Background: Brainstem Cavernous Malformations (BSCMs) are vascular alterations that allow blood to pass into the central nervous tissue. When surgery is indicated, the preoperative use of DTI/DTT appears to improve prognosis. Objectives: Analyze the use of DTI/DTT in the surgical planning of BSCMs and their prognostic repercussions. Methods: An integrative review in which 25 articles in English from the last 14 years were found in the Pubmed database in April 2021, using the descriptors “brainstem”, “cavernous malformations” and “diffusion tensor imaging” and the boolean operator “And”. 4 articles from 2015 to 2021 were selected. Exclusion criteria: (1) Reviews; (2) Case reports; (3) Unrelated topic. Results: BSCMs commonly distort the region’s tracts, whose location and direction can be determined by DTI/DTT, offering a safer surgical planning. In a series with 10 BSCMs patients, in which 5 underwent preoperative DTI, 64% of the analyzed fibers presented some deformation, with 2 patients needing to have their surgical plan altered. A randomized clinical trial analyzed 23 BSCMs patients who underwent preoperative DTI/DTT and 24 conventionally evaluated, surgical morbidity and the percentage of patients with worsened motor deficits were lower in the DTI/DTT group (30,4% and 1,7%) than control (79,2% and 37,5%), indicating that such techniques may have better results. Conclusion: Preoperative DTI/DTT appears to be related to a better prognosis and surgical safety. However, further studies are needed to confirm its effectiveness in improving the prognosis of BSCMs patients.

The caroticoclinoid (CF) and the interclinoid (IF) foramina are variant formations of the middle cranial fossa, which result from idiopathic and possibly atavistic ossifications of the caroticoclinoid and interclinoid ligaments, respectively. Topographically, these foramina are intimately associated, to varying degrees, depending on their conformations, with the neurovascular elements of the paraclinoid region and have important clinical and surgical significance. Thus, this study, conducted from 38 dry skulls belonging to the shared collection of the Federal University of Juiz de Fora, Governador Valadares campus, revealed 11 skulls (28.95 %) with one of the two complete formations -the caroticoclinoid or the interclinoid, and in 6 skulls the caroticoclinoid foramen occurred uni or bilaterally. As a result, 50 % of these skulls presented the CF exclusively on the right (or 62.5 % of the total number of variant foramina), with an average transverse diameter of 4.91 mm and 5.8 mm AP (anteroposterior) diameter and an average area of 22.5 mm 2 . Concerning the IF, the findings occurred in 5 skulls with variable distributions between the clinoid processes and lateralities. The average length of the bone bridges in the IF was 7.7 mm. In conclusion, detailed anatomical knowledge of the caroticoclinoid and the interclinoid foramina is fundamental to the practice of neurosurgical procedures, since they have intimate relationships at a location of high structural complexity.

Background: Alzheimer’s disease (AD) is a neurodegenerative disorder, whose treatment is limited to drugs that offer comfort to the patient. Immunotherapy with monoclonal antibodies (mAbs) has been the subject of a study with the promise of reversing cognitive deficits. In this scenario, we conducted a systematic review to elucidate aspects about the effectiveness of such treatment. Objectives: Analyze the prognostic of patients with AD through immunotherapy using anti-amilody mAbs. Methods: It was used the PubMed database using the descriptors: “Amyloid beta-Peptides AND Alzheimer disease AND Immunotherapy”. Filters: clinical trial, randomized controlled trial. 6 articles from 2015 to 2021 were selected. Inclusion criteria: (1) mAbs as treatment for AD; (2) Analyze the prognostic. Results: The immunotherapy with bapineuzumab and solanezumab didn’t showed no statistically significant difference between the groups of bapineuzumab 0,5 mg / kg (p = 0,979) and placebo (p = 0,973) and a change of 6.65 in the solanezumab group and 7.44 in the placebo group (difference, −0.80; P = 0 , 10). However, subcutaneous treatment of bapineuzumab exhibited fewer abnormalities of images related to amyloid with edema or effusion (AIRA), so, better tolerated compared to intravenous treatment. In the study with the ABvac40 vaccine, about 92% of the individuals in the test group developed specific anti-Aβ 40 antibodies. Conclusion: Bapineuzumab and solanezumab didn’t achieve significant results in the reduction of cognitive decline, however bapineuzumab enabled the prevention of Aβ aggregation. However, the use of mAbs can trigger collateral effects, requiring an individual analysis.