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Rodrigues T.,University of Sao Paulo | Rodrigues M.,Hospital Albert Einstein | Paz D.,University of Sao Paulo | Costa M.D.,University of Sao Paulo | And 7 more authors.
Arquivos de Neuro-Psiquiatria | Year: 2015

The central sulcus region is an eloquent area situated between the frontal and parietal lobes. During neurosurgical procedures, it is sometimes difficult to understand the cortical anatomy of this region. Objective: Find alternative ways to anatomically navigate in this region during neurosurgical procedures. Method: We analyzed eighty two human hemispheres using a surgical microscope and completed a review of the literature about central sulcus region. Results: In 68/82 hemispheres, the central sulcus did not reach the posterior ramus of the lateral sulcus. A knob on the second curve of the precentral gyrus was reliably identified in only 64/82 hemispheres. Conclusion: The morphometric data presented in this article can be useful as supplementary method to identify the central sulcus region landmarks © 2015, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.

Chaddad-Neto F.,Federal University of São Paulo | Chaddad-Neto F.,Institute Ciencias Neurologicas ICNE | Doria-Netto H.L.,Federal University of São Paulo | Doria-Netto H.L.,Institute Ciencias Neurologicas ICNE | And 6 more authors.
Arquivos de Neuro-Psiquiatria | Year: 2016

Objective: Didactically describe the orbitozygomatic craniotomy made in three pieces. Method: This approach was performed, from 2002 to 2011, in 49 patients admitted at Beneficência Portuguesa of São Paulo Hospital. Results: Twenty-seven patients had vascular lesions and twenty-two suffered for intracranial skull base tumors. The vascular lesions varied from cavernous angiomas inside the mesencephalum, high bifurcation basilar tip aneurysms, superior cerebellar arteries aneurysms and arteriovenous malformations in the interpeduncular cistern. Skull base tumors as meningiomas, interpeduncular hamartomas and third ventricle floor gliomas were among the neoplastic lesions approached. We had no permanent injuries and minimal transient complications had occurred. Conclusion: It is a descriptive text, organized in the sequence of the main stages in which such a craniotomy is performed, describing in details the technique in which this group of evolutionarily authors came to accomplish the task. © 2016, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.

PubMed | Institute Ciencias Neurologicas ICNE
Type: Journal Article | Journal: Journal of neurosurgical sciences | Year: 2016

Comprehensive understanding of the vascular anatomy, including anatomic variations, anatomy of the perforators, and areas of irrigation for each specific vascular trunk is relevant for the treatment of intracranial aneurysms. Understanding the microanatomy of the cerebral vessels helps surgeons to select the most appropriate microsurgical approach for each case. Anterior circulation aneurysms may be originated from the internal carotid artery and its branches, anterior cerebral artery, middle cerebral artery and anterior communicating artery. Although presenting different surgical nuances, we favor the use of the pterional approach for most anterior circulation aneurysms. In some instances, extensions of the pterional approach improve the surgical exposure and may be selected. In its turn, posterior fossa aneurysms remain a challenge to the neurosurgeon. The exquisite eloquence and complexity of posterior fossa contents require a through knowledge of microsurgical anatomy of this region. Such anatomic background guides the surgeon to the most appropriate approach, which may vary dependind on the size, position of the aneuryms and its relatonship to the surrounding structures.

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