Antonioaversa do Souto - Academia.edu (original) (raw)

Papers by Antonioaversa do Souto

PubMed, May 1, 2003

Cavernous hemangiomas of the cavernous sinus belong to a well-distinguished entity of extra-axial... more Cavernous hemangiomas of the cavernous sinus belong to a well-distinguished entity of extra-axial cavernous hemangiomas located in the cavernous sinus and have a typical appearance on magnetic resonance imaging (MRI). Severe intraoperative bleeding has been described during the excision of these lesions that is probably associated with their pathological features. An atypical case of a sclerosing lesion with distinct MRI features is described. In these particular cases, especially with giant hemangiomas where en bloc excision would be difficult, safe internal decompression and resection can be achieved.

Journal of neurological surgery, Feb 1, 2023

The objective of this study is to evaluate the meningioma`s hormone receptor expression in patien... more The objective of this study is to evaluate the meningioma`s hormone receptor expression in patients who presented synchronous or metachronous meningioma and breast cancer and compare its pro le to the non-breast cancer associated meningiomas described in the literature. Methods The authors conducted a retrospective descriptive study evaluating all cases of synchronous and metachronous meningiomas and breast cancer from January 1st, 1990 to December 31st, 2020. The study was approved by the Ethics Review Board. Variables related to meningioma (age and year of diagnosis, histological grade and subtype, topography, the presence of progesterone and/or estrogen receptors) and to breast cancer (age and year of diagnosis, the histological grade and subtype, the presence of progesterone and/or estrogen receptors) were collected on the hospital`s electronic health records. Results A total of 12 cases were included in the study, being 2 (17%) synchronous and 10 (83%) metachronous. The mean age at meningioma diagnosis was 60.58 (± 10,99). The most frequent intracranial topography was convexity and sphenoid wing meningiomas (25% each). Ten patients (83%) had grade 1 meningiomas and 2 patients (16.6%) presented with grade 2 meningiomas. Eleven cases of meningiomas expressed progesterone receptors (91.67%) while 3 cases expressed estrogen receptors (25%). One patient did not express hormonal receptor. Conclusion The WHO histological analysis and steroid receptors pro le did not seem to be different in the meningiomas included in this sample when compared to the description of no-breast cancer associated meningiomas.

Pediatric Blood & Cancer, Nov 12, 2021

BackgroundMedulloblastoma (MB),the most common malignant brain tumor of childhood has survival ou... more BackgroundMedulloblastoma (MB),the most common malignant brain tumor of childhood has survival outcomes exceeding 80% for standard‐risk and 60% for high‐risk patients in high‐income countries (HICs). These results have not been replicated in low‐ and middle‐income countries (LMICs), where 80% of children with cancer live.MethodsThis is a retrospective review of 114 children aged 3–18 years diagnosed with MB from 1997 to 2016 at National Cancer Institute (INCA). Sociodemographic, clinical, and treatment data were extracted from the medical records and summarized descriptively. Overall survival (OS) and progression‐free survival (PFS) were calculated using the Kaplan–Meier method.ResultsThe male‐to‐female ratio was 1.32 and the median age at diagnosis was 8.2 years. Headache (83%) and nausea/vomiting (78%) were the most common presenting symptoms. Five‐year OS was 59.1% and PFS was 58.4%. The OS for standard‐risk and high‐risk patients was 69% and 53%, respectively. The median time to diagnosis interval was 50.5 days and the median time from surgery to radiation therapy initiation was 50.4 days. Patients who lived >40 km from INCA fared better (OS = 68.2% vs. 51.1%, p = .032). Almost 20% of families lived below the Brazilian minimum wage. Forty‐five patients (35%) had metastatic disease at admission. Gross total resection was achieved in 57% of the patitents.ConclusionsAlthough there are considerable barriers to deliver effective MB treatment in countries like Brazil, the OS seen in the present study demonstrates that good outcomes are not only feasible but can and should be increased with appropriate interventions.

