ORCID Profile
0000-0003-2453-5205
Current Organisation
UNSW Sydney
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Georg Thieme Verlag KG
Date: 23-11-2019
Abstract: Meningitis or meningoencephalitis are the most common presentations of Koch bacilli infection on the central nervous system (CNS), especially in immunosuppressed patients, in whom the bacilli normally reaches the meninges and the cerebral parenchyma.. A least common pathological presentation is the tumoral growth pattern disease known as tuberculoma. This pathological entity is more common in the cerebral hemispheres and is rarely located in the brainstem. The present case report describes a case of a 55-year-old patient under regular antiretroviral therapy who was hospitalized with signs of brainstem and cerebellar disturbances. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed an exophytic lesion in the dorsal region of the pons. The patient underwent total resection of the lesion and the histopathologic analysis was consistent with a tuberculoma.
Publisher: Jornal Brasileiro de Neurocirurgia
Date: 2022
Publisher: Scientific Scholar
Date: 2016
Publisher: FapUNIFESP (SciELO)
Date: 2021
DOI: 10.1590/0004-282X-ANP-2020-0115
Abstract: ABSTRACT Background: About 50% of patients that suffer from trigeminal neuralgia do not experience sustained benefit from the use of oral medication. For their adequate management, a few surgical procedures are available. Of these, percutaneous balloon compression (PBC) and microvascular decompression (MD) are two of the most performed worldwide. In this retrospective study, we present the outcomes of these techniques through estimation of initial pain relief and subsequent recurrence rate. Methods: Thirty-seven patients with medically refractory trigeminal pain surgically treated at Hospital Cajuru, Curitiba, Brazil, with PBC, MD or both between 2013 and 2018 were enrolled into this retrospective study. The post-procedural rate for pain relief and recurrence and associations between patient demographics and outcomes were analyzed. Results: MD had an earlier recurrence time than balloon compression. Of the 37 patients, the mean age was 61.6 years, approximately one third were male and most had type I neuralgia. The most affected branch was the maxillary (V2). The time for recurrence after surgery was on average 11.8 months for PBC and 9.0 months for MD. Complications were seen only with microsurgery. Conclusions: MD presented with a more precocious recurrence of pain than PBC in this article. Moreover, it had a higher recurrence rate than described in the literature as well, which is possibly explained by the type of graft (muscle) that was used to separate the neurovascular structures.
Publisher: SAGE Publications
Date: 20-07-2021
DOI: 10.1177/19714009211026895
Abstract: Neurosurgery is historically a specialty with a wide male predominance. Interventional neuroradiology, considered in many countries to be a subspecialty of neurosurgery (but also radiology and neurology), has never been the setting for this discussion, but the even greater gender inequality of professionals working in this area is well known. The initial objective of this research was to describe the personal and professional profile of the few women in Brazil who practise neurosurgery and interventional neuroradiology, and the difficulties they encountered throughout their careers just because they are women. However, the shocking stories they experienced led the team to expand searches around the world, obtaining data from some other countries, mainly in South America. Machismo, harassment, misogyny, discrimination and wage inequality go beyond borders. Current times do not allow these situations anymore, but which, according to the narrative descriptions of 28 interventional neuroradiology women interviewed, still occur very frequently. A more inclusive vision must be sought by interventional neuroradiology societies, and it is up to the leaders to take care of those who need more attention (which does not mean they are more fragile).
Publisher: Springer Science and Business Media LLC
Date: 17-05-2021
Publisher: GN1 Genesis Network
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 28-08-2020
DOI: 10.1007/S13760-020-01480-6
Abstract: The aim of this article is to discuss the importance of staged surgeries when approaching atypical central neurocytoma in children. Also, we show the preoperative embolization of the lesion as a maneuver to reduce the intraoperative bleeding. Central neurocytomas represent less than 0.5% of all intracranial tumors, and atypical central neurocytomas usually have unfavorable outcome, with high recurrence rate. The intraventricular location is frequent, with a predilection for the lateral ventricles. When completely resected, these lesions have a good prognosis. We report a case of a 12-year old male patient that presented with a history of headache for about 6 months, which worsened for 1 week prior to admission. Magnetic resonance imaging (MRI) brain showed a massive lesion occupying both lateral ventricles. He underwent a microsurgical treatment of a highly vascularized lesion, but the perioperative bleeding required interruption of the surgery. Thus, a preoperative embolization was able to occlude most arterial feeders and allowed subtotal resection in a second surgery. The patient had complete neurological recovery despite immediate post-operative deficits, and the histopathology was suggestive of atypical neurocytoma. Two-stage surgery with preoperative adjuvant embolization is a feasible strategy for treatment of large central neurocytomas in children.
