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1.
Rev. argent. neurocir ; 35(3): 287-287, sept. 2021.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1427069

RESUMO

Con regularidad, llegan a mi consulta pacientes con aneurismas que fueron hallazgos incidentales durante estudios de imagen realizados por otras causas puntuales (v.gr. cefalea recurrente, adormecimiento facial, trauma craneal o simplemente por estudios de revisión rutinarios). El hallazgo de una imagen compatible con un aneurisma inicia una serie de comentarios y recomendaciones por el médico tratante (que frecuentemente no es neurocirujano). Algunas de ellas son dirigidas con conocimiento del tema hacia opciones quirúrgicas o endovasculares, en otros casos, existe un sesgo evidente y recomendaciones que se salen de las guías de manejo hechas por las asociaciones dedicadas al tema. Un factor muy común es el hecho de que el paciente llega frecuentemente aterrorizado al consultorio por las recomen-daciones realizadas por el médico que hace el diagnóstico ("es una lesión mortal", "tiene alto riesgo de ruptura si no se trata inmediatamente", "no debe hacer ningún esfuerzo", etc.). Desafortunadamente, estas afirmaciones son en ocasiones ratificadas por neurocirujanos.


Assuntos
Aneurisma , Pacientes , Neurocirurgiões , Cefaleia
2.
Rev. argent. neurocir ; 35(3): 288-289, sept. 2021.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1427070

RESUMO

El gran avance de los estudios neuro-radiológicos no invasivos ha resultado en un incremento en el diagnóstico de aneurismas cerebrales incidentales. Esto genera un dilema frente a la indicación de tratamiento preventivo de los aneurismas no rotos que se diagnostican en forma casual, teniendo en cuenta la devastadora cifra de morbimortalidad de la hemorragia subaracnoidea aneurismática. La prevalencia de los aneurismas intracraneanos en la población general es del 3.2 % 1, mientras que la incidencia de la hemorragia subaracnoidea es 6-10/100.000 habitantes/año; por lo que podemos inferir que la tasa de ruptura es baja 2,3. El riesgo de ruptura de un aneurisma no roto oscila del 0.1 al 4% por año dependiendo de los factores de riesgo a los que esté asocia-do, lo cual debe confrontarse con los riesgos inherentes al tratamiento de los aneurismas no rotos tanto por vía quirúrgica convencional como endovascular a la hora de tomar una decisión sobre su manejo


Assuntos
Aneurisma , Terapêutica , Diagnóstico , Neurocirurgiões
3.
Rev. argent. neurocir ; 35(3): 290-291, sept. 2021.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1427072

RESUMO

La amable invitación a escribir este artículo me llevó al interesante ejercicio de reflexionar sobre qué hago y cómo enfrento a un paciente que llega a la consulta derivado con un aneurisma cerebral incidental: día normal en el consultorio, tratar de resolver en forma simple problemas que son com-plejos.Como en toda consulta primero hay que escuchar y hacerse la idea de cómo viene el paciente, si está asustado, si muestra buena predisposición ¿Pregunta tranquilo qué hacer después de un hallazgo inesperado o llega desconfiado, de consulta en consulta, buscando definiciones u opiniones acerca de un aneurisma que le han encontrado en un estudio por una cefalea poco clara?Comprendo la ansiedad y la incertidumbre que genera la noticia. Ponerlo en contexto general a veces ayuda: 3 al 5% de la población tiene aneurismas cerebrales, la mayoría pequeños y la posibilidad de un sangrado es del 1% anual o menos


Assuntos
Aneurisma , Pacientes , Aneurisma Intracraniano , Neurocirurgiões
4.
Rev. argent. neurocir ; 35(1): 59-63, mar. 2021.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1397688

