Robson Luis Oliveira De Amorim | Universidade de São Paulo (original) (raw)
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Papers by Robson Luis Oliveira De Amorim
Annali italiani di chirurgia
Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head... more Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head injuries. In this paper the Authors describe a case of patient victim of transorbital stab with brain injury with good recovery and review the literature about cranial stab wound. A 23-year-old man was involved in an altercation which resulted in the patient sustaining wounds to the head, with penetrating in left transorbital, affecting the eye. At arrival to the first trauma center the patient was conscent and complete responsive with 15 points in Glasgow Coma Scale, and motor deficit grade III. CT scan demonstrated left periventricular brain hematoma and supraorbital fracture. A four-vessel cerebral angiogram demonstrated no abnormality. In this evolution patient presented good neurologic outcome. In patients conscents with no surgical lesion like our patient, the hospital discharge must occur after the angiogram have excluded intracranial vascular lesion.
![Research paper thumbnail of [The pathophysiological mechanisms following traumatic brain injury]](https://attachments.academia-assets.com/44880081/thumbnails/1.jpg)
](Revista da Associação Médica Brasileira (1992)
Traumatic brain injury is the main cause of death and disability in children and adults in Wester... more Traumatic brain injury is the main cause of death and disability in children and adults in Western Countries. The definitive brain injury is a consequence of pathophysiological mechanisms that begin at the moment of an accident and may extend for days or weeks. Traumatic brain injury may be classified as diffuse or focal. These two mechanisms are commonly associated in a patient, however one is generally predominant. Therefore knowledge of the pathophysiological mechanisms of brain injury in head trauma is important to establish the therapeutic, clinical and surgical measures. In this paper the authors present a critical review of the literature on the pathophysiological principles of traumatic brain injury.
Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be... more Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be fatal. Postoperative cerebellar hemorrhage as a complication of supratentorial surgery, with a radiological appearance known as zebra sign, is an increasingly recognized clinical entity and is associated mainly with vascular neurosurgery or temporal lobe resection. The pathophysiology remains unclear. Three cases of remote cerebellar hematoma occurred after neck clipping of anterior communicating artery aneurysms. All patients had similar clinical findings and underwent pterional craniotomy with the head in accentuated extension. One patient died and the two were discharged without symptoms. Cerebellar hemorrhage probably has a multifactorial origin involving positioning associated with abundant cerebrospinal fluid drainage causing cerebellar sag with resultant vein stretching and bleeding, and use of aspirin or other antiplatelet agents.
Revista da Associação Médica Brasileira, 2009
Rev Assoc Med Bras 2009; 55(1): 75-81 *Correspondência: Rua Dr Ovídio Pires de Campos, 171 -apto ... more Rev Assoc Med Bras 2009; 55(1): 75-81 *Correspondência: Rua Dr Ovídio Pires de Campos, 171 -apto 511 CEP 05403-010 -São Paulo -SP wellingsonpaiva@yahoo.com.br
Revista de Medicina, 2007
Andrade AF de, Amorim RLO de, Paiva WS, Figueiredo EG, Barros e Silva LB de, Teixeira MJ. Propost... more Andrade AF de, Amorim RLO de, Paiva WS, Figueiredo EG, Barros e Silva LB de, Teixeira MJ. Propostas para revisão dos critérios clínicos de morte encefálica. Rev Med (São Paulo). 2007 jul.-set.;86(3):132-7. RESUMO: Atualmente, quase 70 mil pessoas aguardam doação de órgãos no Brasil. O Hospital das Clínicas da Universidade de São Paulo -HCFMUSP é referência em transplantes de órgãos e tecidos e, ao mesmo tempo que se realizam cirurgias de alta complexidade, capacita os profi ssionais de saúde, sendo um facilitador para a integração dos mesmos. A morte encefálica hoje deve ser considerada uma emergência médica, pois pode salvar várias vidas. O seu diagnóstico é realizado de acordo com a Resolução do Conselho Federal de Medicina nº 1.480/97 e, baseado nessa resolução e em nossa experiência com todo o processo de captação até o transplante, apresentamos neste artigo propostas para evitar a perda de potenciais doadores.
