Albert Brasil - Academia.edu (original) (raw)

Papers by Albert Brasil

Rev Bras Ortop, 1997

RESUMO Seis pacientes com fraturas do cinto de segurança da coluna lombar foram tratados com redu... more RESUMO Seis pacientes com fraturas do cinto de segurança da coluna lombar foram tratados com redução, fixação interna com instrumental de Harrington de compressão e artrodese seguida de imobilização externa. Em todos os pacientes foi obtida redução ...

THE ANATOMY OF Liliequist's membrane was studied in seven adult human cadavers by a technique... more THE ANATOMY OF Liliequist's membrane was studied in seven adult human cadavers by a technique that preserves the cisternal shape, stains arachnoid membranes violet, and fills the arteries with red gelatin. Our findings suggest the following about Liliequist's membrane: it is located between the interpeduncular cistern posteriorly, the carotid cisterns anterolaterally, and the chiasmatic cistern anteromedially; it is attached laterally to the mesial surface of the temporal lobe above the tentorial edge; it lies posterior to the infundibulum; and it presents a free edge between the optic tract and the temporal uncus. Few authors have provided specific descriptions of the compartmentalization of the subarachnoid space (SAS) by arachnoid membranes or of the relationship of these membranes with vascular and neural elements (2,5,6,10,14,15). Most information about the anatomy of subarachnoid cisterns comes from radiological articles (1,3,4,7,9–12). References are made to an arachn...

Arq Bras Neurocir, Dec 1, 1987

BMC Musculoskeletal Disorders

Background To describe success and failure (S&F) after lumbar spine surgery in terms equally unde... more Background To describe success and failure (S&F) after lumbar spine surgery in terms equally understandable across the entire health ecosystem. Methods Back and leg pain and disability were prospectively recorded before and up to 12 months after the procedure. Satisfaction was recorded using a Likert scale. Initially, patients were classified as satisfied or unsatisfied. Optimal satisfaction/unsatisfaction cutoff values for disability and pain were estimated with ROC curves. Satisfied and unsatisfied groups underwent a second subdivision into four subcategories: success (satisfied AND pain and disability concordant with cutoff values), incomplete success (satisfied AND pain and disability nonconformant with cutoff values), incomplete failure (unsatisfied AND pain and disability nonconformant with cutoff values), and failure (unsatisfied AND pain and disability concordant with cutoff values). Results A total of 486 consecutive patients were recruited from 2019–2021. The mean values o...

Surgical Neurology International

Background: The association between remote cerebellar hematoma (RCH) and spinal surgery is poorly... more Background: The association between remote cerebellar hematoma (RCH) and spinal surgery is poorly understood and rarely reported. We present seven cases of RCH after spinal surgery. Methods: Seven patients were diagnosed with RCH utilizing computed tomography and/or magnetic resonance, between 2012 and 2016. Their clinical presentations, imaging data, treatment modalities, and outcome were analyzed. There were five females and two males with an average age of 55.8 ± 8.4 years. The age of onset ranged from 43 to 67 years and the time to clinical presentation ranged from 3 h to 5 days. Patients presented with: diplopia/strabismus (one patient), dysphagia/urinary incontinence (one patient), respiratory arrest (one patient), meningismus (one patient), and dysarthria (two patients), along with other symptoms/signs. Results: Three patients were successfully managed without surgery, two required external ventricular drainage, and two were treated with posterior fossa decompression plus ven...

