AbsTRACT study design: Two case reports of a choroidal fissure cyst in the temporal horn associated with complex partial seizure. Objectives: To describe the clinical course, image findings and literature review of choroidal fissure... more
AbsTRACT study design: Two case reports of a choroidal fissure cyst in the temporal horn associated with complex partial seizure. Objectives: To describe the clinical course, image findings and literature review of choroidal fissure cysts. summary and background data: there are few reported cases of choroidal fissure cysts. Results: We report two patients with complex partial seizures and temporal choroidal fissure cysts. The seizures were controlled in both patients. Conclusion: The choroidal fissure cyst diagnosis must highlight the importance of considering this lesion in the differential diagnosis of temporal lobe cyst and temporal lobe seizure. REsumO Cistos da fissura coroidal temporal e epilepsia do lobo temporal: dois relatos de casos Desenho do estudo: Dois relatos de caso de cisto de fissura coroidal no corno temporal associado com crise parcial complexa. Objetivos: Descrever o curso clínico, achados radiológicos e fazer uma revisão da literatura a respeito de cistos da fissura coroidal. Resumo dos dados da literatura: existem poucos casos descritos de cistos da fissura coroidal. Resultados: Nós descrevemos dois pacientes com crises parciais complexas e cistos de fissura coroidal. As crises foram controladas em ambos os pacientes. Conclusão: O diagnóstico de cisto da fissura coroidal deve ser levado em conta no diagnóstico diferencial de cistos do lobo temporal e em crises de lobo temporal.
Resumo: A técnica de dissecção de fibras é um método clássico, utilizado por renomados anatomistas do passado, para a demonstração dos tratos e fascículos integrantes da substância branca do cérebro. Esta técnica, utilizada desde o século... more
Resumo: A técnica de dissecção de fibras é um método clássico, utilizado por renomados anatomistas do passado, para a demonstração dos tratos e fascículos integrantes da substância branca do cérebro. Esta técnica, utilizada desde o século XVII, envolve a ...
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Resumo: Objetivo: Revisão crítica dos aspectos anatômicos da abordagem dos aneurismas da artéria cerebelar inferior posterior (ACIP); a abordagem extremo-lateral e os detalhes de suas variantes foram analisados. Métodos: Revisão da... more
Resumo: Objetivo: Revisão crítica dos aspectos anatômicos da abordagem dos aneurismas da artéria cerebelar inferior posterior (ACIP); a abordagem extremo-lateral e os detalhes de suas variantes foram analisados. Métodos: Revisão da literatura e análise da experiência ...
Citation: Dobrowolski S, Rassier GI, Lepski G (2011) Hyperosmolar Solution Reduces Apoptosis in the Acute Spinal Cord Injury Model in Rats. J Cytol Histol 2:124.
The posterior cerebral artery (PCA) is divided into 4 segments: precommunicating segment (P1), postcommunicating segment (P2), quadrigeminal segment (P3), and calcarine segment (P4). Small aneurysms are more prevalent than large aneurysms... more
The posterior cerebral artery (PCA) is divided into 4 segments: precommunicating segment (P1), postcommunicating segment (P2), quadrigeminal segment (P3), and calcarine segment (P4). Small aneurysms are more prevalent than large aneurysms in patients with ruptured aneurysms. P2 and P3 aneurysms are usually managed by the subtemporal approach. This is a case report of rupture saccular aneurysm of posterior cerebral artery on P2P segment. The authors show the surgical steps of these rare aneurysms with an illustrative case.
The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. To describe the hippocampal anatomy in detail and to present a technique in which... more
The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. To describe the hippocampal anatomy in detail and to present a technique in which preoperative anatomical points in MRI are identified to guide the corticotomy. Microsurgical dissections were performed in twenty brain hemispheres and eight cadaveric heads to identify temporal lobe and hippocampus structures. Thirty two patients with drug-resistant temporal lobe epilepsy underwent a selective amygdalohippocampectomy with Niemeyer's technique being measured three preoperative MRI preoperative distances to guide the corticotomy. The hippocampus was divided in head, body and tail and its microsurgical anatomy described in detail. The MRI measurements are presented and discussed. The knowledge of the complex anatomy of the hippocampus can be achieved in a three-dimensional way during microsurgical dissections. The preoperative MRI me...
