Papers by Hildo Azevedo-Filho
American journal of biomedicine, May 13, 2018
The objective of this study is to compare two cohorts of patients affected by this disease in dif... more The objective of this study is to compare two cohorts of patients affected by this disease in different periods and evaluate specifically the role of decompressed laminectomy.
Neurovascular Surgery, 2018
JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA, 2018
Objective: Discuss cognitive deficits caused by subarachnoid hemorrhage (SAH) after rupture of ce... more Objective: Discuss cognitive deficits caused by subarachnoid hemorrhage (SAH) after rupture of cerebral aneurisms, since about half of the patients have severe or at least striking declines in one or more functions of the cognitive domain. Methods: This paper presents a literature review on cognitive deficits secondary to aneurysmal SAH. There was no delimitation of periods of publications or the locality where it was applied. The bibliographic references were accessed through the database PubMed (http://www.ncbi.nlm.nih.gov/pubmed/). Results: There are three main etiologies for the development of cognitive worsening: the effect of the initial bleeding, the consequences of vasospasm and delayed ischemia and the secondary ones to the treatment. Aneurysms located in the anterior communicating artery and in the middle cerebral artery seem to be related to worse evaluations. As surgical treatment seems to contribute to cognitive worsening, at least when evaluated early. Conclusion: Defi...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2017
ResumoHemorragia subaracnóidea (HSA) representa de 5 a 10% de todos os tipos de acidente vascular... more ResumoHemorragia subaracnóidea (HSA) representa de 5 a 10% de todos os tipos de acidente vascular encefálico, estando a ruptura de aneurismas cerebrais relacionada a déficits na memória, nas funções executivas e na linguagem. As alterações nas funções cerebrais parecem estar relacionadas à presença de sangue no espaço subaracnóideo, sendo a escala de Fisher (EF) a forma de mensuração do conteúdo hemático, realizada através de tomografia computadorizada (TC). Este artigo apresenta uma revisão da literatura sobre a associação da EF com déficits cognitivos secundários a HSA aneurismática (HSAa), tendo como banco de dados para a pesquisa o PubMed. A tentativa de correlacionar a quantidade de sangue identificada na TC de crânio com o desenvolvimento de alterações cognitivas apresenta dados bastante conflitantes, evidenciando que alguns dos trabalhos não realizaram testes cognitivos, ou não demostraram diferenças entre os graus da EF por dificuldade na amostragem. A EF, mesmo com suas li...
British Journal of Neurosurgery, 2021
A middle age male presented a right total brachial plexus injury after motorcycle fall one year a... more A middle age male presented a right total brachial plexus injury after motorcycle fall one year ago. Subsequent electromyographic evaluation was consistent with C5, C6, C7, C8 and T1 root avulsion. The patient was submitted to a right transfer of the phrenic nerve to musculocutaneous nerve , using rural nerve graft.
Interdisciplinary Neurosurgery, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Neurosurgical Focus, 2019
Infectious intracranial aneurysms (IIAs) represent 2%–6% of all intracranial aneurysms and, class... more Infectious intracranial aneurysms (IIAs) represent 2%–6% of all intracranial aneurysms and, classically, have been associated with bacterial or fungal agents. The authors report the case of a 42-year-old woman who presented with a typical history of subarachnoid hemorrhage. Digital subtraction angiography (DSA) showed an aneurysmal dilatation on the frontal M2 segment of the left middle cerebral artery (MCA). The patient was treated surgically, and multiple cysts were found in the left carotid and sylvian cisterns, associated with a dense inflammatory exudate that involved the MCA. The cysts were removed, and a fusiform aneurysmal dilatation was identified. The lesion was not amenable to direct clipping, so the authors wrapped it. Histopathological analysis of the removed cysts revealed the typical pattern of subarachnoid neurocysticercosis. The patient received cysticidal therapy with albendazole and corticosteroids, and she recovered uneventfully. Follow-up DSA performed 6 months ...