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

Resumo Objetivo: Uma das alternativas para o tratamento cirúrgico das fraturas tóraco-lombares em... more Resumo Objetivo: Uma das alternativas para o tratamento cirúrgico das fraturas tóraco-lombares em explosão (TLBF) é a técnica de instrumentação longa e fusão curta (RLFS) utilizando o sistema de Harrington. A altura do corpo vertebral fraturado geralmente retorna a valores próximos do normal imediatamente após a cirurgia, mas, alguns meses depois, esse ganho é perdido (achatamento). Nosso objetivo é verificar os resultados clínicos e radiológicos com a técnica RLFS com sistema de instrumentação universal. Método: Doze casos de TLBF (masculino/feminino=9/3, média de idade=35,7 anos, Escala de Frankel: E=9, C=3) foram estudados. Através de abordagem posterior, instrumentação universal foi realizada dois níveis acima e dois níveis abaixo da vértebra fraturada. Enxerto ósseo foi colocado de um nível acima a um nível abaixo da fratura. Após pelo menos nove meses, o instrumental localizado além da área enxertada foi removido. Os resultados clínicos foram medidos pela Escala de Frankel e p...

The open orthopaedics journal, 2018

Previous studies on the correlation between cervical sagittal balance with improvement in quality... more Previous studies on the correlation between cervical sagittal balance with improvement in quality of life showed significant results only for parameters of the anterior translation of the cervical spine (such as C2-C7 SVA). We test whether a new parameter,, can predict clinical success in this type of surgery. The focused group involved patients who underwent surgical treatment of cervical degenerative disk disease by the posterior approach, due to myelopathy, radiculopathy or a combination of both. Neurologic deficit was measured before and after surgery with the Nurick Scale, postoperative quality of life, physical and mental components of SF-36 and NDI. Cervicothoracic lordosis and various sagittal balance parameters were also measured. Cervicothoracic lordosis was defined as the angle between: a) the line between the centroid of C2 and the centroid of C7; b) the line between the centroid of C7 and the centroid of T6. Correlations between postoperative quality of life and sagitta...

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, d... more Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, due to mechanical, biological and genetic factors, becomes ossified. Due to its nature and anatomic location, OLF produces symptoms characteristic of spinal cord compression. The diagnostic confirmation is based primarily on imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI). Ossification of the ligamentum flavum most often affects Asian populations, rarely occurring in black people. The authors report a case of a 61-year-old black man with progressive paraparesis due to OLF, and review the literature regarding the pathology's prevalence, pathogenesis, clinical features, diagnosis, treatment and prognosis.

Arquivos de Neuro-Psiquiatria, 2016

Objective To analyze the cumulative effect of risk factors associated with early major complicati... more Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. Conclusions This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for...

Introdução Os tumores que comprometem o sistema nervoso central (SNC) correspondem a uma grande p... more Introdução Os tumores que comprometem o sistema nervoso central (SNC) correspondem a uma grande parcela das doenças neurocirúrgicas. Primários ou metastáticos, continuam sendo um desafio para neurocirurgiões, oncologistas e pesquisadores. Objetivo Conhecer melhor a epidemiologia dos tumores no nosso meio. Casuística Foram analisados retrospectivamente, 1189 pacientes consecutivos portadores de tumores relacionados ao SNC que foram submetidos a tratamento cirúrgico no Hospital São José da Santa Casa de Porto Alegre, no período e 1999 a 2004. Resultados Dos 1189 pacientes operados 651(54,8%) eram mulheres e 538 (45,2%) homens. Os tumores foram intracranianos em 1022 (85,9 %), e destes, 69,6% foram abordados por craniotomia e 16,3 % utilizou-se a via transfenoidal. Os tumores raquianos, 166(14,1%),foram abordados por laminectomia acompanhada ou não de instrumentação. Quanto as topografias mais comuns das lesões, 222(18,7%) foram na sela turca, 216(18,2) frontais e 159(13,3%) localizavam-se na fossa posterior. Lesões metastáticas foram encontradas em 218(18,3%) pacientes, sendo o pulmão, mama e rim os sítios primários mais comuns. Conclusão Os tumores mais freqüentes na cavidade craniana foram: meningeoma (217/18,3%), glioblastomas (112/9,4%), adenomas de hipófise (205/17,2%), adenocarcinomas metastáticos (105/8,6%) e astrocitomas (92/8%). Na raque, do total de 166 tumores, 70 (42,1 %) eram metástases sendo o segmento cérvico-torácico o mais acometido.

