80 resultados para FRONTAL LOBE EPILEPSY


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The authors report a case of 36-year-old woman presented with epileptic seizures and headaches. Magnetic resonance imaging (MRI) revealed an enhancing lesion with surrounding edema and mild mass effect in the left frontal lobe. Stereotactic brain biopsy demonstrated intraparenchymal granulomas surrounding S. mansoni eggs. Praziquantel was started (60mg/kg of body weight, in a single dose), followed by Prednisone (80mg/day) for seven days to treat the cerebral edema. The patient's symptoms resolved following medical treatment and the follow-up MRI yielded normal findings.

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Purpose: the purpose of this study was to evaluate complications occurring after immediate reconstruction of severe frontal sinus fractures, including cases where the fracture was not limited to the anterior wall and also involved the posterior wall and/or sinus floor.Patients and Methods: the records of twenty-six patients presently undergoing follow-up for frontal sinus fracture reconstruction were reviewed. Information regarding demographics, fracture characteristics and causes, associated facial fractures, use of grafts or implants, type of fixation used, nasofrontal duct management, use of antibiotics, and complications were noted. Patients were asked to return for clinical and radiographic follow-up to access late complications.Results: the average age of patients with frontal fractures was 29.1 years and 92.3% were male. Mean follow-up was 3.6 years. The most common causes of fracture were motor vehicle accidents and physical aggression. All patients presented with comminuted and dislocated anterior wall fractures, 34.6% presented with posterior wall fractures, and 46% had sinus floor fractures. Complications occurred in 7 patients (26.92%) and included pneumoencephalus, frontal cutaneous fistula, frontal bone irregularity, and sinusitis.Conclusions: Frontal sinus reconstruction is a good procedure for immediate fracture treatment if there is not excessive comminution, dislocation, or instability of the posterior wall and if the frontonasal duct area is intact or can be repaired. Most complications result from incorrect indication for reconstruction. (C) 2004 American Association of Oral and Maxillofacial Surgeons.

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Purpose: In this study, we evaluated the results of spontaneous osteoneogenesis of the frontal sinus with autogenous bone plug versus obliteration with heterogeneous (human) bone in monkeys (Cebus apella).Materials and Methods: Eight young adult male C apella monkeys underwent an ostectomy of the anterior wall of the frontal sinus, removal of the sinus mucosa, and inner decortication of the bony walls and then were divided into 2 groups of 4 each, as follows. Group I monkeys underwent obliteration of the nasofrontal ducts with a free segment of frontallis muscle and corticocancellous heterogeneous bone, followed by full obliteration of the sinus with corticocancellous heterogeneous bone (Dayton Regional Tissue Bank, Dayton, OH). Group II monkeys underwent obliteration of the nasofrontal ducts with a frontal muscle segment and tibial autogenous bone plug, without full obliteration of the frontal sinus. In all animals, the sinus anterior wall was repositioned and fixed with 1.0 plate and screws. The monkeys were killed after 180 days, and routine laboratory procedures were followed for hematoxylin-eosin staining and histologic evaluation of the specimens.Results: the 2 studied techniques were both effective in obliterating the frontal sinus with newly formed bone. The nasofrontal ducts were obliterated by new bone formation or fibrous tissue (1 animal only).Conclusions: Both methods used for frontal sinus obliteration were effective; the heterogeneous bone (human bone) was well tolerated and presented low antigenicity. The nasofrontal duct obliteration with autogenous muscle associated with autogenous tibial bone (group II) or with heterogeneous bone (group I) was effective, isolating the frontal sinus from the nasal cavity. The spontaneous obliteration resulted, in the period analyzed, in earlier bone maturation compared with the obliteration by heterogeneous bone. (C) 2003 American Association of Oral and Maxillofacial Surgeons.

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The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.

