Publications by authors named "Henrique Carrete"

Article Synopsis
  • The study investigates the usefulness of Transcranial Doppler (TCD) and MRI in assessing cerebrovascular risks in patients with antiphospholipid syndrome (APS) and related conditions.
  • It involved 94 participants, including patients with primary and secondary APS, systemic lupus erythematosus (SLE), and healthy controls, using TCD and MRI scans to analyze cerebral hemodynamics and brain abnormalities.
  • Findings indicated that patients with secondary APS showed more lacunar infarcts, and those with intracranial stenosis had significantly higher occurrences of various types of brain infarcts, highlighting the importance of evaluating intracranial blood flow in APS patients at risk of strokes.
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Purpose: To characterize a 10-year series of patients with mesial temporal lobe epilepsy (MTLE) and unilateral hippocampal sclerosis (HS) and determine the histopathological characteristic of the association between granule cell dispersion (GCD) and hippocampal neuronal loss.

Methods: The study included 108 MTLE/HS patients. Histopathological analyses were performed in NeuN-stained hippocampal sections for HS pattern, neuronal density, dentate gyrus (DG) pathology, and granule cell layer width.

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Background And Purpose: Parkinsonism is commonly seen in many clinical conditions, and the establishment of its etiology may take many years. The possible development of neuroprotective treatments for Parkinsons disease (PD) in the near future will require correct and early diagnosis. This study aims to analyze the accuracy of a low-cost MRI sequence to differentiate PD from patients with essential tremor (ET) and healthy control (HC) individuals.

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This case report describes a combined neurosurgical and endovascular approach for the treatment of a conus medullaris arteriovenous malformation resulting in considerable improvement in the patient's neurological condition (modified Rankin Scale score 2).

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This case report describes a combined neurosurgical and endovascular approach for the treatment of a conus medullaris arteriovenous malformation resulting in considerable improvement in the patient's neurological condition (modified Rankin Scale score 2).

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Traditional radiology reports are narrative texts that include a description of imaging findings. Recent implementation of advanced reporting software allows for incorporation of annotated key images and hyperlinks directly into text reports, but these tools usually do not substitute in-person consultations with radiologists, especially in challenging cases. Use of on-demand audio/visual reports with screen capture software is an emerging technology, providing a more engaged imaging service.

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Background And Purpose: The PHASES score was formulated to predict the 5-year risk of rupture for intracranial aneurysms. We retrospectively analyzed all patients treated in our institution for aneurysmal SAH and applied the PHASES score to estimate the probable predicted risk of bleeding in this group of patients.

Methods: Between February 2015 and August 2018, all patients with aneurysmal SAH were retrospectively analyzed and the PHASES score was applied.

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Temporal lobe epilepsy (TLE) is a chronic disease, characterized by severe and refractory seizures, triggered in the hippocampus and/or amygdala, disrupting the blood-brain barrier. This disruption can sustain, or aggravate, the epileptic condition. The aim of this study was to evaluate the activation of the kallikrein-kinin system in patients with TLE, as it relates to the maintenance of blood-brain barrier.

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Background: Aneurysms of the anterior communicating artery (ACoA) are difficult to treat with coiling or clipping because of the anatomical variation in this region. Flow diversion represents a feasible treatment, but no consensus exists as to which stent deployment technique is more suitable.

Methods: All patients with ACoA aneurysms treated with flow diverters between April 2014 and November 2018 were retrospectively analyzed.

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Purpose: To evaluate if the duration of epilepsy influences MRI volumes of the hippocampus, amygdala, parahippocampal gyrus, entorhinal cortex and temporal pole of both hemispheres and epileptogenic hippocampus neuronal cell density and dentate gyrus granular cells distribution in patients with refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS).

Methods: Seventy-seven patients with refractory MTLE/HS submitted to surgery were included. Histopathological analysis included: (1) quantitative: hippocampal subfields and total estimated hippocampal cell density (HCD), thickness of the dentate gyrus - normal, thinning or dispersion; (2) qualitative: type of HS and granule cells pathology in the dentate gyrus (normal, neuronal cell loss, dispersion and bilamination).

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Article Synopsis
  • The study aimed to determine if patients with mesial temporal lobe epilepsy and lower IQ levels have greater brain atrophy than those with higher IQ levels and to assess if IQ could influence surgical outcomes.
  • A total of 106 patients who underwent surgery were analyzed, revealing that those with lower IQ had significantly reduced total cortical volume and specific areas of brain atrophy.
  • Despite the differences in brain volume and thickness based on IQ, the research found no significant relationship between IQ levels and the success of seizure outcomes post-surgery.
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Article Synopsis
  • The anterior cingulate gyrus plays a role in fear response extinction and is linked to conditions like posttraumatic stress disorder (PTSD) in children and adolescents.
  • A study was conducted using magnetic resonance spectroscopy to analyze the ratios of N-acetylaspartate and choline in children exposed to violence versus non-trauma controls, over a year.
  • Results showed no significant differences in metabolite levels between PTSD and control groups, but a negative correlation was found between PTSD symptoms and metabolite levels in the PTSD group over time.
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Purpose: Corticoamygdalohippocampectomy (CAH) improves seizure control, quality of life, and decreases mortality for refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). One-third of patients continue having seizures, and it is pivotal to determine structural abnormalities that might influence the postoperative outcome. Studies indicate that nonhippocampal regions may play a role in the epileptogenic network in MTLE-HS and could generate seizures postoperatively.

