WELLINGSON SILVA PAIVA
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 - Líder
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Brain Abscess After Halo Fixation for the Cervical Spine(2017) LOPES, Arthur; ANDRADE, Almir; SILVA, Igor; PAIVA, Wellingson; BROCK, Roger; TEIXEIRA, ManoelBACKGROUND: Halo fixation is one of the possible treatments for cervical spine fractures. However, improper use of these devices may lead to many complications, such as pin loosening, halo dislocation, pin site infection, and intradural penetration. CASE DESCRIPTION: We report the case of a 43-year-old man who first presented with a seizure and an altered level of consciousness 5 months after halo-vest placement for an odontoid fracture. Brain imaging showed a brain abscess, under the previous left parietal pin. The patient underwent abscess drainage and antibiotics were administered for 12 weeks. On hospital discharge, he presented with only mild impairments. CONCLUSIONS: Misapplication of halo fixation devices may lead to serious complications, including intracranial pin penetration and brain abscesses. Proper use of the recommended technique may decrease the risk for complications related to the procedure.
- Traumatic brain injury and hyperglycemia(2017) OLIVEIRA, Daniel Vieira de; AMORIM, Robson Luis; VIEIRA, Rita de Cassia Almeida; PAIVA, Wellingson Silva
- Holmes Tremor Secondary to a Stabbing Lesion in the Midbrain(2017) CURY, Rubens Gisbert; BARBOSA, Egberto Reis; FREITAS, Christian; GODOY, Luis Filipe de Souza; PAIVA, Wellingson SilvaBackground: The development of Holmes tremor (HT) after a direct lesion of the midbraia has rarely been reported in the literature, although several etiologies have been linked with HT, such as stroke, brainstem tumors, multiple sclerosis, head trauma, or infections. Phenomenology Shown: A 31-year-old male, having been stabbed in the right eye, presented with a rest and action tremor in the left upper limb associated with left hemiparesis with corresponding post-contrast volumetric magnetic resonance imaging T1 with sagittal oblique reformation showing the knife trajectory reaching the right midbrain. Educational Value: Despite the rarity of the etiology of HT in the present case, clinicians working with persons with brain injurieshot should be aware of this type of situation.
- Clinical Outcome, Tumor Recurrence, and Causes of Death: A Long-Term Follow-Up of Surgically Treated Meningiomas(2017) ALMEIDA, Antonio Nogueira de; PEREIRA, Benedito Jamilson Araujo; AGUIAR, Paulo Henrique Pires; PAIVA, Wellingson Silva; CABRERA, Hector Navarro; SILVA, Clemar Correa da; TEIXEIRA, Manoel Jacobsen; MARIE, Suely Kazue NagahashiOBJECTIVE: The medical literature still lacks information about the impact of surgery and adjuvant treatment on the life of patients with meningioma. The clinical outcome, timing of tumor recurrence, and causes of death are often overlooked. This study evaluates these data taking into account tumor localization and histologic grade. METHODS: The article is a cross-sectional study of patients operated on between 2000 and 2014 in a single institution. The series has 593 adult patients (442 females and 151 males) and follow-up of 68.8 +/- 48.9 months. Imaging of 434 patients was reviewed and 379 patients/families interviewed. RESULTS: Sixty-eight deaths were related to tumor treatment/progression and 36 to other causes. After 2 years of surgery, deaths not related to tumor were 7 times more frequent than were tumor-related deaths (odds ratio, 7.1; 95% confidence interval, 2.8e19.5; P < 0.0001). Ten-year survival was expected in 85% of patients with grade I (GI) meningioma, 35% of patients with atypic (GII) meningioma, and 0% of patients with anaplastic (GIII) meningioma. Convexity tumors had about half the risk of recurrence compared with other localizations (odds ratio, 0.4; 95% confidence interval, 0.27-0.67; P = 0.0002). In GI meningioma, recurrence was neither related to death nor to impairment of independent life. All patients with GII and GIII meningioma who had recurrence died. 96.3% of interviewees reported neurologic improvement or stability after the surgery. CONCLUSIONS: Histologic grade is the most important factor for long-term survival. Complete resection has to be pursued in GII and GIII meningioma but must be carefully weighed against morbidities in GI meningioma.
