A subdural hematoma is defined as clot formation in the space after vessel rupture or brain parenchyma damage. Several demographic and tomographic factors were associated to poor prognosis, although some debate according their specific roles still remains.

A 39-year-old man presented with 1-year history of shoulder pain, swelling, and limitation movement. There was a 20-year left arm numbness. Examination showed decreased vibratory sensitivity on shoulder, glenohumeral instability, dislocation. Radiography humeral head destruction (figure 1); spine MRI tonsillar herniation cervical syringomyelia 2). Arthropathy related to diagnosed.

The Sotos syndrome is an autosomal dominant disorder characterized by haploinsufficiency of NSD1 gene, with some individuals affected epilepsy and, rarely, drug-resistant seizures. A 47-years-old female patient was diagnosed focal-onset seizures in left temporal lobe, left-side hippocampal atrophy, and neuropsychological testing decreased performance several cognitive domains. Patient treated lobe resection developed complete awake seizure control 3-years follow-up, marked improvement...

Ulnar nerve mononeuropathy diagnosis can be challenging depending on where neural lesion is present. Repetitive trauma during cycling a rare cause of ulnar neuropathy.We describe two patients who developed the handlebar syndrome, an palsy at Guyon's canal after cycling. The first patient had syndrome short-distance ride and she was treated surgically, while second classical long received conservative treatment. Surgical treatment led to functional recovery.Handlebar neuropathy caused by...

The impact of pulse timing is an important factor in our understanding how to effectively modulate the basal ganglia thalamocortical (BGTC) circuit. Single low-frequency DBS-evoked potentials generated through electrical stimulation subthalamic nucleus (STN) provide insight into circuit activation, but long-latency components change as a function not well-understood. We investigated between pulses delivered STN region influence neural activity and cortex. DBS leads implanted five patients...

Brain edema is the leading cause of death in patients with malignant middle cerebral artery (MCA) infarction. Midline shift (MLS) has been used as a monohemispheric brain marker several studies; however, it does not precisely measure edema. It now possible to directly hemisphere volume. Knowledge about time course after infarction may contribute condition's management.Therefore, our goal was evaluate MCA treated decompressive craniectomy (DC) using hemispheric volumetric...

The therapeutic efficacy of deep brain stimulation (DBS) the subthalamic nucleus (STN) for Parkinson's disease (PD) may be limited some patients by presence stimulation-related side effects. Such effects are most often attributed to electrical current spread beyond target region. Prior computational modeling studies have suggested that changing degree asymmetry individual phases biphasic, stimulus pulse allow more selective activation neural elements in To extent different contribute vs....

High accuracy and precision are essential in stereotactic neurosurgery, as targeting errors can significantly affect clinical outcomes. Image registration is a vital step stereotaxis, understanding the error associated with different image methods important to inform choice of equipment techniques neurosurgery. The authors aimed quantify test-retest reliability cone-beam CT (CBCT) compared current gold-standard technique (i.e., CT).

To improve reproducibility of positive outcomes from cerebellar dentate stimulation for chronic stroke, we hypothesized that the volume tissue activated (VTA) (dentateVTA) proximity to functionally connected ipsilesional motor-associated cortices (dentateFC-ipsi-motor) would be associated with improved arm impairment/function metrics. DentateVTA was estimated using computed tomography and T1-weighted MRI. DentateFC-ipsi-motor fMRI (resting state). Significant correlations metric improvement...

Malignant middle cerebral artery (MCA) infarction is associated with high mortality, mainly due to intracranial hypertension. This malignant course develops when two-thirds or more of MCA territory infarcted. Randomized clinical trials demonstrated that in patients infarction, decompressive craniectomy (DC) better prognosis. In these patients, some prognostic predictors are already known, including age and time between stroke DC. The size bone flap was not long-term prognosis the previous...