RESUMO

Introducción: El entrenamiento y la cuidadosa planificación preoperatoria son importantes para el éxito de cualquier procedimiento neuroquirúrgico. Un modelo 3D de una lesión en base de cráneo ha probado ser de especial utilidad en evidenciar la disposición espacial específica del tumor, y sus relaciones, agregando factores que optimizan la planificación quirúrgica. Objetivos: Emular la práctica de Impresión 3D en nuestro medio y analizar su utilidad para la planificación quirúrgica. Presentación del caso: Paciente femenino de 41 años que concurre a la consulta por trastornos endócrinos, campimétricos y cefalea. Al examen paciente estaba lúcida, con pupilas intermedias hipo reactivas, hemianopsia bitemporal, movilizando 4 miembros sin déficit. En RM de cerebro se observa lesión espacio ocupante selar-supraselar con aspecto multilobulado, que invade cisterna interpeduncular y desplaza estructuras del tercer ventrículo. Intervención: La paciente fue sometida a cirugía resectiva por abordaje subfrontal, logrando resección macroscópica completa. Evolucionando posteriormente con GOS 5. Conclusión: La realización de modelos en impresión 3D provee importantes perspectivas para el abordaje a la lesión y constituyen una importante herramienta de bajo costo para neurocirujanos en formación. Destacamos la importancia de la interdisciplinariedad para el arribo a resultados favorables.


Introduction: Effective surgical training and careful preoperative planning are important for success in neurosurgical procedures. As a 3D printed skull base lesion model shows the specific spatial arrangement of a tumor, and its anatomical relations, we believe it could play an important role in surgical planning. Objectives: Emulate the practice of 3D Printing in our environment and analyze its usefulness for surgical planning. Case presentation: 41-year-old female patient who attends the consultation for endocrine, visual field disorders and headache. On examination, the patient was lucid, with hypo reactive intermediate pupils, bitemporal hemianopia, mobilizing 4 extremities without deficit. In MRI of the brain, a selar-suprasellar space-occupying lesion with a multilobed appearance is observed, which invades the interpeduncular cistern and displaces structures of the third ventricle. Intervention: The patient underwent resective surgery through a subfrontal approach, achieving complete macroscopic resection. Evolving later with GOS 5 Conclusion: 3D printing models provide to us important of perspectives for the approach to the lesion and constitute an important low-cost tool for neurosurgeons in training. We highlight the importance of interdisciplinarity for the arrival of favorable results.


Assuntos
Feminino , Neoplasias , Crânio , Base do Crânio , Procedimentos Neurocirúrgicos , Planejamento , Impressão Tridimensional , Neurocirurgiões , Neurocirurgia
5.
Rev. argent. neurocir ; 34(4): 262-279, dic. 2020. ilus, tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1150434

RESUMO

Introducción: En las últimas décadas el uso de la posición sentada ha disminuido en frecuencia a causa de 2 complicaciones mayores: el embolismo aéreo venoso y la hipotensión intraoperatoria. Sin embargo es innegable que la posición sentada ofrece una serie de ventajas al neurocirujano, el anestesiólogo y al electrofisiólogo. Materiales y métodos: Estudio retrospectivo de pacientes operados en dos instituciones de Tucumán, entre enero de 2015 y diciembre de 2019. Resultados: Se operaron un total de 119 pacientes en posición sentada por vía posterior. Conclusión: Se presentó la técnica de posición semisentada paso a paso y consejos específicos. Se ilustró la utilidad de la misma mediante la presentación de casos representativos


Introduction: In the last decades, the use of the sitting position has been abandoned due to 2 major complications: venous air embolism and intraoperative hypotension. However, it is undeniable that the sitting position offers a series of advantages to the neurosurgeon, the anesthesiologist and the electrophysiologist. Materials and methods: Retrospective study of patients operated at two institutions in Tucumán, between January 2015 and December 2019. Results: A total of 119 patients were operated in a sitting position and posterior approach. Conclusion: The sitting position technique was presented step by step in detail, with the key steps and a series of tricks. The usefulness of the position was illustrated by presenting representative cases


Assuntos
Embolia Aérea , Posicionamento do Paciente , Neurocirurgiões , Neurocirurgia
6.
Rev. argent. neurocir ; 34(4): 337-341, dic. 2020. tab, graf
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1150486

