Epilepsy and anesthesia.

Background And Objectives: Epilepsy is one of the most frequent chronic neurological diseases. Although anesthesia for epilepsy patients is more common in neurosurgery, this group of patients needs, just as the general population, anesthesia for different diagnostic and therapeutic procedures. This article aims to address the issues of greatest interest to the anesthesiologist in the perioperative management of epileptic patients undergoing anesthesia for non-neurosurgical procedures.

Cognitive deficits in multiple sclerosis: a systematic review.

Objective: To present the results of prospective and retrospective studies on multiple sclerosis patients cognitive dysfunctions, as well as to discuss the batteries of neuropsychological tests used in these investigations.

Method: A systematic review was performed involving 40 studies published from 1997 to 2009, in PubMed, Scopus, Ovid, ISI Web of Knowledge, Scientific Electronic Library on line (Scielo) and Latin-American and Caribbean Center of Health Sciences Informations database. Clear description of multiple sclerosis patients cognitive deficits evaluation, study design, sample size; inclusion-exclusion and discontinuation criteria; instruments for neuropsychological evaluation, diagnostic methods, evaluated functions and detailed statistical analysis had been the inclusion criteria.

Applicability of the prevention protocol of pressure ulcers in intensive care unit.

Objective: The avoidance of pressure ulcers development in critically ill patients is a major nursing challenge. Prevention is thus relevant for assurance of high quality care. This study aimed to evaluate the applicability of the Braden scale in intensive care unit patients.

Diagnostic methods for extra-temporal neocortical focal epilepsies: present and future.

The progress of epilepsies diagnosis has been great, but, amongst the diagnostic detailing that demand research, one of the most important is the essential lateralization and localization of epileptogenic zone, considered as the cerebral cortex region, that removed, will result in a free state of seizures. The present study aims to analyze the possible uses of proton spectroscopy for clinical and pre-surgical evaluation of focal extratemporal epilepsies, since this group presents the highest difficulty degree for lateralizing and locating epileptogenic zones. In almost all cases, a non invasive diagnosis can be performed using routine electroencephalography, video-electroencephalography - considered as gold standard, and magnetic resonance imaging.

Hypertonic saline more efficacious than mannitol in lethal intracranial hypertension model.

Background: Medical management of brain edema and elevated intracranial pressure (ICP) is a crucial challenge in neurosurgical practice. Depending on the cause, the treatments for brain edema fall into three categories: stabilization of the blood-brain barrier, depletion of brain water and surgical decompression. Although mannitol is the mainstay of hyperosmolar therapy, hypertonic saline (HS) is emerging as an effective alternative to traditional osmotic agents.

Transmaxillary approach to the cranial base: an evaluation of 11 cases.

Unlabelled: Surgical access to the skull base is always difficult, especially because of the noble anatomic structures present there. Maxillary osteotomy provides direct view to the clivus region and the neck spine, and it also bears less morbidity when compared to the many other accesses described in the literature.

Aim: to assess 11 patients submitted to transmaxillary osteotomy, describing the surgical technique and postoperative results and complications.

Pediatric multiple sclerosis: analysis of clinical and epidemiological aspects according to National MS Society Consensus 2007.

Objective: To describe the epidemiological and clinical characteristics of child/adolescence multiple sclerosis (MS).

Method: According to a descriptive, cohort study, with comparison of groups, data of 31 cases of child/adolescent MS, diagnosed at State Reference Center for Demyelinating Diseases-Hospital da Restauração, Recife, Pernambuco, Brazil, from 1987 to July 2007, were analyzed. The variables were: sex, initial symptoms, time for diagnosis, time of disease onset (early childhood, later childhood and adolescence), time of follow-up, number of relapses, relapses index and disability.

[Effect of partially hidrolized guar-gum in the treatment of functional constipation among hospitalized patients].

The effect of hydrolyzed partially guar-gum was evaluated in the treatment of functional constipation among hospitalized patients. Following a randomized blind controlled-trial 64 adults were allocated to two groups: one received daily high-fiber diet (approximately 30 g) and the other similar diet plus 10 g of hydrolyzed partially guar-gum, during 15 days. Dietary fiber reduced functional constipation by 78.

Ganglioglioma: comparison with other low-grade brain tumors.

Method: Forty-two patients with low-grade brain tumor and refractory epilepsy were studied. The mean age was 22.3 years.

Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report.

Background: Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms.

Case Description: We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out.

[Neurological manifestations of dengue: study of 41 cases].

Unlabelled: The increase of encephalitis and meningoencephalitis in patients with dengue, diagnosed at a public hospital, Neurology State reference, we adopted systematic data collection.

Objective: The objective was to present 41 cases of neurological manifestations of dengue and to compare data with literature.

Method: This is a descriptive study, retrospective from March to July 1997 and, prospective, from February to May 2002, analyzing damaged neurological regions and diagnostic of 41 patients.

[Intraoperative mapping of motor areas during brain tumor surgery: electrical stimulation patterns].

Unlabelled: Brain mapping with direct electrical stimulation is usefull when the tumor is located near or has infiltrated the central lobe.

Objective: To analyze the surgical findings with direct electrical stimulation of the cortex and white matter under general anesthesia during surgery for brain tumors related to the central lobe.

Method: We studied 42 patients operated on from June 2000 to June 2003.

[Epidemiology of 118 cases of multiple sclerosis after 15 years of follow-up on the reference center of Hospital da Restauração, Recife, Pernambuco, Brazil].

Unlabelled: The prevalence of multiple sclerosis (MS) has a considerable variability all over the world. According to Kurtzke, South America is considered to have low prevalence (minor than 5 cases: 100000 habitants).

Objective: To describe the MS epidemiology on a reference center, compared to eight Brazilian series.

[Partial epilepsy associated to primary brain tumors].

Objective: To characterize the epileptic syndrome of patients with primary cerebral tumor of slow growth.

Method: Clinical evaluation of fourty two patients with refractory epilepsy associated with cerebral tumor of slow growth were operated between June 1992 and September 1999.

Results: Almost 75% of the patients were less than 15 years old when they began the epileptic crises, 67.

Progression of an arterial infundibulum to aneurysm: case report.

In this case an aneurysm of the right posterior communicating artery developed 11 months after an infundibular dilation of this artery had been angiographycally and surgically demonstrated. In the best of the authors' knowledge, there are only eleven such cases reported in the literature. This report brings about diagnostic and therapeutic questions regarding arterial infundibula and the need of a better understanding of those lesions.