José Correia de Farias Brito

Neuroesquistossomose medular avaliação clínico-laboratorial de 5 anos

A incidencia da esquistossomose no Brasil continua alta, atingindo cerca de 10% da populacao. Desde o primeiro relato da neuroesquistossomose (NE) em nosso pais, ha mais de 4 decadas, seu comparecimento na literatura nacional tem mostrado acrescimo significativo. O presente trabalho tem como substrato o estudo de 5 casos de NE medular. Estes casos foram avaliados sob o ponto de vista clinico-laboratorial e submetidos a tratamento medicamentoso. Alem disso, e nosso proposito incentivar a pesquisa de novos casos, em portadores de quadros sugestivos desta patologia, sobretudo pelos resultados obtidos neste estudo.Schistosomiasis mansoni is an endemic disease in Brazil. Cases of nervous system schistosomiasis have been referred in our medical literature for the past forty years. In this report five cases of schistosomiasis of the spinal cord are studied. A review of the literature has been made and some clinical, laboratory and therapeutical aspects are discussed.

Hemiatrofia facial progressiva (doença de Parry-Romberg): relato de dois casos associados a trigeminalgia e câimbras

The authors report two cases of progressive facial hemiatrophy (PFH) associated with cranial nerves hyperexcitability. One of them (Case 1), a 41-year-old-woman noticed a slight atrophy on the left side of her face at age of ten. For the last three months, she has been suffering from fits of neuralgic pains on the left side of her face which have not ceased by drug treatment In view of this, a surgery procedure was planned for the patient. The other patient (Case 2), a 33-year-old-woman has a 8 year history which started with cutaneous abnormalities (white and dark spots). Two years later she observed that her right cheek and right thigh had got a mild atrophy. Frequently, she has been complaining of cramps in the mandibular region which are precipitated, sometimes, by opening the mouth. A probable relation between neural excitability and PHF is discussed.

Mielopatias: consideraçöes clínicas e aspectos etiológicos

We studied 97 inpatients with myelopathy at the University Hospital Lauro Wanderley from 1985 to 2002. Ages ranged from 10 to 78 years and average age was 39.8 years. All patients were examined by neurologist. Cerebrospinal fluid (CSF) was analysed in 44 (45.3%) cases and immunofluorescence reactions and/or ELISA in CSF were made in 32 (32.9%) cases. Radiologic investigation of the vertebral spine and spinal cord of the 32 (32.9%) cases consisted of 8 radiographies, 10 computed tomography and 14 magnetic resonance image. In 41 (42.2%) cases the lesions were situated in the lower dorsal and lumbar level and complete transverse lesion were registred in 61 (62.8%) cases. There was predominance of transverse myelitis (43.2%) and spinal cord compression (15.46%). Spinal cord schistosomiasis was the form more often of the transverse myelitis (13.4%).

Edema pulmonar agudo neurogênico: relato de caso

The autors report a case of acute neurogenic pulmonary edema in a 28-year-old woman who presented rupture of an internal carotid artery aneurysm and subarachnoid hemorrhage. The respiratory disorders started at the same time the patients symptomatology aggravated. Some etiological and pathophysiological aspects on neurogenic pulmonary edema are revised.

Aracnoidite constritiva causada por pantopaque resultando em siringomielia e paraparesia: relato de caso

We present an unusual case of thoracic constrictive arachnoiditis after pantopaque myelography, used 10 years before in the diagnosis of intradural arachnoid cyst.

Mielopatia transversa em adulto portador de leucemia aguda linfoblástica: relato de caso

We report a case of transverse myelopathy in a 31 year old white man with acute lymphoblastic leukemia, subtype L3 (ALL-L3). This is a severe form of leukemia that affects children more often than adults. Less than 1% of leukemic patients develop neurologic complication in the spinal cord. The symptomatology in the present case started with back pain, flaccid paraplegia, and loss of sensibility and vegetative functions below the lesion. The etiologic diagnostic was obtained through peripheral blood study, bone marrow cytology, cerebrospinal fluid analysis and magnetic resonance image of the dorsal cord. The antileukemic treatment with specific drugs had no influence on the fatal outcome of the disease.

Hemorragia intracerebral espontânea: estudo retrospectivo de 72 casos operados

We analysed 72 cases of primary intracranial hemorrhage surgically treated from 1970 to 1999. The hemorrhages were diagnosed by computerized axial tomography in 52 patients. Most hematomas were situated in the cerebral hemispheres (30 percent in thalamus-basal ganglia region and 50 percent in the subcortical matter). There were 10 patients with cerebellar hemorrhage. Hypertension (based in blood pressure recordings in the hospital and history) was found in 24 patients (33 percent). The most frequent findings were coma, intracranial hypertension and hemimotor deficit. The death rate registered was 27.7 percent; however, it was found a significant difference in the mortality index when considering the 70-79 decade (62.7 percent) and the 90-99 decade (20.7 percent). A critical analysis was made about depth hematomas, consciousness state and intracranial hypertension with herniation related to surgical procedure.

Cisto aracnoideo intracraniano. Relato de nove casos operados

Analysis of nine patients with intracranial arachnoid cysts surgically treated from 1974 to 1995. The treatment consisted of cystoperitoneal shunt in seven patients and craniotomy with excision of cyst membrane in the other two cases. After surgery, bacterial meningitis and failure shunt device were observed in three cases. Both the infectious process and the shunt device were respectively treated and corrected at once. It has been observed total clinical improvement in all nine cases. A review of the literature has been made and some pathophysiological, diagnostic and therapeutic aspects are discussed.Analysis of nine patients with intracranial arachnoid cysts surgically treated from 1974 to 1995. The treatment consisted of cystoperitoneal shunt in seven patients and craniotomy with excision of cyst membrane in the other two cases. After surgery, bacterial meningitis and failure shunt device were observed in three cases. Both the infectious process and the shunt device were respectively treated and corrected at once. It has been observed total clinical improvement in all nine cases. A review of the literature has been made and some pathophysiological, diagnostic and therapeutic aspects are discussed.

Impressão basilar e malformação de Arnold-Chiari: considerações técnico-cirúrgicas a propósito de 13 casos

The surgical technic for decompression of the posterior fossa in cases of basilar impression and malformation of Arnold-Chiari mainly based in (1) endotracheal intubation without any flexion of the head, (2) position of the head without anterior flexion during the surgery, (3) plastic of the posterior fossa with dura-mater of cadaver conserved in glicerina, was emploied in 13 patients. The plastic was made to create space at the craniocervical joint in order to avoid cerebrospinal fluid fistula and to restore the integrity of the dura. Infection was not observed.

Achados cirúrgicos em 260 casos de impressão basilar e/ou malformação de Arnold-Chiari

A impressao basilar e malformacao frequentemente observada no Nordeste do Brasil. No periodo de 1971 a 1992 foram operados, em nosso Servico, 260 pacientes com malformacoes occipitocervicais, sendo 29 (11,1%) casos de impressao basilar pura, 18 (6,9%) com malformacao de Arnold-Chiari e 213 (81,9%) com impressao basilar associada a malformacao de Arnold-Chiari. Sao relatados os achados cirurgicos do plano osseo, da dura-mater, do tecido nervoso e dos vasos da fossa posterior.: The surgical findings observed in a series of 260 patients with craniovertebral anomaly are presented. There were 29 (11.1%) patients only with basilar impression, 18 (6.9%) cases of pure Arnold-Chiari malformation and 213 (81.9%) cases of basilar impression associated with Chiari malformation. The surgical findings on bone, dura-mater, nervous tissue and blood vessels of this region are reported.