus racemosus (surgical verification) rather than to the much more prevalent infestation by Cysticercus cellulosae. We attempted to establish CT criteria for differentiating the more severe and always fatal form of C. racemosus. The CT appearance occasionally encountered in C. racemosus resembles a "bunch of grapes"; this appears to be the only criterion of differential value.

[Infections in neurosurgery]. / Infecções em neurocirurgia.

The incidence of infection in neurological surgery is analysed by the author due to an almost epidemic occurrence of wound contamination by staphylococcus aureus in the year 1977. A brief review of the literature data is presented concerning the factors related to the patient's own immunity, the operative wound and the hospital environment, that may cause infection. Based on 733 operations done in a period of 50 months the author exposes the modifications installed for avoiding the infective sources. Antiseptic technic and surgical tactic were modified during the three steps of this study. In the first two periods, each of one lasting 17 months, the infection rates for clean surgical procedures were 10,3 and 6,7% respectively. By the last 15 months, when topical oxacyllin powder was added, the infection rate dropped to 0,6%. The general infection rates for clean, clean with implants, clean-contaminated and contaminated operations, during the three periods were 7,08, 6,8 and 3,4%. A critical review of the data concerning to systemic and topical prophylactic antibiotic therapy is followed by comments on the basis of the technical changes made in this clinical study. Shaving close to the operation, dry preparation of the scalp flap and muscle, use of only bipolar coagulation, restrict use of serum irrigation during the epidural stages of the operation an topical use of oxacillin powder before wound closure were the main technical modification introduced.

Infeccoes em neurocirurgia. / Infections in neurosurgery

Baseado em 733 cirurgias neurologicas realizadas em um periodo de 50 meses o autor expoe as providencias tomadas para conter o surto infeccioso.Alteracoes de tecnica de antissepsia e tatica cirurgica foram levadas a efeito durante os tres periodos de duracao do estudo. Nas duas primeiras etapas, de l7 meses cada uma, a incidencia de infeccao em cirurgias limpas foi de 10,3 e 6,7%. Na ultima etapa de 15 meses, quando se associou o uso de antibiotico topico (oxalina em po), este indice caiu para 0,6%.As taxas gerais de infeccao para os tres periodos, somando-se as cirurgias limpas, limpas com implantes, limpas contaminadas e contaminadas foi de 7,08%, 6,8 e 3,4%, respectivamente. Uma revisao sumaria dos dados de literatura referentes a antibioticoterapia profilatica sistemica e topica antecedem os comentarios sobre as bases da mudanca de tecnica efetuadas durante o estudo Tricotomia proxima a operacao, adocao de tecnica seca para a preparacao do retalho da pele e musculatura, uso exclusivo do coagulador bipolar, uso restrito de soro epidural, e uso de oxacilina em po antes do fechamento foram os itens principais das modificacoes realizadas