RESUMO

La Federación Nacional de Neurocirugía (FNNC) fue fundada en la ciudad de Rosario el 23 de agosto de 2019, con el objetivo de crear una organización que nu-clee a todas las sociedades y asociaciones de neurociru-gía de nuestro país, con un perfil netamente gremial. La FNNC reconoce a la Asociación Argentina de Neuroci-rugía (AANC) como la organización que rige la activi-dad académica-profesional de la neurocirugía en todo el territorio de la República Argentina.Uno de los propósitos principales es lograr condiciones laborales dignas y correctamente remuneradas para to-dos los neurocirujanos que residan en suelo argentino. Pensamos que una de las herramientas necesarias para conseguir dicho propósito es lograr un equilibrio entre el número de neurocirujanos en actividad, el número de plazas de residentes, y el número de habitantes en Ar-gentina.Actualmente no existen datos concretos para realizar un diagnóstico de situación. Es por ello que la FNNC, apoyada y avalada por la AANC, tomó la iniciativa de realizar un análisis descriptivo de la situación actual y su proyección en los próximos años en relación con el nú-mero de neurocirujanos en Argentina.El objetivo del presente trabajo es presentar de forma sintética y clara los aspectos más relevantes de dicho es-tudio.


Assuntos
Neurocirurgia , Trabalho , Neurocirurgiões
7.
Rev. argent. neurocir ; 34(4): 342-347, dic. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1150489

RESUMO

Uno de los objetivos de la Asociación Argentina de Neurocirugía (AANC) es la educación. La heterogeneidad en la formación teórica de los neurocirujanos argentinos originó la falta de un estándar en la adquisición, crecimiento y mantenimiento de las competencias. Para resolverlo se comenzó un proceso centrado en la educación de calidad que buscó establecer estándares teóricos. Fue esencial el uso del aprendizaje electrónico para poder llegar a todos los rincones del país y lograr una formación teórica homogénea. Al aprobar los contenidos de los cursos on-line, más la experiencia práctica obtenida durante la residencia, el postulante estaría en condiciones de rendir el examen final de certificación e ingresar como miembro titular a la AANC. Los resultados de esta estrategia mostraron que todos los postulantes para los exámenes de certificación tuvieron la misma formación teórica. También se produjo un gran aumento de los postulantes a la certificación. Los resultados demuestran que cuando se crean las condiciones adecuadas, los profesionales participan y se someten a las exigencias de un examen de certificación.


One of the objectives of the Asociación Argentina de Neurocirugía (AANC) is education. Heterogeneity in the theoretical training of Argentine neurosurgeons caused the lack of a standard in the acquisition, growth and maintenance of competencies. To resolve this, a process focused on quality education began, which sought to establish theoretical standards. The use of electronic learning was essential to be able to reach all corners of the country and achieve homogeneous theoretical training. By passing the contents of the online courses, plus the practical experience obtained during the residency, the applicant would be able to take the final certification exam and enter the ANA as a full member. The results of this strategy demonstrated that all applicants for the certification exam had the same theoretical training. Also, there was a large increase in applicants for certification and that when the right conditions are created, professionals participate and submit to the demands of a certification exam


Assuntos
Neurocirurgia , Certificação , Educação , Cursos , Neurocirurgiões , Aprendizagem
8.
Arq. bras. neurocir ; 39(3): 192-196, 15/09/2020.
Artigo em Inglês | LILACS | ID: biblio-1362433

RESUMO

We know Kocher's name as an anatomical reference in neurosurgery. In fact, Theodor Kocher was a Swiss general surgeon, and his contributions were such that Kocher was honored in 1909 with the Nobel Prize in Medicine and Physiology, and he was the first surgeon to receive this honor. Kocher participated in the initial scientific phase of medicine, livingwith names that are in history, as well as him; Langenbeck and Virchow, Lucke, Billroth, Horsley, Lister, Halstedt, Pasteur, Osler, Lawson Tait, Verneuil, and a long list and other icons of the time. The present account rescues the many important facets and contributions of the Swiss surgeonTheodor Kocher, and his relationship with several of them. Kocher's memory, surgical instruments and literary production are preserved in a small wing of the University of Bern. The present article highlights how intense Kocher's dedication to the medical field was.


