MATHEUS FERNANDES DE OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- Intraoperative Ultrasound in Chiari Type I Malformation(2020) BROCK, R. S.; TARICCO, M. A.; OLIVEIRA, M. F. De; OLIVEIRA, M. De Lima; TEIXEIRA, M. J.; BOR-SENG-SHU, E.The advent of intraoperative ultrasonography (USG) has allowed identification of craniocervical junction (CVJ) anatomy and cerebrospinal fluid dynamics and CVJ structures with real-time images. It is possible to use intraoperative USG in patients with Chiari malformation type I as a method for selection of candidates for posterior fossa decompression with bone removal alone. This chapter describes the authors’ experience using intraoperative USG. © Springer Nature Switzerland AG 2020.
- Long term follow-up of shunted idiopathic normal pressure hydrocephalus patients: a single center experience(2021) OLIVEIRA, Matheus Fernandes de; SORTE JR., A. A. Boa; EMERENCIANO, D. L.; ROTTA, J. M.; MENDES, G. A. S.; PINTO, F. C. G.Idiopathic normal pressure hydrocephalus (iNPH) is a condition characterized by gait disturbance, dementia and/or urinary incontinence and enlarged ventricular system due to disturbance of cerebrospinal fluid (CSF). This study aims to describe the long-term experience with patients with iNPH submitted to ventriculoperitoneal shunt (VPS) with the programmable valve STRATA (R) (Medtronic). We prospectively selected a cohort of patients with a diagnosis of iNPH from January 2010 to April 2013 in a Brazilian tertiary hospital. All patients underwent clinical evaluation, which consists of the Mini-Mental State Examination and Time Up and Go tests and the application of Japanese Scale for Idiopathic Normal Pressure Hydrocephalus in three stages: prior to the TT, 3 h after the TT and 72 h after the TT. Fifty patients were submitted to VPS and followed. There were 32 men and 18 women. Mean age was 77.1 with standard deviation of 10.9. Follow-up time ranged from 96 to 120 months, with mean of 106 months. After 1 year of follow-up, 42 (83%) patients presented with clinical improvement, decreasing to 62% of patients at mid-term follow-up and 38% of patients at late follow-up. Complications occurred in 18% of subjects, needing reoperation in 16%. Our results show relevant clinical impact of shunting in iNPH patients, decreasing over time. Complications should not be underestimated, reaching up to 18% and demanding reoperation in 16% of cases. Thus, although much has been improved with current shunt technology, it is still important to consider the drawbacks of treatment.
- 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.
- Psychiatric symptoms are frequent in idiopathic intracranial hypertension patients(2021) OLIVEIRA, Matheus Fernandes de; YAMASHITA, R. H. G.; SORTE JR., A. A. Boa; ROTTA, J. M.; NORREMOSE, K. A.; TEIXEIRA, M. J.; PINTO, F. C. G.Idiopathic intracranial hypertension (IIH) is a rare disease with an incidence rate of 0.5-2.0/100,000/year. Characteristic symptoms are headache and several degrees of visual impairment. Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In this study, we evaluated IIH subjects to determine the association with psychiatric symptoms. We evaluated thirty consecutive patients with IIH submitted to neurosurgery from January 2017 to January 2020 in two Brazilian tertiary hospitals. They underwent clinical evaluation, obtaining medical history, comorbidities, body mass index (BMI-kg/m(2)), and applying Neuropsychiatric Inventory Questionnaire (NPI-Q). There were 28 females and 2 males. Ages ranged from 18 to 66 years old, with mean age of 37.97 +/- 12.78. Twenty-five (83%) presented comorbidities, being obese and having arterial hypertension the most frequent. Body mass index ranged from 25 to 35 kg/m(2)and mean value was 31 +/- 3.42. After application of Neuropsychiatric Interview, 26 of 30 presented psychiatric symptoms (86%). Depression-anxiety syndromes were reported in 25 patients (83%). Nighttime disturbances were reported by 14 subjects (46%). Appetite and eating disorders were described by 23 (76%). Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In our sample, twenty-six out of 30 (86%) reported psychiatric symptoms. We highlight the high prevalence of psychiatric symptoms among IIH patients and the need of managing these patients with a multidisciplinary team, including psychiatrists.
