A5049204828- Acute Ischemic Stroke Management
- Intracranial Aneurysms: Treatment and Complications
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Vascular Malformations Diagnosis and Treatment
- Traumatic Brain Injury and Neurovascular Disturbances
- Venous Thromboembolism Diagnosis and Management
- Neurosurgical Procedures and Complications
- Long-Term Effects of COVID-19
- Spinal Fractures and Fixation Techniques
- Moyamoya disease diagnosis and treatment
- Retinal and Optic Conditions
- Cardiovascular Health and Disease Prevention
- Vascular Anomalies and Treatments
- Medical Imaging and Analysis
- Business and Management Studies
- Spinal Dysraphism and Malformations
- Academic Research in Diverse Fields
- Intraocular Surgery and Lenses
- Sarcoma Diagnosis and Treatment
- Cerebrovascular and genetic disorders
- Meningioma and schwannoma management
- Cerebrospinal fluid and hydrocephalus
- Teratomas and Epidermoid Cysts
- Peripheral Artery Disease Management
Universidade Federal de São Paulo
1998-2023
Hospital Israelita Albert Einstein
2023
Hospital Sírio-Libanês
2021
Hospital Geral de Fortaleza
2020
Fundação de Apoio à Universidade Federal de São Paulo
2020
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2016
Universidade de São Paulo
2008-2015
Coordenação de Aperfeicoamento de Pessoal de Nível Superior
1998
Randomized trials involving patients with stroke have established that outcomes are improved the use of thrombectomy for large-vessel occlusion. These were performed in high-resource countries and had limited effects on medical practice low- middle-income countries.
We studied the angiographic findings in patients with small epidural hematomas and cranial fractures crossing over trajectory of middle meningeal artery its branches. Additionally, occurrence traumatic vascular lesions their clinical relevance treatment are discussed.A consecutive analysis was performed for 24 who harbored topography associated fractures. Computed tomographic scans plain x-ray studies were used to diagnose linear Patients large or excluded from study. Selective ipsilateral...
Background The RESILIENT trial demonstrated the clinical benefit of mechanical thrombectomy in patients presenting acute ischemic stroke secondary to anterior circulation large vessel occlusion Brazil. Aims This economic evaluation aims assess cost-utility from a public healthcare perspective. Methods A analysis was applied compare plus standard medical care (n = 78) vs. alone 73), subset sample (151 221 patients). Real-world direct costs were considered, and utilities imputed according...
Aneurysms of the anterior communicating artery (ACoA) are difficult to treat with coiling or clipping because anatomical variation in this region. Flow diversion represents a feasible treatment, but no consensus exists as which stent deployment technique is more suitable.All patients ACoA aneurysms treated flow diverters between April 2014 and November 2018 were retrospectively analyzed. Aneurysm characteristics, follow-up results, clinical outcome data recorded, new classification comparing...
Carotid artery stenosis due to arteriosclerosis increases the risk of cerebral ischemia via embolic phenomena or reduced blood flow. The changes in perfusion that may occur after treatment are not clearly understood. This study evaluated microcirculation following carotid angioplasty with stenting (CAS) under protection filters using ultrafast gradient echo (GRE) weighted imaging (PWI) magnetic resonance (MRI). Prospectively, 21 cervical patients, mean age 69.95 years, underwent MRI 12 h...
Background RESILIENT is a prospective, multicenter, randomized phase III trial to test the safety, efficacy, and cost-effectiveness of mechanical thrombectomy as compared medical treatment alone in patients treated under less than ideal conditions typically found public healthcare system developing country. Methods Subjects must fulfill following main inclusion criteria: symptom onset ≤8 h, age ≥18 years, baseline NIHSS ≥8, evidence intracranial ICA or proximal MCA (M1 segment) occlusion,...
Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to healthcare system provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue occur and require adequate treatment. The allocation both material human resources fight cannot overshadow care a time-sensitive emergency with an inefficient treatment further increase mortality...
Intracranial circumferential fusiform aneurysms of the posterior circulation involving arterial branches or perforating vessels are difficult to treat. This article shows an endovascular reconstruction technique not yet described, using a telescoping self-expandable stent (LEO+) and flow-diverter device (SILK) at different surgical times. Two patients with aneurysm, one being aneurysm segments P2 P3 cerebral artery, diagnosed after headache, other partially thrombosed lower basilar following...
Giant brain aneurysms account for approximately 5% of all intracranial aneurysms, often presenting with intraluminal thrombosis that causes a mass effect in surrounding neural structures. Although its exact growing mechanism remains unknown, they have to be treated. Despite the most recent advances neurosurgical fields, best treatment modality unknown and surgery giant superior cerebellar artery (SCA) still is challenge even experienced neurosurgeons, due their deep location, perforating...
A 42-year-old woman presented with headache, galactorrhoea, marked hyperprolactinemia and normal neurologic examination. CT, MR MR-angiography showed an intracavernous carotid artery aneurysm minimal displacement of the pituitary stalk. Treatment by embolisation using GDC coils allowed exclusion aneurysm. Galactorrhoea resolved serum prolactin levels fell to after eight months. Follow-up absence aneurysm, although discrete mass effect persisted, suggesting that hyperprolactinaemia was due...
Here we describe a successful mechanical thrombectomy (MT) for acute large vessel occlusion in stroke treatment with one passage (thrombolysis cerebral infarction, TICI 3). Immediately after the withdrawing of stent retriever, narrowing middle artery was diagnosed. The rate vasospasms during this procedure can be as higher 41% (range from 6-41%). our protocol when is visualized retriever withdrawn. A patient presented emergency room National Institute Health Stroke Scale (NIHSS) 21, Alberta...
This is a case demonstrating combined traumatic lesion of the internal carotid artery (dissection and cavernous fistula [CCF]) in patient who was beaten during robbery and, while trying to escape, hit by vehicle. Endovascular approach for treatment chosen using retrograde access from vertebral sinus posterior communicating (Pcom) due occlusion ipsilateral carotid. Because impossible, Pcom done treat direct CCF. A presented with left hemiplegia proptosis, chemosis, right eye ptosis. Computed...
This case report describes a combined neurosurgical and endovascular approach for the treatment of conus medullaris arteriovenous malformation resulting in considerable improvement patient’s neurological condition (modified Rankin Scale score 2).
Background: Despite evidence supporting the overall efficacy of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) anterior circulation, it is unclear whether treatment effect MT differs by sex different populations. We assessed impact differences RESILIENT trial. Methods: was a prospective, multicenter, randomized phase III trial that designed assess safety, efficacy, and cost-effectiveness as compared medical alone patients treated under less...
Background. Anatomical variation in the anterior communicating artery complex is one of challenging points when choosing between endovascular or surgical approach to treat aneurysms this region. Besides, most common location for aneurysms. Here we present our diagnostic angiography image protocol using overlay tool fully understand anatomical region which assists best therapeutic planning lesions location. Method. The authors performed a review available data regarding reconstruction tool....
OBJECTIVES : Our purpose is to describe the experience of our service with thrombotic vasculopathies through your main imaging findings and etiologies. BACKGROUND Among many causes ischemic stroke, some events occur without a well-defined etiology are labeled as cryptogenic. Cryptogenic stroke accounts for about 30 percent strokes in most modern registries databases. The cerebral (CTV) (usually associated primary prothrombotic disorders) possible cryptogenic diagnostic challenges, usually...