Assuntos
História do Século XIX , História do Século XX , Cirurgia Geral/história , Procedimentos Neurocirúrgicos/história , Epilepsia/cirurgia , Neurocirurgiões/história , Instrumentos Cirúrgicos/história , Neurocirurgia/história , Neurocirurgia/instrumentação
9.
Rev. argent. neurocir ; 34(3): 194-199, sept. 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1120912

RESUMO

El manejo de pacientes debido a la aparición del nuevo coronavirus 2019 (COVID-19) representa un desafío para los equipos médicos y quirúrgicos, ya que modificó el funcionamiento de los sistemas de salud en casi todo el mundo. Para contribuir a la re organización del sistema de salud, el Servicio de Neurocirugía del Hospital Italiano de Buenos Aires trabajó en adoptar distintas medidas en concordancia con las tomadas a nivel institucional y nacional; por lo que se analizó la bibliografia publicada, asi como las normas dictadas por el comité de crisis de nuestra institucion. A su vez realizamos una breve encuesta dirigida a neurocirujanos de america latina para conocer como se manejaban actualmente en relación a niveles de protección y realización de cirugias. La actual pandemia de COVID-19 es el mayor desafío que enfrentan los sistemas nacionales de salud en los últimos tiempos. Los neurocirujanos podemos contribuir a la reducción del riesgo de infección nosocomial de los trabajadores de la salud al adaptar distintos protocolos en pacientes con COVID-19.


Patient's management due to the appearance of new coronavirus 2019 (COVID-19) represents a challenge for medical and surgical departments, since it modified the running of health systems in almost all the world. In order to help in this new situation, the Neurosurgical Department of our institution has adopted different measures in accordance with those taken at institutional and national level. In order to do this, we made a literature review and we added to this, the norms dictated by the crisis committee of our hospital. We also carried out a brief survey among neurosurgeons from Latin America to find out how they managed protection levels in relation to surgery. COVID-19 pandemic is certainly one of the greatest challenge national health systems face in a century. Adapting different protocols in neurosurgical patients with COVID-19 can contribute in reducing the risk of nosocomial infection of health workers.


Assuntos
Humanos , Infecções por Coronavirus , Pessoal de Saúde , Coronavirus , Pandemias , Neurocirurgiões , Neurocirurgia
10.
Arq. bras. neurocir ; 39(2): 68-78, 15/06/2020.
Artigo em Inglês | LILACS | ID: biblio-1362493

RESUMO

Introduction The neurosurgical practice often involves situations that require rapid and immediate decisionmaking, and a very lowmargin for error may eventually lead to an unsatisfactory clinical outcome. Thus, neurosurgery is considered as a medical specialty with high risk for the occurrence of litigation for supposed malpractice. The main objective of the present study was to identify the most prevalent epidemiological profile of the authors of civil claims for alleged malpractice against neurosurgeons, as well as to identify the legal strategies most commonly employed in this type of lawsuit. Methods This is a descriptive, retrospective and quantitative study, with review of the initials/exordials of all civil actions motivated by alleged malpractice against neurosurgeons, defended by an office specialized in Medical Law, from 2008 to 2018. Data were collected relative to the author of the action; the disease that led to the outbreak of the action; and some legal information of interest for the outcome of the litigation. Results During the period studied, 16 compensation/eviction claims were identified as being motivated by supposed neurosurgical malpractice. The average age of the authors was 51 years old; with a high school or undergraduate level of education in 75% of the cases, and especially from the Class B social extract (43%). Degenerative affections of the lumbar spine (12 cases, 75%) were the most common diseases that motivated the litigation, followed by brain tumors (2 cases, 12.5%), 1 case of carpal tunnel syndrome, and 1 case of chronic pain due to inflammatory radiculitis. The average value of the sponsored claim was 649,000.00 reais. Justice gratuity was granted in 80% of the cases and the reversal of the burden of proof by 30%. The main documentary evidence was medical reports ­ from third parties or the surgeon him/herself, and medical records.