Posterior fossa arteriovenous malformations (AVMs) can be a challenging disease, especially those large in size. AVMs treated with combination of endovascular treatment and microsurgery. Here, the authors present case 16-year-old female patient progressive dizziness episodic syncope. The workup showed hemispheric cerebellar AVM, Spetzler-Martin grade IV. She underwent combined (endovascular microsurgery) no complications cure malformation. video found here: https://youtu.be/rNw_Kyd76Mg

A 29-year-old male patient with an untreated HIV infection for seven years presented a two-month history of neck pain, progressive left-hand weakness and numbness.Physical examination showed C5-C6 territory hypoesthesia urinary bladder retention.A spinal MRI (Figure 1) single contrast-enhanced lesion at C4-C6 level, cerebrospinal fluid analysis 3.6 white blood cells/mm 3 positive IgG toxoplasma.Despite empiric treatment, the disease progressed locally to brainstem.Autopsy 2) disseminated CNS...

A 44-year-old woman presented with childhood-onset refractory complex partial seizures.Medical history revealed neonatal macrosomia and hypotonia, early-onset overgrowth in infancy, macrocephaly mild intellectual disability.Examination macrodolichocephaly prominent forehead facial dysmorphisms, scoliosis, large hands arachnodactyly (Figure 1).Neuroimaging showed macrocerebellum, ventriculomegaly persistent cavum septum pellucidum 2).Clinical neuroimaging features were diagnostic of Sotos...

Apresentacao do caso: Paciente de 55 anos, generp masculino, com aneurisma roto segmento oftálmico da artéria carótida interna, no qual foi utilizado a técnica híbrida para remocão em bloco processo clinoideo anterior por meio craniotomia minipterional. A inicia-se drilagem asa menor esfenóide, seguida abertura dural, relaxamento cerebral, dissecção fissura silviana e exposição clinoide anterior, após ressecção dura-mater que recobre. Visualizado o plano esfenoidal, segue-se deste desconexão...

Introdução: Hipertensão intracraniana idiopática também denominada pseudotumor cerebral e hipertensão benigna é uma doença caraterizada por sem lesão de massa ou aumento ventricular, sendo mais prevalente em mulheres idade fértil obesas. Os cistos Tarlov são preenchidos líquido cerebrospinal que normalmente se posicionam próximos dos gânglios sensitivos nervos espinais. Não sabe exatamente a etiologia destes cistos, porém alguns autores sugerem sua relação com pressão intracraniana.

Introdução: Dilatações diverticulares ventriculares geralmente estão associadas a, conforme consta na literatura, hidrocefalia obstrutiva crônica, sendo que esta deformidade pode ser causada pelo choque do fluxo pulsátil líquor contra as paredes dos ventrículos por longos períodos de tempo. Esta alteração morfológica costuma acometer a parede medial átrio laterais, mas outras porções dessas cavidades também podem eventualmente acometidas. Nosso relato traz um caso uma paciente 21 anos, sexo...

Introdução: A dor lombar discogênica representa um dos mecanismos etiológicos da nos transtornos degenerativos de disco lombar. Sua etiologia é parcialmente entendida, com uma hipótese descrevendo a origem partir distorção das lamelas do anel fibroso discal decorrente degeneração núcleo pulposo, levando à sensibilização nociceptores na periferia intervertebral, além já por substâncias produzidas nas cascatas inflamatórias (fosfolipase A2, óxido nitroso, interleucina-1 e enzimas família...

Realizada análise da casuística dos pacientes submetidos, pelos membros do setor de Cirurgia Coluna disciplina Neurocirurgia UNIFESP/EPM, a artrodese com cage autoancorado inserido por via anterior e sem suplementação posterior (“ALIF”). Todos os procedimentos foram realizados meio acesso feito mini-incisão retroperitoneal esquerda um especialista em Vascular. Usamos como critério inclusão para realização procedimento presença discopatia degenerativa com, pelo menos, 4 mm altura disco....