Alexandre Bruno Raul Freitas

Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases

Guyons canal syndrome, an ulnar nerve entrapment at the wrist, is a well-recognized entity. The most common causes that involve the ulnar nerve at the wrist are compression from a ganglion, occupational traumatic neuritis, a musculotendinous arch and disease of the ulnar artery. We describe two cases of Guyons canal syndrome and discuss the anatomy, aetiology, clinical features, anatomical classification, diagnostic criteria and treatment. It is emphasized that the knowledge of both the surgical technique and anatomy is very important for a satisfactory surgical result.

Causes and treatment of intracranial haemorrhage complicating shunting for paediatric hydrocephalus

Abstract Intracranial haematomas are a well-known complication of shunting procedures for hydrocephalic patients. Most are subdural haematomas, and epidural haematomas are much less common in this setting. Their aetiology is thought to be due to an overdrainage of cerebrospinal fluid and a rapid lowering of intracranial pressure, leading to the development of these haematomas. Since the advent of modern neuroimaging techniques, prompt diagnosis of postshunting intracranial haematoma has been possible even in asymptomatic patients. The choice between surgical and nonsurgical management of postshunting intracranial haematoma is a difficult and controversial issue, especially in asymptomatic patients. Several therapeutic options have been proposed for the treatment of postshunting intracranial haematoma. Evacuation of the haematoma by conventional neurosurgical methods with the implantation of a higher pressure valve system is the most common option adopted. Intraventricular haemorrhage is occasionally reported, chiefly in children with hydrocephalus associated with vein of Galen malformation.

Meduloblastoma em adultos: análise de uma casuística e resultados cirúrgicos

We report on 15 cases of medulloblastoma of adult onset (8 male and 7 female) operated upon posterior fossa approach from February 1988 to October 1995. Tumors were localized in cerebellar hemisphere in 7 cases (one with extension to supratentorial notch and another case reaching the cerebello-pontine angle cistern), in vermis and hemisphere in four, only in vermis in another four. Resection was total in seven patients, subtotal in other seven, and partial in one.There was no operative mortality. Aspects regarding biological behavior, diagnosis, pathological findings, surgery and survival are discussed as well as prognostic factors.