Arquivos de neuro-psiquiatria
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The harvesting of the sural nerve for autologous grafting usually produces symptoms of low intensity and short duration. In rare occasions that procedure may lead to the formation of a symptomatic neuroma in the proximal stump. ⋯ In this paper we present the case of a patient with a sural nerve neuroma submitted to surgical treatment by a variant of the centro-central anastomosis technique, developed for the treatment of amputation neuromas, that resulted in remission of the painful symptomatology. The different options of surgical treatment for this rare entity are discussed.
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Randomized Controlled Trial Clinical Trial
[Efficacy of three drugs in the treatment of migrainous aura: a randomized placebo-controlled study].
In spite of the enormous amount of research regarding classification, epidemiology, diagnosis, pathophysiology and treatment of migraines, aura, one of its hallmarks, stays much less studied. The objective of this study is, therefore, to evaluate the evolution of aura in patients submitted to placebo and three different drugs available in Brazilian public health units. We studied 86 patients during an acute migrainous attack, with aura at the moment of the evaluation. ⋯ Magnesium sulphate was superior to placebo (p <0,05) 30 and 60 minutes after its administration. Dipyrone and chlorpromazine reduced the duration of the aura, when compared to placebo, 60 minutes following their administration. Our findings make possible some speculations about the pathophysiology of migraine, as well as about the therapeutic approach of patients presenting migrainous aura.
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Randomized Controlled Trial Clinical Trial
[Intramuscular diclofenac in the acute treatment of migraine: a double-blind placebo controlled study].
The aim of this study is to assess, in a double blind fashion, the effect of diclofenac on the pain and associated symptoms in patients with acute migraine. 60 patients with migraine with aura and 60 patients with migraine without aura were assigned at random to receiving intramuscular diclofenac, 75 mg associated to intravenous physiological saline, 10 ml, or physiological saline alone. We used 3 parameters of analgesic evaluation and an analogical scale to asses associated symptoms. We also observed the recurrence and rescue medication percentiles. ⋯ They did not present difference, compared to placebo, on the intensity of associated symptoms. We observed a reduction on the recurrence and rescue medication utilization. Despite being an option to treat migraines attacks in the emergency room settings, diclofenac has a slow onset action and no effects on the associated symptoms.
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We report our experience with a supraorbital eyebrow minicraniotomy. This technique is suitable to lesions situated in the region of the anterior fossa, suprasellar cisterns, parasellar region and Sylvian fissure. ⋯ Sixteem patients harboring different lesions were operated on with good postoperative and cosmetic results. We conclude that this approach is safe and useful in selected cases.
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Comparative Study
[Comparative study for ruptured aneurysms treated by surgery and endovascular method].
The management of intracranial aneurysms has truly evolved after the introduction of the endovascular treatment. In this paper we compare patients that were operated or embolized for intracranial aneurysms. ⋯ In the endovascular group, 95% of cases the clinical outcome was very good with only 42.8% of total exclusion of the aneurysm. By the endovascular method for treatment of aneurysms, we can obtain a good clinical outcome but a poor radiological outcome and sometimes need a complementary surgical procedure to treat residual aneurysm.