João Flávio Mattos Araújo

Cisticercose espinhal leptomeníngea pura

An adult female patient presented with an exclusively spinal leptomeningeal infestation by cysticercosis (restricted to the cauda equina), verified in surgery. The role of the vertebral vein system in the spread of cysticercotic larvae is discussed. A commentary on the possibility that cysticercosis of the batal cisterns may be due to ascending migration of primarily spinal cysticerci, as originally proposed by Isamat de la Riva, is stated.An adult female patient presented with an exclusively spinal leptomeningeal infestation by cysticercosis (restricted to the cauda equina), verified in surgery. The rôle of the vertebral vein system in the spread of cysticercosis larvae is discussed. A commentary on the possibility that cysticercosis of the basal cisterns may be due to ascending migration of primarily spinal cysticerel, as originally proposed by Isamat de la Riva, is stated.

Angiolipoma epidural torácico: relato de caso

Angiolipomas of the spine are rare (40 cases in the literature). When they are intraspinal, these masses are epidural in more than 90% of the cases. Angiolipomas are benign tumors containing vascular and mature adipose elements. The clinical symptomatology is non specific, but computed tomography and mostly MRI provide a precise diagnosis. With one additional case and a review of the literature, we define the main characteristics of these tumors.

Evoluçäo maligna de um ganglioglioma: relato de caso

We present the case of a 8-years-old boy, admitted with a history of headache, nausea and vomiting. Cerebral angiography showed a non-vascular mass on frontal lobe. The patient underwent craniotomy and the lesion was removed. Neuropathological study revealed that the tumor was a ganglioglioma. The patient received pos-operative radiotherapy. On follow-up, 16 years after, a computed tomographic scan showed a recurrence of the tumor, and a second surgery revealed a glioblastoma multiform. Gangliogliomas are rare tumors of the central nervous system containg neoplastic ganglion cells and low grade neoplastic glial cells. The malignant degeneration occurs only in the glial component, so the prognosis of these tumors is related to the grade of that component.We present the case of a 8-years-old boy, admitted with a history of headache, nausea and vomiting. Cerebral angiography showed a non-vascular mass on frontal lobe. The patient underwent craniotomy and the lesion was removed. Neuropathological study revealed that the tumor was a ganglioglioma. The patient received pos-operative radiotherapy. On follow-up, 16 years after, a computed tomographic scan showed a recurrence of the tumor, and a second surgery revealed a glioblastoma multiform. Gangliogliomas are rare tumors of the central nervous system containg neoplastic ganglion cells and low grade neoplastic glial cells. The malignant degeneration occurs only in the glial component, so the prognosis of these tumors is related to the grade of that component.

Observações sobre o deslocamento da dura-máter nas punções cisternais laterais

Report of an anatomic study of the lateral cisternal punctures (at the atlanto-occipital and C1-2 interspaces), carried out on fresh cadavers. Direct visualization of the internal surface of the dura mater (DM) at the cranio-cervical junctions was possible by removing the calvarium and brain (sectioned at the upper cervical spinal cord). Dislocation («tenting») of the DM over the needle was observed in all occasions (n = 42), measuring 3.46 mm (2-6 mm).

Melanomas metastáticos intracranianos: análise de 13 casos

The authors present a retrospective review of 13 patients with the diagnostic of intracranial metastatic malignant melanoma. Their ages ranged from 28 to 84 years. The time interval from diagnosis of primary tumor to development of cerebral metastases ranged from 6 to 60 months. There was preoperative evidence of extracranial disease in 9 patients. All patients underwent craniotomy, and the 30-day mortality was zero. The patients survived 2 to 55 months after surgery. Medium survival time for all patients was 14 months. The excision of metastatic melanoma from the brain, although not curative, may increase survival in patients with this metastatic cancer. The criteria for consideration of surgery, radiotherapy and chemotherapy are discussed.The authors present a retrospective review of 13 patients with the diagnostic of intracranial metastatic malignant melanoma. Their ages ranged from 28 to 84 years. The time interval from diagnosis of primary tumor to development of cerebral metastases ranged from 6 to 60 months. There was preoperative evidence of extracranial disease in 9 patients. All patients underwent craniotomy, and the 30-day mortality was zero. The patients survived 2 to 55 months after surgery. Medium survival time for all patients was 14 months. The excision of metastatic melanoma from the brain, although not curative, may increase survival in patients with this metastatic cancer. The criteria for consideration of surgery, radiotherapy and chemotherapy are discussed.

Hematoma subdural crônico: análise de 35 casos

Thirty five patients with chronic subdural hematoma were treated surgically between 1988 and 1995. The patients, aged 19 to 80 years, were graded retrospectively according to the Bender scale. The clots were removed via burr-holes with irrigation of the subdural space to ensure as complete an evacuation of subdural colletion, and craniotomy with membranectomy. The mortality rate was 16.6% with craniotomy and 0% with burr-hole. The patients who died, 80% were in grade III or IV. The pathogenesis and surgical treatment of chronic subdural hematoma has been controversial, and still remains obscure.

Mestástase cerebral de carcinoma prostático simulando meningioma: relato de caso

The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.

Aneurisma intracraniano gigante em criança de nove anos: relato de caso

E relatado o caso de menina de 9 anos de idade com quadro de hemorragia intracraniana devido a aneurisma gigante da porcao distai da arteria cerebral media. Aneurismas cerebrais sao considerados raros em criancas, principalmente na primeira decada de vida. Em criancas, eles tendem a ocorrer principalmente em ramos arteriais perifericos e sao frequentemente gigantes. Sao discutidos os achados clinicos e a patogenese dessa lesao.

Diabetes insipidus traumático: relato de caso

This case report refers to a thirty-nine years old female patient with severe head injury and other body injuries who developed symptoms of diabetes insipidus. The patient died eleven days after hospital admission during which magnetic resonance imaging and computerized tomography were done, showing characteristic hypothalamic lesions. This stimulated the authors to review the literature and call attention to the prevention and prognosis of endocrine syndromes which may appear in patients secondarily and late, and whose morbidity may be decreased with early diagnosis and treatment.This case report refers to a thirty-nine years old female patient with severe head injury and other body injuries who developed symptoms of diabetes insipidus. The patient died eleven days after hospital admission during which magnetic resonance imaging and computerized tomography were done, showing characteristic hypothalamic lesions. This stimulated the authors to review the literature and call attention to the prevention and prognosis of endocrine syndromes which may appear in patients secondarily and late, and whose morbidity may be decreased with early diagnosis and treatment.This case report refers to a thirty-nine years old female patient with severe head injury and other body injuries who developed symptoms of diabetes insipidus. The patient died eleven days after hospital admission during which magnetic resonance imaging and computerized tomography were done, showing characteristic hypothalamic lesions. This stimulated the authors to review the literature and call attention to the prevention and prognosis of endocrine syndromes which may appear in patients secondarily and late, and whose morbidity may be decreased with early diagnosis and treatment.

Síndrome do túnel do carpo: estudo retrospectivo de 106 casos e complicações

The authors present a short review of anatomic and pathophysiological bases of the carpal tunnel syndrome, and its surgical treatment and complications. They report the cases of two patients who developed sympathetic alterations with hand edema and vascular changes (Raynaud phenomenon), and propose an explanation which they name «sympathetic denervation». This is the only complication of their series and it occurred during the immediate post-operative period, coinciding with removal of immobilization of the wrist on the 22nd post-operative day.