Effect of postoperative tranexamic acid on recurrence rate and complications in chronic subdural hematomas patients: preliminary results of a randomized controlled clinical trial.

Chronic subdural hematoma (CSDH) is a frequent neurosurgical disease which mainly affects elderly patients. Tranexamic acid (TXA) has been hypothesized as an oral agent to avoid CSDH progression and/or recurrence. We performed an evaluation to determine whether the postoperative use of TXA reduces recurrence rate.

Role of Neural Plasticity of Motor Cortex in Gliomas Evaluated by Brain Imaging and Mapping Techniques in Pre- and Postoperative Period: A Systematic Review.

Background:  Resection of infiltrative neuroepithelial primary brain tumors, such as low-grade gliomas (LGGs) remains a neurosurgical challenge. Usual lack of clinical deficit despite LGGs growing in eloquent brain areas may be explained by reshaping and reorganization of functional networks. The development of modern diagnostic imaging techniques could disclose better understanding of the rearrangement of the brain cortex; however, mechanisms underlying such compensation and how it occurs in the motor cortex remain unclear.

Brain cryptococcoma mimicking a glioblastoma in an immunocompetent patient: A rare case report and comprehensive review.

Background: Cryptococcosis is an invasive fungal infection primarily affecting lungs and potentially spreading to the central nervous. This fungal infection might be misdiagnosed as other infection diseases, such as tuberculosis; granulomatous diseases, like sarcoidosis; and even neoplastic diseases. Some previous reports described cases of cryptococcomas resembling brain tumors.

Association between Brachycephaly, Chiari Malformation, and Basilar Invagination.

Background:  There is evidence that Chiari malformation (CM) and basilar invagination (BI) are largely due to disproportion between the content and volume of the posterior fossa. A recent study identified an increased association between brachycephaly and BI. In several types of craniosynostosis, the posterior fossa volume is smaller than normal, and this is more pronounced in coronal synostosis.

Largest neurosurgical social media group and its impact on communication and research.

Background: The use of social media to communicate and disseminate knowledge has increased exponentially, especially in the field of neurosurgery. 'Neurosurgery cocktail' (NC) was developed by a group of young neurosurgeons as a means of sharing didactic materials and clinical experiences via social media. It connects 35.

Effect of Stereotactic Radiosurgery on Residual or Relapsed Pituitary Adenoma: A Systematic Review and Meta-Analysis.

Background: In pituitary tumors, the presence of residual tumor after transsphenoidal surgery and recurrence of the tumor after resection are frequent, and the best treatment is not well established. The effects and complications of stereotactic radiosurgery have not been extensively studied.

Objective: We aimed to reveal the effect of stereotactic radiosurgery on residual and recurrent adenomas.

Analysis of survival in patients with brain metastases treated surgically: Impact of age, gender, oncologic status, chemotherapy, radiotherapy, number and localization of lesions, and primary cancer site.

Objective: To evaluate the survival of patients with brain metastases treated surgically according to the potentially involved factors.

Methods: 71 patients treated surgically were analyzed with the diagnosis of brain metastases during the period from January 2011 to November 2014, totaling 47 months of follow-up. The Kaplan-Meier curve method was used for survival analysis.

Development of the Portuguese Version of the Modified Japanese Orthopaedic Association Score: Cross-Cultural Adaptation, Reliability, Validity, and Responsiveness.

Background: Spondylotic cervical myelopathy (SCM) is a common cause of spinal-related disability in elderly patients. The assessment of this disability is a challenging task and depends on the subjective evaluation of the investigator. As a widespread-used scale, the modified version of the Japanese Orthopaedic Association score (mJOA) should be translated and culturally adapted in the Brazilian Portuguese language (i.

Microsurgical treatment of basilar tip aneurysms: is it still acceptable?

Objective: Basilar tip aneurysms (BTAs) have a complex anatomy, making them difficult to treat. We describe our surgical results for BTAs.

Methods: From 2004 to 2015 (12 years), a total of 25 small BTAs and two giant BTAs were treated in the Hospital do Servidor Público Estadual de São Paulo.

Surgical flow modification of the anterior cerebral artery-anterior communicating artery complex in the management of giant aneurysms of internal carotid artery bifurcation: An alternative for a difficult clip reconstruction.

Background: Internal carotid artery bifurcation (ICAb) aneurysms account for about 2-15% of all intracranial aneurysms. In giant and complex cases, treatment may be difficult and dangerous, once some aneurysms have wide neck and anterior cerebral artery (ACA) and middle cerebral artery (MCA) may arise from the aneurysm itself. Clip reconstruction may be difficult in such cases.

Malignant transformation of low-grade gliomas in patients undergoing adjuvant therapy.

Low-grade gliomas (LGG) comprise nearly 15-20 % of all central nervous system glial tumors. Several factors have been recognized as playing role in LGG malignant transformation (MT). A breakthrough analysis of a multidisciplinary group pointed that temozolomide may play a role in MT of LGGs.

