HighlightsMonopolar mapping is effective for cortical and subcortical language areas.250–500 Hz stimulation parameters are adequate and safe for speech testing.It may improve resection rate of infiltrating tumor areas involving the speech area.
Objective: To establish the method of isolation and culture of human glioblastoma neurospheres, and the purification of their stem cells, followed by the process of obtaining tumor subspheres, immunophenotypically characterizing this clonogenic set. Methods: Through the processing of glioblastoma samples (n=3), the following strategy of action was adopted: (i) establish primary culture of glioblastoma; (ii) isolation and culture of tumor neurospheres; (iii) purify cells that initiate tumors (CD133 + ) by magnetic separation system (MACS); (iv) obtain tumor subspheres; (v) study the expression of the markers nestin, CD133, and GFAP. Results: The study successfully described the process of isolation and culture of glioblastoma subspheres, which consist of a number of clonogenic cells immunophenotypically characterized as neural, which are able to initiate tumor formation. Conclusion: These findings may contribute to a better understanding of the process of gliomagenesis.
RESUMO IntroduçãoÀ medida que uma massa cresce dentro do espaço craniano, uma proporcional quantidade de líquido cefalorraquidiano é retirada dessa caixa. Nesse período, a pressão intracraniana (PIC) não se eleva. Deveríamos esperar que, quando todo compartimento liquórico fosse extraído de dentro do crânio, a curva que determina a relação entre a PIC e o volume acrescido ao espaço -curva pressão/volume -assumisse um caráter retilíneo, e a PIC fosse aumentando linearmente à medida que a massa continuasse crescendo. Entretanto, tal curva assume um traçado gráfico exponencial denotando uma rápida ascensão da PIC após a fase em que todo o liquor foi expulso do compartimento em questão. Nessa fase de ascensão rápida, pequenos acréscimos de volume causam variações positivas da PIC cada vez maiores para um mesmo volume acrescentado. No caso dos inchaços, reperfusionais ou não, esses acréscimos de volume são volêmicos sanguíneos, ou seja, intravasculares. 1,17,19,20,24,25,27,38 Muito provavelmente, como veremos à frente, tal ascensão exponencial relaciona-se a um acúmulo progressivo de volume sanguíneo intracraniano associado à vasodilatação isquêmica desproporcionalmente grande em relação ao aumento da massa que vem crescendo. Provavelmente, esse aumento de volume sanguíneo é que proporciona o aparecimento da fase exponencial ascendente da curva de Langfitt. Esse acúmulo progressivo de volume sanguíneo encefálico estaria certamente relacionado ao desencadeamento e à persistência da cascata vasodilatadora, já citada em publicações prévias. 1,24,25,27 Curva de Langfitt A curva de Langfitt compreende o traçado que relaciona o eixo da PIC, na vertical, e o eixo do volume que é acrescido à caixa craniana, na horizontal (Figura 1). Nota-se que, no início, o aumento da massa não implica
Introduction Head injury is a direct determinant of morbidity, disability, and mortality in the young population. Sedatives and analgesics are commonly used in patients with brain injury to retrieve an ICP, CMRO2, and CBF, preserving the cerebral regulation system and self-avoiding hypotension. Objective The objective of this paper is to review on this topic, linking the main drugs, side effects, costs, anxiolytic properties, anticonvulsants, and correlating them with complacency and brain metabolism. Methods We perform a literature review using PubMed database, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and Clinical trials. We selected papers from the period between 1958 and 2014, which totaled 254 papers. Of these, we selected 129 papers based on keywords, inclusion, and exclusion criteria. Evidence Review The volume of the brain decreases due to dislocation of the CBV out of the skull. The main sedatives and analgesics are propofol, midazolam, etomidate, ketamine, barbiturates, dexedetomedina, morphine, fentanyl, alfentanil, sulfenatil, and remifentanil. We hereby discuss the algorithm for a fast intubation sequence and the algorithm for intracranial hypertension treatment regarding the systematic sedation therapy. A range of sedatives and analgesic agents are available for sedation. Each class has its own positive and negative effects on neurotrauma patients.
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