Surgical Neurology International, 2012
Background: To present the accumulated experience from treating chronic subdural hematomas (CSDH)... more Background: To present the accumulated experience from treating chronic subdural hematomas (CSDH) in a local hospital of a third world country. Methods: One hundred and twenty-five consecutive patients with CSDH who were surgically treated in the Neurosurgical Department of the Hospital da Restauração, Recife-PE, Brazil, between January 2006 and May 2008, were retrospectively studied. Glasgow Outcome Scale (GOS) was employed to define outcome at 6 months as good (GOS 4 and 5) or poor (GOS ≤ 3). Age, admission Glasgow Coma Scale (GCS), location of hematomas (unilateral/bilateral), drainage system placement and recurrence were all analyzed for potential impact on final outcome. Results: The median age was 69 years, with a male/female ratio of 102/23. History of trauma was present in 60.8% of the patients. The median GCS on admission was 14. In 64 patients, the hematoma was on the left side, while in 42 patients it was on the right side. Bilateral hematomas were present in 19 cases (15.2%). Drainage systems were used in 93.6% of the cases. Recurrence occurred in 8.8% of the patients. One hundred and three patients obtained a good outcome at 6 months. The mortality rate was 11.2%. Patients with GCS ≥9 on admission presented better outcome (P < 0.05). Recurrent cases presented a poor outcome (P < 0.05). Conclusions: This study suggests that the main factors associated with outcome in patients harboring CSDH are the admission GCS score and the recurrence status. Advanced age is not a contraindication for surgical treatment. This study, solely focused on the Brazilian population, is the first of its kind in the English literature, and it could serve as a useful introduction to a more complex, multivariate, debate.
International Journal of Surgery Case Reports, 2020
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2020
The COVID-19 pandemic has affected a large number of patients in all countries, overwhelming heal... more The COVID-19 pandemic has affected a large number of patients in all countries, overwhelming healthcare systems worldwide. In this scenario, surgical procedures became restricted, causing unacceptable delays in the treatment of certain pathologies, such as glioblastoma. Regarding this tumor with high morbidity and mortality, early surgical treatment is essential to increase the survival and quality of life of these patients. Association between COVID-19 and neurosurgical procedures is quite scarce in the literature, with a few reported cases. In the present study, we present a rare case of a patient undergoing surgical resection of glioblastoma with COVID-19.
Romanian Neurosurgery, 2020
Decompressive craniectomy (DC) is an urgent neurosurgical procedure, effective in the reduction o... more Decompressive craniectomy (DC) is an urgent neurosurgical procedure, effective in the reduction of intracranial pressure (ICP) in patients with elevated ICP and in complications of brain infarction that do not respond to clinical treatment; traumatic brain injury (TBI); intracerebral haemorrhage (ICH) and aneurysmal intracerebral haemorrhage. Symptomatic hydrocephalus is present in 2 to 29% of patients who undergo craniectomy. They may require a ventriculoperitoneal shunt (VPS). The literature does not yet show standard management of cranioplasty in patients who have previously undergone a shunt, showing evidence of sinking skin flap syndrome. This case shows parenchymal expansion after VPS occlusion and cranioplasty in the patient’s profile. The 23-year-old male patient, right-handed, went to the hospital in January 2017 due to severe traumatic brain injury following multiple traumas. The patient underwent urgent DC surgery for the management of elevated ICP. The patient developed ...
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery, 2012
There are few reports in the literature of transorbital penetration brain damage. We reported a t... more There are few reports in the literature of transorbital penetration brain damage. We reported a transorbital craniocerebral injury caused by a barbecue skewer in a child in the context of domestic-accident. A 7-year-old male child accidentally fell and a barbecue skewer penetrated his right orbit. The object was pulled out immediately by the boy's father. On admission, he demonstrated disproportioned right hemiparesis and Axial CT images showed no evidence of fracture of orbital wall on the right side and a small hematoma and traumatic subarachnoid hemorrhage on the left hemisphere. Surgery was not indicated, antibiotics were administered for 14 days, his neurological impairment recovered completely on seven days. On the 12th post-admission day, a CT was done which showed no hematoma. At the time of discharge, the boy was alert without any physical sequelae or complication. Children are frequently harmed during play and are mainly jeopardized by accidents at home, and it is nece...