Surgical clipping is still a good choice for the treatment of paraclinoid aneurysms.

Unlabelled: Paraclinoid aneurysms are lesions located adjacent to the clinoid and ophthalmic segments of the internal carotid artery. In recent years, flow diverter stents have been introduced as a better endovascular technique for treatment of these aneurysms.

Method: From 2009 to 2014, a total of 43 paraclinoid aneurysms in 43 patients were surgically clipped.

Effect of repeated transsphenoidal surgery in recurrent or residual pituitary adenomas: A systematic review and meta-analysis.

Background: Recurrent or residual pituitary adenomas previously treated by transsphenoidal surgery are not uncommon. There are no strongly established guidelines to perform treatment of such cases. The objective of this study is to elucidate the effect of transsphenoidal reoperation in residual or recurrent pituitary adenomas.

Is there a relationship between spinal instability in neoplastic disease and Tokuhashi scoring system?

Spinal instability neoplastic score (SINS) classification evaluates spinal stability by adding together six radiographic and clinical components. The objective of this study was to verify the association between SINS and Tokuhashi scoring system (TSS) score. Fifty-eight patients with vertebral metastases were admitted from 2010 to 2014 at Hospital do Servidor Público Estadual de São Paulo.

Blister-Like Aneurysms: Report of Successful Surgical Treatment of Consecutive Cases and Review of the Literature.

Introduction: Blister-like aneurysms (BAs) are usually defined as arterial lesions arising from nonbranching sites on intracranial arteries. Because of specific peculiarities such as different pathophysiology, fragility of the aneurysmal wall, high risk of intraoperative bleeding, and high probability of losing parent vessel patency, their treatment is controversial, and both endovascular and surgical options have been reported.

Methods: From 2006 to 2015 (10 years), 7 aneurysms in 6 patients were treated.

Upper airway dimensions in patients with craniocervical junction malformations with and without sleep apnea. A pilot case-control study.

Objective: Patients with craniocervical junction malformations (CCJM) tend to suffer more frequently from sleep respiratory disturbances, which are more frequent and severe in patients with basilar invagination. Here we evaluate if patients with CCJM and sleep respiratory disorders (SRD) present smaller airway dimensions than patients without SRD.

Method: Patients with CCCM with and without sleep respiratory disturbances were evaluated clinically by Bindal's score, modified Mallampati classification, full-night polysomnography and upper airway cone beam tomography.

Survival analysis in patients with metastatic spinal disease: the influence of surgery, histology, clinical and neurologic status.

Unlabelled: Spine is the most common site for skeletal metastasis in patients with malignancy. Vertebral involvement quantification, neurological status, general health status and primary tumor histology are factors to set surgical planning and therapeutic targets. We evaluated the impact of general clinical and neurological status, histologic type and surgery in survival.

Risk of complications in spine surgery: a prospective study.

Purpose: Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence.

Methods: Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014.

Natural course of subarachnoid hemorrhage is worse in elderly patients.

Unlabelled: Aging is a major risk factor for poor outcome in patients with ruptured or unruptured intracranial aneurysms (IA) submitted to treatment. It impairs several physiologic patterns related to cerebrovascular hemodynamics and homeostasis.

Objective: Evaluate clinical, radiological patterns and prognostic factors of subarachnoid hemorrhage (SAH) patients according to age.

Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage.

Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge.

Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram.

Malignant transformation of intracranial epidermoid cyst.

Intracranial epidermoid cysts (ECs) are rare, histologically benign, slow-growing, congenital neoplasms of central nervous system that may arise from retained ectodermal implants. Malignant transformation of an EC to squamous-cell carcinoma is rare; only 13 cases have been reported. We present the case of a 42-year-old woman presenting with left hemiparesis 18 months after performing partial resection of an epidermoid cyst of right middle and posterior fossa, whose pathological report revealed to be a malignant transformation of previous epidermoid tumor.

Quantification of vertebral involvement in metastatic spinal disease.

Introduction: For patients with a solitary and well-delimitated spinal metastasis that resides inside the vertebral body, without vertebral canal invasion, and who are in good general health with a long life expectancy, en bloc spondylectomy/total vertebrectomy combined with the use of primary stabilizing instrumentation has been advocated. However, clinical experience suggests that these qualifying conditions occur very rarely.

Objective: The purpose of this paper is to quantify the distribution of vertebral involvement in spinal metastases and determine the frequency with which patients can be considered candidates for radical surgery (en bloc spondylectomy).

Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients.

Unlabelled: Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, dementia and /or urinary incontinence, dilation of the ventricular system and normal opening cerebrospinal fluid pressure. Shunt surgery is the standard treatment of iNHP. Diversions with programmable valves are recommended, once drainage pressure can be changed.