RESUMO
A retro- and prospective study was carried out in 150 patients who underwent surgery for benign (grade I) intracranial meningiomas (ICM). The mean duration of the follow-up was of 4 years. The subjects were divided into 4 groups according to the intervals of follow-up examination. The following variables were analysed: preoperative (clinical and paraclinical diagnosis), operative (macroscopic investigation) and postoperative (complications, sequelae, recurrences). The data were statistically processed. Conclusions are drawn concerning early results as well as predictors of long-term prognosis. Immediate improvement of the neurological and mental status was noted in 51% of patients. Late favourable outcome was found in only 35% of patients, demonstrating a tendency of late worsening. Postoperative morbidity includes complications (21%), sequelae (32%) and recurrence (22%). Predictor criteria in operated ICM patients are: onset type of illness, preoperative score, tumor location, edema and excessive vascularization of the brain as inspected at operation, early and late sequelae. Histological predictors for recurrence are: nuclear pleiomorphism, cellular mitoses, cell agglomerations. The frequency of recurrence, regardless of the operative technique, demonstrates the tendency toward malignancy of many of these tumors.
Assuntos
Neoplasias Meníngeas/patologia , Meningioma/patologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Incidência , Avaliação de Estado de Karnofsky , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Revascularização Cerebral , Transtornos Cerebrovasculares/cirurgia , Adolescente , Adulto , Idoso , Angiografia Cerebral , Artérias Cerebrais/cirurgia , Transtornos Cerebrovasculares/complicações , Criança , Hemiplegia/etiologia , Humanos , Pessoa de Meia-Idade , Artérias Temporais/cirurgiaRESUMO
The colo-vesical fistula, most frequently of diverticular origin, usually occurs at a later age, when the diverticular disease is complicated by local and peri-sigmoidal processes. A characteristic of this disturbance is the fact that, although the causal affection is colical, the manifestation, at least initially, is mostly at the level of the urinary bladder, under the form of repeated bouts of cystitis of an apparently undetermined origin. Such manifestations should prompt, besides exploration of the urinary apparatus, also an exploration of the colon. The exclusively surgical treatment should be applied as early as possible after the identification of the fistular lesion, in view of preventing more severe local complications and ascendent urinary infections.