- The Timed Up and Go Test as a Diagnostic Criterion in Normal Pressure Hydrocephalus(2017) MENDES, Gabriel Andre Silva; OLIVEIRA, Matheus Fernandes de; PINTO, Fernando Campos GomesINTRODUCTION: Normal-pressure hydrocephalus (NPH) is a disease characterized by gait disturbance, urinary incontinence, and dementia. Our objectives were to define an average value of the test for the population, check the specificity and test sensitivity as evaluation criteria and diagnostic testing, and correlate with other already used more frequently. METHODS: A study conducted at the Neurosurgery Division of the Hospital do Servidor Publico Estadual de Sao Paulo in which a group of 30 patients with NPH was submitted to the Mini-Mental State Test Examination, Time Up and Go (TUG), test and Japanese scale for NPH before the Tap Test 3 hours and 72 hours after the Tap Test. After being subjected to ventriculoperitoneal shunt, patients were evaluated 3 months, 6 months, and 12 months after surgery. A control group was used composed of 30 individuals of the same age and who had no diagnosis of NPH who were submitted to the TUG test to determine an average, which was compared with that of patients with NPH. RESULTS: TUG did not show good correlation with other tests used, but there was excellent specificity (0.967) and sensitivity (0.933) for cut-off value of 16.5 seconds for the diagnosis of NPH. CONCLUSIONS: TUG is a good test for the diagnosis of NPH because there is very good specificity and sensitivity, with a mean value of 16.5 seconds as the cut-off.
- Development of the Brazilian Portuguese version of the ""Grading scale for idiopathic normal pressure hydrocephalus"": cross-cultural adaptation, reliability and validity(2018) LOPES, Maria Izabel Romao; TORNAI, Juliana Benevenuto; JENG, Fernanda Letkaske de Miranda; LOPES, Bianca di Virgilio; MENDES, Gabriel Andre da Silva; OLIVEIRA, Matheus Fernandes de; PINTO, Fernando Campos GomesObjective: The current study translated to Portuguese and validated the normal pressure hydrocephalus (NPH) scale originally developed in English as the Grading Scale for Idiopathic Normal Pressure Hydrocephalus. Methods: Following Guillemin's validation protocol, the last version of the Portuguese NPH scale was applied to 121 consecutive patients with a diagnosis of normal pressure hydrocephalus (73 men and 48 women) from the Group of Cerebral Hydrodynamics from July 2010 to March 2012. Results: The mean age was 71.09 years old, ranging from 35 to 92 years. The rate of agreement and reproducibility was high, as confirmed by Cohen's Kappa coefficient, with excellent intraobserver correlation for the NPH scale items individually evaluated: gait (0.80), dementia (0.90) and incontinence (0.87). Conclusions: The Portuguese version of the Grading Scale for Idiopathic Normal Pressure Hydrocephalus was successfully translated and validated for use in Brazilian patients.
- Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study(2019) AMORIM, Robson Luis; MORAIS, Barbara Albuquerque; PEREIRA, Francisco Otavio Camargo; OLIVEIRA, Matheus Fernandes; ANDRADE, Almir Ferreira; BOR-SENG-SHU, Edson; OLIVEIRA, Marcelo Lima; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaObjective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975-0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569-0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488-0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415-0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.
