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This article reports the evolution and consolidation of the knowledge of neuroanatomy through the analysis of its history. Thus, we propose to describe in a historical review to summarize the main theories and concepts that emerged throughout brain anatomy history and understand how the socio-historical context can reflect on the nature of scientific knowledge. Therefore, among the diverse scientists, anatomists, doctors, and philosophers who were part of this history, there was a strong influence of the studies of Claudius Galen (AD 129–210), Leonardo da Vinci (1452– 1519), Andreas Vesalius (1514–1564), Franciscus Sylvius (1614–1672), Luigi Rolando (1773–1831), Pierre Paul Broca (1824–1880), Carl Wernicke (1848–1905), Korbinian Brodmann (1868–1918), Wilder Penfield (1891–1976), Mahmut Gazi Yasargil (1925), and Albert Loren Rhoton Jr. (1932–2016) on the fundamentals of neuroanatomy.

Introdução Craniofaringioma é uma malformação embrionária rara de natureza histológica benigna da região selar e suprasselar. O tratamento cirúrgico é a primeira opção terapêutica para essa condição, devido ao comprometimento da fluidez do líquido cefalorraquidiano pelo tumor e a morbidade envolvendo a visão, sistema endócrino e neuropsicológico desta condição; As duas principais abordagens cirúrgicas descritas na literatura são a transventricular e translamina-terminalis. Objetivo Analisar e identificar as principais condutas cirúrgicas terapêuticas e desfechos para o tratamento do craniofaringioma, a partir do relato de um raro caso de CF intraventricular. Métodos Trata-se de um relato de caso de uma paciente de 15 anos de idade diagnosticada com CF adenomatosa no terceiro ventrículo e submetida a uma cirurgia com shunt ventriculoperitoneal e abordagem transcalosa para exérese completa do tumor, que obteve desfecho favorável ao tratamento. O caso foi analisado a partir de uma breve revisão de literatura a fim de identificar a prevalência da doença. ResultadosDevido a relação do terceiro ventrículo com estruturas complexas, a ressecção do tumor pode levar a injúrias como perda de memória, endocrinopatia exacerbada, hemiparesia ou perda da visão, o que requer. Há três principais abordagens de acesso ao terceiro ventrículo: transcortical, endoscópica e transcalosa, porém a opção terapêutica mais apropriada permanece controversa na literatura. A escolha adequada deve se basear no tamanho, composição, localização e características anatômicas do tumor. ConclusãoA decisão quanto a abordagem cirúrgica para acessar o terceiro ventrículo e remover a lesão com segurança é importante para determinar o desfecho e prognóstico da doença. Além disso, é fundamental um segmento interdisciplinar entre a neurointensiva e a oncologia para a recuperação do paciente. Palavras-chave: Craniofaringioma, Terceiro ventrículo, Neoplasias do ventrículo cerebral, Neurocirurgia.

Background: Utilizing the Brazilian Medical Demography analysis and a literature review, we evaluated how women choose to become neurosurgeons in Brazil and around the world, specifically citing the Europe, the USA, India, and Japan. Methods: We utilized the Brazilian Medical Demography prepared by the Federal Council of Medicine and the Regional Council of Medicine of the State of São Paulo (2011, 2013, 2015, and 2018). We also included an evaluation of 20 articles from PubMed, the Scientific Electronic Library Online, and National Health Library databases (e.g., using descriptors “Women in neurosurgery” and “Career”). Results: In Brazil in 2017, women comprised 45.6% of active doctors, but only 8.6% of all neurosurgeons. Of 20 articles identified in the literature, 50% analyzed the factors that influenced how women choose neurosurgery, 40% dealt with gender differences, while just 10% included an analysis of what it is like to be a female neurosurgeon in different countries/continents. Conclusion: The participation of women in neurosurgery has increased in recent years despite the persistence of gender inequality and prejudice. More women need to be enabled to become neurosurgeons as their capabilities, manual dexterity, and judgment should be valued to improve the quality of neurosurgical health-care delivery.

Chronic migraine is an important cause of functional disability and quality of life deficits, affecting 12% of the world population. Therefore, more treatment alternatives that promote better pain control are needed. So, botulinum toxin type A presents itself as a therapeutic option for this purpose. This integrative review aimed to analyze the functionality of the PREEMPT protocol applied for the treatment of chronic migraine, analyzing the time of pain control, the frequency of repetition of the treatment and the possible subtypes of pain that benefit most from botulinum toxin. Data were collected from the National Library of Medicine and Lilacs databases, and the research concluded in July 2022. 31 articles were found, of which only 22 publications were considered eligible to compose this study, and those that contemplated the research objectives were selected. above. Botulinum toxin type A presents an effective, safe and well-tolerated preventive profile for patients with chronic migraine, increasing the patient's quality of life and works in pain control.

