BackgroundConsidered as a moment of psychological vulnerability, adolescence is remarkably a risky period for the development of psychopathologies, when the choice of the correct therapeutic approach is crucial for achieving remission. One of the researched therapies in this case is electroconvulsive therapy (ECT). The present study reviews the recent and classical aspects regarding ECT use in adolescents.MethodsSystematic review, performed in November 2012, conformed to the PRISMA statement.ResultsFrom the 212 retrieved articles, only 39 were included in the final sample. The reviewed studies bring indications of ECT use in adolescents, evaluate the efficiency of this therapy regarding remission, and explore the potential risks and complications of the procedure.ConclusionsECT use in adolescents is considered a highly efficient option for treating several psychiatric disorders, achieving high remission rates, and presenting few and relatively benign adverse effects. Risks can be mitigated by the correct use of the technique and are considered minimal when compared to the efficiency of ECT in treating psychopathologies.

Professor Manoel Jacobsen Teixeira is the Chairman of the Division and has provided the Division with the best available technological resources, performing more than 3,000 surgeries a year and training professionals who will, certainly, be some of the future leaders of brazilian neurosurgery.

PALAVRAS-CHAVEAneurisma intracraniano, aneurisma roto, procedimentos neurocirúrgicos. ABSTRACT The clip-wrap technique: a literature review The clip-wrap technique is used when the neurosurgeon is confronted with aneurysms that cannot be cut by means of traditional techniques, due to a wide neck, calcification, atherosclerotic plaques, fusiforms aneurysms or when there are vessels from the aneurysm body. Various types of materials can KEYWORDSIntracranial aneurysm, aneurism ruptured, neurosurgical procedures.

ResumoOs aneurismas fusiformes são pouco frequentes e geralmente não estão associados a fatores de risco específicos. Ocorrem principalmente nas artérias cerebrais, por meio de uma dilatação circunferencial na parede da artéria, garantindo seu aspecto morfológico típico: ausência de colo aneurismático. Por essa razão, não podem ser usualmente clipados ou embolizados, necessitando de métodos alternativos de tratamento que representam um desafio para os neurocirurgiões. As alternativas cirúrgicas estão associadas a um melhor prognóstico e incluem as técnicas de revascularização com o uso de bypass, a oclusão da artéria aferente (PAO, sigla em inglês) e “wrapping” ou clip-wrap. Métodos endovasculares, como o uso de stents, representam uma opção para restauração mais fisiológica do fluxo sanguíneo, embora necessitem de mais estudos para confirmar a eficácia.

It is possible to consider the stimulation of the cingulate gyrus in its portion below the corpus callosum (SCC, or subcallosal cingulate cortex) as an effective, promising, and safe alternative intervention for treatment-resistant depression. In studies with deep brain stimulation - DBS, when follow-on with functional magnetic resonance imaging and/or PET-CT (Positron emission tomography–computed tomography) is performed, it is observed an increase in the blood supply and glucose metabolism in this region, which is the anterior part of the limbic system. This same location has good experimental results also for the treatment of anorexia nervosa. The hypotheses suggest a greater activation of the reward system, a greater sense of well-being, and a consequent reduction in depressive symptoms, the objective of the treatment. Over the last 20 years, multicenter studies have shown symptomatic improvement in 50–60% of patients, and about a third even reach criteria for remission of the depressive disorder.