Publications by authors named "Cavalheiro S"

Objective: The authors aimed to describe a low-cost and easily reproducible alteration of the Bruner and Tulipan procedure to preserve uterine muscular fibers. They conducted a retrospective cohort study of 10 pregnant women whose fetuses developed lumbosacral myelomeningocele (MM). The MM was repaired through a fetal neurosurgical procedure using a tubular single-port endoscope-assisted technique.

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Background And Objectives: Scaphocephaly is a craniofacial deformity caused by the premature fusion of the sagittal suture, which can affect skull growth and shape. For decades, surgical treatment or craniosynostosis has involved open procedures, ranging from the removal of a single suture to complex cranial remodeling techniques with large skin incisions. Since the 1990s, endoscopic approaches have emerged as potentially less invasive options.

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Objective: To evaluate the efficacy of hemilaminectomy as an approach to intradural tumors and to assess the risk of postoperative spinal instability.

Methods: This is a retrospective cohort study of 38 patients who underwent surgical resection of intradural tumors between November 2014 and March 2019. Clinical and radiologic data were documented in medical records, from which we obtained clinical data including age, gender, tumor etiology, lesion level, type of resection, and postoperative instability during follow-up.

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  • Encephaloceles are serious birth defects involving the herniation of brain tissue through the skull, with a significant risk of developmental issues in survivors.
  • This study compared outcomes between patients who had surgery before birth (fetal group) and those who had it after (postnatal group), focusing on neuropsychomotor development and microcephaly reversal.
  • Results showed that fetal surgery led to better developmental scores and a higher chance of reversing microcephaly, indicating that early intervention may offer protective benefits for brain development.
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Objective: The aim of this study was to understand the dynamics of families with children with myelomeningocele undergoing intrauterine fetal surgery.

Methods: A retrospective cohort pilot study was carried out with 11 mothers of children who had undergone intrauterine myelomeningocele repair. Participants in this study responded to an electronic questionnaire (via Google Forms), developed by the study authors, that consisted of 22 multiple-choice questions, of which 17 were closed-ended and 5 had a standardized format.

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  • - Intraventricular hemorrhage (IVH) is a severe condition with high mortality, and recent studies suggest that neuroendoscopic treatment, specifically endoscopic brainwashing (EBW), may improve outcomes compared to traditional external ventricular drainage (EVD).
  • - A retrospective analysis of adult IVH patients showed that those receiving EBW had larger hemoventricles and more chronic conditions but exhibited lower short-term mortality and better long-term outcomes compared to EVD patients.
  • - The study concluded that EBW appears to lead to improved functional outcomes over time, with a greater percentage of patients achieving favorable results than those treated with EVD alone.
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  • * A total of 42 brainstems were analyzed, revealing a significant increase in surgical exposure from 42 mm² to 159.6 mm² after QLC resection, aiding in procedures involving the pons and cerebellum.
  • * After evaluating 59 patients who underwent this surgery, it was found that while some experienced temporary side effects like ataxia, all symptoms resolved within a year, and overall patient outcomes improved.
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Background: Non-germinomatous germ cell tumors (NGGCT) accounts for one third of intracranial GCT. While the germinoma group have an excellent overall survival, the standard of practice for children with NGGCT is still under evaluation.

Aims: Describe the results of the of the Brazilian consortium protocol.

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The ventriculoperitoneal shunt placement procedure is common throughout the world, with a prevalence of approximately 30,000 procedures per year in the United States (5). However, the rate of complications is still important and must be remembered, with a percentage of 11 to 25% after the first year of implantation. Abdominal complications are described in 5-47% of the cases (6), and the abdominal pseudocyst is one of them.

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Purpose: The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns.

Methods: Twenty-eight patients (aged 1-6 days) with simple depressed skull fractures underwent skull elevation using negative-pressure vacuum devices.

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  • The study aimed to compile and analyze published cases of intrinsic brainstem epidermoid cysts, focusing on their characteristics and treatment methods, especially in pediatric patients.
  • Researchers reviewed existing literature and presented a case of a 1.5-year-old boy who underwent successful gross total resection of a cyst discovered incidentally.
  • Results showed 21 patients (10 boys, 11 girls) with an average age of 4.85 years, experiencing symptoms like cranial nerve palsy (71.4%) and headache (52.38%), highlighting the need for careful surgical approaches to maximize lesion removal while preserving function.
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  • Fetal neurosurgery is unique in its number of cases and potential for new procedures during pregnancy, requiring specialized medical centers for effective treatment.
  • These centers need to have expert diagnosis in fetal pathologies, complex obstetrics services, and multidisciplinary support for both mothers and infants post-birth.
  • The manuscript aims to highlight the diagnostic options and treatment possibilities for various neurosurgical conditions in fetuses, including hydrocephalus, tumors, occipital encephalocele, and myelomeningocele.
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  • The study aimed to evaluate survival rates and factors influencing the clinical outcomes of patients under 18 diagnosed with posterior fossa ependymomas, focusing on aspects like tumor removal and location.
  • Researchers reviewed data from 55 relevant patients treated since 2000, finding that the average overall survival was 44 months, with survival rates significantly varying over 1, 5, and 10 years.
  • Survival analysis revealed that tumor involvement in the hindbrain affected progression-free survival, specifically indicating lower PFS in cases with more extensive tumor involvement, highlighting its prognostic significance.
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  • The study explores factors affecting prognosis in pediatric patients with different types of pineal region tumors over a 30-year period at a single institution.
  • It analyzes 151 patients and finds significant survival rate differences across tumor types, with germinoma having the best prognosis and atypical teratoid rhabdoid tumors leading to rapid mortality.
  • Key prognostic factors include gender, presence of metastasis, treatment approaches, and age, emphasizing the need for tailored, multidisciplinary treatment strategies for affected children.
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  • Brain edema significantly contributes to mortality in patients with malignant middle cerebral artery (MCA) infarction, and midline shift has been used as a measurement tool but is not highly accurate.
  • The study aimed to track the progression of brain edema using hemispheric volumetric measurements in patients who underwent decompressive craniectomy (DC).
  • Results showed that the peak of cerebral edema occurs around the 7th day (168.84 hours) post-stroke symptom onset, suggesting that future research should focus on treatments for brain edema even after undergoing DC.
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Objective: Pineal region tumors account for 2.7%-11% of all CNS tumors in children. In this series, the authors present their surgical results and long-term outcomes from a pediatric pineal region tumor cohort.

