Gamma Knife Radiosurgery for Transmodiolar Schwannoma.

BACKGROUND: Rare and deep located tumors are surgical challenge with high morbidity. Minimal invasive techniques should be encouraged for a better outcome. Intralabyrinthine schwannoma (ILS) is a rare benign tumor that usually presents with hearing loss and tinnitus. Surgery is associated with high rate of facial paralysis and deafness. Radiosurgery is an option for tinnitus treatment, without the risk of facial paralysis. CASE DESCRIPTION: A young male patient presented with severe hearing loss and incapacitating tinnitus. Magnetic resonance revealed the presence of a small ILS. Radiosurgery was performed and obtained tinnitus control without complications and no further tumor growth. CONCLUSIONS: Tumor control and symptoms relief could be safely achieved through a precisely plan using Gamma Knife radiosurgery, decreasing morbidity. This is the first radiosurgical description for a transmodiolar schwannoma.

Hidrocefalia aguda: uma revisão bibliográfica / Acute hydrocephalus: a bibliographic review

Introdução: o diagnóstico de hidrocefalia é dado de acordo com o quadro clínico, que geralmente se correlaciona com o achado tomográfico de dilatação do sistema ventricular (ventriculomegalia). A definição de tal condição é definida através do Índice de Evans, que se dá pela razão da maior distância entre as extremidades dos cornos anteriores dos ventrículos laterais pela maior distância entre os hemisférios cerebrais. Objetivo: revisar a fisiopatologia da hidrocefalia aguda, suas apresentações clínicas e condutas que proporcionem uma melhor resolução do quadro dessa emergência neurocirúrgica. Método: informações obtidas através de revisão bibliográfica. Considerações finais: a análise bibliográfica demonstra a importância do rápido diagnóstico da hidrocefalia aguda, suas apresentações clínicas, as melhores condutas a serem definidas para que possam beneficiar a saúde do paciente, porque as consequências geradas pelo aumento da pressão intracraniana podem causar danos irreversíveis.

Introduction: the diagnosis of hydrocephalus is given according to the clinical picture, which usually correlates with the tomographic findings of dilation of the ventricular system (ventriculomegaly). The definition of such condition is defined by the Evans Index, which is given by the ratio of the greater distance between the extremities of the anterior horns of the lateral ventricles by the greater distance between the cerebral hemispheres. Objectives: review the pathophysiology of acute hydrocephalus, its clinical presentations and conducts that provide a better resolution of that neurosurgical emergency. Methods: information obtained through a bibliographic review. Final considerations: the bibliographic review demonstrates the importance of the faster diagnosis of acute hydrocephalus, its clinical presentations and a better resolution to be define a way that could be benefit to patient's health, because the consequences generated by intracranial high-levels pressure can cause irreversible damage.