Assuntos
Brasil/epidemiologia , Erros Médicos/legislação & jurisprudência , Decisões Judiciais , Neurocirurgiões/ética , Epidemiologia Descritiva , Estudos Retrospectivos , Imperícia , Neurocirurgia/ética
11.
Rev. cuba. med. mil ; 49(2): e525, abr.-jun. 2020.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139004

RESUMO

Experiencias y reflexiones del Dr. José Hernán Salas Rubio, presentadas en forma de conferencia, en el Congreso Internacional Neuro-Cuba 2017. Es profesor titular y consultante, uno de los más prominentes neurocirujanos cubanos. Ha trabajado como neurocirujano desde 1962 y contribuido a la formación de jóvenes neurocirujanos. Ha publicado cinco libros y más de cincuenta artículos científicos(AU)


Experiences and reflections of Dr. José Hernán Salas Rubio, presented as a lecture, at the Neuro-Cuba International Congress 2017. He is a full professor and consultant, one of the most prominent Cuban neurosurgeons. He has worked as a neurosurgeon since 1962 and contributed to the training of young neurosurgeons. He has published five books and more than fifty scientific articles(AU)


Assuntos
Humanos , Masculino , Feminino , Neurocirurgiões/história , Mentores/história , Consultores
12.
Rev. argent. neurocir ; 33(3): 147-150, sep. 2019. graf
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1177355

RESUMO

Introducción: Debido a la naturaleza impredecible y demandante de la neurocirugía, es necesaria una comunicación segura y rápida entre colegas. WhatsApp se presenta, en este contexto, como una solución rentable, fácil, accesible y rápida. Por la característica fugaz de la tecnología los avances preceden a las normativas. Actualmente WhatsApp es una herramienta frecuente en los equipos neuroquirúrgicos y nos encontramos utilizando una herramienta de forma diaria e ignorando las consecuencias que puede traer el intercambio de información de pacientes en un medio que no se encuentra diseñado para tal fin. El presente trabajo pretende medir la adhesión de WhatsApp en neurocirugía y el nivel de conocimiento sobre sus ventajas y desventajas. Métodos: Se elaboró una encuesta sobre el uso del WhatsApp en Neurocirugía que se entregó impresa aleatoriamente a 150 neurocirujanos. Resultados: Se encuestaron 112 neurocirujanos con una edad promedio de 34 años. Un 98% usa Smartphone y la totalidad de estos usa WhatsApp. Un 96% utiliza WhatsApp para resolver cuestiones médicas fuera de su horario de trabajo. Ninguno de los entrevistados conoce el marco legal de WhatsApp. Conclusiones: Existe una fuerte adhesión al uso de WhatsApp en la práctica médica por parte de los neurocirujanos en Argentina. Esto se debe a su uso fácil, rápido, grupal y económico, que se adecua a la perfección con el ritmo y complejidad de nuestra profesión. Sin embargo, existe un total desconocimiento del marco legal de esta aplicación, del déficit de seguridad de los datos on-line; lo que se traduce en un potencial riesgo a la confidencialidad del acto médico.


Background: Due to the unpredictable and demanding nature of neurosurgery, safe and rapid communication between colleagues is necessary. WhatsApp is presented as a cost-effective, easy and accessible solution. Because of the rapid advanced of technology, it usually precedes regulations. Currently WhatsApp is a frequent tool in neurosurgical teams and we find ourselves using an instrument on a daily basis and ignoring the consequences that the exchange of patient information using this method can bring. The present work aims to measure the adherence of WhatsApp in neurosurgery and the level of knowledge about its advantages and disadvantages. Methods: A survey was developed on the use of WhatsApp in Neurosurgery that was delivered randomly to 150 neurosurgeons. Results: 112 neurosurgeons with an average age of 34 years were surveyed. 98% use Smartphone and all of them use WhatsApp. 96% use WhatsApp to resolve medical issues outside of their work hours. None of the interviewees knows the legal framework of WhatsApp. Conclusions: There is a strong adherence to the use of WhatsApp in medical practice by neurosurgeons in Argentina. This is due to its easy, fast, and economic use, which is perfectly adapted to the rhythm and complexity of our profession. However, there is a total ignorance of the legal framework of this application which translates into potential risks to patient's confidentiality.