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Purpose: This prospective Brazilian single-arm trial was conducted to determine response to chemotherapy and survival after response-based radiotherapy in children with intracranial germinomas, in the setting of a multi-institutional study in a middle-income country (MIC) with significant disparity of subspecialty care.

Patients And Methods: Since 2013, 58 patients with histologic and/or serum and CSF tumor marker evaluations of primary intracranial germ cell tumors were diagnosed; 43 were germinoma with HCGβ levels ≤200 mIU/mL and five between 100 and 200 mIU/mL. The treatment plan consisted of four cycles of carboplatin and etoposide followed by 18 Gy whole-ventricular field irradiation (WVFI) and primary site(s) boost up to 30 Gy; 24 Gy craniospinal was prescribed for disseminated disease.

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  • Forehead osteomas are benign tumors that can cause cosmetic issues due to their growth on the skull's outer layer.
  • A case study of a 40-year-old woman highlighted the successful endoscopic removal of these tumors, which involved a minimally invasive surgical technique with no visible incision.
  • The endoscopic method proved effective for complete tumor removal, leading to excellent cosmetic results and suggesting that neurosurgeons should adopt this approach for similar cases.
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  • - Fetal surgery for myelomeningocele can reduce the risk of hydrocephalus by about 50%, prompting the need for training in a new endoscopic repair technique using multi-portals.
  • - The study developed a training model in two stages: first, familiarizing surgeons with 2D endoscopic skills and then applying these skills to simulate myelomeningocele closure using chicken breast and basketball models.
  • - The training involved testing two setups: a three-portal system allowing bimanual maneuvers for more complex procedures, and a two-portal system where the surgeon and assistant work side by side, with limited bi-manual capabilities.
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Purpose: Russel described a rare clinical entity known as diencephalic syndrome (DS) in 1951, which was traditionally caused by a neoplasm in the hypothalamic-optic chiasmatic region. DS is characterized by severe emaciation despite adequate or slightly reduced caloric intake, locomotor hyperactivity, euphoria and other minor features. Current evidence suggests that a rare population of children with a similar phenotype may have their tumor located in the posterior fossa instead, defining the DS-like presentation, a rare entity with few cases reported in the literature.

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  • The study investigates whether opening the ventricular system during surgery for brain tumors in children leads to increased postoperative complications, particularly focusing on cases from 2002 to 2020 involving 43 patients.
  • Findings showed that while ventricular opening was linked to a higher rate of subdural hygroma (43% vs. 0%), it did not significantly increase risks for complications like hydrocephalus or infections.
  • Overall, the research suggests that ventricular opening during these surgeries is not associated with severe complications and has comparable survival rates to surgeries without ventricular involvement.
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  • This study examines the relationship between atlantoaxial rotatory fixation (AARF) and neurosurgery in children, showcasing successful treatment outcomes through halo-gravity traction and C1-C2 stabilization using the Harms technique.
  • The case involves a 4-year-old boy who developed AARF after surgery for a cerebellar tumor; he was treated with cranial traction and the Harms technique, leading to positive postoperative results.
  • The findings suggest that careful selection of surgical techniques for AARF is crucial, and while the Harms technique showed promise, more research is needed to identify the best approaches for children.
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Background: Malignant middle cerebral artery (MCA) infarction is associated with high mortality, mainly due to intracranial hypertension. This malignant course develops when two-thirds or more of MCA territory is infarcted. Randomized clinical trials demonstrated that in patients with malignant MCA infarction, decompressive craniectomy (DC) is associated with better prognosis.

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  • Low-grade gliomas make up 30% of pediatric brain tumors, and the success of treatment relies heavily on how much of the tumor is surgically removed, with sodium fluorescein (Na-Fl) being used to assist in this process.
  • A study of pediatric patients undergoing tumor removal with Na-Fl showed impressive results in identifying tumor cells and achieving complete resection, supported by a review of existing literature.
  • The findings indicate that Na-Fl might be an effective tool for improving surgical outcomes in pediatric low-grade gliomas, but further research, including randomized controlled trials, is needed to confirm its benefits.
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  • - Schistosomiasis, caused by the Schistosoma mansoni parasite, is a common disease in tropical regions like Brazil, with neuroschistosomiasis being a significant form affecting the spine.
  • - Children are particularly vulnerable to infection due to their frequent swimming in contaminated water and their developing immune systems.
  • - Early diagnosis of neuroschistosomiasis can lead to effective treatment, allowing for complete recovery from neurological issues.
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