No abstract

Em fevereiro de 2018, a Organização Mundial de Saúde divulgou a lista atualizada de agentes patogênicos prioritários, que podem causar emergências de saúde pública para as quais não existem medidas suficientes de contenção, como drogas ou vacinas. A lista é elaborada e atualizada periodicamente, visando a aceleração de pesquisas.  Febre do Congo, de Marburgo, de Lassa, o Ebola, vírus zika, dentre outras, estava a Doença X. Segundo a OPAS (2018), a doença X representa o conhecimento de que uma epidemia internacional grave pode ser causada por um patógeno, atualmente desconhecido, que provoca doenças humanas e para o qual o mundo deveria se preparar antecipadamente. Então, em dezembro de 2019, a China comunica à OMS sobre a ocorrência de casos atípicos de pneumonia em Wuhan, província de Hubei (WHO, 2020). Ainda na primeira semana de janeiro, as autoridades chinesas confirmam se tratar de um novo agente patogênico: Um coronavírus, posteriormente denominado Sars-Cov-s e a doença Covid19.

In the past four decades, enormous advances have been made in the neuroendoscopic techniques, along with improvement of illumination, and the development of effective instruments. As a result, endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC) have become consolidated techniques for the treatment of hydrocephalus. In particular, endoscopic cauterization of the choroid plexus has increased the effectiveness of hydrocephalus treatment in combination with ETV. In the past decade, the use of flexible endoscopes has enabled surgeons to resect even the temporal segment of the choroid plexus at the lateral ventricles, which has increased the success of treatment. In this technical note, we describe CPC with the use of a rigid endoscope, which we used to selectively disconnect the glomus of the choroid plexus, in addition to choroid plexus coagulation, as an alternative way to facilitate ETV. This new procedure optimized the visualization of the choroid plexus and the temporal horn and prevented additional difficulties in coagulation of this mobile region of the choroid plexus in selected patients. To achieve the best outcome, avoid bleeding, and optimize the standard technique, it was important to recognize both the classical anatomic structure of the choroid plexus and some variations, and previous expertise in ETV and CPC were necessary. We demonstrate that resection of the glomus of the choroid plexus in selected patients is safe and feasible.

Introduction: Wormian bones (WB) are accessory bones positioned within the sutures or fontanelles. Although several studies have associated them with genetic disorders, ethnicity, and skull deformations, their relationship with nonsyndromic craniosynostosis (CS) has not been established, especially among Brazilians. Therefore, this study was conducted to analyze the incidence and association of WB with nonsyndromic CS in Brazilian children. Methods: An observational and retrospective study was conducted using computed tomography with 3D reconstruction in Brazilian children aged <3 years to compare the incidence and number of WB between regular children (group 1) and those with nonsyndromic CS (group 2). Results: A total of 140 children, comprising 62.9% boys (p < 0.001) with a mean age of 8.78 months, were included in this study. The most common types of CS were trigonocephaly (34; 48.6%), scaphocephaly (25; 35.7%), anterior plagiocephaly (5; 7.1%), posterior plagiocephaly (3; 4.2%), and brachycephaly (3; 4.2%). WB were more common in regular children (41; 58.6%) than in children with CS (28; 40.0%) (p = 0.028). Regular children had an average of 2.12 WB versus 1.32 WB in children with nonsyndromic CS (p = 0.024). Conclusion: The significantly less incidence of WB in Brazilian children with nonsyndromic CS was quite different from that reported in other studies and could indicate the tendency of this disease to have disturbance in ossification of the cranial vault, the impact of ethnicity, and probably the lack of additional compensatory skull growth.