HAMILTON MATUSHITA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
56 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 56
- Brain abnormalities in myelomeningocele patients(2020) MORAIS, Barbara Albuquerque; SOLLA, Davi Jorge Fontoura; YAMAKI, Vitor Nagai; FERRACIOLLI, Suely Fazio; ALVES, Cesar Augusto P. F.; CARDEAL, Daniel Dante; MATUSHITA, Hamilton; TEIXEIRA, Manoel JacobsenBackground Myelomeningocele (MMC) is often related to hydrocephalus and Chiari malformation (CM) type 2; however, other brain abnormalities have been reported in this population. In order to better understand and quantify other forebrain abnormalities, we analyzed magnetic resonance imaging (MRI) of MMC patients treated in utero or postnatal. Methods Between January 2014 and March 2017, 59 MMC were treated in our hospital. Thirty-seven patients (32 postnatal and 5 intrautero repair) had brain MRI and were enrolled at the study. MRI was analyzed by two experienced neuroradiologists to identify the supra and infratentorial brain abnormalities. Results A wide range of brain abnormalities was consistently identified in MMC patients. As expected, the most common were hydrocephalus (94.5%) and CM type II (89.1%). Of note, we found high incidence of corpus callosum abnormalities (86.4%), mostly represented by dysplasia (46%). Conclusions The data are consistent with the concept that brain abnormalities related to MMC can be both infratentorial and supratentorial, cortical, and subcortical. More studies are needed to correlate these forebrain abnormalities to long-term functional outcome and their prognostic value for these patients.
bookPart Tumores do Tronco Cerebral em Crianças(2015) MATUSHITA, Hamilton; ANDRADE, Fernanda; CARDEAL, Daniel Dante- Surgical approaches to IV ventricle - anatomical study(2015) MUSSI, Antonio Cesar de Melo; MATUSHITA, Hamilton; ANDRADE, Fernanda Goncalves; RHOTON, Albert L.Knowledge of anatomy of the IV ventricle is basic to surgical approach of any kind of lesion in its compartment as well as for those located in its neighborhood. The purpose of this study is to demonstrate the surgical approach options for the IV ventricle, based on the step by step dissection of anatomical specimens. Fifty formalin-fixed specimens provided were the material for this study. The dissections were performed in the microsurgical laboratory in Gainesville, Florida, USA. The IV ventricle in a midline sagittal cut shows a tent-shaped cavity with its roofs pointing posteriorly and the floor formed by the pons and the medulla. The superior roof is formed by the superior cerebellar peduncles laterally and the superior medullary velum on the midline. The inferior roof is formed by the tela choroidea, the velum medullary inferior, and the nodule. The floor of the IV ventricle has a rhomboid shape. The rostral two thirds are related to the pons, and the caudal one third is posterior to the medulla. The median sulcus divides the floor in symmetrical halves. The sulcus limitans runs laterally to the median sulcus, and the area between the two sulci is called the median eminence. The median eminence contains rounded prominence related to the cranial nucleus of facial, hypoglossal, and vagal nerves. The lateral recesses are extensions of the IV ventricle that opens into the cerebellopontine cistern. The cerebellomedullary fissure is a space between the cerebellum and the medulla and can be used as a surgical corridor to the IV ventricle. We obtained in this study a didactic dissection of the different anatomical structures, whose recognition is important for addressing the IV ventricle lesions.
- Neurocysticercosis: challenges in pediatric neurosurgery practice(2023) YAMAKI, Vitor Nagai; TELLES, Joao Paulo Mota; YAMASHITA, Renata Harumi Gobbato; MATUSHITA, HamiltonPurposeNeurocysticercosis (NCC) is considered a neglected infectious disease, but the most common parasitic disease of the central nervous system (CNS). Due to oral tendencies in childhood, it is hypothesized that individuals are infected around this age and develop symptoms as lately as during young adulthood. Although it is considered a benign disease, it may cause great impact in the patient's quality of life due to epilepsy, visual symptoms, and hydrocephalus, which eventually requires frequent hospitalizations. The treatment of hydrocephalus is the main challenge for neurosurgeons.MethodsWe performed a concise review on neurocysticercosis in children and the main presentations of NCC in the neurosurgery practice and a systematic review on hydrocephalus secondary to extraparenchymal NCC.ResultsOur review showed a rate of complete resolution of hydrocephalus secondary to NCC of around 80% with the first attempt of surgical treatment combined with medication therapy. Endoscopic removal of the intraventricular cysts with third ventriculostomy was the most common treatment modality. Patients previously managed with ventricular shunts are likely to have worse outcomes and complications.ConclusionEndoscopic approach is the gold standard surgical treatment for hydrocephalus secondary to neurocysticercosis.