The Journal of Trauma and Acute Care Surgery, 2012
BioMed Research International, 2014
Background. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is no... more Background. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is not well known, but patients with these lesions are more likely to have delayed bleeds. In this paper, we described a series of patients with epidural hematoma who underwent angiotomography (CTA) for MMA vascular lesion diagnosis. Methods. Eleven patients admitted to our emergency unit with small acute epidural hematoma were prospectively studied. All patients with temporal acute epidural hematomas underwent CTA and cerebral angiogram at our institution for diagnosis of posttraumatic lesions of middle meningeal artery. The findings of angiotomography and digital angiography were reviewed by radiologist and angiographers, respectively, to ensure that the lesions were readily diagnosed without knowing the results of angiotomography and to compare CTA findings with standard angiogram. Results. The causes of head injury were traffic accidents, falls, and aggression. Three of these patients presented traumatic MMA pseudoaneurysm. CT angiography was able to diagnose all of them, with dimensions ranging from 1.5 to 2.8 mm. Conventional angiography confirmed the findings of CT angiography, and the lesions presented with similar dimensions at both methods. Conclusions. We believe that angiotomography can be a useful technique for diagnosis of vascular lesion associated with small epidural hematoma.
Clinical Ophthalmology, 2010
Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4%... more Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4% of all head injuries. Transorbital penetrating brain injury is an unusual occurrence in emergency practice and presents with controversial management. We report the case of a 10-year-old boy who fell forward on a bamboo stick while playing with other children, causing a penetrating transorbital injury, resulting in meningitis. We performed a combined surgical approach with neurosurgeons and ophthalmogic surgeons. Upon discharge, the patient had a Glasgow Coma Scale score of 15, no motor deficit and no visual loss. We discuss the management of this case and review current literature.
Arquivos de Neuro-Psiquiatria, 2007
Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of th... more Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.
Arquivos de Neuro-Psiquiatria, 2008
Objective: The main objective when resecting benign brain lesions is to minimize risk of postoper... more Objective: The main objective when resecting benign brain lesions is to minimize risk of postoperative neurological deficits. We have assessed the safety and effectiveness of craniotomy under local anesthesia and monitored conscious sedation for the resection of lesions involving eloquent language cortex. Method: A retrospective review was performed on a consecutive series of 12 patients who underwent craniotomy under local anesthesia between 2001 and 2004. All patients had lesions close to the speech cortex. All resection was verified by post-operative imaging. Six subjects were male and 6 female, and were aged between 14 and 52 years. Results: Lesions comprised 7 tumour lesions, 3 cavernomas and 1 dermoid cyst. Radiological gross total resection was achieved in 66% of patients while remaining cases had greater than 80% resection. Only one patient had a post-operative permanent deficit, whilst another had a transient post-operative deficit. All patients with uncontrollable epilepsy had good outcomes after surgery. None of our cases subsequently needed to be put under general anesthesia. Conclusion: Awake craniotomy with brain mapping is a safe technique and the "gold standard" for resection of lesions involving language areas.
Journal of Neurosurgery, 2008
This 31-year-old man presented in the emergency department after sustaining a 12-gauge shotgun wo... more This 31-year-old man presented in the emergency department after sustaining a 12-gauge shotgun wound to the neck and face, resulting in multiple perforations. There was no evidence of violation of the cranium. The patient was comatose, received a score of 7 on the Glasgow Coma Scale, and had complete right hemiplegia. A skull radiograph showed multiple shotgun pellets in his face, and a head CT scan revealed hypodensity in the left temporoparietal area with a midline shift . A carotid arteriogram was performed that confirmed complete occlusion of the left middle cerebral artery (MCA) by a bullet .
