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Article ; Online: Intracystic interferon-alpha in pediatric craniopharyngioma patients.

Cavalheiro, Sergio

2017 Volume 19, Issue 10, Page(s) 1419

MeSH term(s)	Child ; Craniopharyngioma ; Humans ; Injections, Intralesional ; Interferon-alpha ; Pituitary Neoplasms
Chemical Substances	Interferon-alpha
Language	English
Publishing date	2017-08-30
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2028601-6
ISSN	1523-5866 ; 1522-8517
ISSN (online)	1523-5866
ISSN	1522-8517
DOI	10.1093/neuonc/nox123
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Zs.A 5307: Show issues

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Article ; Online: Posterior C1-C2 fusion for atlantoaxial rotatory fixation after posterior fossa craniotomy in a 4-year old: a case report.

de Meldau Benites, Vinicius / da Costa, Marcos Devanir Silva / Cavalheiro, Sergio

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 39, Issue 6, Page(s) 1647–1651

Abstract: Introduction: This study aimed to highlight that atlantoaxial rotatory fixation (AARF) can be related to neurosurgery procedures in children, with an afterward demonstration of good results after halo-gravity traction and C1-C2 stabilization using the ... ...

Abstract	Introduction: This study aimed to highlight that atlantoaxial rotatory fixation (AARF) can be related to neurosurgery procedures in children, with an afterward demonstration of good results after halo-gravity traction and C1-C2 stabilization using the Harms technique. Case description: To the best of our knowledge, this is the first case to report a 4-year-old boy who presented with AARF after a posterior fossa craniotomy to treat a cerebellar astrocytoma. At our medical facility, AARF was diagnosed using plain radiography and computed tomography imaging. The patient was treated with continuous cranial traction for 14 days. Initially, we detected that the patient had no C1 posterior arch or C2 spinous process; therefore, the best option was to perform the Harms technique. Postoperatively, the patient was placed in a cervical collar for 4 weeks. At the 4-year postoperative follow-up, the patient was doing well and had not developed any complications. Conclusion: Herein, we report a case in which AARF can be developed after neurosurgical procedure. Surgical techniques used for atlantoaxial subluxation should be carefully selected. In our case, the Harms technique after cranial traction was an excellent option for correcting and stabilizing the abnormal neck position. However, further studies are required to determine the best technique to use in the pediatric population.
MeSH term(s)	Male ; Humans ; Child ; Child, Preschool ; Atlanto-Axial Joint/diagnostic imaging ; Atlanto-Axial Joint/surgery ; Joint Dislocations/complications ; Radiography ; Tomography, X-Ray Computed ; Craniotomy
Language	English
Publishing date	2023-01-27
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-05862-y
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Article ; Online: In utero myelomeningocele repair and high-risk bladder pattern. a prospective study.

Macedo, Antonio / Ottoni, Sérgio Leite / Moron, Antonio / Cavalheiro, Sergio / da Cruz, Marcela Leal

International braz j urol : official journal of the Brazilian Society of Urology

2022 Volume 48, Issue 4, Page(s) 672–678

Abstract: Objectives: High-risk bladder pattern can be defined by Urodynamic Evaluation (UE) as overactive bladder with detrusor leak point pressure higher than 40 cmH2O and/or higher filling pressures also above 40 cmH2O. We wanted to evaluate response to ... ...