Assuntos
Neurocirurgia , Tecnologia , Comunicação , Disseminação de Informação , Ética , Smartphone , Neurocirurgiões
13.
Arq. bras. neurocir ; 38(3): 246-249, 15/09/2019.
Artigo em Inglês | LILACS | ID: biblio-1362582

RESUMO

This article describes the milestones in the life Brazil's greatest neurosurgeons, Professor Fernando Costa. Born and raised in the city of Pelotas, RS, Professor Fernando was an exemplary doctor. As former director and professor at the Catholic University of Pelotas, School of Medicine, his courage as well as his ethical attitude and transparency were the central traits of this masterful teacher. He will be eternally remembered as a great physician, teacher, father, husband, grandfather and friend.


Assuntos
História do Século XX , História do Século XXI , Docentes de Medicina/história , Neurocirurgiões/história , Neurocirurgia/história
14.
Arq. bras. neurocir ; 37(4): 309-316, 15/12/2018.
Artigo em Inglês | LILACS | ID: biblio-1362659

RESUMO

Introduction The objective of the present study was to review the epidemiological aspects of malpractice in neurosurgery and to identify preventive measures regarding malpractice for neurosurgeons. Methods The following terms (alone or in combination) were searched in the PubMed and Biblioteca Virtual em Saúde databases: neurosurgery (neurocirurgia), lawsuits (ações judiciais), malpractice (erro médico), and litigation (litígio) and identifying studies on these topics published from 2000 to April 2018. Literature Review In Brazil, 6.9% of the physicians are sued per year. The most common type of malpractice alleged in litigation is negligence. According to the literature, the neurosurgical disease that has sparked the most litigation is spinal disease. The outcomes of these cases vary: sometimes the neurosurgeon prevails, and at other times the plaintiff prevails. To prevent or reduce malpractice claims, the neurosurgeon should take the following precautions: 1. follow medical protocols; 2. perform surgeries in an environment consistent with good medical practice; 3. evaluate and monitor antibiotic prophylaxis; 4. develop a good relationship with the patient based on ethics, good faith and transparency; 5. request the presence of the patient and of his or her family when there is a problem in order to didactically explain the case; 6. keep good medical records to document all of the actions performed (informed consent and description of the surgery and of the pre and postoperative); 7. always seek technical improvement (continuing education/professional development); 8. in the case of attending physicians, monitor patients, treating any postoperative complications; and 9. conduct multidisciplinary team meetings to optimize treatment decisions and to share responsibility for making difficult decisions.


Assuntos
Erros Médicos/legislação & jurisprudência , Erros Médicos/prevenção & controle , Ética Médica , Imperícia/legislação & jurisprudência , Neurocirurgia/legislação & jurisprudência , Prática Profissional , Brasil , Neurocirurgiões/ética
15.
Arq. neuropsiquiatr ; 74(12): 1008-1013, Dec. 2016. tab
Artigo em Inglês | LILACS | ID: biblio-828005

RESUMO

ABSTRACT In order to verify indications for surgery, 27 patients with refractory epileptic seizures and brain tumor, aged up to 19 years at the time of surgery, were studied between 1996 and 2013 and followed up for at least one year. The mean interval between the onset of seizures and the diagnosis of the tumor was 3.6 years, and from diagnosis to the surgery, 18 months. The location of the tumor was in the temporal lobe in 16, with ganglioglioma and dysembryoplastic neuroepithelial tumors being the most frequent. Among the patients, 92.5% and 90.4% were seizure-free in the first and fifth year after surgery, respectively. Twelve of 16 children were successful in becoming drug-free, with complete withdrawal by 3.2 years. Surgery proved to be potentially curative and safe in these cases, suggesting that the tumor diagnosis and surgery cannot be postponed.


