Navegando por Palavras-chave "Cephalocentesis"

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    Antenatal management of fetal neurosurgical diseases
    (Springer, 2017) Cavalheiro, Sergio [UNIFESP]; Silva da Costa, Marcos Devanir [UNIFESP]; Mendonca, Jardel Nicacio [UNIFESP]; Dastoli, Patricia Alesssandra [UNIFESP]; Suriano, Italo Capraro [UNIFESP]; Barbosa, Mauricio Mendes [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]
    The advance in the imaging tools during the pregnancy (ultrasound and magnetic resonance) allowed the early diagnose of many fetal diseases, including the neurological conditions. This progress brought the neurosurgeons the possibility to propose treatments even before birth. Myelomeningocele is the most recognized disease that can be treated during pregnancy with a high rate of success. Additionally, this field can be extended to other conditions such as hydrocephalus and encephaloceles. However, each one of these diseases has nuances in the diagnostic evaluation that should fit the requirements to perform the fetal procedure and overbalance the benefits to the patients. In this article, the authors aim to review the neurosurgical aspects of the antenatal management of neurosurgical conditions based on the experience of a pediatric neurosurgery center.
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    Fetal hydrocephalus
    (Springer, 2011-10-01) Cavalheiro, Sergio [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Almodin, Carlos Gilberto [UNIFESP]; Suriano, Italo Capraro [UNIFESP]; Hisaba, Vagner [UNIFESP]; Dastoli, Patricia [UNIFESP]; Barbosa, Mauricio Mendes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction Hydrocephalus is the most frequent and devastating illness affecting a fetus. the development of both ultrasonography and magnetic resonance, associated with laboratorial tests, has greatly facilitated its diagnosis.Materials and methods in the Fetal Medicine Service of the Federal University of São Paulo and in the Santa Joana/Pro-Matre Paulista Hospital Complex, in São Paulo, SP, Brazil, repeated cephalocenteses, ventricular-amniotic shunting, and neuroendoscopy were used to treat 57 fetuses with hydrocephalus, all of them at a gestational age under 32 weeks. Another eight fetuses had myelomeningocele and underwent correctional open surgery to prevent hydrocephalus.Results Thirty-nine patients were followed up for a period longer than 3 years and had their intelligence coefficient assessed: 26 of them were considered normal (IQ above 70); six had mild or moderate handicaps (IQ from 35 to 70), and seven were severely handicapped (IQ below 35). Out of the eight patients operated for correction of myelomeningocele, only two came to require shunting. There were no cases of maternal morbidity, and no infectious condition was observed in any of the patients subjected to intrauterine treatment.Conclusion Selected cases of isolated, evolutive, non-destructive hydrocephaly diagnosed before 32 gestational weeks may benefit from fetal neurosurgical procedures. With the accuracy improvement of diagnoses, the number of patients fitting into that group has become very small.