Abstract	Objectives: High-risk bladder pattern can be defined by Urodynamic Evaluation (UE) as overactive bladder with detrusor leak point pressure higher than 40 cmH2O and/or higher filling pressures also above 40 cmH2O. We wanted to evaluate response to treatment in myelomeningocele patients operated in utero in this subgroup. Patients and methods: From our prospective cohort of in utero MMC we have identified patients in the high-risk group. Treatment consisted of anticholinergics (Oxybutynin 0.2 mg/Kg) 2 or 3 times daily in association with CIC. At every UE, patients were reclassified in high-risk or low-risk patterns. Patients not responding were proposed bladder reconstruction or diversion according to age. Results: Between 2011 to 2020, we have been following 121 patients and 60 (49.6%) of them were initially categorized as high-risk. The initial UE was performed at a mean age of 7.9 months and detrusor overactivity was found in 83.3% (mean maximum pressure of 76.5cmH20). When evaluating patients with 2 or more UE, we identified 44 patients (follow-up: 36.8months). It was observed in the group of patients who underwent 2 to 5 UE, that response to treatment was validated by the finding of 40% of low-risk bladder patterns in the second UE and between 62% to 64% in the third to the fifth UE. The incidence of surgery was 13.3%. Conclusions: Early urological treatment of high-risk bladder pattern was effective in approximately 60%. We reinforce the need to correctly treat every patient with myelomeningocele, in accordance with UE, whether undergoing in utero or postnatal treatment.
MeSH term(s)	Humans ; Infant ; Meningomyelocele/complications ; Meningomyelocele/surgery ; Prospective Studies ; Urinary Bladder/surgery ; Urinary Bladder, Neurogenic/surgery ; Urodynamics
Language	English
Publishing date	2022-04-04
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2206649-4
ISSN	1677-6119 ; 1677-5538
ISSN (online)	1677-6119
ISSN	1677-5538
DOI	10.1590/S1677-5538.IBJU.2022.0053
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Zs.A 6174: Show issues

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Article ; Online: Endoscopic Approach for Resection of Frontal Forehead Osteoma: Technical Case Report Instruction.

da Costa, Marcos Devanir Silva / Suzuki, Fernando Seiji / Biló, João Pedro / Cavalheiro, Sergio

World neurosurgery

2023 Volume 175, Page(s) 11

Abstract: Forehead osteomas are benign bone tumors. They are frequently associated with exophytic growth in the outer table of the skull, causing cosmetic disfigurement of the face. ...

Abstract	Forehead osteomas are benign bone tumors. They are frequently associated with exophytic growth in the outer table of the skull, causing cosmetic disfigurement of the face.
MeSH term(s)	Female ; Humans ; Adult ; Forehead/diagnostic imaging ; Forehead/surgery ; Skull Neoplasms/diagnostic imaging ; Skull Neoplasms/surgery ; Endoscopy/methods ; Frontal Bone/diagnostic imaging ; Frontal Bone/surgery ; Osteoma/diagnostic imaging ; Osteoma/surgery
Language	English
Publishing date	2023-04-06
Publishing country	United States
Document type	Case Reports ; Video-Audio Media
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.03.135
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Zs.A 1159: Show issues

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Article ; Online: Everolimus as a possible prenatal treatment of in utero diagnosed subependymal lesions in tuberous sclerosis complex: a case report.

Cavalheiro, Sergio / da Costa, Marcos Devanir Silva / Richtmann, Rosana

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2021 Volume 37, Issue 12, Page(s) 3897–3899

Abstract: Introduction: The association between cardiac rhabdomyoma and intraventricular tumors and/or subcortical nodules is characteristic of tuberous sclerosis complex (TSC). Patients with TSC may have refractory seizures, autistic behavior, and cognitive ... ...

Abstract	Introduction: The association between cardiac rhabdomyoma and intraventricular tumors and/or subcortical nodules is characteristic of tuberous sclerosis complex (TSC). Patients with TSC may have refractory seizures, autistic behavior, and cognitive decline. Case report: The patient received the fetal diagnosis of TSC at the age of 19 weeks of gestations, where presented at prenatal ultrasound cardiac and brain tumors. Fetal MRI showed a lesion in the right and left lateral ventricles near the foramen of Monro associated with subependymal lesions along the entire ependyma of the lateral ventricles and several subcortical tubercles, and the fetal Doppler echocardiogram revealed three cardiac lesions. The fetus underwent intrauterine treatment with everolimus and presented regression and subsequent stabilization of the cardiac and brain lesions; additionally, the patient did not develop seizures or autism and presented good neuropsychomotor development. Conclusion: It is the first evidence that mTOR inhibitors may help to prevent neurological complications associated with TSC.
MeSH term(s)	Everolimus/therapeutic use ; Female ; Heart Neoplasms/drug therapy ; Humans ; Infant ; MTOR Inhibitors ; Pregnancy ; Rhabdomyoma/complications ; Rhabdomyoma/diagnostic imaging ; Rhabdomyoma/drug therapy ; Tuberous Sclerosis/complications ; Tuberous Sclerosis/diagnostic imaging ; Tuberous Sclerosis/drug therapy
Chemical Substances	MTOR Inhibitors ; Everolimus (9HW64Q8G6G)
Language	English
Publishing date	2021-05-18
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-021-05218-4
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Article ; Online: Diencephalic syndrome-like presentation of brainstem tumor: a series case-based review.