Arquivos Brasileiros de Neurocirurgia, Jan 28, 2022

The authors describe a rare case of abducens nerve schwannoma, manifested with headache and diplo... more The authors describe a rare case of abducens nerve schwannoma, manifested with headache and diplopia, associated to right side cerebellar syndrome. During surgery, the authors identified that the origin of the tumor was from the abducens nerve, and the histopathological diagnosis confirmed that it was a schwannoma. A gross total tumor resection was performed, and the patient recovered from her symptoms 1 month after surgery. The authors followed the Case Report guidelines (CARE) guideline and the patient authorized the authors to publish the present case report by signing an informed consent form. Palavras-chave ► relato de caso ► neurinoma ► nervo abducente ► paresia da motilidade ocular ► neoplasias da base do crânio ► schwannoma Resumo Os autores descrevem um raro caso de Schwannoma do nervo abducente, cuja manifestaçāo clínica foi com cefaleia e diplopia, associadas à síndrome cerebelar hemisférica direita. Durante a cirurgia, os autores identificaram que o tumor tinha sua origem junto ao nervo abducente, e o diagnóstico histopatológico confirmou schwannoma. Realizou-se uma ressecção completa do tumor e o paciente apresentou melhora total dos sintomas em um mês após a cirurgia. Os autores seguiram as diretrizes do CARE para produzir este relato e o paciente assinou o termo de consentimento livre e esclarecido, autorizando a publicação deste caso.

Skull Base Surgery, Mar 1, 2007

Skull Base Surgery, May 19, 2004

Cavernous hemangiomas of the cavernous sinus belong to a welldistinguished entity of extra-axial ... more Cavernous hemangiomas of the cavernous sinus belong to a welldistinguished entity of extra-axial cavernous hemangiomas located in the cavernous sinus and have a typical appearance on magnetic resonance imaging (MRI). Severe intraoperative bleeding has been described during the excision of these lesions that is probably associated with their pathological features. An atypical case of a sclerosing lesion with distinct MRI features is described. In these particular cases, especially with giant hemangiomas where en bloc excision would be difficult, safe internal decompression and resection can be achieved.

Arquivos Brasileiros de Neurocirurgia, Sep 1, 2022

The authors describe a very rare case of an angiosarcoma originating from the petrous portion of ... more The authors describe a very rare case of an angiosarcoma originating from the petrous portion of the temporal bone that evolved as an indolent lesion until it became a giant retroauricular mass. A biopsy demonstrated that it was an angiosarcoma. A presurgical embolization from the left occipital and left parietal branches of the left middle meningeal artery was performed, followed by a total resection of the tumor. The patient developed a transient dysphasia during early follow-up, from which, subsequently, she fully recovered. There were no signs of recurrence in the current 3 years of follow-up. Free margins can be achieved even in some giant tumors and remain the most important prognostic factor for soft tissue malignant tumors with intracranial infiltration. Palavras-chave ► sarcoma ► base de crânio ► osso temporal ► relato de caso Resumo Os autores descrevem um raro caso de angiossarcoma proveniente da porção petrosa do osso temporal, que evoluiu como uma tumoração indolente até tornar-se uma volumosa lesāo retroauricular. Foi realizada uma biópsia incisional, cujo diagnóstico foi de angiossarcoma. Foi realizada embolização pré-operatória da lesāo pela artéria occipital esquerda e pelo ramo parietal da artéria cerebral média esquerda, seguida de ressecção do tumor. No pós-operatório imediato, a paciente evoluiu com disfasia transitória, recuperando-se completamente durante o seguimento. Nāo houve sinais de recidiva nos três anos de seguimento pós-operatório. A ressecção com margens livres de tumores de grande volume segue sendo o fator prognóstico mais importante para tumores malignos de partes moles com infiltração intracraniana.

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Research Square (Research Square), Aug 31, 2022

![Research paper thumbnail of Analysis of the Meningiomas` hormonal profile in patients with Meningioma and Breast Cancer](https://attachments.academia-assets.com/109653072/thumbnails/1.jpg)

Purpose The objective of this study is to evaluate the meningioma`s hormone receptor expression i... more Purpose The objective of this study is to evaluate the meningioma`s hormone receptor expression in patients who presented synchronous or metachronous meningioma and breast cancer and compare its profile to the non-breast cancer associated meningiomas described in the literature. Methods The authors conducted a retrospective descriptive study evaluating all cases of synchronous and metachronous meningiomas and breast cancer from January 1st, 1990 to December 31st, 2020. The study was approved by the Ethics Review Board. Variables related to meningioma (age and year of diagnosis, histological grade and subtype, topography, the presence of progesterone and/or estrogen receptors) and to breast cancer (age and year of diagnosis, the histological grade and subtype, the presence of progesterone and/or estrogen receptors) were collected on the hospital`s electronic health records. Results A total of 12 cases were included in the study, being 2 (17%) synchronous and 10 (83%) metachronous. Th...