RESUMO A fim de verificar os aspectos da indicação cirúrgica, vinte e sete pacientes com epilepsia refratária secundária a tumor cerebral, com idade de até 19 anos na cirurgia, operados entre 1996 e 2013 e seguidos por pelo menos um ano, foram estudados. O intervalo médio entre o início das crises e o diagnóstico do tumor foi de 3,6 anos, e deste para a cirurgia, 18 meses. A localização do tumor foi lobo temporal em 16, sendo ganglioglioma e DNET os tipos mais frequentes. Entre os pacientes, 92,5% e 90,4% estavam livres de crises no primeiro e no quinto ano após a cirurgia, respectivamente. Doze de 16 crianças obtiveram sucesso na retirada de drogas, com a média de tempo de 3,2 anos após o procedimento. A cirurgia provou ser potencialmente curativa e segura nestes casos, o que sugere que perante o diagnóstico de tumor esta não pode ser adiada.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Neoplasias Encefálicas/cirurgia , Epilepsia/cirurgia , Período Pós-Operatório , Neoplasias Encefálicas/complicações , Cuidados Pré-Operatórios , Estudos Transversais , Estudos Retrospectivos , Seguimentos , Neoplasias Neuroepiteliomatosas/cirurgia , Neoplasias Neuroepiteliomatosas/complicações , Ganglioglioma/cirurgia , Ganglioglioma/complicações , Procedimentos Neurocirúrgicos , Epilepsia/complicações , Neurocirurgiões
16.
Cambios rev. méd ; 15(1): 67-69, ene. - 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-1008566

RESUMO

Introducción: Los traumatismos craneoencefálicos penetrantes son cada vez más frecuentes en la sociedad actual, por lo que el neurocirujano debe estar preparado para atenderlas, siguiendo las guías y recomendaciones para su manejo. Caso: Paciente masculino joven, quien recibió puñalada en el rostro, llegó a la sala de emergencia desorientado y hemiparético. Se comprobó la presencia de arma blanca intracraneal y luego de los exámenes de imagen se procedió en sala de operaciones a retirar el arma retenida, luego de hemostasia y cierre de fístula. Luego de la intervención quirúrgica, fue atendido en la Unidad de Cuidados Intensivos. El control tomográfico posoperatorio no evidenció sangrado. Hubo reversióncompleta de la hemiparesia, sin signos de fistula ni infección. El paciente tuvo una buena evolución hasta su egreso, 12 días más tarde. Discusión: Las imágenes tomográficas y de angiotomografía son de gran ayuda para el neurocirujano, quien precisa de esa información para prevenir potenciales complicaciones intraoperatorias y secuelas neurológicas en el tratamiento quirúrgico de pacientes que han sufrido un trauma craneoencefálico penetrante.


Introduction: Penetrating head injuries are becoming more and more frequent in nowadays socity, therefore, the neurosurgeon should be prepared to deal with. We must stick at rigid surgical protocols. Case: A young male patient stabbed on his face was admitted in the emergency unit of our hospital. He was disoriented and hemiparetic with a knife inside the skull shown by image examns. Patient was sent to the operating room where the neurosurgeon proceeded to remove the knife, under controlled conditions and hemostasis. A brain fistula was closed and the patient was sent to the Intensive Care Unit in the postoperative period. Tomographic control showed no bleeding. Eventually, he was discharged in good condition after 12 days with complete reversal of hemiparesis, without infection or fistula. Discusion: Tomographic imaging and angiography are useful tools for the neurosurgeon, who needs key information to prevent surgical complications and neurologic sequelae when dealing with patients who suffered penetrating head trauma.


Assuntos
Humanos , Masculino , Adulto , Paresia , Tomografia , Traumatismos Cranianos Penetrantes , Neurocirurgiões , Lesões Encefálicas Traumáticas , Hemostasia , Patologia , Emergências , Unidades de Terapia Intensiva
17.
Arq. neuropsiquiatr ; 73(8): 688-691, 08/2015. tab
Artigo em Inglês | LILACS | ID: lil-753038

RESUMO

The power of interpretation in the analysis of cranial computed tomography (CCT) among neurosurgeons and radiologists has rarely been studied. This study aimed to assess the rate of agreement in the interpretation of CCTs between neurosurgeons and a radiologist in an emergency department. Method 227 CCT were independently analyzed by two neurosurgeons (NS1 and NS2) and a radiologist (RAD). The level of agreement in interpreting the examination was studied. Results The Kappa values obtained between NS1 and NS2 and RAD were considered nearly perfect and substantial agreement. The highest levels of agreement when evaluating abnormalities were observed in the identification of tumors, hydrocephalus and intracranial hematomas. The worst levels of agreement were observed for leukoaraiosis and reduced brain volume. Conclusions For diseases in which the emergency room procedure must be determined, agreement in the interpretation of CCTs between the radiologist and neurosurgeons was satisfactory. .