Arq Bras Neurocir, Sep 1, 2006

Arquivos de Neuro-Psiquiatria

Objective: To study the impact of surgery on pain, disability, quality of life, and patient satis... more Objective: To study the impact of surgery on pain, disability, quality of life, and patient satisfaction in a sample of patients with Degenerative Lumbar Disease (DLD). Methods: Retrospective analysis of prospectively collected data. Comparison between pre and postoperative (6 – 12 months) ODI and SF-36, plus postoperative Patient Satisfaction Index. Results: From a total of 216 patients included, improvement was observed in average scores of pain (201.2%), disability (39.7%), physical quality of life (42%), and mental quality of life (37.8%). Among these patients, 57.7% reached or surpassed the minimal clinically important difference (MCID) for ODI, 57.7% for the SF-36 pain component, 59.7% for the SF-36 physical component summary, and 50.5% achieved or surpassed the MCID for the SF-36 mental component summary. Conclusions: Surgery produced a significantly positive impact on pain, disability, and quality of life of patients. Overall, 82.5% of the patients were satisfied.

Neurosurgery, Jul 1, 1993

The anatomy of Liliequist's membrane was studied in seven adult human cadavers by... more The anatomy of Liliequist's membrane was studied in seven adult human cadavers by a technique that preserves the cisternal shape, stains arachnoid membranes violet, and fills the arteries with red gelatin. Our findings suggest the following about Liliequist's membrane: it is located between the interpeduncular cistern posteriorly, the carotid cisterns anterolaterally, and the chiasmatic cistern anteromedially; it is attached laterally to the mesial surface of the temporal lobe above the tentorial edge; it lies posterior to the infundibulum; and it presents a free edge between the optic tract and the temporal uncus.

Spinal Cord, 1998

The neurological outcome of 146 patients who survived spinal cord injury in a neurosurgical hospi... more The neurological outcome of 146 patients who survived spinal cord injury in a neurosurgical hospital of a developing country, were compared to those reported from Stoke Mandeville, UK. The average recuperation in the two groups was similar.

Rev Bras Ortop, 1997

RESUMO Seis pacientes com fraturas do cinto de segurança da coluna lombar foram tratados com redu... more RESUMO Seis pacientes com fraturas do cinto de segurança da coluna lombar foram tratados com redução, fixação interna com instrumental de Harrington de compressão e artrodese seguida de imobilização externa. Em todos os pacientes foi obtida redução ...

THE ANATOMY OF Liliequist's membrane was studied in seven adult human cadavers by a technique... more THE ANATOMY OF Liliequist's membrane was studied in seven adult human cadavers by a technique that preserves the cisternal shape, stains arachnoid membranes violet, and fills the arteries with red gelatin. Our findings suggest the following about Liliequist's membrane: it is located between the interpeduncular cistern posteriorly, the carotid cisterns anterolaterally, and the chiasmatic cistern anteromedially; it is attached laterally to the mesial surface of the temporal lobe above the tentorial edge; it lies posterior to the infundibulum; and it presents a free edge between the optic tract and the temporal uncus. Few authors have provided specific descriptions of the compartmentalization of the subarachnoid space (SAS) by arachnoid membranes or of the relationship of these membranes with vascular and neural elements (2,5,6,10,14,15). Most information about the anatomy of subarachnoid cisterns comes from radiological articles (1,3,4,7,9–12). References are made to an arachn...

Arq Bras Neurocir, Dec 1, 1987

BMC Musculoskeletal Disorders

Background To describe success and failure (S&F) after lumbar spine surgery in terms equally unde... more Background To describe success and failure (S&F) after lumbar spine surgery in terms equally understandable across the entire health ecosystem. Methods Back and leg pain and disability were prospectively recorded before and up to 12 months after the procedure. Satisfaction was recorded using a Likert scale. Initially, patients were classified as satisfied or unsatisfied. Optimal satisfaction/unsatisfaction cutoff values for disability and pain were estimated with ROC curves. Satisfied and unsatisfied groups underwent a second subdivision into four subcategories: success (satisfied AND pain and disability concordant with cutoff values), incomplete success (satisfied AND pain and disability nonconformant with cutoff values), incomplete failure (unsatisfied AND pain and disability nonconformant with cutoff values), and failure (unsatisfied AND pain and disability concordant with cutoff values). Results A total of 486 consecutive patients were recruited from 2019–2021. The mean values o...