IntroductionFalcotentorial meningiomas (FTM) are a rare entity of tumors, corresponding to 2-8% of pineal tumors and 1% of all intracranial meningiomas and are more prevalente in womens. These tumors originate from posterior portion of the velum interpositum or falcotentorial union and can present different relationships with vital neuroanatomical structures. The surgical treatment is not well established in literature, due to the necessity of validating criteria for the surgical approach and the discussion of the risks to obtain radical resections.Case descriptionIt is a case report of a 41-year-old man with FTM, who was admitted with progressive paresis in the left lower limb for the last one year as the only neurological symptom. A computed tomography (CT) was realized, revealing a solid mass in the pineal region, causing hydrocephalus. After that, brain magnetic resonance imaging (MRI) showed a solid mass inside the third ventricule in contact with the falcotentorial dural junction. The patient was submited of a subtotal tumor resection by an approach throught occipito-transtentorial acess.CommentsThe clinic of the FTMs varies with headaches (the most common symptom), ataxia, personality changes and bradpsychia with homonymous hemianopsia. There exists four types of FMTs tumors according to Boussioni classification, which is based on the location of the tumor and, in this case, the tumor is type I, which originated from posterior cerebral falx and displaced the venous system inferiorly. This classification it’s important to guide the decision of the surgical approach. The surgical objective is to relieve or solve neurological/clinical symptoms and acquire a tissue sample for histological diagnosis. Some surgical approaches can be done for these tumors, but the transtentorial/transfalcine occipital approach is most frequently used for pineal meningiomas, especially in types I and IV FTMs.ConclusionThe choice of the surgical approach is essential for the effective treatment of a FTM tumor, and can be analysed with the help of imaging tests. This case of a subtotal resection showed success on the reduce of neurological defict of the patient. Keywords: Falcotentorial meningiomas, Surgical approach, Neurosurgery.

Introdução Ferimento por arma de fogo no crânio é o mais letal das lesões penetrantes cerebrais, com taxas de mortalidade relatadas a partir de 85% a 93%. Nas grandes cidades do Brasil, a prevalência da violência urbana é elevada, devido aos conflitos associados ao tráfico de drogas nas comunidades periféricas, assim como os conflitos armados com a polícia. Objetivo Este estudo tem como objetivo avaliar os fatores preditivos de morbidade e mortalidade e identificar a prevalência de fatores prognósticos em pacientes pediátricos que sofreram ferimentos de bala na cabeça. Método Revisamos uma série de 43 pacientes internados entre 2010 e 2019. Foram coletados dados de 43 pacientes submetidos a tratamento cirúrgico na instituição, sendo considerados os seguintes parâmetros na análise: a escala inicial de Coma de Glasgow (ECG), idade, sexo, local de entrada e trajetória do projétil. Tomografia computadorizada (TC) na internação, complicações, cruzamento médio e escala de pontuação de Glasgow no momento da alta (Escala de Resultado de Glasgow; GOS) também foram contabilizados. Resultados O sexo masculino correspondeu a 90,7% dos casos (n = 39), e 16 a 17 anos de idade foi a idade mais comum (60,5%). A região frontal foi o local de entrada mais comum (41,9%), seguido pela parede parietal e entrada occipital. A trajetória penetrante foi mostrada em 48,8% dos casos, perfuração/transfixação em 39,5%, e tangencial em 11,6%. A tomografia mostrou que o afundamento é a alteração mais comum (74,4%), seguido por contusão cerebral (44,2%). Segundo a GOS, 23,3% morreram, 23,3% foram classificados por desfecho desfavorável (GOS, 2-3) e 53,5% de resultado favorável (GOS, 4 e 5). Conclusão Em nosso estudo, houve associação significativa entre os baixos escores de ECG na admissão e baixo GOS (1-3; p = 0,001) no momento da alta. Pacientes com feridas que cruzaram a linha média também apresentaram associação significativa com baixo GOS (p = 0,014) em nossa experiência clínica. Concluímos que os baixos escores de GCS na admissão e crianças com uma ferida que cruza a linha média são fatores preditivos de alta mortalidade e morbidade, em nossa experiência clínica. Palavras-chaves: Traumatismo cranioencefálico, Arma de fogo, Pediátrico, Prognostico.

Introduction The millenary pragmatism of using corpses in the teaching of human anatomy has slowly been weakened. The study of anatomy has been enhanced, specially during the current pandemic, with virtual reality to supplement medical education, which was previously limited to cadavers. Objective To explore the literature on Medicine and Teaching in articles found in databases about the diffusion of technology in the teaching of neuroanatomy during the pandemic. Methods Databases used were PubMed, Virtual Health Library, and Google Scholar. The search for articles obeyed the following keywords: Covid-19, 2019-nCOV, SARS-CoV-2, Medical Students, Neuroanatomy, Anatomy, Virtual Reality, Technology. Boolean operators “OR” and “AND” were accurately applied to optimize the search. Results Students are limited to studying cadavers in class, which limits their resources when it comes to learning. However, the pandemic,was responsible for an abysmal change in the anatomy teaching. To compensate for the reduction of student contact with anatomical parts in laboratories, medical universities have adopted several technological mechanisms. Although cadavers are necessary for the study of anatomy, particularly the nervous system, new teaching techniques are essential for a holistic and comprehensive understanding of organs and systems. Besides the difficulties of handling cadavers and human organs in the teaching of so-called modern neuroanatomy, the technological environment in the field of teaching makes teaching easier. One of the technologies in consolidation in the era of computerization of medical education is the use of printers in 3 dimensions since it produces low-cost pieces but with high reproducibility of the anatomical characteristics of real cadaveric parts. Anatomage Table is a fully segmented 3d human anatomy application. The Anatomage Table is a system that promotes a deeper study of anatomy and is therefore being adopted by many medical schools worldwide. Its technology is advanced and combines several other – X-ray, ultrasound, CT scan, magnetic resonance – to build images. Conclusion The use of 3D images, anatomage and virtual reality emerges as an alternative and tool to add to the learning of neuroanatomy, as it is believed, as published studies point out, that their use is an effective option for the consolidation of learning in neuroanatomy. Keywords: Covid-19, Teaching-learning, Neuroanatomy, Technology, Virtual reality.