WAGNER MALAGO TAVARES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
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article 0 Citação(ões) na Scopus Cerebellopontine angle empyema after lumbar disc herniation surgery(2015) NASCIMENTO, Clarissa Gambara; BROCK, Roger Schmidt; MORAIS, Barbara Albuquerque; TAVARES, Wagner Malago; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaBackground: Lumbar discectomy is still one of the most common spinal surgeries performed today. Nevertheless, there are few publications considering severe complications. Case Description: We report a case with severe complication, without any previous report, a brain empyema after cerebrospinal fluid leak with good outcome afterword. A 45 years old man, returned six days after surgery, presenting cerebrospinal fluid leak, which after clinical and laboratory deterioration was reoperated. In the 14th postoperative facing worsening level of consciousness was diagnosed empyema in cerebellopontine angle and hydrocephalus underwent emergency surgery. Evolved with hemiplegia in the first postoperative attributed to vasculitis, completely recovered after 5 days. Conclusions: Although infrequent, lumbar discectomy is subject to severe complications, which as the case presented, can be dramatic. In surgeries must be careful to avoid cerebrospinal fluid leak e infectious complications.article 10 Citação(ões) na Scopus Hemodynamic stroke caused by strangulation(2014) NETO, Hugo Sterman; NEVILLE, Iuri Santana; BEER-FURLAN, Andre; TAVARES, Wagner Malago; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaWe report a case of watershed ischemic stroke in a 36-year-old male secondary to manual strangulation. The patient presented with a right hemiparesis with grade IV motor deficit and an expressive aphasia. Radiological investigation revealed an ischemic stroke on the left distal middle cerebral artery territory and in watershed areas of the left anterior and posterior cerebral arteries. There was no evidence of injury of cervical vessels. The hemodynamic mechanism and associated brain injury secondary to manual strangulation is described and discussed based on a literature review.article 10 Citação(ões) na Scopus Brown-Sequard syndrome associated with unusual spinal cord injury by a screwdriver stab wound(2014) BEER-FURLAN, Andre Luiz; PAIVA, Wellingson Silva; TAVARES, Wagner Malago; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel JacobsenIntroduction: Stab wounds resulting in spinal cord injuries are very rare. In direct central back stabbings, the layers of muscles and the spinal column tends to deflect blades, rarely causing injuries to the spinal cord. We report an unusual case of traumatic spinal cord injury by a screwdriver stab, presented as Brown-Sequard syndrome and discuss possible pitfalls on the surgical treatment. Case report: A 34 year-old man was brought to the emergency department after a group assault with a single screwdriver stab wound on the back. Neurological examination revealed an incomplete Brown-Sequard syndrome, with grade IV motor deficit on the left leg and contralateral hemihypoalgesia below T9 level. Radiological evaluation showed a retained 9 cm screwdriver that entered and trespassed the spinal canal at T6 level, reaching the posterior mediastinum with close relation to the thoracic aorta. Vascular injury could not be excluded. The joint decision between the neurosurgery and the vascular surgery teams was the surgical removal of the screwdriver under direct visualization. A left mini-thoracotomy was performed. Simultaneously, a careful dissection was done and screwdriver was firmly pulled back on the opposite path of entry under direct visualization of the aorta. The neurological deficit was maintained immediately after the surgical procedure. Follow-up visit after 1 year showed minor motor deficit and good healing. Conclusions: It is important to consider all aspects of secondary injury on the surgical planning of penetrating spinal cord injury. The secondary injury can be minimized with multidisciplinary planning of the surgical procedure.article 4 Citação(ões) na Scopus Giant acute epidural hematoma after ventriculoperitoneal shunt: a case report and literature review(2014) NOLETO, Gustavo; NEVILLE, Iuri Santana; TAVARES, Wagner Malago; SAAD, Felippe; PINTO, Fernando Campos; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaCerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve. After discharge, on the second day after the procedure, he presented with headache and impaired level of consciousness. At hospital admission he was in a coma and anisochoric. Underwent endotracheal intubation and a head CT, showed epidural hematoma. We performed emergency craniotomy to drain the hematoma, the patient died in the operating room despite resuscitation attempts. In conclusion, prompt diagnosis and emergency craniotomy is recommended in these cases. We must be aware of this possible evolution and maintain high suspicion besides a longer in-hospital observation after these procedures.