Operative Neurosurgery

INDICATIONS: CORRIDORS AND LIMITS OF EXPOSURE: Subcranial approach is a versatile keyhole approac... more INDICATIONS: CORRIDORS AND LIMITS OF EXPOSURE: Subcranial approach is a versatile keyhole approach mainly indicated to the tumors of the anterior fossa and midline invasive tumors from the nasal cavity and paranasal sinus. 1-5 Endoscopic endonasal video assistance enhances the exposure and the safety of the approach. ANATOMIC ESSENTIALS: NEED FOR PREOPERATIVE PLANNING AND ASSESSMENT: Preoperative images depicted the size of the frontal sinuses and the relations of the lesions with frontal, ethmoid, and orbits. ESSENTIAL STEPS OF THE PROCEDURE: After performing a bifrontal scalp flap and a pericranial flap, periorbits are dissected from the superior and medial orbital rims. After frontonasal osteotomy, we drill the posterior wall of the frontal sinus. PITFALLS/AVOIDANCE OF COMPLICATIONS: Avoiding disruption of the cantal ligaments prevents telecantus. Watertight closure of the dura with temporal fascia graft and reinforcement with the pericranial flap makes cerebrospinal fluid leak o...

Surgical Neurology International, 2014

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA

ABSTRACT- We present a case of a 46-year old woman with a ventral epidural angiolipoma at the lum... more ABSTRACT- We present a case of a 46-year old woman with a ventral epidural angiolipoma at the lumbosacral level with erosion of the sacrum. About ninety cases of spinal angiolipomas have been previously described in the literature, most of them situated on the thoracic region, dorsal to the dural sac. Angiolipomas can be radically excised with a good prognosis even in the presence of bone erosion. We did not find any other angiolipoma at the sacral level surgically explored in the review of the literature. KEY WORDS: angiolipoma, spinal tumors, sacral tumors. Angiolipoma lombosacral: relato de caso RESUMO- Descrevemos o caso de uma mulher de 46 anos com um angiolipoma lombosacral ventral ao saco dural que erodia o sacro. Cerca de noventa casos de angiolipomas foram publicados na literatura, sendo na maioria localizados na região torácica e dorsal ao saco dural. Angiolipomas podem ser ressecados de maneira radical, com bom prognóstico mesmo na presença de infiltração óssea. Não encon...

Arquivos de Neuro-Psiquiatria, 2006

In the treatment of complex paraclinoidal and giant cavernous aneurysms, preservation of the pate... more In the treatment of complex paraclinoidal and giant cavernous aneurysms, preservation of the patency of the internal carotid artery (ICA) is not always possible, and therapeutic occlusion of the carotid is still an important option for their management. A complete preoperative evaluation of the carotid reserve circulation, including the use of temporary balloon occlusion test and single photon emission computerized tomography (SPECT) should be included in the current paradigms of paraclinoidal and intracavernous aneurysms management. We present a series of fifteen patients with sixteen giant or complex carotid cavernous or ophthalmic aneurysms that were treated following a protocol for our preoperative decision-making analysis. Extracranial to intracranial saphenous vein bypass was reserved to the cases where carotid occlusion would be associated with high risk of ischemic complications and was performed in three patients. Besides the difficulties in dealing with those complex aneur...

Arquivos de Neuro-Psiquiatria, 1995

Aneurysms arising at the proximal intracranial carotid artery (between cavernous sinus and poster... more Aneurysms arising at the proximal intracranial carotid artery (between cavernous sinus and posterior communicating artery) and at the anterior communicating complex may present with technical difficulties regarding appropriate access without excessive brain retraction. In a series of 15 patients the authors show the use of the cranio-orbital approach, formerly designed in the access of skull base tumors, for these subgroups of aneurysms. They discuss the advantages of a basal avenue in minimizing brain retraction, better anatomical orientation, obviation of tissue ressection and easier extra-dural bone removal. It was not identified any complication due to the described approach.

