ROBSON LUIS OLIVEIRA DE AMORIM
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
9 resultados
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Agora exibindo 1 - 9 de 9
- Psychosurgery for schizophrenia: history and perspectives(2013) SOARES, Matheus Schmidt; PAIVA, Wellingson Silva; GUERTZENSTEIN, Eda Z.; AMORIM, Robson Luis; BERNARDO, Luca Silveira; PEREIRA, Jose Francisco; FONOFF, Erich Talamoni; TEIXEIRA, Manoel JacobsenFollowing the early studies of Moniz and Lima, psychosurgery had considerable scientific credibility until the advent of modern antipsychotics in the mid 1950s. Thereafter, psychosurgery was almost abandoned in large medical centers as a common treatment for schizophrenia, although is still used for some affective and anxiety disorders. We reviewed relevant papers cited in the Medline/Index Medicus, Cochrane, and Scielo databases from 1930 to 2012. In our review of the literature, we show from recent studies that there are still many patients with schizophrenia who have serious deficits even after being treated with current noninvasive therapies. The value of psychosurgery remains controversial. There are no data available to support the use of stereotactic procedures for schizophrenia. Well designed controlled trials are needed to establish the effectiveness of psychosurgery in patients with schizophrenia.
- Esthetics outcomes in patients submitted to pterional craniotomy and its variants: A scoping review(2021) GONçALVES, D. B.; SANTOS, M. I. A. dos; CABRAL, L. de Cristo Rojas; OLIVEIRA, L. M.; COUTINHO, G. C. da Silva; DUTRA, B. G.; MARTINS, R. V.; REIS, F.; PAIVA, W. S.; AMORIM, R. L. O. deBackground: Highly performed nowadays, the pterional craniotomy (PC) has several widespread variants. However, these procedures are associated with complications such as temporalis muscle atrophy, facial nerve frontal branch damage, and masticatory difficulties. The postoperative cranial aesthetic is, nonetheless, the main setback according to patients. This review aims to map different pterional approaches focusing on final aesthetics. Methods: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were classified through the Oxford method. We searched PubMed/MEDLINE, EMBASE, and Cochrane Library from January 1969 to February 2021 for cohorts and randomized clinical trials that met our inclusion criteria. Results: 1484 articles were initially retrieved from the databases. 1328 articles did not fit the inclusion criteria. 118 duplicates were found. 38 studies were found eligible for the established criteria. 27 (71.05%) were retrospective cohorts, with low evidence level. Only 5 (13.15%) clinical trials were found eligible to the criteria. The majority of the studies (36/38) had the 2B OXFORD evidence level. A limited number of studies addressed cosmetic outcomes and patient satisfaction. The temporal muscle atrophy or temporal hollowing seems to be the patient’s main complaint. Only 17 (44.73%) studies addressed patient satisfaction regarding the aesthetics, and only 10 (26.31%) of the studies reported the cosmetic outcome as a primary outcome. Nevertheless, minimally invasive approaches appear to overcome most cosmetic complaints and should be performed whenever possible. Conclusion: There are several variants of the classic PC. The esthetic outcomes are poorly evaluated. The majority of the studies were low evidence articles. ©2021 Published by Scientific Scholar on behalf of Surgical Neurology International
- The Puzzling Olfactory Groove Schwannoma: A Systematic Review(2011) FIGUEIREDO, Eberval Gadelha; SOGA, Yougi; AMORIM, Robson Luis Oliveira; OLIVEIRA, Arthur Maynart Pereira; TEIXEIRA, Manoel JacobsenWe systematically reviewed the literature concerning the anterior cranial fossa schwannomas to understand their pathogenesis, determine their origin, and standardize the terminology. We performed a MEDLINE, EMBASE, and Science Citation Index Expanded search of the literature; age, gender, clinical presentation, presence or absence of hyposmia, radiological features, and apparent origin were analyzed and tabulated. Cases in a context of neurofibromatosis and nasal schwannomas with intracranial extension were not included. Age varied between 14 and 63 years (mean = 30.9). There were 22 male and 11 female patients. The clinical presentation included seizures (n = 15), headache (n = 16), visual deficits (n = 7), cognitive disturbances (n = 3), and rhinorrhea (n = 1). Hyposmia was present in 14 cases, absent in 13 cases (39.3%), and unreported in five. Homogeneous and heterogeneous contrast enhancement was observed in 14 and 15 cases, respectively. The region of the olfactory groove was the probable site in 96.5%. Olfactory tract could be identified in 39.3%. The most probable origin is the meningeal branches of trigeminal nerve or anterior ethmoidal nerves. Thus, olfactory groove schwannoma would better describe its origin and pathogenesis and should be the term preferentially used to name it.
