Tratamento cirúrgico de fratura do côndilo occipital: relato de caso / Surgical treatment of occipital condyle fracture: case report

As fraturas do côndilo occipital são raras e de difícil diagnóstico. A tomografia computadorizada constitui o meio mais importante para o diagnóstico e para o planejamento terapêutico. Raramente está indicado o tratamento cirúrgico dessa fratura. Descrevemos o caso de fratura do côndilo com sinais de acometimento cerebelar e de nervos cranianos baixos, tratado através de acesso occipital extremo lateral com sucesso.

Tumores da lâmina quadrigêmea na infância / Tumours of the quadrigeminal plate in the childhood

Os autores apresentam os dados clínicos e neurorradiológicos de 6 crianças portadoras de tumores da regiäo tectal e periaquedutal. Todos os casos foram tratados inicialmente com derivaçäo liquórica e apresentaram boa evoluçäo em intervalos de acompanhamento que väo de 10 meses a 5 anos. Säo discutidos, à luz da literatura, os aspectos específicos destes tumores bem como as dificuldades diagnósticas.

Estudo clínico-epidemiológico de 1.001 casos de doença meningocócica no Instituto Estadual de Infectologia Säo Sebastiäo 1983-1988 / Clinical-epidemiological study of 1.001 cases of meningococcal diseases in the Säo Sebastiäo Institute of Infectolohy in the period 1983-1985

A thousand and one cases were revised in retrospective of the meningococcal disease in the Säo Sebastiäo Institute of Infectology in the period 1983-1988. Tjhe criteria for inclusion were: symptoms compatible with meningococcal diseae (petechiae and/or purpura associated or not to meningitidis), detection of gram negative diplicocci, test of the latex and/or positive culture in the CSF for N. meningitis. Tje progressive increase occurred in the number of cases without having any lost in the older age group. Predominance remained of 78% in children of 12 years, bein 46% in children of 4 years, with a greater incidence in males. The greater number of cases occured in the second half of the year. The death rate remained about 15%, and the death occurred mainly in the first 24 hours. The diagnosis was made on a bacteriological bais in 83.2% of the cases. Of the total of 805 cultures realized 33.7% were positive but not identified, 7.8% of group A, 31.3% of the group B, 5.4% of the group C and 21.6% negtive. A predominance occurred of the serogroup b beginning in 1985. The clinical form more frequent was the meningoencephalitis 42.7%, followed by meningitis with purpura 36%, purpura with meningitidis and shock 10.9%, purpura with shock 6.8%, and purpura without meningitidis 2.7%. Deafness was the most common residual effect totalizing 3% of the cases