Tavares, Louise Scridelli / Pinho, Ricardo Silva / Aragão, Marcelo de Melo / Cappellano, Andréa Maria / Dastoli, Patrícia Alessandra / Cavalheiro, Sérgio / da Silva, Nasjla Saba

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 39, Issue 5, Page(s) 1115–1122

Abstract: Purpose: Russel described a rare clinical entity known as diencephalic syndrome (DS) in 1951, which was traditionally caused by a neoplasm in the hypothalamic-optic chiasmatic region. DS is characterized by severe emaciation despite adequate or slightly ...

Abstract	Purpose: Russel described a rare clinical entity known as diencephalic syndrome (DS) in 1951, which was traditionally caused by a neoplasm in the hypothalamic-optic chiasmatic region. DS is characterized by severe emaciation despite adequate or slightly reduced caloric intake, locomotor hyperactivity, euphoria and other minor features. Current evidence suggests that a rare population of children with a similar phenotype may have their tumor located in the posterior fossa instead, defining the DS-like presentation, a rare entity with few cases reported in the literature. Methods: A thorough search of three databases (PubMed, Ovid Medline, and Ovid Embase) was conducted to identify relevant papers reporting children with DS associated with brainstem tumors. To our knowledge, only seven cases have been documented in the literature. Moreover, we present four of our own cases, focusing on the unusual clinical presentation, the diagnosis process, and the lag time between the initial symptoms and the definitive diagnosis. Results: In this review, the mean lag time between the onset of symptoms and diagnosis was 20.9 months (median: 16 months; range: 1.5-72 months), whereas in our series of cases, the time was 32.5 months (median: 33 months; range: 7-57 months). Conclusion: Despite recent significant advances in neuro-oncology diagnostic tools, this mean lag time did not improve when compared with the previous literature review from 1976. Throughout these data, we aim to raise awareness in the hopes of detecting intracranial neoplasms earlier in cases of children with profound emaciation of unknown cause.
MeSH term(s)	Humans ; Hypothalamic Diseases/complications ; Emaciation/complications ; Pituitary Diseases ; Brain Stem Neoplasms/complications ; Brain Stem Neoplasms/diagnostic imaging ; Optic Chiasm ; Syndrome
Language	English
Publishing date	2023-02-08
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-05869-5
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Article ; Online: Prognostic factors of pediatric pineal region tumors at a single institution.

Valsechi, Linoel Curado / da Costa, Marcos Devanir Silva / Dastoli, Patrícia Alessandra / Nicácio, Jardel Mendonça / Suzuki, Fernando Seiji / Leite, Adriana Lima / Cavalheiro, Sérgio

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 39, Issue 9, Page(s) 2329–2339

Abstract: Purpose: This study aimed to identify factors of a worse prognosis among different histological types of pineal region tumors in pediatric patients treat at a single institution in a 30-year period.: Material and methods: Pediatric patients (151; < ... ...

