GIANT FUSIFORM ANEURYSM ARISING FROM FENESTRATED POSTERIOR CEREBRAL ARTERY and BASILAR TIP VARIATION: CASE REPORT

OBJECTIVE: A giant fusiform aneurysm in the posterior cerebral artery (PCA) is rare, as is fenestration of the PCA and basilar apex variation. We describe the angiographic and surgical findings of a giant fusiform aneurysm in the P1-P2 PCA segment associated with PCA bilateral fenestration and superior cerebellar artery double origin.CLINICAL PRESENTATION: A 26-year-old woman presented with a 2-month history of visual blurring. Digital subtraction angiography showed a giant (2.5 cm) fusiform PCA aneurysm in the right P1-P2 segment. The 3-dimensional view showed a caudal fusion pattern from the upper portion of the basilar artery associated with a bilateral long fenestration of the P1 and P2 segments and superior cerebellar artery double origin.INTERVENTION: Surgical trapping of the right P1 -P2 segment, including the posterior communicating artery, was performed by a pretemporal approach. Angiograms performed 3 and 13 months after surgery showed complete aneurysm exclusion, and the PCA was permeated and filled the PCA territory. Clinical follow-up at 14 months showed the patient with no deficits and a return to normal life.CONCLUSION: To our knowledge, this is the first report of a giant fusiform aneurysm of the PCA associated with P1-P2 segment fenestration and other variations of the basilar apex (bilateral superior cerebellar artery duplication and caudal fusion). Comprehension of the embryology and anatomy of the PCA and its related vessels and branches is fundamental to the decision-making process for a PCA aneurysm, especially when parent vessel occlusion is planned.

Natal teeth: Case report

The natal teeth are defined as the presence of teeth at birth and the etiology is rather obscure. Clinically, the teeth show normal size and shape, although they reveal an immature appearance. The histological aspect show enamel with the possibility of presenting normal mineralization or being hypoplastic. The dentin may show alterations. The incidence of natal teeth varies greatly, with a predisposition for the female sex. This paper relates a case report of two partially erupted natal teeth in a female baby 9 days-old. The presence of teeth made the parents anxious. In their mind, that meant the child was abnormal. On the radiograph the erupted teeth showed little radioopacity, without a radicular formation. The therapy utilized was the keeping of the teeth and a periodic monitoring, cleaning and daily topical applications sodium fluoride. The case was monitored by monthly consultations. At 9 months of age the primary central lower did not present mobility. On the radiograph examination incomplete radicular formation was observed.

Adaptação cultural e validação do JAMAR - Juvenile Arthritis Multidimensional Assessment Report para a artrite idiopática juvenil

Pós-graduação em Saúde Coletiva - FMB

Therapist’s directive and nondirective behavior: analysis of their effects in a parent training group

The study described the interaction between therapist and clients in a group intervention with two mothers and a grandmother. Five out of thirteen taped sessions were designated for analysis. Main results: a) therapist’s categories that stood out: approval, recommendation, interpretation, information and information request; b) clients’ categories that stood out: report, agreement, relation, and opposition, c) the probability for recommendation coupled with use of approval exceeded the probability of occurrence of other combinations. Possible explanations for the results were offered and new research questions were raised.