Publisher: SAGE Publications
Date: 14-02-2018
Abstract: Patients with polycystic kidney disease have a higher prevalence of intracranial aneurysms and may progress to renal failure requiring transplantation. The endovascular treatment of intracranial aneurysms may improve prognosis, since rupture often causes premature death or disability, but the nephrotoxicity risk associated with contrast medium must be always considered in cases of renal impairment. A 55-year-old female patient with polycystic kidney disease and grafted kidney associated with anterior communicant artery aneurysm was successfully treated by embolization. The renal function remained normal after the procedure. To the authors’ knowledge, this is the first case of endovascular treatment of brain aneurysm in a transplanted patient reported in the medical literature. The endovascular procedure in renal transplant patients is feasible and can be considered to treat this population. Further studies and cases are needed to confirm its safety.
Publisher: Georg Thieme Verlag KG
Date: 04-01-2022
Abstract: Introduction Vagal nerve stimulation (VNS) is an adjuvant therapy used in the treatment of patients with refractory epilepsy who are not candidates for resective surgery or who have limited results after surgical procedures. Currently, there is enough evidence to support its use in patients with various types of epilepsy. Therefore, the present study was conducted to explore the possibility of optimizing therapy by reducing the consumption of the system's battery. Methods The prospective and double-blind analysis consisted in the evaluation of 6 patients submitted to VNS implantation for 3 months, followed by adjustment of the stimulation settings and continuity of follow-up for another month. The standard protocol was replaced by another with a frequency value of 20 Hz instead of 30 Hz to increase battery life. The safety of this procedure was evaluated through the assessment of two main variables: seizures and side effects. Results The stimulation at 20 Hz showed 68% reduction in the incidence of seizures (p = 0.054) as well as low incidence of side effects. Conclusion The present study suggests that the reduction of the stimulation frequency from 30 to 20 Hz is a safe procedure, and it does not compromise the effectiveness of therapy.
Publisher: Georg Thieme Verlag KG
Date: 24-04-2021
Abstract: Sarcoidosis is a systemic disease characterized by granulomatous inflammation. Pulmonary and lymphatic granulomatous involvement are common. We present a rare case report of involvement of the central nervous system affecting the ocular region and mimicking optic nerve sheath meningioma. We report the case of a 79-year-old female patient with progressive visual impairment with an evolution of 4 years. A magnetic resonance imaging scan of the cranium with gadolinium and intense homogeneous contrast enhancement revealed an expansive lesion in the right optic nerve, at the height of the optic canal. The patient was submitted to the neurosurgical approach with lesion biopsy, which showed sarcoidosis of the central nervous system. Due to the rarity of central nervous system involvement, the diagnosis of this pathology may unfortunately be postponed. The present article aims to elucidate this pathology as a differential diagnosis of retro-orbital tumors.
Publisher: Georg Thieme Verlag KG
Date: 02-04-2019
Abstract: When the proximal occlusion or stenosis of the subclavian or of the brachiocephalic artery may require distal arterial filling through reversal flow from the vertebral artery, causing clinically significant blood supply reduction to the brainstem, it is called subclavian steal syndrome (SSS). We report a 54-year-old male patient who presented with multiple episodes of syncopes and vascular claudication due to right SSS. He underwent an angioplasty, evolving with complete improvement of the symptoms. We review the clinical presentation, the diagnostic methods, and the treatment options of the disease.
Publisher: Informa UK Limited
Date: 21-12-2020
Publisher: Georg Thieme Verlag KG
Date: 23-05-2019
Abstract: Background Fibromuscular dysplasia (FMD) affects predominantly the cervical and renal arteries and may cause the classical angiographic pattern of string-of-beads. The diagnosis is increasing with the advances of imaging techniques. Case Report A 37-year-old man presenting with subarachnoid hemorrhage due to a dissecting aneurysm of the vertebral artery was treated by angioplasty with stent, with good outcome. All of the cervical and renal arteries were diseased and showed dysplasia and/or ectasias. Conclusions There are no guidelines or protocols to treat patients with FMD.