Abstract	Purpose: This study aimed to identify factors of a worse prognosis among different histological types of pineal region tumors in pediatric patients treat at a single institution in a 30-year period. Material and methods: Pediatric patients (151; < 18 years of age) treated between 1991 and 2020 were analyzed. Kaplan-Meyer survival curves were created, and the log-rank test was used to compare the main prognostic factors in the different histological types. Results: Germinoma was found in 33.1%, with an overall 60-month survival rate of 88%; the female sex was the only factor of a worse prognosis. Non-germinomatous germ cell tumors were found in 27.1%, with an overall 60-month survival rate of 67.2%; metastasis upon diagnosis, residual tumor, and the absence of radiotherapy were associated with a worse diagnosis. Pineoblastoma was found in 22.5%, with an overall 60-month survival rate of 40.7%; the male sex was the only factor of a worse prognosis; a tendency toward a worse outcome was found in patients < 3 years of age and those with metastasis upon diagnosis. Glioma was identified in 12.5%, with an overall 60-month survival rate of 72.6%; high-grade gliomas were associated with a worse prognosis. Atypical teratoid rhabdoid tumors was found in 3.3%, and all patients died within a 19-month period. Conclusion: Pineal region tumors are characterized by the heterogeneity of histological types, which exert an influence on the outcome. Knowledge of the prognostic factors for each histological types is of extreme importance to the determination of guided multidisciplinary treatment.
MeSH term(s)	Child ; Humans ; Male ; Female ; Pinealoma/surgery ; Prognosis ; Pineal Gland/surgery ; Brain Neoplasms/surgery ; Glioma/pathology
Language	English
Publishing date	2023-05-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-05952-x
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Article ; Online: Intrinsic epidermoid cyst of the brainstem in children-review and case report.

Malveira, Adib Saráty / da Costa, Marcos Devanir Silva / Flores, Esdras Ismael Borrayo / Vaz, Herisson Harrider Silva / Dastoli, Patricia Alessandra / Nicácio, Jardel Mendoça / Cavalheiro, Sergio

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 39, Issue 12, Page(s) 3361–3369

Abstract: Purpose: The study aimed to summarize all published cases of intrinsic brainstem epidermoid cysts in a timeline to highlight the specific characteristics and individualize the disease, in addition to discussing the best treatment used.: Methods: The ... ...

Abstract	Purpose: The study aimed to summarize all published cases of intrinsic brainstem epidermoid cysts in a timeline to highlight the specific characteristics and individualize the disease, in addition to discussing the best treatment used. Methods: The scientific literature on pediatric cases of intrinsic epidermoid cysts of the brainstem was analyzed. We present the case of a 1.5-year-old male with incidental presentation, who was treated with gross total resection. We summarize all previously published cases to individualize the disease. Results: We identified 21 patients, including 10 boys and 11 girls, with a mean age of 4.85 (1-15) years at the time of surgery. The most frequent symptoms were cranial nerve palsy (71.4%), pyramidal tract deficit (57.14%), and headache (52.38%). Among the affected cranial nerves, VII was the most frequently reported in 10 patients. Conclusion: Brainstem epidermoid cysts are extremely rare pathologies with relevant age involvement in young children. The treatment objective should be the maximum resection of the lesion through a careful approach and with the appropriate tools for the functional preservation of the patient.
MeSH term(s)	Male ; Female ; Humans ; Child ; Child, Preschool ; Infant ; Epidermal Cyst/diagnostic imaging ; Epidermal Cyst/surgery ; Brain Stem/diagnostic imaging ; Brain Stem/surgery ; Brain Stem/pathology ; Cranial Nerves
Language	English
Publishing date	2023-11-29
Publishing country	Germany
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-06175-w
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Article ; Online: Treatment of depressed skull fractures with vacuum devices in the neonatal period: A case series.

Cavalheiro, Sergio / Puch Ramírez, Mauricio D / Fernández, María Carolina Portela / Dastoli, Patricia Alessandra / da Costa, Marcos Devanir Silva

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2023 Volume 40, Issue 4, Page(s) 1213–1219

Abstract: Purpose: The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns.: Methods: ... ...

