Ricardo Andrade

Hemorragia intracraniana na gravidez e puerpério: experiência com quinze casos

A hemorragia intracraniana que acontece na gravidez e um fenomeno raro, porem, apresenta mortalidade e morbidades elevadas. Analisamos 15 pacientes com hemorragia intracraniana que ocorreu durante a gravidez ou puerperio. Em cinco casos a hemorragia decorria da ruptura de aneurisma, em 6, de malformacao. A mortalidade materna foi 20%, e a fetal 33%. Quando a causa do sangramento e proveniente de ruptura de um aneurisma, deve-se realizar a oclusao cirurgica do aneurisma durante a gravidez o que aconteceu em 4 pacientes desta serie. Entretanto, se a hemorragia decorre de uma malformacao arteriovenosa, o melhor tratamento ainda nao esta estabelecido.

Familial cerebral cavernous malformations: Rio de Janeiro study and review of the recommendations for management

OBJECTIVE Multiple cerebral cavernous malformation (CCM) is the hallmark of familial presentation of cavernous malformation in the brain. We describe an ongoing Familial Cerebral Cavernous Malformation Project in the Rio de Janeiro state showing genetic profile and the pattern of emergent neuroimaging findings of this particular population besides a review of the updated recommendations for management of familial CCM versus patients harboring sporadic lesions. METHOD Four families of our cohort of 9 families were genetically mapped showing mutational profile linked to CCM1. The neuroimaging paradigm was shifted from T2*gradient-echo (GRE) sequence to susceptibility weighting MR phase imaging (SWI). RESULTS Only two index cases were subjected to surgery. There was no surgical intervention in any of the kindreds of our entire cohort of 9 families of our Neurovascular Program within seven years of follow-up. The genetic sequencing for mutational profile in four of these families has demonstrated only CCM1 gene affected. Our management of the familial CCM is according to the review of the literature recommendations. CONCLUSIONS The Project of Familial Cerebral Cavernous Malformations of Rio de Janeiro detected mutations of the gene CCM1 in the first four families studied. Familial cavernous malformation are to be settled apart from the more common sporadic lesion. A set of recommendations was searched for in the literature in order to deal with these specific patients and kindreds.

Angioma cavernoso intracraniano

Clinical, radiological and histopathological features of eight cases of symptomatic cavernous angioma are presented. Five patients were being evaluated for seizure, two for mass lesions and one for intracranial hemorrhage. CT and/or MRI detected the lesion in all cases, but there is not a characteristic image for cavernous angioma. Good results were obtained by microsurgical approach to these malformations in seven patients with only one patient suffering a worsening of neurological status after surgery.

Socioeconomic and educational factors interference in the prognosis for glioblastoma multiform

Abstract Background. To compare the survival of glioblastoma multiforme (GBM) patients operated on at public hospital with that of patients operated on at the private hospitals. Method. We carried out a retrospective analysis of the patients’ medical records, the surgical reports and the pre- and post-operative images of patients with a histopathological confirmed adult supratentorial GBM. Sixty-three patients were treated at public hospital and twenty-one at private hospitals. Results. The present study revealed that the survival of patients treated in private hospitals was statistically superior to that of patients treated in public hospitals (11.9 vs. 7.7). Conclusions. Our study advances towards the confirmation of the hypothesis that socioeconomic and educational factors influence the Karnofsky Performance Score (KPS) and the performance of radiotherapy treatment, with negative effects over the GBM patients’ survival.

DYNAMIC RESPONSE ANALYSIS OF A SMALL-SCALE MODEL TENSION LEG PLATFORM

Experimental tests performed on a hydroelastic small-scale model of a tension leg platform for deep water are reported. Comparison between the processed experimental dynamic signals and theoretical responses obtained with a simplified six degrees of freedom model are made. Moreover, some effects of fluid-structure interaction are briefly discussed in the light of results from both impact and wave loading tests.

Outcome of 337 intracranial aneurysms patients operated in a public hospital.

Many recent series of surgery for intracranial aneurysms have been based on experience of developed countries with great resources and a state of art health care. The purpose of the current study is to correlate the outcome of patients operated for intracranial aneurysms, reported from intensive high technology neurosurgical centers with the results of low technology, environment, where we practice. Between January 1986 and December 1996, 337 patients with intracranial aneurysms were operated on at the Servidores do Estado Hospital. We retrospectively reviewed the medical and radiologic records and compared the outcome of this group with other series derived from developed countries. The overall mortality of this series was 6.9%. Of the 313 good grades surgical patients, the mortality was 4.7% and the successful results were obtained in 88.8% individuals. We conclude that patients harboring intracranial aneurysms can be satisfactory handled in less developed nations, if a meticulous intraoperative technique is employed, even though sophisticated technology and equipment are not available.

DEVELOPMENT OF A SYSTEM FOR THE ESTIMATIONOF FRFs USING MIMO TECHNIQUE

The present paper treats with the development of a system for estimating the Frequency Response Functions (FRFs) using Multiple Input Multiple Output (MIMO) Technique. The system was developed using Lab VIEW software (Laboratory Virtual Instrument Engineering Workbench), which uses a graphical programming language, and includes libraries for data acquisition, instrument control, data analysis and data presentation. Results of experimental tests carried on a prototype of a simply supported beam were used to test the developed system. Experimental tests were also carried on a small scale model of an offshore platform using two orthogonal simultaneous random excitations. The response of 32 accelerometers were measured, and the obtained FRFs between all acceleration responses and excitation forces were calculated. The obtained FRFs were then used to estimate the modal parameters. According to the tests, the developed system could be used for experimental tests of small scale models and offshore structures prototypes.