Publisher: Peytchinski Publishing Ltd.
Date: 10-2021
DOI: 10.5272/JIMAB.2021274.3995
Abstract: Only a few cases of intramedullary meningiomas in the cervical and thoracic region have been reported in the literature. We present a rare case of intramedullary meningioma in the lower thoracic region. A 68-year-old woman with complaints of back pain, gait disturbance, and paresthesias in both lower extremities for 4 months was admitted to our institution. Initially, she presented with weakness in her legs that gradually deteriorated over time. The patient had been operated on for breast cancer 2 years prior to the onset of current complaints. The neurological examination revealed spastic inferior paraparesis (McCormick grade IV), hypoesthesia below Th10 dermatome, bowel and bladder disturbances. Magnetic resonance imaging of the thoracic spine demonstrated intramedullary tumor that was hypointense on T1 and T2-weighted images but showed homogenous enhancement after gadolinium administration. After gross total resection, the histopathological examination confirmed the diagnosis of atypical intramedullary meningioma. CONCLUSION: The intramedullary meningiomas are extremely rare, but they should not be excluded from the differential diagnosis, especially in cases of intramedullary tumors with homogenous enhancement on magnetic resonance imaging. The best treatment strategy is gross total removal of the tumor.
Publisher: Jornal Brasileiro de Neurocirurgia
Date: 13-12-2018
Abstract: Ossification of the ligamentum flavum (OLF) of thoracic spine occurs along with a progressive spine lesion, and is a rare myelopathy in non-Oriental patients. Computed Tomography or Magnetic Resonance imaging of spine are used for diagnosis, and early decompressive laminectomy is the treatment of choice. We report a case of female patient, 73-year-old, who presented progressive and symmetrical paraparesis, and painful tactile hypoesthesia at T4 level with two months of evolution of the case. After OLF diagnosis, with myelopathy on T1-T2 segment, we performed spine decompression with significant functional better results. According to our research and knowledge, this is the third case to be reported on Brazilian medical literature of a patient with non-Oriental descent.
Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
Date: 2022
DOI: 10.3171/2021.10.FOCUS21523
Abstract: In this study, the authors aimed to describe a new technique of sacroiliac joint (SIJ) fusion using a robotic navigation guidance system and to document clinical results with patient-reported visual analog scale (VAS) scores. Patients diagnosed with SIJ dysfunction were surgically treated using 2 hydroxyapatite (HA)–coated, threaded screws with the aid of the robotic navigation system. In a total of 36 patients, 51 SIJs were fused during the study period. Patients’ VAS scores were used to determine clinical improvement in pain. Postoperative imaging at routine intervals during the follow-up period was also performed for assessment of radiological fusion. In addition, complication events were recorded, including reoperations. All 36 patients had successful fusion evidenced by both CT and clinical assessment at the final follow-up. Two patients underwent reoperation because of screw loosening. The mean preoperative VAS score was 7.2 ± 1.1, and the mean 12-month postoperative VAS score was 1.6 ± 1.46. This difference was statistically significant (p 0.05) and demonstrated a substantial clinical improvement in pain. Robotic navigation–assisted SIJ fusion using 2 HA-coated, threaded screws placed across the joint was an acceptable technique that demonstrated reliable clinical results with a significant improvement in patient-reported VAS pain scores.
Publisher: Georg Thieme Verlag KG
Date: 08-2018
Abstract: The present report is about a 25-year-old woman who had a motorcycle accident with brain trauma injury. Although she was admitted at another institution disoriented but alert, she progressively evolved to an altered level of consciousness and required orotracheal intubation. She was then transferred to our hospital sedated, and the admission head computed tomography showed signs of posterior fossa ischemia. The angiography demonstrated a vertebral artery dissection with subsequent embolization to the basilar artery, which provoked its complete occlusion. After drug withdrawal, the patient recovered level of consciousness but was aphasic and did not exhibit purpose movements apart from eye blinking, as expected in patients with locked-in syndrome.