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Knowledge of structural and physiological differences among the prostatic lobes (PL) is the basis for development of experimental studies in traditional laboratory rodents. Although Mongolian gerbil reproductive organs have been increasingly investigated, its prostate structure is far from being properly known, and investigations of this organ focused on the ventral lobe (VL). Thus, the present study provides a thorough morphological description of prostatic complex in the male adult gerbil on the basis of topographic, histological, and ultrastructural analysis and ductal branching. Like other rodents, four pairs of PL were observed. However, in contrast to the rat and mouse, the VL is the least voluminous component and the dorsolateral lobe (DLL) is the most prominent and spatially isolated from remaining PL. The occurrence of a dorsal lobe (DL), hidden between bladder and insertion of seminal vesicles, has not been mentioned in previous reports with Mongolian gerbil. Collagenase digestion followed by microdissection revealed that, except for DL, which has a tubularacinar organization, all PL exhibit tubular organization and variable ductal branching. Distinct histological and ultrastructural features such as secretory epithelium, aspect of luminal secretion and stromal organization are reported for each PL and are confirmed by morphometric and stereological methods. Histological sections showed at least three intralobar segments in VL and DL. Ultrastructural analysis evidenced that, although luminal epithelial cells of PL share typical features of exocrine secretory cells, there are striking lobe phenotypical variations. Both merocrine and apocrine pathways are observed in variable rates in all PL, with the predominance of the former in the DLL and the latter in the CG. The morphological observations presented herein point to distinct structural identities for each PL, which probably reflects,specific functional compromise of seminal fluid secretion. These data also point to the gerbil as a good model for investigations concerning the regulation of prostate development and homeostasis, mainly with regard to the dorsal and dorsolateral PL.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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O acesso ao seio frontal usando a técnica do retalho osteoplástico está indicada em lesões que não podem ser abordadas pela via endonasal. O aprendizado da técnica pode ser realizado em cães, mas a delimitação do seio do cão, de forma como se faz no homem, não é facilmente realizável. OBJETIVO: Apresentar um método de localização e delimitação do seio frontal do cão que permita reproduzir a técnica osteoplástica. FORMA DE ESTUDO: Técnica cirúrgica em animal. MATERIAL E MÉTODO: em cães traçaram-se duas linhas retas, uma delas ao longo da linha média da região frontal, outra passando pela pupila, inclinada 45º em direção à linha anterior. No ponto de intersecção, mede-se um ou um centímetro e meio para frente e um centímetro para trás. A partir destas medidas desenha-se um retângulo incompleto que delineia os limites aproximados do seio frontal. RESULTADOS: O procedimento foi realizado 12 vezes com a participação de médicos residentes. O seio frontal foi aberto facilmente em todos os animais, reproduzindo a técnica osteoplástica sem erros de localização do seio. CONCLUSÃO: O método de localização e de limitação do seio frontal do cão mostrou-se útil no ensino da técnica osteoplástica de acesso por ser reproduzível de forma realística.

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O trauma do seio frontal não é raro, correspondendo a 8% das fraturas faciais. Pode afetar a lâmina anterior e/ou posterior, com ou sem envolvimento do ducto nasofrontal. Tem alto potencial para complicações e seu manejo ainda é controvertido em algumas situações. OBJETIVO: Apresentar a epidemiologia, o diagnóstico e tratamento clínico e cirúrgico de 24 pacientes com fratura do seio frontal. MATERIAL E MÉTODOS: Estudo retrospectivo, não randomizado, de 24 pacientes com fratura de seio frontal operados no Hospital das Clínicas da Faculdade de Medicina de Botucatu, São Paulo, Brasil. RESULTADOS: Dos 24 pacientes, 16 tinham fraturas da lâmina externa e 8, da lâmina interna e externa. em 2 casos havia lesão do ducto nasofrontal. Vinte (83,4%) pacientes tiveram fraturas faciais associadas e em 13 (54,2%) foram observadas complicações intracranianas. A incisão em asa de borboleta, abaixo da sobrancelha, foi empregada na maioria dos casos cirúrgicos com bom resultado estético. Fixação dos fragmentos ósseos com diferentes materiais (fio de aço, mononylon, miniplacas de titânio) e, se necessário, reconstrução da tábua anterior com material aloplástico ou osso parietal. CONCLUSÃO: A causa principal das fraturas do seio frontal é acidente com veículos. O tratamento depende de sua complexidade, pois comumente há lesões cranioencefálicas associadas. As técnicas cirúrgicas utilizadas são as incisões, retalho bicoronal ou na sobrancelha, infra-orbital (em asa de borboleta), associadas à cirurgia endoscópica em casos de infecção fístula liquórica e complicações orbitárias.

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