Objective: The authors show their experience with brainstem cavernomas, comparing their data with the ones of a literature review. Methods: From 1998 to 2009, 13 patients harboring brainstem cavernomas underwent surgical resection. All plain films, medical records and images were reviewed in order to sample the most important data regarding epidemiology, clinical picture, radiological findings and surgical outcomes, as well as main complications. Results: The mean age was 42.4 years (ranging from 19 to 70). No predominant gender: male-to-female ratio, 6:7. Pontine cases were more frequent. Magnetic resonance imaging was used as the imaging method to diagnose cavernomas in all cases. The mean follow-up was 71.3 months (range of 1 to 138 months). Clinical presentation was a single cranial nerve deficit, VIII paresis, tinnitus and hearing loss (69.2%). All 13 patients underwent resection of the symptomatic brainstem cavernoma. Complete removal was accomplished in 11 patients. Morbidity and mortality were 15.3 and 7.6%, respectively. Conclusions: Cavernomas can be resected safely with optimal surgical approach (feasible entry zone) and microsurgical techniques, and the goal is to remove all lesions with no cranial nerves impairment. Keywords

Introduction Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis, and it can compromise the central nervous system (CNS) in 10-27% of all cases. Case Report A 31-year-old man presented to the Emergency Department with headache, left-sided weakness, clonus at the ankle and a positive Babinski sign. Head computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a 5.1 Â 3.8 cm lobulated lesion with areas of liquefaction in the right centrum semiovale. Discussion Central nervous system PCM can mimic a brain tumor, and most cases are diagnosed by biopsy of the lesion. The treatment includes antibiotics, but some cases require surgery. Conclusion Due to high morbimortality rates, the diagnosis must be considered, and early treatment started in patients who live in rural regions endemic for PCM when a ring-enhancing mass associated with perilesional edema is observed on MRI scans.

Objective: Natalizumab is a new and efficient treatment for multiple sclerosis (MS). The risk of developing progressive multifocal leukoencephalopathy (PML) during the use of this drug has created the need for better comprehension of JC virus (JCV) infection. The objective of the present study was to assess the prevalence of JCV-DNA in Brazilian patients using natalizumab. Method: Qualitative detection of the JCV in the serum was performed with real-time polymerase chain reaction (PCR). Results: In a group of 168 patients with MS who were undergoing treatment with natalizumab, JCV-DNA was detectable in 86 (51.2%) patients. Discussion: Data on JCV-DNA in Brazil add to the worldwide assessment of the prevalence of the JCV in MS patients requiring treatment with natalizumab.

ObjectiveTo compare brain structures using volumetric magnetic resonance imaging with isotropic resolution, in T1-weighted gradient-echo (GRE) acquisition, with and without inversion recovery (IR).Materials and methodsFrom 30 individuals, we evaluated 120 blocks of images of the left and right cerebral hemispheres being acquired by T1 GRE and by T1 IR GRE. On the basis of the Naidich et al. method for localization of anatomical landmarks, 27 anatomical structures were divided into two categories: identifiable and inconclusive. Those two categories were used in the analyses of repeatability (intraobserver agreement) and reproducibility (interobserver agreement). McNemar's test was used in order to compare the T1 GRE and T1 IR GRE techniques.ResultsThere was good agreement in the intraobserver and interobserver analyses (mean kappa > 0.60). McNemar's test showed that the frequency of identifiable anatomical landmarks was slightly higher when the T1 IR GRE technique was employed than when the T1 GRE technique was employed. The difference between the two techniques was statistically significant.ConclusionIn the identification of anatomical landmarks, the T1 IR GRE technique appears to perform slightly better than does the T1 GRE technique.

RESUMOIntrodução: O entendimento da anatomia integral do sistema de conexão do corpo caloso permite que as principais síndromes calosas sejam melhor compreendidas. Objetivo: Realizar uma revisão das principais síndromes calosas com ênfase na síndrome da mão alienígena baseado nas diferentes partes do corpo caloso seguindo a divisão proposta por Witelson em 1989. Material e Métodos: Os autores realizaram uma revisão sobre a síndrome da mão alienígena após busca de dados no PUBMED e MEDLINE. Conclusão: O conhecimento da anatomia e da função do corpo caloso pode auxiliar na detecção de patologias neurológicas que cursam com distúrbios do movimento, além de doenças psiquiátricas. Palavras-chave: Corpo caloso, Síndromes calosas, Síndrome da mão alienígena, Main étrangère, Anatomia, TopografiaABSTRACT Background: The knowledge of the integral anatomy of the corpus callosum connection system allows the main callosal syndromes to be better understood. Objective: to conduct a review of the main callosal syndromes with emphasis on alien hand syndrome based on different parts of the corpus callosum according to the division proposed by Witelson in 1989. Material and Methods: The authors performed a review of the alien hand syndrome after search data in PUBMED and MEDLINE. Conclusion: The knowledge of the anatomy and function of the corpus callosum may aid in the detection of brain disorders which occur with movement disorders, and psychiatric disorders.