O poder de interpretação na análise de tomografias de crânio (TCC) entre neurocirurgiões e radiologistas tem sido pouco estudada. O objetivo deste estudo é avaliar as taxas de concordância na interpretação de TCCs entre neurocirugiões e radiologista em um departamento de emergência. Método 227 TCCs foram independentemente analizadas por 2 neurocirugiões (NC1 e NC2) e um radiologista(RAD). O índice de concordância nas análises foi estudada posteriormente. Resultados O valor de Kappa obtido entre os NC1 e NC 2 e entre estes e RAD foram quase perfeitos e substancial respectivamente. O maiores índices de concordância quando avaliadas anormalidades foram observados na identificação de tumores, hidrocefalia e hematomas intracranianos. O piores índices foram observados com relação a leucaraiose e redução volumétrica. Conclusão Para doenças apresentadas em um departamento emergência que demandam tratamento mais agressivo o índice de concordância na interpretação de TCCs entre RAD e NC foi satisfatório. .


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Encefalopatias , Serviço Hospitalar de Emergência/normas , Neurocirurgiões/normas , Radiologia/normas , Tomografia Computadorizada por Raios X/normas , Corpo Clínico Hospitalar/normas , Variações Dependentes do Observador , Valores de Referência , Crânio
19.
Coluna/Columna ; 12(3): 218-223, 2013. ilus
Artigo em Português | LILACS | ID: lil-694040

RESUMO

OBJETIVO: Realizar estudo transversal identificando o perfil do cirurgião de coluna no Brasil. MÉTODOS: Foram coletados dados por meio de questionários com múltiplas alternativas, em dois eventos de relevância para a cirurgia de coluna no âmbito nacional em 2011, o Congresso da Sociedade Brasileira de Coluna (SBC) e o Simpósio Internacional de Coluna (SINCOL). Os dados foram submetidos a análise estatística comparando e estratificando as informações obtidas conforme o perfil encontrado. RESULTADOS: Obtivemos 182 questionários respondidos por ortopedistas e neurocirurgiões com particularidades e semelhanças em suas condutas médicas. CONCLUSÕES: Os dados obtidos nessa pesquisa podem ser importantes para o desenvolvimento de políticas de saúde na área de cirurgia de coluna no Brasil.


OBJECTIVE: To conduct cross-sectional study identifying the profile of the Brazilian spinal surgeon. METHODS: Data were collected through a questionnaire with multiple alternatives during two major events for spine surgery at national level in 2011, the Congresso da Sociedade Brasileira de Coluna (Congress of the Brazilian Spine Society) and Simpósio Internacional de Coluna (International Spine Symposium, SINCOL). The data were submitted to statistical analysis comparing and stratifying the information obtained according to the profile. RESULTS: We obtained 182 questionnaires answered by orthopedists and neurosurgeons with peculiarities and similarities on their medical management. CONCLUSIONS: The data obtained in this study may be important for the development of health policies in the spine surgery in Brazil.


OBJETIVO: Llevar a cabo estudio transversal para identificar el perfil del cirujano de columna en Brasil. MÉTODOS: Los datos fueron recolectados por medio de cuestionarios con opciones múltiples, en dos eventos de relevancia para la cirugía de columna vertebral, a nivel nacional en 2011, Congreso Brasileño de la Sociedad Brasileña de Columna (SBC) y el Simposio Internacional de Columna (SINCOL). Los datos fueron sometidos a análisis estadístico, comparándose y estratificándose las informaciones obtenidas, de acuerdo con el perfil encontrado. RESULTADOS: Se obtuvieron cuestionarios respondidos por 182 ortopedistas y neurocirujanos, con particularidades y similitudes en sus actividades médicas. CONCLUSIONES: Los datos obtenidos en este estudio pueden ser importantes para el desarrollo de políticas de salud en el área de la cirugía de columna en Brasil.


Assuntos
Estudos Transversais , Coluna Vertebral/cirurgia , Neurocirurgiões , Cirurgiões Ortopédicos
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