EBERVAL GADELHA FIGUEIREDO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Neurologia, Faculdade de Medicina - Docente
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
44 resultados
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- A Bibliometric Study of the Most Cited Reports in Central Nervous System Arteriovenous Malformations(2019) RAMOS, Miguel Bertelli; TEIXEIRA, Manoel Jacobsen; PREUL, Mark C.; SPETZLER, Robert F.; FIGUEIREDO, Eberval GadelhaOBJECTIVE: We performed a bibliometric analysis of studies reporting cases of brain and spinal arteriovenous malformations (AVMs). METHODS: We retrieved the 100 most cited reports in brain and spinal AVM research from Scopus and assessed the citation count, journal of publication and its impact factor, year of publication, first author and corresponding authors and their h-index, country, institution, department, and study category. RESULTS: The median number of citations per article was 215. The Journal of Neurosurgery was the most prolific journal (39 reports and 12,069 citations), including 9 of the 10 most cited reports. Seventy reports (19,251 citations), including 8 of the 10 most cited, were from the United States. The Barrow Neurological Institute was the most cited institution (7 reports; 2792 citations), and the Mayo Clinic had the greatest number of reports (8 reports; 1994 citations). Most studies had been reported before 2000 (71 reports; 19,262 citations). The most discussed topics were treatment (40 studies; 9560 citations) and natural history and/or clinical features (37 studies; 9595 citations). Neurosurgery was the most prolific department (58 studies; 15,860 citations). Spetzler was the author with the highest number of articles (n = 7) and citations (n = 2792). CONCLUSIONS: Brain and spinal AVM research was centralized in the United States, has been mainly reported in specific neurosurgical journals, and has been more often related to treatment and natural history and/or clinical features. It is possible that high impact AVM research has been decreasing recently. Because the best approach to these pathological entities remains controversial, research stimulation within this field should be encouraged.
- The minipterional craniotomy: beyond the keyhole concept(2021) RABELO, Nicollas Nunes; TEIXEIRA, Manoel Jacobsen; SPETZLER, Robert F.; FIGUEIREDO, Eberval Gadelha
- Does the use of oral contraceptives or hormone replacement therapy offer protection against the formation or rupture of intracranial aneurysms in women?: a systematic review and meta-analysis(2023) SANTANA, Diana Lara Pinto de; GONCALVES, Mariangela Barbi; ZIMPEL, Vanessa Milanese Holanda; FIGUEIREDO, Eberval GadelhaOBJECTIVE: The aim of this study was to carry out a systematic review of the literature with meta-analysis to evaluate the effect of using oral contraceptive and hormone replacement therapy as a protective factor in the formation of intracranial aneurysms and subarachnoid hemorrhage.METHODS: This is a systematic review of the literature with meta-analysis, using PubMed and Embase as databases and the PRISMA method. Casecontrol and cohort studies published until December 2022 were included in this review.RESULTS: Four studies were included in this review; three of which were eligible for meta-analysis. Regarding the use of oral contraceptive and the development of subarachnoid hemorrhage, there was a lower risk of aneurysm rupture with an odds ratio 0.65 (confidence interval 0.5-0.85). In the analysis of patients using hormone replacement therapy and developing subarachnoid hemorrhage, there was also a lower risk of aneurysm rupture with an OR 0.54 (CI 0.39-0.74). Only one article analyzed the formation of intracranial aneurysm and the use of hormone replacement therapy and oral contraceptive, and there was a protective effect with the use of these medications. oral contraceptive: OR 2.1 (CI 1.2-3.8) and hormone replacement therapy: OR 3.1 (CI 1.5-6.2).CONCLUSION: The use of hormone replacement therapy and oral contraceptive has a protective effect in intracranial aneurysm rupture and formation.
- The current state of global contribution to open access publishing in neurosurgery: A bibliometric analysis(2023) KOESTER, Stefan W.; BISHAY, Anthony E.; BATISTA, Savio; BERTANI, Raphael; NAIK, Anant; HAIZEL-COBBINA, Josie; ISAACS, Albert; FIGUEIREDO, Eberval Gadelha; PAIVA, Wellingson Silva; DEWAN, Michael C.