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Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis. Involvement of the central nervous system (CNS) occurs in about 10% of cases. A 57-year-old white man presented with the complaint... more
Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis. Involvement of the central nervous system (CNS) occurs in about 10% of cases. A 57-year-old white man presented with the complaint of headache and an episode of focal seizure 1 month earlier. Magnetic resonance imaging (MRI) revealed a ring-enhancing lesion in the right parietal lobe with peri-lesional vasogenic edema suggestive of a primary neoplasm. The patient underwent craniotomy and the intraoperative finding was a yellowish, hard lesion with thick content and yellow inside. Anatomo-pathological findings were pathognomonic of PCM: large, thick-walled, spherical yeast cells with multiple peripheral buds. The patient tested negative for human immunodeficiency virus (HIV). Encephalitis and meningitis were ruled out by cerebrospinal fluid analysis. Culture confirmed the diagnosis of PCM and the patient was treated with amphotericin B. The patient responded well to treatment wit...
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The foramen spinosum is an easily identifiable landmark in microsurgery of the middle cranial fossa, and knowledge of the variations in its relationship to the surrounding neurovascular structures is important when operating in this area.... more
The foramen spinosum is an easily identifiable landmark in microsurgery of the middle cranial fossa, and knowledge of the variations in its relationship to the surrounding neurovascular structures is important when operating in this area. We studied the anatomical relationship of the foramen spinosum to the foramen ovale, the mandibular branch of the trigeminal nerve, the greater superficial petrosal nerve, and the petrous part of the internal carotid artery in 12 cadaver heads. We also tried to define an external landmark for early identification of the location of the foramen spinosum in ten dry skulls. We found considerable variations in the anatomy around the foramen spinosum. This knowledge may improve the identification and preservation of the neurovascular structures when using approaches to the middle cranial fossa.
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The microsurgical anatomy of the temporal lobe : its rule in epilepsy surgery. ...
Potenciais evocados motor intra-operatório no manejo dos tumores complexos do sistema nervoso central: série inicial de 10 casos e revisão da literatura. ...
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... reported a case of a pineal region heman-gioblastoma causing hydrocephalus2. ... J Neurosurg 2002;97:727. 2. Isolan GR, Krayenbühl N, Mahmoud M, Al-Mefty O. A hemangioblastoma in the pineal region: case report. Neurosurgery... more
... reported a case of a pineal region heman-gioblastoma causing hydrocephalus2. ... J Neurosurg 2002;97:727. 2. Isolan GR, Krayenbühl N, Mahmoud M, Al-Mefty O. A hemangioblastoma in the pineal region: case report. Neurosurgery 2007;61:423. 3. Melmon KL, Rosen SW. ...
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Copyright: © 2011 Bragatti JA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the... more
Copyright: © 2011 Bragatti JA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
CONTEXTO: O conhecimento das estruturas anatômicas da artéria carótida externa por meio do estudo estereoscópico pode determinar melhores resultados em microcirurgias da artéria carótida externa. OBJETIVO: Descrever as estruturas da... more
CONTEXTO: O conhecimento das estruturas anatômicas da artéria carótida externa por meio do estudo estereoscópico pode determinar melhores resultados em microcirurgias da artéria carótida externa. OBJETIVO: Descrever as estruturas da artéria carótida externa sob a visão estereoscópica, identificando seus múltiplos aspectos. MÉTODOS: Doze regiões cervicais foram dissecadas, utilizando-se microscópico cirúrgico com 3 a 40x de aumento. As dissecções anatômicas foram documentadas utilizando-se a técnica para obtenção de imagens tridimensionais (3D), objetivando a produção de impressões estereoscópicas. RESULTADOS: O uso da técnica estereoscópica possibilitou a abordagem da circulação arterial extracraniana, sendo realizados estudos cirúrgicos do tipo combinado fossa posterior e fossa infratemporal, tornando as microcirurgias e os procedimentos neurocirúrgicos vasculares mais precisos. CONCLUSÃO: O uso das imagens obtidas pela técnica estereoscópica produziu um resultado mais assertivo em...
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The infratemporal fossa (ITF) is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone that is sitting deep to the ramus of the... more
The infratemporal fossa (ITF) is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone that is sitting deep to the ramus of the mandible. The principal structure to understanding its relationships is the lateral pterygoid muscle. Other important structures are the medial pterygoid muscle, the maxillary artery, the pterygoid venous plexus, the otic ganglion, the chorda tympani nerve and the mandibular nerve. In this study, we describe the microsurgical anatomy of the ITF, as viewed by step-by-step anatomical dissection and also through the perspective of three lateral approaches and one anterior surgical approach. Eight cadaver specimens were dissected. In one side of all specimens, an anatomical dissection was done in which a wide preauricular incision from the neck on the anterior border of the sternoclidomastoid muscle at the level of the cricoid cartilage to the superior ...
