Mario Ferreira Coutinho

Neurocriptococose na infância: relato de três casos na primeira década de vida

The authors report three cases of central nervous system cryptococcosis in children in the first decade of life, from Rio Grande do Sul State, Brazil. Diagnosis was supported by demonstration of Cryptoccoccus neformans with India-ink preparations of the spinal fluid and Sabourauds media culture. Clinical presentation included acute, subacute and chronic forms. Increased intracranial pressure and hydrocephalus were the complications during the course of the disease, and a ventriculoperitoneal shunt was used in one case. Undernutrition was associated with all cases and tubercle bacillus infection with one. Specific therapy was administered to the three patients. One patient was cured and the other two died.The authors report three cases of central nervous system cryptococcosis in children in the first decade of life, from Rio Grande do Sul State, Brazil. Diagnosis was supported by demonstration of Cryptococcus neoformans with India-ink preparations of the spinal fluid and Sabourauds media culture. Clinical presentation included acute, subacute and chronic forms. Increased intracranial pressure and hydrocephalus were the complications during the course of the disease, and a ventriculoperitoneal shunt was used in one case. Undernutrition was associated with all cases and tubercle bacillus infection with one. Specific therapy was administered to the three patients. One patient was cured and the other two died.

Hemorragias em metastases intracranianas de melanoma: registro de dois casos

Two cases of intra-cerebral haemorrhage secondary to malignant melanoma metastasis are reported. When dealing with subarachoid haemorrhages, one should think of brain secondaries and a biopsy should always be performed whenever a spontaneous intra-cerebral hematoma is found.Sao relatados dois casos de metastases cerebrais de melanoma maligno cuja manifestacao clinica foi de hemorragia cerebro-meningea. E feita a revisao da literatura pertinente, enfatizando-se a importância da inclusao das metastases no diagnostico diferencial das hemorragias cerebrais e da realizacao de biopsia da parede de hematomas intra-cerebrais espontâneos.

Displasia fibrosa do crânio: manifestações neurológicas

Foram estudados, retrospectivamente, oito pacientes com displasia fibrosa de ossos do crânio, analisando-se suas manifestacoes neurologicas. Na presente serie, o osso frontal estava comprometido em 75% dos pacientes, o esfenoide ou o temporal em 37,5% e o parietal em 25%. Observou-se que, alem das deformidades osseas (presentes em todos os casos com excecao de um), 87,5% dos pacientes queixavam-se de cefaleia, 50% apresentavam diminuicao da acuidade visual, 25% tinham proptose e em 12,5% predominavam sintomas auditivos. Dos seis pacientes submetidos a tratamento neurocirurgico, quatro apresentavam alteracoes oftalmologicas progressivas, havendo melhora acentuada pos-operatoria em tres deles. Todos os casos foram seguidos ambulatorialmente, sem que em qualquer deles fosse observada a recidiva ou piora dos sintomas, confirmando a natureza benigna da displasia fibrosa.

Síndrome de Dandy-walker

Sao relatados os casos de 4 pacientes com sindrome de Dandy-Walker diagnosticada pela pneumencefalografia fracionada e ventriculografia. O tratamento e a patogenia desta malformacao sao discutidos com base em dados embriologicos.

Melanose neurocutânea: estudo autópsico de um caso

The clinical, radiological and autopsy features of a 5-month-old child with neurocutaneous melanosis are described. The patient had multiple disseminated benign cutaneous nevi. The pneumoencephalogram showed non-obstructive hydrocephalus. The patient died at the third day of hospitalization and autopsy was performed. A mild hydrocephalus and melanic specks in cerebellum and in the brainstem were disclosed.

Paralisia periodica tireotoxica: registro de um caso

A case of thyrotoxic periodic paralysis based on clinical grounds, laboratory data and therapeutic response as well is reported. The authors comment on the differential diagnosis with the most frequent types of periodic paralysis. The importance of a correct diagnosis and treatment as early as possible is stressed as to prevent further development of permanent paralysis due to irreversible degenerative myofibril changes as stated in literature.

Neurocitoma no sistema nervoso central

E relatado o caso de uma paciente com 6 anos de idade, hospitalizada com sindrome de hipertensao intracraniana. Apos o exame neuro-radiologico que evidenciou processo expansivo frontal direito, a paciente foi submetida a cirurgia, durante a qual ocorreu o obito. O exame histo-patologico do material retirado durante o ato operatorio, permitiu o diagnostico de neurocitoma, tumor raro no sistema nervoso central.

Hidroma subdural na fossa posterior

Os autores relatam um caso de hidroma subdural na fossa craniana posterior consequente a traumatismo na regiao occipital. O paciente foi operado com pleno sucesso. A raridade da localizacao de hidroma na fossa posterior e salientada, sendo discutidos os possiveis mecanismos etio-patogenicos.

Tumores intracranianos na infância: estudo de 106 casos

The authors analyze 106 intracranial tumors occurring in patients from 0 to 15 years of age. This study was carried on during the period from 1962 up to 1977. In 85 cases the diagnostic work up was made on clinical, radiological, and histological grounds; the remaining 21 cases had their diagnosis based solely on clinical and radiological evidence. Observations involving incidence according to age, sex, localization and histological types are made. The signs and symptoms and supplementary examination are discussed. The frequency of primary intracranial tumors in children under 1 Year of age is stressed.The authors analyze 106 intracranial tumors occurring in patients from 0 to 15 years of age. This study was carried on during the period from 1962 up to 1977. In 85 cases the diagnostic work up was made on clinical, radiological, and histological grounds; the remaining 21 cases had their diagnosis based solely on clinical and radiological evidence. Observations involving incidence according to age, sex, localization and histological types are made. The signs and symptoms and supplementary examination are discussed. The frequency of primary intracranial tumors in children under 1 year of age is stressed.

Meningeoma e glioblastoma concomitantes: registro de um caso

A case of coincidental glioblastoma and meningioma in which the first manifestation were focal convulsive fits is reported. As the association of intracranial tumors is infrenquent, their clinical ways of presentation and the theories on their origin are discussed, as well as the importance of the preoperative diagnosis for the surgical planning and prognosis.