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Purpose: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome.

Methods: Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery.

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Background: The role of transcranial Doppler (TCD) ultrasonography in identifying children with sickle cell anemia (SCA) at risk for stroke is well known; however, the major studies that evaluated TCD velocities in children with SCA did not report posterior circulation evaluation data. The objective of our study was to describe the pattern of blood flow velocities in the posterior circulation of patients with SCA and to examine their relationship with findings on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA).

Methods: All adult patients with SCA followed in the outpatient clinic of our hospital were evaluated with TCD and MRI/MRA.

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Purpose: We conducted a retrospective study in order to investigate the clinical significance of temporopolar grey/white matter abnormalities (GWMA) in patients with temporal lobe epilepsy (TLE) and unilateral hippocampal sclerosis (HS) with a long post-surgical follow-up.

Methods: The study comprised 122 consecutive patients with medically refractory TLE and unilateral HS who underwent epilepsy surgery and had a minimum postoperative follow-up of 5 years. Patients were divided into two groups, based on findings of pre-surgical MRI: group 1 with GWMA and 2 with normal signal and grey/white matter definition in temporal pole.

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Objective: Thimet oligopeptidase (TOP) is a metalloprotease that has been associated with peptide processing in several nervous system structures, and its substrates include several peptides such as bradykinin, amyloid beta (Aβ), and major histocompatibility complex (MHC) class I molecules. As shown previously by our research group, patients with temporal lobe epilepsy (TLE) have a high level of kinin receptors as well as kallikrein, a kinin-releasing enzyme, in the hippocampus.

Methods: In this study, we evaluated the expression, distribution, and activity of TOP in the hippocampus of patients with TLE and autopsy-control tissues, through reverse-transcription polymerase chain reaction (RT-PCR), enzymatic activity, Western blot, and immunohistochemistry.

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Objective: Borderline personality disorder (BPD) is a devastating condition that causes intense disruption of patients' lives and relationships. Proper understanding of BPD neurobiology could help provide the basis for earlier and effective interventions. As neuroimaging studies of patients with BPD are still scarce, volumetric and geometric features of the cortical structure were assessed to ascertain whether structural cortical alterations are present in BPD patients.

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Article Synopsis
  • The study explores how gender differences influence brain structure and damage in patients with temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS).
  • It utilizes voxel-based morphometry (VBM) to analyze differences in 120 TLE-MTS patients and 50 controls, revealing that left-sided TLE shows more widespread abnormalities.
  • Results indicate that women exhibit more damage in temporal areas, while men show greater impact in frontal regions, highlighting the importance of gender and brain hemisphere in understanding brain damage severity.
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Startle epilepsy is a syndrome of reflex epilepsy in which the seizures are precipitated by a sudden and surprising, usually auditory, stimulus. We describe herein a girl who had been suffering with startle-induced seizures since 2 years of age. She had focal, tonic and tonic-clonic seizures, refractory to antiepileptic treatment.

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Gastaut type idiopathic childhood occipital epilepsy is an uncommon epileptic syndrome characterised by frequent seizures, most commonly presenting as elementary visual hallucinations or blindness. Other occipital (non-visual) symptoms may also occur. Interictal EEG typically shows occipital paroxysms, often with fixation-off sensitivity.

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This study aimed to analyze the impact of ictal dystonic posturing (DP) in postoperative seizure outcome and to assess the influence of DP in generalized tonic-clonic seizure (GTCS) occurrence during video-EEG monitoring of patients with temporal lobe epilepsy with mesial temporal sclerosis. The impact of DP on surgical outcome remains controversial. Moreover, DP has been recently associated with brain networks avoiding GTCS occurrence.

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Introduction: Rasmussen's encephalitis (RE) is a progressive pathology affecting the brain that causes unilateral hemispheric atrophy, neurological dysfunction and refractory epilepsy. Hemispherotomy is considered the most effective treatment today, but some cases present certain peculiarities that can seriously affect the decision to go ahead with this procedure.

Aims: To evaluate the post-operative progress made by children with RE who have undergone hemispherotomy surgery, and who, in the pre-operative assessment, presented certain characteristics that complicated the decision to perform surgery.

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Morphological variations of hippocampal formation (MVHF) are observed in patients with epilepsy but also in asymptomatic individuals. The precise role of these findings in epilepsy is not yet fully understood. This study analyzes the hippocampal formation (HF) morphology of asymptomatic individuals (n = 30) and of patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS) (n = 68), patients with malformations of cortical development (MCD) (n = 34), or patients with pure morphological variations of hippocampal formation (pure MVHF) (n = 12).

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