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The astrocytic neoplasms respond by 60% of the central nervous system tumors, being the study of the molecular biology an important step for the understanding of the genesis and biological behavior of these diseases. The Ki-67 proteins,... more
The astrocytic neoplasms respond by 60% of the central nervous system tumors, being the study of the molecular biology an important step for the understanding of the genesis and biological behavior of these diseases. The Ki-67 proteins, which are markers of the cellular proliferation, and p53, which is the product of the tumor suppressor gene TP53, are both important tumoral markers. This study intends to identify and quantify the Ki-67 and p53 proteins in astrocytic tumors of different grades of malignancy, as well as to analyze their relations with age and gender. Ki-67 and p53 proteins in 47 patients with surgically resected astrocytic neoplasms were studied through immunohistochemistry. They have been previously classified and reviewed concerning their histological grade, as suggested by the World Health Organization. The immunomarked cellular nuclei were quantified by the program Imagelab-softium for the absolute parametric reason between the nuclei of the positive cells and th...
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... Cerebral Revascularization Part II: Techniques Niklaus Krayenbühl, MD, Miguel Abdo, MD, Gustavo Rassier Isolan, MD, and Ali F. Krisht, MD Learning ... surgery. Neurosurgery 41:1225, 1997 Isolan GR, Ribas Filho JM, Malafaia O, et al. ...
Although reported to occur throughout the central nervous system, hemangioblastomas are principally found in the cerebellum and spinal cord. Pineal region tumors comprise approximately 1% of central nervous system neoplasms. A wide... more
Although reported to occur throughout the central nervous system, hemangioblastomas are principally found in the cerebellum and spinal cord. Pineal region tumors comprise approximately 1% of central nervous system neoplasms. A wide variety of tumors can affect this region, the most common being germ cell tumors, gliomas, and pineal cell tumors. In the literature, we found only one case of hemangioblastoma in the pineal region in association with von Hippel-Lindau disease. We describe the case of a patient with a symptomatic hemangioblastoma in the pineal region with no clinical criteria for von Hippel-Lindau disease. The patient had a 1-month history of short-term memory loss, headache, difficulty concentrating and writing, disturbed balance, and loss of bladder function. At the time of physical examination, she was awake, alert, and oriented. An ophthalmoscopic examination revealed nystagmus with conjugate upward gaze and papilledema. Radiological images showed a mass in the pineal...
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Since the pioneering work of Parkinson, several studies have described the microsurgical anatomy and surgical procedures involving the cavernous sinus (CS). A proposed geometric construct has been adopted as nomenclature for the region by... more
Since the pioneering work of Parkinson, several studies have described the microsurgical anatomy and surgical procedures involving the cavernous sinus (CS). A proposed geometric construct has been adopted as nomenclature for the region by many neurosurgeons. However, authors differ in naming and describing some of these triangular spaces. The purpose of this study is to present the anatomy and measure the dimensions of the 10 triangles in and around this region. Eighteen CS of five cadaveric heads and four skull bases fixed in formalin were dissected using 3 x to 40 x magnification of the surgical microscope. The heads and skull bases were injected with colored silicone and the sides and area of the triangles were measured. Each cadaveric head was placed in a Sugita head-holder and a cranio-orbitozygomatic approach and a combined extra- and intradural approach were performed. The last step was the detachment of the brain from the skull base and measurement of the inferolateral paraclival and inferomedial paraclival triangles. The measurements of the medial border, lateral border, and base of each triangle as well as the standard deviation and area are presented. The posteromedial middle fossa triangle was the largest and the clinoidal triangle the smallest. The normal anatomy of the CS triangle and its areas are important in the approach of the CS lesions because these spaces are natural corridors through which the lesions can be reached. The same concept must be used for the triangles around this space. Whenever these geometric spaces might be distorted by pathology or surgical maneuvers, the surgeon must have precise knowledge about their normal sizes.
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The understanding of the course of the facial nerve and its relationship to the different connective tissue layers in the temporal area is paramount to preserving this nerve during surgery. But the use of different nomenclatures for... more
The understanding of the course of the facial nerve and its relationship to the different connective tissue layers in the temporal area is paramount to preserving this nerve during surgery. But the use of different nomenclatures for anatomical structures such as for the different fascial layers or fat pads in the temporal region as well as the difference in description of the course of the fronto-temporal branches of the facial nerve in relationship to the fascial layers can lead to confusion. Therefore we have reviewed the literature about this topic and tried to apply the information to practical anatomical dissection.