- Consensus statement from the international consensus meeting on post-traumatic cranioplasty(2021) IACCARINO, C.; KOLIAS, A.; ADELSON, P. D.; RUBIANO, A. M.; VIAROLI, E.; BUKI, A.; CINALLI, G.; FOUNTAS, K.; KHAN, T.; SIGNORETTI, S.; WARAN, V.; ADELEYE, A. O.; AMORIM, R.; BERTUCCIO, A.; CAMA, A.; CHESNUT, R. M.; BONIS, P. De; ESTRANEO, A.; FIGAJI, A.; FLORIAN, S. I.; FORMISANO, R.; FRASSANITO, P.; GATOS, C.; GERMANO, A.; GIUSSANI, C.; HOSSAIN, I.; KASPRZAK, P.; PORTA, F. La; LINDNER, D.; MAAS, A. I. R.; PAIVA, W.; PALMA, P.; PARK, K. B.; PERETTA, P.; POMPUCCI, A.; POSTI, J.; SENGUPTA, S. K.; SINHA, A.; SINHA, V.; STEFINI, R.; TALAMONTI, G.; TASIOU, A.; ZONA, G.; ZUCCHELLI, M.; HUTCHINSON, P. J.; SERVADEI, F.Background Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach. Methods The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP. Results The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations. Conclusions This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.
- Current clinical approach to patients with disorders of consciousness(2016) AMORIM, Robson Luis Oliveira de; NAGUMO, Marcia Mitie; PAIVA, Wellingson Silva; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel JacobsenSummary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.
- Treatment of traumatic acute posterior fossa subdural hematoma: report of four cases with systematic review and management algorithm(2014) AMORIM, Robson Luis Oliveira de; STIVER, Shirley I.; PAIVA, Wellingson Silva; BOR-SENG-SHU, Edson; STERMAN-NETO, Hugo; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel JacobsenTraumatic posterior fossa subdural hematomas (SDHs) are rare lesions. Despite improvements in intensive care and surgical management of traumatic brain injuries over the last decades, the outcome for posterior fossa subdural hematomas remains poor. We conduct a retrospective study over a 2-year period of patients sustaining traumatic brain injury and posterior fossa SDH. Additionally, a systematic review of case series published to date was performed. The incidence of posterior fossa SDH was 0,01 % (4/326). All patients in this current series had poor prognosis. Three out of four exhibited ischemic/edema lesions in postoperative CT scans leading to fourth ventricle effacement and persistent brainstem compression. Our literature review retrieved 57 patients from only seven case series. Unfavorable outcomes were seen in 63 % of patients. Our data and data from the literature do not provide sufficient evidence to establish an optimal treatment strategy for posterior fossa SDH. However, based on lessons learned with these four cases, together with results from review of the literature, we propose an algorithm for the management of this rare condition.