- OTX1 and OTX2 Genes in Medulloblastoma (vol 127, pg e58, 2019)(2019) MUOIO, Valeria Marques Figueira; UNO, Miyuki; OBA-SHINJO, Sueli; SILVA, Roseli da; PEREIRA, Benedito Jamilson Araujo; CLARA, Carlos; MATUSHITA, Hamilton; MARIE, Suely K. N.
- Anthropometric changes in the skull base in children with sagittal craniosynostosis submitted to surgical correction(2021) LUCIO, Jose Erasmo Dal'Col; MATUSHITA, HamiltonPurpose Studies have examined the impact of fusion of the sagittal suture in the skull base while others have evaluated the growth of the skull base before and after surgery. This study aims to perform the anthropometric measures of the skull base in children with scaphocephaly to evaluate the influence of surgical repair in the remodeling of the skull base and anthropometric measures. Methods Twenty-one children with diagnosis of scaphocephaly were operated between April 2007 and October 2008, and anthropometric measures at the skull base were performed before and after a year of surgery. The measures were the cranial index (CI), distance between the crista galli and tuberculum sellar (CG-TS), distance between the crista galli and the internal auditory meatus (CG-IAM), distance between the oval foramen (OF-OF), distance between the internal auditory meatus (IAM-IAM), the angle of the skull base (a1), and the angle between the nasion, center of sella, and basion ((A) over cap2). Results There was a normalization of the CI in all children, confirming an appropriate cranial remodeling. The CG-TS measure evaluated the anterior skull base, with proportional growth of 12.5%. The mediolateral growth was observed by the increase of OF-OF measures by 8.5% and IAM-IAM by 9.5%. The CG-TS measure grew by 7.2%. There was no statistical difference in the angles analyzed. Conclusion Surgical treatment of scaphocephaly led to remodeling of the skull base, confirmed by the changes of anthropometric measures taken before and after a year of surgery.
- PROP1 and CTNNB1 expression in adamantinomatous craniopharyngiomas with or without beta-catenin mutations(2011) CANI, Carolina M. G.; MATUSHITA, Hamilton; CARVALHO, Luciani R. S.; SOARES, Ibere C.; BRITO, Luciana P.; ALMEIDA, Madson Q.; MENDONCA, Berenice B.INTRODUCTION: Activating mutations in exon 3 of the beta-catenin gene are involved in the pathogenesis of adamantinomatous craniopharyngiomas. Recently, the interaction between beta-catenin and PROP1 has been shown to be responsible for pituitary cell lineage determination. We hypothesized that dysregulated PROP1 expression could also be involved in the pathogenesis of craniopharyngiomas. OBJECTIVES: To determine whether dysregulated gene expression was responsible for tumor pathogenesis in adamantinomatous craniopharyngiomas, the beta-catenin gene was screened for mutations, and the expression of the beta-catenin gene and PROP1 was evaluated. METHODS: The beta-catenin gene was amplified and sequenced from 14 samples of adamantinomatous craniopharyngiomas. PROP1 and beta-catenin gene expression was assessed by real-time RT-PCR from 12 samples, and beta-catenin immunohistochemistry was performed on 11 samples. RESULTS: Mutations in the beta-catenin gene were identified in 64% of the adamantinomatous craniopharyngiomas samples. Evidence of beta-catenin gene overexpression was found in 71% of the tumors with beta-catenin mutations and in 40% of the tumors without mutations, and beta-catenin immunohistochemistry revealed a nuclear staining pattern for each of the analyzed samples. PROP1 expression was undetectable in all of the tumor samples. CONCLUSION: We found evidence of beta-catenin gene overexpression in the majority of adamantinomatous craniopharyngiomas, and we also detected a nuclear beta-catenin staining pattern regardless of the presence of a beta-catenin gene mutation. These results suggest that WNT signaling activation plays an important role in the pathogenesis of adamantinomatous craniopharyngiomas. Additionally, this study was the first to evaluate PROP1 expression in adamantinomatous craniopharyngiomas, and the absence of PROP1 expression indicates that this gene is not involved in the pathogenesis of this tumor, at least in this cohort.
