Publications by authors named "Filipi F Andreao"

Introduction: Meningioma is the most common benign tumor in the central nervous system and may arise from the sphenoid wing region. The tumor can involve the cavernous sinus medially, periorbital and orbital apex structures anteriorly, and infratemporal fossa inferiorly. Surgical approaches more currently used include the fronto-temporal approach, the pterional approach, and even the frontotemporal-orbitozygomatic approach.

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Resection has traditionally been the gold standard for treating jugular foramen schwannomas (JFSs). However, given the high risk of neurological deficits associated with surgical intervention, stereotactic radiosurgery (SRS) has emerged as a promising alternative. Despite its growing popularity for other brain tumors, there remains a paucity of data on the outcomes of SRS for JFSs.

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Purpose: Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid artery and cavernous sinus, often causing ocular symptoms like chemosis, proptosis, and diplopia. Endovascular embolization is the preferred treatment, typically performed via the transfemoral transvenous route through the inferior petrosal sinus (IPS). However, we present a case and a systematic review of indirect CCF treated through deep orbital puncture of the superior ophthalmic vein (SOV) for embolization.

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Aim: To examine the potential of transbrachial access (TBA) in carotid artery stenting (CAS).

Material And Methods: This systematic review and meta-analysis aimed to comprehensively evaluate the safety and efficacy of TBA for CAS by conducting a thorough search on Medline, Cochrane Library, Embase, and Web of Science databases. Studies reporting TBA for CAS and evaluating primary outcomes such as good neurological results, procedural success, and complications were included.

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Background: Arteriovenous malformations (AVMs) pose a risk of neurologic deterioration, particularly when located in eloquent areas. While awake surgery is well-established for treating low-grade gliomas near eloquent areas, its efficacy for AVMs is less conclusively reported.

Methods: This study conducted a systematic review and individual patient data meta-analysis following Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

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Background: Neurosurgical training requires a deep understanding of brain anatomy, especially white matter fiber pathways, to enhance surgical precision. Traditional dissection techniques, such as Klingler's white matter dissection, are essential, but newer methods can provide additional clarity. This study explores the application of a fluorescent-assisted technique to improve the visualization and understanding of white matter fibers during neurosurgical training.

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Aim: To evaluate the usage and the effectiveness of LVIS Jr device technology in managing wide-neck intracranial aneurysms.

Material And Methods: PubMed, Embase, and Web of Science databases, comprising studies with outcomes related to LVIS Jr use in wide-neck intracranial aneurysms were searched systematically. Data was extracted from the selected articles and subjected to statistical analysis.

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Article Synopsis
  • Neurosurgery is a hard field to get into, especially for international medical graduates (IMGs) who need to show they have done research to stand out.
  • Even though it’s tough, some Brazilian medical students have done really well by publishing important studies in big neurosurgery journals without needing a lot of money or resources.
  • The article suggests that IMGs can start their research careers by writing literature reviews and letters to the editor, which are easier ways to get involved in research.
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Background: High-grade gliomas (HGG) are the most aggressive primary brain tumors with poor prognoses despite conventional treatments. Immunotherapy has emerged as a promising avenue due to its potential to elicit a targeted immune response against tumor cells.

Objective: This meta-analysis aimed to evaluate the efficacy and safety of various immunotherapeutic strategies, including immune checkpoint inhibitors (ICI), virotherapy, and dendritic cell vaccines (DCV) in treating HGG.

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Purpose: Stereotactic brain biopsies are highly efficient for diagnosing intracerebral pathologies, particularly when surgical resection is infeasible. Fluorescence-based agents such as 5-aminolevulinic acid (5-ALA) and fluorescein sodium (NaFl) can enhance diagnostic accuracy and safety, improving the visualization of lesional tissues. This meta-analysis aimed to evaluate their effect on diagnostic yield and complication rates of brain biopsies.

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Objective: Unruptured middle cerebral artery aneurysm (uMCAA) has traditionally been treated with open surgical clipping (SC). Endovascular treatments (EVTs) were designed to reduce surgical risks in these cases. Nevertheless, despite its potential benefits, many surgeons favor SC for uMCAA.

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Spontaneous intracerebral hemorrhage (ICH) represents a critical and potentially devastating medical event resulting from the rupture of intracerebral vessels. Patients afflicted with ICH face an increased risk of venous thromboembolism (VTE) due to factors such as immobility. However, determining the ideal timing for initiating venous thromboembolism thromboprophylaxis (TP) remains uncertain, as it may carry the potential risk of exacerbating hematoma expansion.

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Article Synopsis
  • Osteoporotic vertebral fractures lead to pain and diminished quality of life, and there’s ongoing debate on how best to manage them, particularly comparing percutaneous vertebroplasty (PV) to non-operative treatments (non-OT).* -
  • The analysis of randomized controlled trials showed PV provided significant pain relief at multiple time points, and notable improvements in quality of life were seen in the short term, but not consistently in the long term.* -
  • A substantial risk of cement leakage (42%) was noted with PV, but it did not increase the risk of new fractures; thus, careful patient selection is vital due to variability among studies.*
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Background: Some centers utilize ventriculopleural shunt (VPLS) for treating hydrocephalus when conventional approaches are not feasible. Nonetheless, the literature regarding this approach is scarce.

Purpose: Evaluate the outcomes of VPLS through a single-arm meta-analysis.

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Background: Jugular paragangliomas are highly vascularized tumors that can grow in challenging neurovascular compartments and are particularly challenging to resect. There is still no consensus whether preoperative embolization should be employed to minimize intraoperative morbidity.

Methods: A systematic review and meta-analysis was conducted by searching PubMed, Web of Science, and Embase databases for key terms including "embolization," "jugular paragangliomas," and "surgery.

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Background: Traditionally, patients undergoing craniotomy were subject to extended hospital stays for intensive monitoring and management of potential complications. However, with the evolution of surgical methods, anesthesia, and postoperative protocols, the feasibility and interest in same-day discharge (SDD) are growing. This study aimed to evaluate whether same-day discharge is a safe and feasible approach in craniotomy through a meta-analysis of the available literature.

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Article Synopsis
  • Cerebral arteriovenous malformations (AVMs) can cause serious health problems like strokes, and researchers are studying a method using adenosine to help treat them safely.
  • They looked at multiple studies involving 79 patients and found that using adenosine during the procedure resulted in no serious complications or deaths.
  • The results suggest that adenosine makes the treatment safer by helping control blood flow, but more studies are needed to confirm these findings.
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Classical trigeminal neuralgia (TN), caused by vascular compression of the nerve root, is a severe cause of pain with a considerable impact on a patient's quality of life. While microvascular decompression (MVD) has lower recurrence rates when compared with partial sensory rhizotomy (PSR) alone, refractoriness can still be as high as 47%. We aimed to assess the efficacy and safety profile of MVD + PSR when compared to standalone MVD for TN.

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Background: Despite the recent increase in publications centered on intracranial-intracranial (IC-IC) bypasses for complex aneurysms, there is no systematic evidence regarding their outcomes. The purpose was to assess the outcomes of patients subjected to IC-IC bypass for aneurysms.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, a systematic review was conducted.

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Objective: In the treatment of skull base chordoma (SBC) surgery is considered the mainstay approach, and gross-total resection has an established relationship with progression-free survival (PFS) and overall survival (OS). However, the tumor's location often interferes with attempts at complete resection. In this case, surgery for maximal resection followed by high-dose radiotherapy has been demonstrated to be the standard treatment.

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