We present the case of a 30-year female patient with multiple systemic metastases of posterior fo... more We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being i... more The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.
Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from he... more Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from health students to specialized professionals in neuroscience. A step by step guide for practical studies of neuroanatomy is required for this kind of knowledge to become more acceptable among medical students, neurosurgeons, neurologists, neuropediatricians and psychiatric physicians. Based on the well known courses of sulci, gyri and ventricles offered by Beneficência Portuguesa Hospital in São Paulo, Brazil, two times a year, since 1994, totalizing more than 20 complete courses, and answering the request of many neuroscience students and professionals whose asked for a practical guide to the neuroanatomy study, the authors suggest a protocol for the study of superficial and deep brain structures showing how to approach the more structures as possible with minimum damage to the anatomic piece and with the smaller number of brains.
Unilateral hippocampal atrophy is indicator of good surgical prognosis in patients with temporal ... more Unilateral hippocampal atrophy is indicator of good surgical prognosis in patients with temporal lobe epilepsy (TLE). Some patients however do not become seizure free after surgery. We assessed if the extent of hippocampal and amygdala resection is associated with outcome. Thirty patients with TLE with unilateral or clearly asymmetric hippocampal atrophy who underwent surgical treatment were evaluated concerning preoperative clinical variables and interictal EEG abnormalities. Amygdala and hippocampal resection was evaluated by post-operative MRI. We compared seizure free versus non-seizure free patients, and patients with good outcome (Engel's classes I and II) versus patients with poor outcome. There was significant association between the extent of hippocampal resection and the outcome. Pre-operative variables and interictal EEG abnormalities did not show relationship with outcome as documented in previous studies. The extent of hippocampal resection is associated with outcome. Incomplete resection of atrophic hippocampus may explain most surgical failures in patients with TLE due to unilateral hippocampal sclerosis.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
We present the case of a 30-year female patient with multiple systemic metastases of posterior fo... more We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being i... more The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.
Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from he... more Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from health students to specialized professionals in neuroscience. A step by step guide for practical studies of neuroanatomy is required for this kind of knowledge to become more acceptable among medical students, neurosurgeons, neurologists, neuropediatricians and psychiatric physicians. Based on the well known courses of sulci, gyri and ventricles offered by Beneficência Portuguesa Hospital in São Paulo, Brazil, two times a year, since 1994, totalizing more than 20 complete courses, and answering the request of many neuroscience students and professionals whose asked for a practical guide to the neuroanatomy study, the authors suggest a protocol for the study of superficial and deep brain structures showing how to approach the more structures as possible with minimum damage to the anatomic piece and with the smaller number of brains.
We present the case of a 30-year female patient with multiple systemic metastases of posterior fo... more We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being i... more The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.
Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from he... more Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from health students to specialized professionals in neuroscience. A step by step guide for practical studies of neuroanatomy is required for this kind of knowledge to become more acceptable among medical students, neurosurgeons, neurologists, neuropediatricians and psychiatric physicians. Based on the well known courses of sulci, gyri and ventricles offered by Beneficência Portuguesa Hospital in São Paulo, Brazil, two times a year, since 1994, totalizing more than 20 complete courses, and answering the request of many neuroscience students and professionals whose asked for a practical guide to the neuroanatomy study, the authors suggest a protocol for the study of superficial and deep brain structures showing how to approach the more structures as possible with minimum damage to the anatomic piece and with the smaller number of brains.
Unilateral hippocampal atrophy is indicator of good surgical prognosis in patients with temporal ... more Unilateral hippocampal atrophy is indicator of good surgical prognosis in patients with temporal lobe epilepsy (TLE). Some patients however do not become seizure free after surgery. We assessed if the extent of hippocampal and amygdala resection is associated with outcome. Thirty patients with TLE with unilateral or clearly asymmetric hippocampal atrophy who underwent surgical treatment were evaluated concerning preoperative clinical variables and interictal EEG abnormalities. Amygdala and hippocampal resection was evaluated by post-operative MRI. We compared seizure free versus non-seizure free patients, and patients with good outcome (Engel's classes I and II) versus patients with poor outcome. There was significant association between the extent of hippocampal resection and the outcome. Pre-operative variables and interictal EEG abnormalities did not show relationship with outcome as documented in previous studies. The extent of hippocampal resection is associated with outcome. Incomplete resection of atrophic hippocampus may explain most surgical failures in patients with TLE due to unilateral hippocampal sclerosis.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
We present the case of a 30-year female patient with multiple systemic metastases of posterior fo... more We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.
Eleven patients with jugular foramen lesions with or without extradural extension were operated a... more Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP), in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.
The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being i... more The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.
Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from he... more Neuroanatomy in addition to neurophysiology, are the basic areas for the proper formation from health students to specialized professionals in neuroscience. A step by step guide for practical studies of neuroanatomy is required for this kind of knowledge to become more acceptable among medical students, neurosurgeons, neurologists, neuropediatricians and psychiatric physicians. Based on the well known courses of sulci, gyri and ventricles offered by Beneficência Portuguesa Hospital in São Paulo, Brazil, two times a year, since 1994, totalizing more than 20 complete courses, and answering the request of many neuroscience students and professionals whose asked for a practical guide to the neuroanatomy study, the authors suggest a protocol for the study of superficial and deep brain structures showing how to approach the more structures as possible with minimum damage to the anatomic piece and with the smaller number of brains.
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Papers by João Mattos