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1.
Rev Med Virol ; 30(5): e2118, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32687681

RESUMO

Human Coronaviruses (HCoVs) have long been known as respiratory viruses. However, there are reports of neurological findings in HCoV infections, particularly in patients infected with the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) amid Coronavirus disease 2019 (COVID-19) pandemic. Therefore, it is essential to interpret the interaction of HCoVs and the nervous system and apply this understanding to the COVID-19 pandemic. This review of the literature analyses how HCoVs, in general, and SARS-CoV-2, in particular, affect the nervous system, highlights the various underlying mechanisms, addresses the associated neurological and psychiatric manifestations, and identifies the neurological risk factors involved. This review of literature shows the magnitude of neurological conditions associated with HCoV infections, including SARS-CoV-2. This review emphasises, that, during HCoV outbreaks, such as COVID-19, a focus on early detection of neurotropism, alertness for the resulting neurological complications, and the recognition of neurological risk factors are crucial to reduce the workload on hospitals, particularly intensive-care units and neurological departments.


Assuntos
Encefalopatias/epidemiologia , Infecções por Coronavirus/epidemiologia , Encefalite Viral/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Betacoronavirus/patogenicidade , Encefalopatias/fisiopatologia , Encefalopatias/virologia , COVID-19 , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Encefalite Viral/fisiopatologia , Encefalite Viral/virologia , Humanos , Coronavírus da Síndrome Respiratória do Oriente Médio/patogenicidade , Sistema Nervoso/fisiopatologia , Sistema Nervoso/virologia , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave/patogenicidade , SARS-CoV-2 , Síndrome Respiratória Aguda Grave/mortalidade , Síndrome Respiratória Aguda Grave/fisiopatologia , Síndrome Respiratória Aguda Grave/virologia , Índice de Gravidade de Doença , Análise de Sobrevida
2.
Neurosurg Rev ; 34(1): 87-99, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20936421

RESUMO

Meningiomas are mostly benign but some are atypical or malignant. Surgical resection is curative when complete removal of benign meningiomas is contemplated. Incompletely excised and recurrent tumors are frequently treated with fractionated radiation therapy or stereotactic radiosurgery. The purpose of this study is to evaluate the short-term radiological and functional outcomes of a single center using linear accelerator (Linac) stereotactic radiosurgery for the treatment of intracranial meningiomas. Twenty-nine patients (12 males and 17 females) with 30 meningiomas, in different brain locations (skull base and non-skull base meningiomas), were treated with Linac-based stereotactic radiosurgery. The mean tumor volume was 6.3 cm³, and the mean tumor marginal and maximum doses were 10.9 and 15 Gy, respectively. The median prescribed isodose line was 80%. The patients were followed-up for a minimum of 3 years. Regarding radiological outcome, nine (30%) meningiomas demonstrated evident volume reduction, 19 (63.3%) meningiomas remained unchanged, and two (6.7%) meningiomas increased in size after radiosurgery. The local tumor control rates for skull base meningiomas and non-skull base meningiomas after radiosurgery were 90.9% and 100%, respectively. Regarding functional outcomes, 64% of patients presenting with cranial neuropathies showed improvement of their cranial nerve functions and 29% of patients remained unchanged. One patient had temporary trigeminal neuropathy. Although radiosurgery for meningiomas is generally effective and quite safe in achieving high control rates with minimum morbidity over short- and intermediate-term periods of follow-up, tumor progression might occur in a delayed manner after initial apparent control for few years. We recommend continued follow-up for longer periods to better assess the long-term outcomes.


Assuntos
Meningioma/cirurgia , Aceleradores de Partículas , Radiocirurgia/métodos , Adolescente , Adulto , Idoso , Doenças dos Nervos Cranianos/terapia , Progressão da Doença , Relação Dose-Resposta à Radiação , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Meningioma/patologia , Pessoa de Meia-Idade , Neoplasias da Base do Crânio/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
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