Surgical Neurology International

Background: The association between remote cerebellar hematoma (RCH) and spinal surgery is poorly... more Background: The association between remote cerebellar hematoma (RCH) and spinal surgery is poorly understood and rarely reported. We present seven cases of RCH after spinal surgery. Methods: Seven patients were diagnosed with RCH utilizing computed tomography and/or magnetic resonance, between 2012 and 2016. Their clinical presentations, imaging data, treatment modalities, and outcome were analyzed. There were five females and two males with an average age of 55.8 ± 8.4 years. The age of onset ranged from 43 to 67 years and the time to clinical presentation ranged from 3 h to 5 days. Patients presented with: diplopia/strabismus (one patient), dysphagia/urinary incontinence (one patient), respiratory arrest (one patient), meningismus (one patient), and dysarthria (two patients), along with other symptoms/signs. Results: Three patients were successfully managed without surgery, two required external ventricular drainage, and two were treated with posterior fossa decompression plus ven...

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

Resumo Objetivo: Uma das alternativas para o tratamento cirúrgico das fraturas tóraco-lombares em... more Resumo Objetivo: Uma das alternativas para o tratamento cirúrgico das fraturas tóraco-lombares em explosão (TLBF) é a técnica de instrumentação longa e fusão curta (RLFS) utilizando o sistema de Harrington. A altura do corpo vertebral fraturado geralmente retorna a valores próximos do normal imediatamente após a cirurgia, mas, alguns meses depois, esse ganho é perdido (achatamento). Nosso objetivo é verificar os resultados clínicos e radiológicos com a técnica RLFS com sistema de instrumentação universal. Método: Doze casos de TLBF (masculino/feminino=9/3, média de idade=35,7 anos, Escala de Frankel: E=9, C=3) foram estudados. Através de abordagem posterior, instrumentação universal foi realizada dois níveis acima e dois níveis abaixo da vértebra fraturada. Enxerto ósseo foi colocado de um nível acima a um nível abaixo da fratura. Após pelo menos nove meses, o instrumental localizado além da área enxertada foi removido. Os resultados clínicos foram medidos pela Escala de Frankel e p...

The open orthopaedics journal, 2018

Previous studies on the correlation between cervical sagittal balance with improvement in quality... more Previous studies on the correlation between cervical sagittal balance with improvement in quality of life showed significant results only for parameters of the anterior translation of the cervical spine (such as C2-C7 SVA). We test whether a new parameter,, can predict clinical success in this type of surgery. The focused group involved patients who underwent surgical treatment of cervical degenerative disk disease by the posterior approach, due to myelopathy, radiculopathy or a combination of both. Neurologic deficit was measured before and after surgery with the Nurick Scale, postoperative quality of life, physical and mental components of SF-36 and NDI. Cervicothoracic lordosis and various sagittal balance parameters were also measured. Cervicothoracic lordosis was defined as the angle between: a) the line between the centroid of C2 and the centroid of C7; b) the line between the centroid of C7 and the centroid of T6. Correlations between postoperative quality of life and sagitta...

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, d... more Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, due to mechanical, biological and genetic factors, becomes ossified. Due to its nature and anatomic location, OLF produces symptoms characteristic of spinal cord compression. The diagnostic confirmation is based primarily on imaging tests such as computed tomography (CT) and magnetic resonance imaging (MRI). Ossification of the ligamentum flavum most often affects Asian populations, rarely occurring in black people. The authors report a case of a 61-year-old black man with progressive paraparesis due to OLF, and review the literature regarding the pathology's prevalence, pathogenesis, clinical features, diagnosis, treatment and prognosis.