Arquivos de Neuro-Psiquiatria, 2002

Diversos fatores têm sido associados ao desenvolvimento de edema peritumoral nos meningiomas. For... more Diversos fatores têm sido associados ao desenvolvimento de edema peritumoral nos meningiomas. Foram estudados os aspectos radiológicos e anátomo-patológicos de 51 meningiomas intracranianos operados no Hospital Universitário Clementino Fraga Filho (HUCFF). Dois terços dos meningiomas apresentavam edema perilesional. O tamanho dos meningiomas correlacionou-se com a presença de edema, sendo mais frequente nos meningiomas grandes (>4cm). A localização parece, também, influenciar no desenvolvimento do edema peritumoral, sendo mais acentuado nos meningiomas da asa do esfenóide e incomum nos meningiomas do tubérculo selar. Os subtipos histológicos de meningioma não se correlacionaram com a intensidade do edema peritumoral. Dos diversos mediadores químicos descritos na literatura recente relacionados ao desenvolvimento de edema peritumoral em tumores intracranianos, destaca-se o fator de crescimento do endotélio vascular (VEGF). A expressão nos meningiomas do VEGF e de seu receptor flk-...

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

World Neurosurgery

BACKGROUND Navigated transcranial magnetic stimulation (nTMS) is being used for different purpose... more BACKGROUND Navigated transcranial magnetic stimulation (nTMS) is being used for different purposes in patients with brain tumors. However, the procedure requires a positive electrophysiological response. For patients with negative response in rest conditions, active motor threshold (AMT) may be used. However, sometimes it is difficult to obtain AMT measures due to inability of the patient to sustain steady muscle contraction. Herein, we describe a simple method by using a hand dynamometer to obtain AMT measures during nTMS session. CASE DESCRIPTION A 68-year-old woman underwent total removal of a right frontal lobe oligodendroglioma World Health Organization grade II, 15 years ago. Cranial magnetic resonance imaging during follow-up revealed local recurrence. In the postoperative period, she developed left upper limb paresis. A postoperative nTMS session was performed for motor electrophysiological evaluation. However, using the standard technique for AMT measurement, the patient was unable to perform sustained muscle contraction as required. A hand dynamometer was used. It allowed sustained muscle contraction for AMT measurement. A counter force for the index finger flexion, the hand support to stabilize hand joints and a numerical screen serving for both the examiner and the patient as a feedback parameter may explain the success obtained with this simple device. CONCLUSION Although more studies are necessary to validate the method, the hand dynamometer should be considered for patients unable to sustain muscle contraction during AMT measurement.

XXXII Congresso Brasileiro de Neurocirurgia

Skull Base

Introduction: Vestibular schwannomas are slow-growing tumors with progressive hearing and vestibu... more Introduction: Vestibular schwannomas are slow-growing tumors with progressive hearing and vestibular symptoms as the usual presentation. Cystic degeneration in schwannomas are found not so rarely, and it is probably secondary to microhemorrhages inside the tumor. We report a very unusual case of vestibular schwannoma with a massive hemorrhage inside the tumor and abrupt clinical presentation. Methods: We reviewed the cases of vestibular schwannomas treated by the authors with particular attention to their presentation symptoms and the occurrence of associated cysts. Results: We report a case of a 52-year-old female with acute presentation symptoms of intracranial hypertension and compression of the brain stem due to a large cystic vestibular schwannoma with massive bleeding inside the cyst. Total removal of the tumor was obtained through a suboccipital retrosigmoidal approach after the drainage of the hemorrhagic collection inside the tumor. Pathological studies confirmed hemosiderin deposition in the walls of the cyst. Conclusions: We report the CT and MR imaging appearance and the operative findings of a very rare case of massive intratumoral bleeding in a vestibular schwanoma. This unusual and unpredictable occurrence would be considered as an additional risk in the cases treated conservatively or with gamma-knife.