Publications by authors named "Marcos da Costa"
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.
View Article and Find Full Text PDFBackground 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.
View Article and Find Full Text PDFRisk assessment for rupture of brain arteriovenous malformations using high-resolution black-blood magnetic resonance imaging: a single-center case series.
Neurosurg Rev
November 2024
Objective: Chronic inflammation's role in the pathogenesis, development, and rupture of vascular malformations is undebated. Advanced magnetic resonance imaging techniques with vessel wall studies, specifically Black Blood (bbMRI), may offer insights into vascular wall instability and predict rupture. This case series aims to assess bbMRI as a predictive diagnostic tool for brain arteriovenous malformations (bAVMs) rupture, suggesting early treatment.
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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.
Model of Arteriovenous Malformation Created in Human Placenta for Training in Vascular Microneurosurgery.
Oper Neurosurg (Hagerstown)
July 2024
Article Synopsis
- Arteriovenous malformations (AVMs) are complex congenital lesions requiring advanced surgical skills, and human placentas offer a realistic training model for AVM surgery.
- The study involved creating AVM-type lesions in 15 human placentas using synthetic materials, allowing neurosurgeons to practice microsurgical techniques in a controlled environment.
- Results showed that this model effectively simulates the key characteristics of AVMs, making it a valuable tool for training in vascular microsurgery.
The long-term effect on functional outcome of endoscopic brainwashing for intraventricular hemorrhage compared to external ventricular drainage alone: A retrospective single-center cohort study.
Surg Neurol Int
March 2024
Article Synopsis
- - 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.
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.
In Reply: Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study.
Neurosurgery
January 2024
Article Synopsis
- 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.
Fetal neurosurgery.
Childs Nerv Syst
October 2023
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- - 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.
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study.
Neurosurgery
June 2023
Article Synopsis
- * Researchers analyzed data from over 500 patients across multiple neurosurgery centers to identify risk factors for ONP, finding that larger aneurysms (≥7.5 mm) and smoking significantly increased the likelihood of developing ONP.
- * Results indicated that 80.7% of patients experienced some improvement in ONP after surgical treatment, with a median recovery time of 90 days, suggesting positive outcomes for those treated.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- - 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.
Background: Lesions in the ventral striatum region (above the anterior perforated substance) are a challenge for neurosurgeons due to their direct relationship with the lenticulostriate arteries, which difficult the surgical access. The standard approaches for this region include the following: 1) transfrontal approach, 2) transanterior perforating substance approach, 3) transcallosal transventricular approach, and 4) pterional transsylvian-transinsular route. In this study, we aimed to describe a novel anatomical approach through the anterior limiting sulcus of the insula in order to access the ventral striatum.
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- The cerebellar interpeduncular region, especially the middle cerebellar peduncle (MCP) and interpeduncular sulcus (IPS), is crucial for surgery due to various vascular and tumor-related issues.
- A study was conducted using cadaveric heads and human brainstems to analyze the surface and vascular anatomy of these areas to identify safer surgical entry points.
- Findings suggest that accessing the middle thirds of the IPS and MCP is safer than the upper and lower thirds, as they have fewer blood vessels and important nerve tracts crossing through them.
Optic pathway gliomas (OPG) can cause elevated cerebrospinal fluid (CSF) protein concentrations. We report on two patients with suprasellar low-grade gliomas and high CSF protein levels (590 and 551 mg/dl) that precluded shunt implantation. After two and three doses of bevacizumab, respectively, the levels dropped dramatically to 191 and 178 mg/dl, respectively.
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- Training in microsurgical neuroanatomy is essential for neurosurgery education, leading to the establishment of specialized laboratories to enhance surgical skills.
- A literature review and analysis of legislative requirements informed the planning and construction of a new training laboratory.
- The successful implementation of the micro neurosurgical skills laboratory was achieved through a public-private partnership, adhering to Brazilian regulations and designed to cater to medical trainees' needs.
Background: Infectious complications of the central nervous system secondary to endovascular procedures have rarely been reported. However, the number of complications has grown exponentially owing to the popularization of these procedures. The success rate of these procedures varies with the pathology, the patient, and surgical performance.
View Article and Find Full Text PDFBackground: Colloid cyst treatment with purely endoscopic surgery is considered to be safe and effective. Complete capsule removal for gross total resection is usually recommended to prevent recurrence but may not always be safely feasible. Our objective was to assess the results of endoscopic surgery using mainly aspiration and coagulation without complete capsule resection and discuss the rationale for the procedure.
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