Arquivos de Neuro-Psiquiatria, 2008
Surgical Neurology International, 2021
Background: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative ... more Background: Endoscopic third ventriculostomy (ETV) has been shown to be a sufficient alternative to shunts in surgical treatment of obstructive hydrocephalus. Long-term failure, age limitations, and outcome by cause are some of the issues debated in literature. The objective of this article is to analyze the clinical success and failure of ETV and its main complications. Methods: A total of 209 patients with hydrocephalus were submitted to ETV, including a mixed population of children and adults (from 0 to 59 years). Patients were divided into five groups: A – tumors, B – aqueductal stenosis, C – myelomeningocele, D – infection and hemorrhage, and E – arachnoid cyst. Variables were analyzed: age, ETV success rate, cerebrospinal fluid (CSF) fistula, mortality, and complications. Results: The two main causes of hydrocephalus were tumors (44.9%) and aqueductal stenosis (25.3%). The overall success rate was of 82.8%, and patients in Group E had the highest rate 90.9%. Group A had a succ...
Jornal Memorial da Medicina
O Exame Para Fellow of the Royal College of Surgeons of Edinburgh
Neurovascular Surgery, Sep 28, 2018
Surgical Neurology International
Background: Cranial reconstruction surgery is a procedure used as an attempt to reestablish the c... more Background: Cranial reconstruction surgery is a procedure used as an attempt to reestablish the cranial bone anatomy. This study evaluates the symptomatic and aesthetic improvement of patients with cranial defects secondary to decompressive craniectomies after cranial reconstruction with customized polymethyl methacrylate (PMMA) prostheses. Secondly, we aim to divide our experience in the production of these prostheses with a low-cost method. Methods: A prospective study was carried out with patients submitted to cranioplasty at the Hospital da Restauração between 2014 and 2017. A total of 63 cranioplasties were performed using customized PMMA prosthesis produced by 3D impression molds. All patients underwent a functional and aesthetic evaluation questionnaire in the preoperative period and in the sixth postoperative month. Results: Sixty-three patients underwent cranioplasty with a mean age of 33 years, ranging from 13 to 58 years, 55 males and 8 females. The mean area of the defect was 147 cm 2. The mean postoperative follow-up of the patients was 21 months, ranging from 6 to 33 months. Fifty-five patients attended the 6-month postoperative consultation. All patients presented symptomatic improvement after reconstruction of the skull. The infection rate was 3.2%, 4.8% of extrusion, 1.6% of prosthesis How to cite this article: Maricevich JPBR, Cezar-Junior AB, de Oliveira-Junior EX, Veras e Silva JAM, da Silva JVL, Nunes AA, et al. Functional and aesthetic evaluation after cranial reconstruction with polymethyl methacrylate prostheses using low-cost 3D printing templates in patients with cranial defects secondary to decompressive craniectomies: A prospective study. Surg Neurol Int 2019;10:1. http://surgicalneurologyint.com/Functional-and-aesthetic-evaluation-after-cranial-reconstruction-with-polymethyl-methacrylate-prostheses-using-low-cost-3D-printingtemplates-in-patients-with-cranial-defects-secondary-to-decompressive-craniectomies:-A-prospective-study/ This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Jornal Memorial da Medicina
Reminicências do antigo Hospital do Pronto Socorro do Recife: Primeiro contato com a Morte Encefá... more Reminicências do antigo Hospital do Pronto Socorro do Recife: Primeiro contato com a Morte Encefálica
Surgical Neurology International
Background: Distal nerve transfers are an innovative modality for the treatment of C8-T1 brachial... more Background: Distal nerve transfers are an innovative modality for the treatment of C8-T1 brachial plexus lesions. The purpose of this case series is to report the authors’ results with hand restoration function by nerve transfer in patients with lower brachial plexus injury. Methods: Three consecutive nerve transfers were performed in a series of 11 patients to restore hand function after injury to the lower brachial plexus: brachialis motor branch to anterior interosseous nerve (AIN) and supinator branch to the posterior interosseous nerve (PIN) in a first surgical procedure, and AIN to pronator quadratus branch of ulnar nerve between 4 and 6 months later. Results: In all, 11 male patients underwent 33 surgical procedures. Time between brachial plexus injury and surgery was a mean of 11 months (range 4–13 months). Postoperative follow-up ranged from 12 to 24 months. We observed recovery of M3 or better finger flexion strength (AIN) and wrist extension (PIN) in 8 of the 11 surgicall...
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Papers by Hildo Azevedo-Filho