Annali italiani di chirurgia
Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head... more Penetrating injury of the skull and brain is relatively uncommon, representing about 0.4% of head injuries. In this paper the Authors describe a case of patient victim of transorbital stab with brain injury with good recovery and review the literature about cranial stab wound. A 23-year-old man was involved in an altercation which resulted in the patient sustaining wounds to the head, with penetrating in left transorbital, affecting the eye. At arrival to the first trauma center the patient was conscent and complete responsive with 15 points in Glasgow Coma Scale, and motor deficit grade III. CT scan demonstrated left periventricular brain hematoma and supraorbital fracture. A four-vessel cerebral angiogram demonstrated no abnormality. In this evolution patient presented good neurologic outcome. In patients conscents with no surgical lesion like our patient, the hospital discharge must occur after the angiogram have excluded intracranial vascular lesion.
Revista da Associação Médica Brasileira (1992)
Traumatic brain injury is the main cause of death and disability in children and adults in Wester... more Traumatic brain injury is the main cause of death and disability in children and adults in Western Countries. The definitive brain injury is a consequence of pathophysiological mechanisms that begin at the moment of an accident and may extend for days or weeks. Traumatic brain injury may be classified as diffuse or focal. These two mechanisms are commonly associated in a patient, however one is generally predominant. Therefore knowledge of the pathophysiological mechanisms of brain injury in head trauma is important to establish the therapeutic, clinical and surgical measures. In this paper the authors present a critical review of the literature on the pathophysiological principles of traumatic brain injury.
Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be... more Hemorrhage in regions remote from the site of initial intracranial operations is rare, but may be fatal. Postoperative cerebellar hemorrhage as a complication of supratentorial surgery, with a radiological appearance known as zebra sign, is an increasingly recognized clinical entity and is associated mainly with vascular neurosurgery or temporal lobe resection. The pathophysiology remains unclear. Three cases of remote cerebellar hematoma occurred after neck clipping of anterior communicating artery aneurysms. All patients had similar clinical findings and underwent pterional craniotomy with the head in accentuated extension. One patient died and the two were discharged without symptoms. Cerebellar hemorrhage probably has a multifactorial origin involving positioning associated with abundant cerebrospinal fluid drainage causing cerebellar sag with resultant vein stretching and bleeding, and use of aspirin or other antiplatelet agents.
Revista da Associação Médica Brasileira, 2009
Rev Assoc Med Bras 2009; 55(1): 75-81 *Correspondência: Rua Dr Ovídio Pires de Campos, 171 -apto ... more Rev Assoc Med Bras 2009; 55(1): 75-81 *Correspondência: Rua Dr Ovídio Pires de Campos, 171 -apto 511 CEP 05403-010 -São Paulo -SP wellingsonpaiva@yahoo.com.br
Revista de Medicina, 2007
Andrade AF de, Amorim RLO de, Paiva WS, Figueiredo EG, Barros e Silva LB de, Teixeira MJ. Propost... more Andrade AF de, Amorim RLO de, Paiva WS, Figueiredo EG, Barros e Silva LB de, Teixeira MJ. Propostas para revisão dos critérios clínicos de morte encefálica. Rev Med (São Paulo). 2007 jul.-set.;86(3):132-7. RESUMO: Atualmente, quase 70 mil pessoas aguardam doação de órgãos no Brasil. O Hospital das Clínicas da Universidade de São Paulo -HCFMUSP é referência em transplantes de órgãos e tecidos e, ao mesmo tempo que se realizam cirurgias de alta complexidade, capacita os profi ssionais de saúde, sendo um facilitador para a integração dos mesmos. A morte encefálica hoje deve ser considerada uma emergência médica, pois pode salvar várias vidas. O seu diagnóstico é realizado de acordo com a Resolução do Conselho Federal de Medicina nº 1.480/97 e, baseado nessa resolução e em nossa experiência com todo o processo de captação até o transplante, apresentamos neste artigo propostas para evitar a perda de potenciais doadores.