bookPart Hidrocefalia Congênita(2015) CARDEAL, Daniel Dante; ANDRADE, Fernanda; MATUSHITA, Hamilton- High Intra-Abdominal Pressure Secondary to Obesity as a Determining Factor for Ventriculoperitoneal Shunt Malfunction(2018) MORAIS, Barbara Albuquerque; YAMAKI, Vitor Nagai; CARDEAL, Daniel Dante; ANDRADE, Fernanda Goncalves; PAIVA, Wellingson Silva; MATUSHITA, Hamilton; TEIXEIRA, Manoel JacobsenThe ventriculoperitoneal shunt (VPS) is an established treatment for hydrocephalus. The functioning of the system requires a pressure difference between the cranial and abdominal cavities. The VPS can be particularly problematic in patients with increased intra-abdominal pressure (IAP). We report the case of a 16-year-old girl with VPS since she was 2 months old due to hydrocephalus secondary to myelomeningocele. The patient had been asymptomatic ever since, but she sought the emergency service with intermittent headache and vomiting. A non-enhanced brain tomography, a shunt trajectory X-ray and an abdominal ultrasound revealed no cause of system malfunction. In view of the persistent clinical picture, a revision of the shunt was performed, which revealed adequate intraoperative functioning. She returned with the same symptoms two weeks after surgery. The patient was obese (body mass index [BMI]: 48). We hypothesized intermittent valve malfunction due to increased intra-abdominal pressure. She underwent a ventriculoatrial shunt, without intercurrences. In the postoperative period, the patient presented transient tachycardia and was asymptomatic at the 6-month follow-up. Obesity should be considered an important variable for the inadequate functioning of the VPS due to increased IAP and catheter dystocia to the extraperitoneal cavity. Studies have already correlated the IAP with the BMI, which reaches between 8mm Hg and 12mm Hg in obese individuals. Therefore, the BMI can be considered during the selection of valve pressure in systems with non-adjustable valves to prevent insufficient drainage. The recognition of obesity as a cause of VPS malfunction is fundamental to avoid unnecessary surgeries and intermittent malfunction of the system. Resumo A derivacAo ventriculoperitoneal (DVP) e um tratamento estabelecido para a hidrocefalia; contudo, algumas variaveis podem influenciar na eficacia desta modalidade. O funcionamento do sistema requer uma diferenca de pressAo entre as cavidades craniana e abdominal. A DVP pode ser particularmente problematica em pacientes com aumento da pressAo intra-abdominal (PIA). Neste artigo, relatamos o caso de uma paciente do sexo feminino, de 16 anos, portadora de DVP desde os 2 meses de idade por hidrocefalia secundaria a mielomeningocele. Desde entAo assintomatica, procurou o pronto-socorro com queixa de cefaleia e vomitos intermitentes. Uma tomografia de cranio sem contraste, um raio X (RX) do trajeto do cateter distal, e uma ultrassonografia (USG) abdominal nAo evidenciaram a causa do mau funcionamento do sistema. Diante do quadro persistente, realizou-se uma revisAo da derivacAo, que mostrou funcionamento adequado no periodo intraoperatorio. A paciente retornou com os mesmos sintomas duas semanas apos a cirurgia. A paciente era obesa (indice de massa corporal [IMC]: 48). Aventou-se possivel funcionamento intermitente da valvula pelo aumento da PIA. A paciente foi submetida a uma derivacAo ventriculo-atrial, que foi realizada sem intercorrencias. No pos-operatorio, ela apresentou quadro transitorio de taquicardia, e nAo apresentou sintomas no acompanhamento feito depois de 6 meses. A obesidade deve ser considerada uma variavel importante para o funcionamento inadequado da DVP, pelo aumento da PIA e pela associacAo com distocia do cateter para a cavidade extraperitoneal. Estudos ja correlacionaram a PIA com o IMC, que pode atingir entre8mm Hg e 12mm Hg em obesos. Logo, o IMC pode ser considerado na selecAo da pressAo da valvula em sistemas com valvulas nAo ajustaveis, para prevenir a drenagem insuficiente. O reconhecimento da obesidade de risco para o mau funcionamento da DVP e fundamental para evitar cirurgias desnecessarias e o mau funcionamento intermitente do sistema.
- Surgical technique of retrograde ventricle-sinus shunt is an option for the treatment of hydrocephalus in infants after surgical repair of myelomeningocele(2015) OLIVEIRA, Matheus Fernandes de; TEIXEIRA, Manoel Jacobsen; NORREMOSE, Karen Andrade; MATUSHITA, Hamilton; OLIVEIRA, Marcelo de Lima; SHU, Edson Bor Seng; PINTO, Fernando Campos GomesIntroduction: Treatment of hydrocephalus is accomplished primarily through a ventricular-peritoneal shunt (VPS). This study aims to describe the application of retrograde ventricle-sinus shunt (RVSS) in patients with hydrocephalus after surgical treatment of myelomeningocele. Method: A prospective, randomized and controlled pilot study. We consecutively enrolled 9 patients with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012. These patients underwent elective RVSS or VPS. Five underwent RVSS and 4 underwent VPS. Patients were followed for one year with quarterly evaluations and application of transcranial Doppler. Results: RVSS group showed outcomes similar to those of VPS group. Doppler revealed significant improvement when comparing preoperative to postoperative period. RVSS group had significantly higher cephalic perimeter than VPS group. Neuropsychomotor development, complications and subjective outcomes did not differ between groups. Conclusion: RVSS shunt is viable; it is an alternative option for the treatment of hydrocephalus.