- Challenges for a successful career as a PhD student(2017) ZANINOTTO, Ana Luiza; PAIVA, Tatiana Saito; ANDRE, Marcia; MATTOS, Beatriz Silva; PAIVA, Wellingson Silva
- Neurocognitive Treatment Using Virtual Reality(2017) FERRO, Karyry Nascimento; MORAES, Thiago Mazzoli; ZANINOTTO, Ana Luiza; PAIVA, Wellingson Silva
- Transcranial Direct Current Stimulation for Post-Concussion Syndrome: Study Protocol for a Randomized Crossover Trial(2017) AMORIM, Robson Luis Oliveira de; BRUNONI, Andre Russowsky; OLIVEIRA, Mirian Akiko Furutani de; ZANINOTTO, Ana Luiza Costa; NAGUMO, Marcia Mitie; GUIRADO, Vinicius Monteiro de Paula; NEVILLE, Iuri Santana; BENUTE, Glaucia Rosana Guerra; LUCIA, Mara Cristina Souza de; PAIVA, Wellingson Silva; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel JacobsenBackground: Mild traumatic brain injury (MTBI) represents 70-80% of all treated brain injuries. A considerable proportion of MTBI patients experience post-concussion symptoms for a prolonged period after MTBI, and these symptoms are diagnosed as persistent post-concussion syndrome (PPCS). PPCS is defined as a range of physical, cognitive, and emotional symptoms. However, memory and executive dysfunction seems to be one of the most debilitating symptoms. Recently, non-invasive brain stimulation has been studied as a potential treatment method for traumatic brain injury (TBI) patients. Therefore, our primary goal is to verify the effects of transcranial direct current stimulation (tDCS) in patients with PPCS who demonstrate cognitive deficits in long-term episodic memory, working memory, and executive function following MTBI. Methods/design: This is a randomized crossover trial of patients with a history of MTBI with cognitive deficits in memory and executive function. Thirty adult patients will be randomized in a crossover manner to receive three weekly sessions of anodal tDCS (2mA) at left dorsolateral prefrontal cortex, left temporal cortex, and sham stimulation that will be performed at 7-day intervals (washout period). The clinical diagnosis of PPCS will be determined using the Rivermead Post-Concussion Symptoms Questionnaire. Patients who meet the inclusion criteria will be assessed with a neuropsychological evaluation. A new battery of computerized neuropsychological tests will be performed before and immediately after each stimulation. Statistical analysis will be performed to determine trends of cognitive improvement. Discussion: There is paucity of studies regarding the use of tDCS in TBI patients, and although recent results showed controversial data regarding the effects of tDCS in such patients, we will address specifically patients with PPCS and MTBI and no brain abnormalities on CT scan other than subarachnoid hemorrhage. Moreover, due to the missing information on literature regarding the best brain region to be studied, we will evaluate two different regions to find immediate effects of tDCS on memory and executive dysfunction.
- Giant Epidermoid Cyst: A Rare Cause of Temporal Lobe Epilepsy(2017) TRINDADE, Vinicius Gomes; GOMES, Marcos de Queiroz Teles; SANTO, Marcelo Prudente do Espirito; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaIntroduction Epidermoid tumors represent approximately 0.3 to 1.8% of all intracranial brain tumors. Only 1.5% of all intracranial epidermoid cysts (ECs) invade the brain and secondary epilepsy is extremely rare. Since August 2014, a 59-year-old male smoker had been presenting bad smell feelings, totaling four episodes with sudden onset and duration of 2 minutes. On September 2014, after a sense of smell episode, it evolved into loss of contact and automatic movements followed by generalized tonic-clonic movements. The brain magnetic resonance imaging revealed an extensive subtemporal lesion affecting anterior, middle, and posterior fossa with invasion of the choroidal fissure and projection to the temporal horn of the lateral ventricle. Pretemporal craniotomy with combined approaches, transsylvian and subtemporal, allowed for the excision of a white keratinized and softened lesion suggestive of EC. Discussion The optimal surgical strategy in individuals with ECs and seizures is not established. The evaluation of the cause and risk-benefit must be held to choose the appropriate surgical strategy: lesionectomy, lobectomy, or amygdalohippocampectomy. In this case, a lesionectomy was performed due to an absence of evidence of involvement of hippocampus and amygdala. Conclusion Epilepsy secondary to ECs is a rare association. Lesionectomy can be an option with good results without increasing the morbidity.
- Monitoring brain multiparameters and hypothermia in severe traumatic brain injury(2017) VASCONCELOS, Fernando Roberto de; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson Silva
- Comparison between Brain Computed Tomography Scan and Transcranial Sonography to Evaluate Third Ventricle Width, Peri-Mesencephalic Cistern, and Sylvian Fissure in Traumatic Brain-Injured Patients(2017) OLIVEIRA, Raphael A. G.; LIMA, Marcelo de Oliveira; PAIVA, Wellingson Silva; MALBOUISSON, Luiz Marcelo de Sa; TEIXEIRA, Manuel Jacobsen; BOR-SENG-SHU, EdsonIntroduction: Transcranial color-coded duplex sonography (TCCS) may help guide multimodal monitoring in the neurocritical setting. It may provide indirect information about intracranial hypertension, such as midline shift, third ventricle width, and peri-mesencephalic cistern obliteration. We aim to assess the agreement between brain computed tomography scan (CT scan) and TCCS in traumatic brain injury (TBI) patients. Methods: In this retrospective cross-sectional observational study, TCCS was performed within 6 h before a brain CT scan. Only the first CT and TCCS after ICU admission were included. The agreement between the CT scan and TCCS was assessed by BlandAltman plots and evaluating the intraclass correlation coefficient. Results: Overall, 15 consecutive patients were included (80% male, 42 +/- 23 years of age, Glasgow Coma Score 5 [4,6]). The mean difference between the brain CT scan and TCCS in measuring the midline shift was 0.30 +/- 2.1 mm (intraclass correlation coefficient: 0.93; p < 0.01). An excellent correlation was also observed between the methods in assessing the third ventricle width (intraclass correlation coefficient: 0.88; p < 0.01). BlandAltman plots did not show any systematic bias in either agreement analysis. TCCS showed good accuracy in predicting non-compressed peri-mesencephalic cisterns (AUC: 0.83, 95% CI 0.461.0) and the presence of the Sylvian fissure (AUC: 0.91, 95% CI 0.731.0) on CT scan. Conclusion: TCCS is a promising tool and may be an alternative to CT scans for evaluating TBI patients.