The Journal of Trauma and Acute Care Surgery, 2012
BioMed Research International, 2014
Background. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is no... more Background. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is not well known, but patients with these lesions are more likely to have delayed bleeds. In this paper, we described a series of patients with epidural hematoma who underwent angiotomography (CTA) for MMA vascular lesion diagnosis. Methods. Eleven patients admitted to our emergency unit with small acute epidural hematoma were prospectively studied. All patients with temporal acute epidural hematomas underwent CTA and cerebral angiogram at our institution for diagnosis of posttraumatic lesions of middle meningeal artery. The findings of angiotomography and digital angiography were reviewed by radiologist and angiographers, respectively, to ensure that the lesions were readily diagnosed without knowing the results of angiotomography and to compare CTA findings with standard angiogram. Results. The causes of head injury were traffic accidents, falls, and aggression. Three of these patients presented traumatic MMA pseudoaneurysm. CT angiography was able to diagnose all of them, with dimensions ranging from 1.5 to 2.8 mm. Conventional angiography confirmed the findings of CT angiography, and the lesions presented with similar dimensions at both methods. Conclusions. We believe that angiotomography can be a useful technique for diagnosis of vascular lesion associated with small epidural hematoma.
Clinical Ophthalmology, 2010
Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4%... more Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4% of all head injuries. Transorbital penetrating brain injury is an unusual occurrence in emergency practice and presents with controversial management. We report the case of a 10-year-old boy who fell forward on a bamboo stick while playing with other children, causing a penetrating transorbital injury, resulting in meningitis. We performed a combined surgical approach with neurosurgeons and ophthalmogic surgeons. Upon discharge, the patient had a Glasgow Coma Scale score of 15, no motor deficit and no visual loss. We discuss the management of this case and review current literature.
Arquivos de Neuro-Psiquiatria, 2007
Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of th... more Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to stablish the correct treatment.
Arquivos de Neuro-Psiquiatria, 2008
Objective: The main objective when resecting benign brain lesions is to minimize risk of postoper... more Objective: The main objective when resecting benign brain lesions is to minimize risk of postoperative neurological deficits. We have assessed the safety and effectiveness of craniotomy under local anesthesia and monitored conscious sedation for the resection of lesions involving eloquent language cortex. Method: A retrospective review was performed on a consecutive series of 12 patients who underwent craniotomy under local anesthesia between 2001 and 2004. All patients had lesions close to the speech cortex. All resection was verified by post-operative imaging. Six subjects were male and 6 female, and were aged between 14 and 52 years. Results: Lesions comprised 7 tumour lesions, 3 cavernomas and 1 dermoid cyst. Radiological gross total resection was achieved in 66% of patients while remaining cases had greater than 80% resection. Only one patient had a post-operative permanent deficit, whilst another had a transient post-operative deficit. All patients with uncontrollable epilepsy had good outcomes after surgery. None of our cases subsequently needed to be put under general anesthesia. Conclusion: Awake craniotomy with brain mapping is a safe technique and the "gold standard" for resection of lesions involving language areas.
Journal of Neurosurgery, 2008
This 31-year-old man presented in the emergency department after sustaining a 12-gauge shotgun wo... more This 31-year-old man presented in the emergency department after sustaining a 12-gauge shotgun wound to the neck and face, resulting in multiple perforations. There was no evidence of violation of the cranium. The patient was comatose, received a score of 7 on the Glasgow Coma Scale, and had complete right hemiplegia. A skull radiograph showed multiple shotgun pellets in his face, and a head CT scan revealed hypodensity in the left temporoparietal area with a midline shift . A carotid arteriogram was performed that confirmed complete occlusion of the left middle cerebral artery (MCA) by a bullet .