Abstract	Purpose: The management of depressed skull fractures in infants can be either conservative or surgical. This study aimed to examine the outcomes of management with a negative-pressure vacuum device on depressed skull fractures in newborns. Methods: Twenty-eight patients (aged 1-6 days) with simple depressed skull fractures underwent skull elevation using negative-pressure vacuum devices. A protocol for nonsurgical management was adopted for infants with such fractures between 2010 and 2023. All patients were initially evaluated with neurological examination and complementary assessments-hematological and coagulation studies, transfontanel transcranial ultrasound, skull radiography, and computed tomography scanning with three-dimensional reconstruction-according to availability and clinical needs. Gentle (negative) extraction pressure was applied with one of several devices (according to institutional availability) for a maximum duration of 60 s; this was performed as soon as possible after diagnosis, preferably within 72 h. Follow-up data, available in the clinical records, were reported. Results: All patients exhibited satisfactory elevation of the depressed bone without associated injuries, except one patient who presented with an associated cephalohematoma which prevented optimal device coupling to generate sufficient vacuum pressure for correction. Neither neurological deficits nor development of epilepsy was noted; normal neurological assessment and oral alimentation tolerance were confirmed within 24 h post procedure. Conclusions: According to our data, ping-pong skull fracture elevation using the vacuum method is a safe and satisfactory treatment in the neonatal period. Early treatment allows for quick resolution, and in our opinion is the strategy of choice for depressed skull fractures in newborns.
MeSH term(s)	Infant ; Humans ; Infant, Newborn ; Skull Fracture, Depressed ; Vacuum ; Skull ; Skull Fractures ; Head
Language	English
Publishing date	2023-12-29
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-023-06261-z
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Article: The long-term effect on functional outcome of endoscopic brainwashing for intraventricular hemorrhage compared to external ventricular drainage alone: A retrospective single-center cohort study.

Sarti, Talita Helena Martins / da Costa, Marcos Devanir Silva / Araujo, Daniel Paz / Watanabe, Rodrigo Akira / Zymberg, Samuel Tau / Suriano, Ítalo Capraro / Cavalheiro, Sergio / Chaddad-Neto, Feres

Surgical neurology international

2024 Volume 15, Page(s) 109

Abstract: Background: Intraventricular hemorrhage (IVH) is a complex condition with both mechanical and chemical effects, resulting in mortality rates of 50-80%. Recent reports advocate for neuroendoscopic treatment, particularly endoscopic brainwashing (EBW), ... ...

Abstract	Background: Intraventricular hemorrhage (IVH) is a complex condition with both mechanical and chemical effects, resulting in mortality rates of 50-80%. Recent reports advocate for neuroendoscopic treatment, particularly endoscopic brainwashing (EBW), but long-term functional outcomes remain insufficiently explored. This study aims to outline the step-by-step procedure of EBW as applied in our institution, providing results and comparing them with those of external ventricular drainage (EVD) alone. Methods: We performed a retrospective analysis of adult patients with IVH who underwent EBW and patients submitted to EVD alone at our institution. All medical records were reviewed to describe clinical and radiological characteristics. Results: Although both groups had similar baseline factors, EBW patients exhibited a larger hemoventricle (median Graeb score 25 vs. 23 in EVD, P = 0.03) and a higher prevalence of chronic kidney disease and diabetes. Short-term mortality was lower in EBW (52% and 60% at 1 and 6 months) compared to EVD (80% for both), though not statistically significant (P = 0.06). At one month, 16% of EBW patients achieved a good outcome (Modified Rankin scale < 3) versus none in the EVD group (P = 0.1). In the long term, favorable outcomes were observed in 32% of EBW patients and 11% of EVD patients (P = 0.03), with no significant difference in shunt dependency. Conclusion: Comparing EBW and EVD, patients submitted to the former treatment have the highest modified Graeb scores and, at a long-term follow-up, have better outcomes, demonstrated by the improvement of the patients in the follow-up.
Language	English
Publishing date	2024-03-29
Publishing country	United States
Document type	Journal Article
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_37_2024
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