bookPart 0 Citação(ões) na Scopus Laser application in hydrocephalus(2016) REIS, R. C.; OLIVEIRA, M. F. De; PINTO, F. C. GomesRosomoffe Carroll pioneered the use of laser in the treatment of neurosurgical conditions. Since then, many lasers systems have been applied to neurosurgery such as carbon dioxide (CO2), argon, Nd:YAG and diode lasers, each one with remarkable different effects in tissues. Likewise, use of laser has been extended through almost all fields in neurosurgery, such as functional neurosurgery, peripheral nerves, pediatrics, neuro-oncology and endoscopic neurosurgery. Main current applications of lasers in neurosurgery are minimally invasive procedures based on laser-assisted endoscopic interventions to treat hydrocephalus and its causes. Different etiologies were treated with this technique: neurocysticercosis, aqueductal stenosis, arachnoid colloid cysts and third ventricle tumor. The purpose of using laser in hydrocephalus is to reduce the invasiveness of intracranial procedures, while preventing brain tissue trauma in order to decrease the risk of neurological and mental deficits. In the present text, we report the main scientific rationale and applications of laser in hydrocephalus treatment. © 2016 by Nova Science Publishers, Inc. All rights reserved.- The Retrograde Ventriculosinusal Shunt in an Animal Experimental Model of Hydrocephalus(2016) PINTO, Fernando Campos Gomes; BECCO, Rodrigo; ALHO, Eduardo Joaquim Lopes; POLI-DE-FIGUEIREDO, Luiz Francisco; SOUZA, Podalyro Amaral de; OLIVEIRA, Matheus Fernandes de; TEIXEIRA, Manoel JacobsenCurrently, hydrocephalus treatment is performed mainly with ventriculoperitoneal shunting. This experimental study aims at assessing whether the experimental model of hydrocephalus in dogs is applicable to the laboratory study of the retrograde ventriculosinusal shunt (RVSS). Four mongrel dogs were assessed. After randomization, the animals were divided into two groups: an experimental group that underwent the induction of hydrocephalus/RVSS and a control group, for the measurement of the mean arterial pressure, intracranial pressure and pressure in the superior sagittal sinus (SSS). The controls presented a mean arterial pressure of 68 mm Hg (71 and 65), an intracranial pressure of 163 mm H2O (149.6 and 176.8) and a pressure at the SSS of 40 mm H2O (40 and 40). The kaolin injection into the cisterna magna at a concentration of 0.3 mg/ml was capable of inducing the clinical and radiological mechanism of hydrocephalus (intracranial pressure = 250 mm H2O, pressure at the SSS = 50 mm H2O). The caliber of the SSS was 2.5 +/- 1.0 mm. The fact that the SSS caliber of the dog was the same size as the external diameter of the catheter used resulted in the complete obstruction of the SSS when the catheter was inserted. We believe we could design and perform an experimental model to test the RVSS. It is applicable and feasible. The model of hydrocephalus, the surgical apparatus and the scenario were adequate, but the shunt system needs to be proportionally made to the canine anatomy. (C) 2016 S. Karger AG, Basel
- Transcranial Doppler in the evaluation of infants treated with retrograde ventriculosinus shunt(2016) OLIVEIRA, Matheus Fernandes de; TEIXEIRA, Manoel Jacobsen; OLIVEIRA, Marcelo de Lima; SENG-SHU, Edson Bor; NORREMOSE, Karen Andrade; PINTO, Fernando Campos GomesHydrocephalus is a prevalent condition among infants. Retrograde ventriculosinus shunt (RVSS) proposes a feasible option to treat hydrocephalus according to the principles presented by El-Shafei. In this essay, we analyze nuances and application of transcranial Doppler (TCD) in patients submitted to RVSS. We consecutively enrolled patients diagnosed with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012, users of Hospital das Clinicas, University of Sao Paulo. They were treated with RVSS. Patients enrolled to the study were consecutively evaluated in an outpatient basis with TCD in preoperative, immediate postoperative period, and late postoperative period (1 year). Except for patient 3, there was an increase in mean flow velocity, decreased pulsatility index, and decreased resistance index in all vessels analyzed. In our sample, transcranial Doppler could be used as a diagnostic and follow-up tool to evaluate hemodynamics and hydrodynamics in the preoperative and postoperative phases of RVSS. It was technically feasible in all patients, had close relation with other clinical and image parameters, and was sensitive to identify system malfunction.