Arquivos de Neuro-Psiquiatria, 2016

Objective To analyze the cumulative effect of risk factors associated with early major complicati... more Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Results Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. Conclusions This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for...

Introdução Os tumores que comprometem o sistema nervoso central (SNC) correspondem a uma grande p... more Introdução Os tumores que comprometem o sistema nervoso central (SNC) correspondem a uma grande parcela das doenças neurocirúrgicas. Primários ou metastáticos, continuam sendo um desafio para neurocirurgiões, oncologistas e pesquisadores. Objetivo Conhecer melhor a epidemiologia dos tumores no nosso meio. Casuística Foram analisados retrospectivamente, 1189 pacientes consecutivos portadores de tumores relacionados ao SNC que foram submetidos a tratamento cirúrgico no Hospital São José da Santa Casa de Porto Alegre, no período e 1999 a 2004. Resultados Dos 1189 pacientes operados 651(54,8%) eram mulheres e 538 (45,2%) homens. Os tumores foram intracranianos em 1022 (85,9 %), e destes, 69,6% foram abordados por craniotomia e 16,3 % utilizou-se a via transfenoidal. Os tumores raquianos, 166(14,1%),foram abordados por laminectomia acompanhada ou não de instrumentação. Quanto as topografias mais comuns das lesões, 222(18,7%) foram na sela turca, 216(18,2) frontais e 159(13,3%) localizavam-se na fossa posterior. Lesões metastáticas foram encontradas em 218(18,3%) pacientes, sendo o pulmão, mama e rim os sítios primários mais comuns. Conclusão Os tumores mais freqüentes na cavidade craniana foram: meningeoma (217/18,3%), glioblastomas (112/9,4%), adenomas de hipófise (205/17,2%), adenocarcinomas metastáticos (105/8,6%) e astrocitomas (92/8%). Na raque, do total de 166 tumores, 70 (42,1 %) eram metástases sendo o segmento cérvico-torácico o mais acometido.

Arq Bras Neurocir, Sep 1, 2006

Arquivos de Neuro-Psiquiatria

Objective: To study the impact of surgery on pain, disability, quality of life, and patient satis... more Objective: To study the impact of surgery on pain, disability, quality of life, and patient satisfaction in a sample of patients with Degenerative Lumbar Disease (DLD). Methods: Retrospective analysis of prospectively collected data. Comparison between pre and postoperative (6 – 12 months) ODI and SF-36, plus postoperative Patient Satisfaction Index. Results: From a total of 216 patients included, improvement was observed in average scores of pain (201.2%), disability (39.7%), physical quality of life (42%), and mental quality of life (37.8%). Among these patients, 57.7% reached or surpassed the minimal clinically important difference (MCID) for ODI, 57.7% for the SF-36 pain component, 59.7% for the SF-36 physical component summary, and 50.5% achieved or surpassed the MCID for the SF-36 mental component summary. Conclusions: Surgery produced a significantly positive impact on pain, disability, and quality of life of patients. Overall, 82.5% of the patients were satisfied.

Neurosurgery, Jul 1, 1993

The anatomy of Liliequist's membrane was studied in seven adult human cadavers by... more The anatomy of Liliequist's membrane was studied in seven adult human cadavers by a technique that preserves the cisternal shape, stains arachnoid membranes violet, and fills the arteries with red gelatin. Our findings suggest the following about Liliequist's membrane: it is located between the interpeduncular cistern posteriorly, the carotid cisterns anterolaterally, and the chiasmatic cistern anteromedially; it is attached laterally to the mesial surface of the temporal lobe above the tentorial edge; it lies posterior to the infundibulum; and it presents a free edge between the optic tract and the temporal uncus.

Spinal Cord, 1998

The neurological outcome of 146 patients who survived spinal cord injury in a neurosurgical hospi... more The neurological outcome of 146 patients who survived spinal cord injury in a neurosurgical hospital of a developing country, were compared to those reported from Stoke Mandeville, UK. The average recuperation in the two groups was similar.