Publisher: Medknow
Date: 2019
Abstract: Brachial plexus neuropathies are uncommon and are rarely caused by a tumor. The clinical presentation of a brachial plexus neuropathy caused by a tumor depends on the degree of malignancy of the tumor and its localization. We report an illustrative case of a 27-year old female subject with a progressively increasing mass lesion causing brachial plexus compression, ipsilateral shoulder pain, C8 dermatomal paresthesia, and impairment of motor power. The patient underwent surgical resection of the mass and neurolysis of the nerves in the vicinity. Following the surgical procedure, the patient had improvement in the pain and paresthesia that he was suffering from. The histopathological diagnosis revealed a hibernoma, an extremely rare tumor described only once previously in this location. A systematic review of the literature was performed utilizing the PubMed database to access articles published before March 2018, using: A - the term 'hibernoma' in the title/abstract associated with the following MeSH terms: brachial plexus neuropathies OR brachial plexus neuropathy OR nerve compression syndrome, OR brachial plexus B - the MeSH term 'brachial plexus' associated with the term 'non neural sheath nerve tumor' or 'peripheral non-neural sheath nerve tumor'. The origin of the hibernoma, as well as its metabolic influence, pathology, and treatment have been discussed.
Publisher: Jornal Brasileiro de Neurocirurgia
Date: 14-12-2021
Abstract: Bilateral thalamus ischemic stroke is a rare condition that carries significant morbidity and mortality in comparison to other forms of stroke. It is usually associated with an anatomical variant with the thalamic paramedian arteries arising from a common trunk from the posterior cerebellar artery, known as Percheron artery. This infarct is difficult to be recognized and early recognition of this syndrome improves survival and functional recovery. We report a case of bilateral thalamic stroke after cardiac surgery.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.WNEU.2022.11.059
Abstract: Unstable thoracolumbar spinal injuries benefit from surgical fixation. However, perioperative complications significantly impact outcomes in surgically-treated spine patients. We evaluated associations between risk factors and postoperative complications in patients surgically treated for thoracolumbar spine fractures. A retrospective multicenter study was conducted collating data from 21 spine centers across nine countries on the treatment of AO-Spine types B and C injuries of the thoracolumbar spine treated via a posterior approach. Comparative analysis was performed between patients with postoperative complications and those without. Univariate and multivariable analyses were performed. Among 535 patients, at least one complication occurred in 43%. The most common surgical complication was surgical-site infection (6.9%), while the most common medical complication was urinary tract infection (13.8%). Among 136 patients with AIS-level A disability, 77.9% experienced at least one complication. Rate of complications also rose sharply among patients waiting >3 days for surgery (p<0.001), peaking at 68.4% among patients waiting ≥30 days. On multivariable analysis, significant predictors of complications were surgery at a governmental hospital (OR=3.38, 95% CI=1.73-6.60), having ≥1 comorbid illness (2.44, 1.61-3.70), surgery delayed due to health instability (2.56, 1.50-4.37), and AIS-level A (3.36, 1.78-6.35), while absence of impairment (0.39, 0.22-0.71), ASIA-level E (0.39, 0.22-0.67) and, unexpectedly, delay caused by OR unavailability (0.60, 0.36-0.99) were protective. Types B and C thoracolumbar spine injuries are associated with a high risk of postoperative complications, especially common at governmental hospitals, and among patients with comorbidity, health instability, longer delays to surgery, and worse pre-operative neurological status.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.JOCN.2022.02.030
Abstract: Intracranial ependymal cysts (IECs) are rare, histologically benign neuroepithelial cysts that mostly occur in the cerebral parenchyma. The majority of these cysts are clinically silent and discovered incidentally, but when symptomatic they may compress surrounding structures, thus surgical intervention is needed. The current data in the literature about ECs is very scarce, and many are misdiagnosed, once they share many radiological characteristics with a variety of intracranial benign cysts. Also their terminology is confusing, and its definitive diagnosis can only be made through a thorough histopathological study, hence a detailed description about these uncommon lesions is necessary. The correct identification of the lesion lead to our better understanding of the condition and further improvement of the patient's prognosis. A descriptive case is presented moreover, a detailed PubMed search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was performed. The data found was analyzed by various criteria in order to correctly describe the characteristics of this lesion. The literature review gathered 9 descriptions of patients with IECs with a erse range anatomopathological and clinical manifestations. All of the included studies found were case reports. Moreover, the authors suggest an updated classification of the lesion, involving their immunohistochemical characteristics. The information obtained from this study highlights IECs rarity and their inaccurately classification. We propose that the definitive diagnosis of IECs shall be made upon histopathological confirmation of an ependyma-lined cyst along with a positive glial fibrillary acidic protein (GFAP).
No related grants have been discovered for Jennyfer Paulla Galdino Chaves.