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Doctoral Thesis
DOI
https://doi.org/10.11606/T.10.2023.tde-11122023-163446
Document
Author
Full name
Leandro de Angelis Côrtes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Kfoury Junior, José Roberto (President)
Bertolini, Luciana Relly
Dias, Luís Gustavo Gosuen Gonçalves
Froes, Tilde Rodrigues
Prada, Irvenia Luiza de Santis
Title in Portuguese
Craniotomia transfrontal bilateral em cães: bases anatômicas e tomográficas de acesso cirúrgico
Keywords in Portuguese
Craniotomia
Imunohistoquímica
Ressonância magnética
Tomografia computadorizada
Tumor intracraniano
Abstract in Portuguese
A cirurgia intracraniana tem sido, cada vez mais, uma realidade na medicina veterinária, particularmente por conta da utilização de técnicas avançadas de imagem como a tomografia computadorizada e a ressonância magnética. Tais técnicas auxiliam na identificação de lesões intracranianas permitindo o planejamento e, consequente, intervenção cirúrgica. As intervenções cirúrgicas para acesso ao encéfalo têm sido utilizadas principalmente nos casos de tumores encefálicos, com destaque para os meningiomas, e traumas crânio-encefálicos, quando se faz necessário a descompressão. Embora as cirurgias intracranianas sejam uma realidade palpável em outros países, há uma escassez de trabalhos relacionados a esse assunto na literatura brasileira. Neste sentido, este estudo avaliou a craniotomia transfrontal bilateral, como aprimoramento dos recursos terapêuticos, possibilitando maior área de manipulação. Foram realizadas Tomografia Computadorizada, Ressonância Magnética e acesso cirúrgico de dez cadáveres de cães, sendo que em cinco deles, que apresentavam sinais neurológicos de alteração intracraniana, encontramos massas expansivas encefálicas que foram melhor definidas pelo exame de Ressonância Magnética em comparação à Tomografia Computadorizada sendo possível a visualização desses tumores e das alterações anatômicas. Verificamos que, nos cinco casos, as imagens tomográficas se mostraram eficazes para avaliação de alterações encefálicas sendo capazes de detectar as lesões. A técnica cirúrgica foi capaz de acessar o encéfalo, localizando as lesões. Concluímos que as técnicas de imagem e as técnicas cirúrgicas aqui relatadas são eficazes para diagnóstico e terapia de tumores intracranianos, no entanto, vale ressaltar a importância de biópsia pré operatória para caracterização do tumor em subtipo e grau para melhor escolha terapêutica.
Title in English
Transfrontal bilateral craniotomy in dogs: anatomical and tomographic basis of surgical access
Keywords in English
Computed tomography
Craniotomy
Imunohistochemistry
Intracranial tumor
Magnetic ressonance imaging
Abstract in English
Intracranial surgeries are becoming, more and more, a reality in veterinary medicine, particularly due to the use of advanced imaging techniques, notably computerized tomography and magnetic resonance imaging. Such techniques aid in the identification of intracranial lesions allowing the planning and, consequently, the surgical intervention. The surgical interventions for the access of the brain have been used mainly in cases of encephalic tumors, with emphasis on meningiomas, and cranio-encephalic trauma, when there is need for decompression. Although intracranial surgeries are a tangible reality in other countries, there is a shortage of studies regarding this subject in Brazilian literature. In this sense, this study evaluated the bilateral transfrontal craniotomy, as an enhancement of the therapeutic resources, allowing a wider area for manipulation. Computerized tomography, magnetic resonance imaging and the surgical access were performed in ten dog corpses, with five of them that presented neurological signs of intracranial alterations presenting expansive encephalic masses, that were better defined through the magnetic resonance imaging when compared with the computerized tomography, allowing for the visualization of these tumors and anatomic alterations. We verified that, in the five cases, both tomographic techniques were effective for the evaluation of encephalic alterations, being capable of identifying the lesions. The surgical technique was able to access the brain, and successfully localize the lesions. We concluded that the imaging techniques and the surgical techniques here described are effective for the diagnosis and therapy of intracranial tumors, however, it′s worth emphasizing the importance of a preoperative biopsy for the characterization of the tumor subtype and grade, for a better therapeutic choice.
 
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Publishing Date
2024-01-17
 
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