- Microsurgical approaches to the pulvinar: A comparative analysis(2022) FIGUEIREDO, Eberval Gadelha; RIBAS, Eduardo Carvalhal; MOSCARDI, Ricardo; NAKAJI, Peter; TELLES, Joao Paulo Mota; SPETZLER, Robert F.; PREUL, Mark C.Objective: To compare the area of exposure to the cisternal thalamus associated with four surgical techniques: supracerebellar-infratentorial (SCIT), occipital interhemispheric (OI), transchoroidal (TC) and subtemporal before and after parahippocampal resection (ST and STh, respectively). Methods: All approaches were performed on both sides of three heads. Qualitative anatomical analyses were performed to understand anatomical limits, advantages, and flaws of each technique. Quantitative analyses for multiple repeated dependent variables assessed significant differences between areas of exposure. Results: Exposure area was significantly more extensive using TC and STh approaches compared to ST, OI, and SCIT. STh achieved a significantly wider exposure compared to ST. Regarding dissection angle, surrounding structures and limitations, ST approaches do not provide adequate exposure, nor alignment with the thalamic axis. The OI and STh may provide a better field of exposure, but without adequate alignment and challenging deeper dissections. TC provides better exposure of the cisternal pulvinar with access to lateral pulvinar at the atrium's anterior wall but is a transcortical route that disrupts non-pathological tissue. SCIT provides an adequate area of exposure with the possibility of alignment with the thalamus axis, thus allowing an easier dissection of deeper lesions. Conclusions: For lesions at the pulvinar surface, OI and STh are adequate. For lesions restricted to medial pulvinar and deep along the thalamus axis, SCIT approaches are recommended. Lesions extending to the lateral pulvinar and ventricular atrium are best removed through TC approaches. The ST approach was not suitable to the cisternal pulvinar due to its limited angular exposure.
- The Learning Curve in Skullbase Surgery Part 2-From the Microsurgical Lab Training to the Operative Room(2022) ISOLAN, Gustavo Rassier; MONTEIRO, Jander; VAZ, Marco Antonio Schlindwein; LAVINSKY, Joel; ARAUJO, Ricardo Lopes de; FIGUEIREDO, Eberval Gadelha; BARK, Samir Aler; POLANSKI, Jose Fernando; RIBAS FILHO, Carmem Australia Paredes; RIBAS FILHO, Jurandir Marcondes; MALAFAIA, OsvaldoIn this second part, the authors review and suggest a methodology for studies in skull base surgery and training in microsurgical laboratory, based on their experiences and reflections. Not only are the foundations for the acquisition of microsurgical skills presented, but also what is needed to be an effective skullbase surgeon with good results. The present article reflects in particular the philosophy of professor Evandro de Oliveira and also serves to present to the neurosurgical community a new state-of-the-art laboratory for hands-on courses in Brazil, at the Faculdade Evang & eacute;lica Mackenzie do Paran & aacute;.
- Effects of Mnemonic Strategy Training on Brain Activity and Cognitive Functioning of Left-Hemisphere Ischemic Stroke Patients(2019) BATISTA, Alana X.; BAZAN, Paulo R.; CONFORTO, Adriana B.; MA, Maria da Graca M.; SIMON, Sharon S.; HAMPSTEAD, Benjamin; FIGUEIREDO, Eberval Gadelha; MIOTTO, Eliane C.Memory dysfunction is one of the main cognitive impairments caused by stroke, especially associative memory. Therefore, cognitive training, such as face-name mnemonic strategy training, could be an important intervention for this group of patients. The goal of this study was to evaluate the behavioral effects of face-name mnemonic strategy training, along with the neural substrate behind these effects, in the left frontoparietal lobe stroke patients. Volunteers underwent 2 sessions of functional magnetic resonance imaging (fMRI) during face-name association task: one prior and the other after the cognitive training. The fMRI followed a block design task with three active conditions: trained face-name pairs, untrained face-name pairs, and a couple of repeated face-name pairs. Prior to each fMRI session, volunteers underwent neuropsychological assessment. Training resulted in better performance on delayed memory scores of HVLT-R, and on recognition on a generalization strategy task, as well as better performance in the fMRI task. Also, trained face-name pairs presented higher activation after training in default-mode network regions, such as the posterior cingulate cortex, precuneus, and angular gyrus, as well as in lateral occipital and temporal regions. Similarly, untrained face-name pairs also showed a nonspecific training effect in the right superior parietal cortex, right supramarginal gyrus, anterior intraparietal sulcus, and lateral occipital cortex. A correlation between brain activation and task performance was also found in the angular gyrus, superior parietal cortex, anterior intraparietal sulcus, and lateral occipital cortex. In conclusion, these results suggest that face-name mnemonic strategy training has the potential to improve memory performance and to foster brain activation changes, by the recruitment of contralesional areas from default-mode, frontoparietal, and dorsal attention networks as a possible compensation mechanism.