- Why Intracranial Pressure Monitoring is Important in Traumatic Brain Injury(2015) ANDRADE, Almir Ferreira de; PAIVA, Wellingson Silva; MORAIS, Barbara Albuquerque; AMORIM, Robson Luis; FIGUEIREDO, Eberval Gadelha; TEIXEIRA, Manoel JacobsenIntracranial hypertension (IH) remains the most frequent cause of death in patients with traumatic brain injury (TBI). Thus invasive monitoring of intracranial pressure is an important tool in these patients. Recently, results of a clinical trial questioned the application of this method. This paper presents a review of the literature about evidence and clinical concerns of invasive intracranial pressure monitoring.
article How can transcranial magnetic stimulation change the way we treat traumatic brain injury?(2018) NEVILLE, Iuri S.; GOMES-OSMAN, Joyce; AMORIM, Robson L. O.; HAYASHI, Cintya Y.; GALHARDONI, Ricardo; ZANINOTTO, Ana Luiza; TEIXEIRA, Manoel J.; PAIVA, Wellingson S.Background: Traumatic brain injury (TBI) is a major health and socioeconomic problem worldwide. Despite improvements in the acute management of TBI over the past decades, which has led to better outcomes, there remains a need for novel treatment protocols that facilitate or enhance neuroplasticity and brain repair. There have been an increasing number of scientific publications describing the use of transcranial magnetic stimulation (TMS) for assessment and treatment in many research settings and clinical conditions, including TBI. Method: This study aimed to identify the role of TMS, a noninvasive brain stimulation technique, in the assessment and treatment of TBI by reviewing articles published to date from the PubMed database. Results: Most published articles on TMS in TBI are case reports. The use of TMS was reported as both a diagnostic tool and therapeutic instrument. There are few controlled trials of TMS in patients with TBI. Conclusion: TMS has the potential to modify the care of patients with TBI. TMS is an important instrument for evaluating brain injury from a functional perspective and also providing insights into neuromodulation approaches that may enhance recovery.- Decompressive craniectomy: a meta-analysis of influences on intracranial pressure and cerebral perfusion pressure in the treatment of traumatic brain injury A review(2012) BOR-SENG-SHU, Edson; FIGUEIREDO, Eberval G.; AMORIM, Robson L. O.; TEIXEIRA, Manoel Jacobsen; VALBUZA, Juliana Spelta; OLIVEIRA, Marcio Moyses de; PANERAI, Ronney B.Object. In recent years, the role of decompressive craniectomy for the treatment of traumatic brain injury (TB!) in patients with refractory intracranial hypertension has been the subject of several studies. The purpose of this review was to evaluate the contribution of decompressive craniectomy in reducing intracranial pressure (ICP) and increasing cerebral perfusion pressure (CPP) in these patients. Methods. Comprehensive literature searches were performed for articles related to the effects of decompressive craniectomy on ICP and CPP in patients with TBI. Inclusion criteria were as follows: 1) published manuscripts, 2) original articles of any study design except case reports, 3) patients with refractory elevated ICP due to traumatic brain swelling, 4) decompressive craniectomy as a type of intervention, and 5) availability of pre- and postoperative ICP and/or CPP data. Primary outcomes were ICP decrease and/or CPP increase for assessing the efficacy of decompressive craniectomy. The secondary outcome was the persistence of reduced ICP 24 and 48 hours after the operation. Results. Postoperative ICP values were significantly lower than preoperative values immediately after decompressive craniectomy (weighted mean difference [WMD] -17.59 mm Hg, 95% CI -23.45 to -11.73, p < 0.00001), 24 hours after (WMD -14.27 mm Hg, 95% Cl -24.13 to -4.41, p < 0.00001), and 48 hours after (WMD -12.69 mm Hg, 95% Cl -22.99 to -2.39, p < 0.0001). Postoperative CPP was significantly higher than preoperative values (WMD 7.37 mm Hg, 95% Cl 2.32 to 12.42, p < 0.0001). Conclusions. Decompressive craniectomy can effectively decrease ICP and increase CPP in patients with TBI and refractory elevated ICP. Further studies are necessary to define the group of patients that can benefit most from this procedure. (http://thejns.org/doi/abs/10.3171/2012.6.JNS101400)