- Letter to the Editor Regarding ""Resection of Pediatric Trigeminal Schwannoma Using Minimally Invasive Approach: Case Report, Literature Review, and Operative Video""(2020) FIGUEIREDO, Eberval Gadelha; YAMAKI, Vitor Nagai; SPETZLER, Robert F.
- MISIAN (Minimally Invasive Surgery for Treatment of Unruptured Intracranial Aneurysms): A Prospective Randomized Single-Center Clinical Trial With Long-Term Follow-Up Comparing Different Minimally Invasive Surgery Techniques with Standard Open Surgery(2021) MANDEL, Mauricio; TUTIHASHI, Rafael; LI, Yiping; JR, Jefferson Rosi; JENG, Brasil Chian Ping; TEIXEIRA, Manoel Jacobsen; FIGUEIREDO, Eberval GadelhaBACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed but treatment is still controversial. Although the descriptions and use of minimally invasive surgery (MIS) have increased, comparative studies with standard approaches are rare. OBJECTIVE: MISIAN (Minimally Invasive Surgery for Treatment of Unruptured Intracranial Aneurysms) is a prospective randomized single-center clinical trial with longterm follow-up comparing different MIS techniques with standard open surgery for treatment of UIAs. METHODS: We randomly allocated a standard pterional approach (PtA) or MIS (1:2) to 111 patients with UIAs of the anterior circulation (mean dome diameter, 6.4 mm; range, 3-20 mm). Patients selected for MIS underwent a second randomization between a transeyelid approach (TelA) or nanopterional approach (NPtA) (1:1). RESULTS: Forty-one patients were randomized to and treated with the PtA, 36 with the TelA, and 34 with the NPtA. Only patients treated with PtA had permanent facial nerve palsy (n = 4 [10%]; P = 0.032). MIS cosmetic results were considered better than those of PtA by independent observers (P < 0.001), and less temporal atrophy in the MIS & nbsp; group was also observed (P = 0.0034). The proportion of excellent results was higher in the TelA group than in the NPtA group (86% vs. 67.6%; P = 0.039). Patients undergoing MIS also reported consistently higher satisfaction and quality-of-life scores (P < 0.001). CONCLUSIONS: MIS is superior to standard PtA for microsurgical clipping of small UIAs of the anterior circulation in terms of cosmetic, satisfaction, and quality-of life outcomes. The TelA or NPtA for UIAs did not show significant outcome differences at 12-18 months.
- Pterygopalatine Fossa: Microsurgical Anatomy and its Relevance for Skull Base Surgery(2021) ISOLAN, Gustavo Rassier; BERNARDI, Julio Mocellin; TELLES, Joao Paulo Mota; RABELO, Nicollas Nunes; FIGUEIREDO, Eberval GadelhaIntroduction The purpose of this study was to define the anatomical relationships of the pterygopalatine fossa (PPF) and its operative implications in skull base surgical approaches. Methods Ten cadaveric heads were dissected at the Dianne and M Gazi Yasargil Educational Center MicrosurgicaLaboratory, in Little Rock, AK, USA. The PPF was exposed through an extended dissection with mandible and pterygoid plate removal. Results The PPF has the shape of an inverted cone. Its boundaries are the pterygomaxillary fissure; the maxilla, anteriorly; the medial plate of the pterygoid process, and greater wing of the sphenoid process, posteriorly; the palatine bone, medially; and the body of the sphenoid process, superiorly. Its contents are the maxillary division of the trigeminal nerve and its branches; the pterygopalatine ganglion; the pterygopalatine portion of the maxillary artery (MA) and its branches; and the venous network. Differential diagnosis of PPF masses includes perineural tumoral extension along the maxillary nerve, schwannomas, neurofibromas, angiofibromas, hemangiomas, and ectopic salivary gland tissue. Transmaxillary and transpalatal approaches require extensive resection of bony structures and are narrow in the deeper part of the approach, impairing the surgical vision and maneuverability. Endoscopic surgery solves this problem, bringing the light source to the center of the surgical field, allowing proper visualization of the surgical field, extreme close-ups, and different view angles. Conclusion We provide detailed information on the fossa's boundaries, intercommunications with adjacent structures, anatomy of the maxillary artery, and its variations. It is discussed in the context of clinical affections and surgical approaches of this specific region, including pterygomaxillary disjunction and skull base tumors.