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A lobectomia frontal é um procedimento neurocirúrgico frequentemente realizado para o tratamento de tumores cerebrais, epilepsia refratária, e outras patologias que requerem remoção extensa do lobo frontal. Embora seja um procedimento relativamente comum, foram encontrados apenas alguns relatos na literatura acerca da técnica cirúrgica, com pouca consideração acerca da anatomia relevante para esse procedimento. OBJETIVOS: O principal objetivo desta tese é apresentar parâmetros anatômicos e considerações técnicas para a remoção da substância cinzenta do lobo frontal (decorticação do lobo frontal) como uma alternativa a lobectomia frontal. A finalidade deste estudo é a maximização da remoção cerebral, diminuindo a perda sanguínea, e evitando a abertura do corno frontal do ventrículo lateral. MATERIAIS E MÉTODOS: O estudo anatômico foi realizado em 15 cabeças cadavéricas adultas. Os dados clínicos foram baseados em 15 decorticações frontais realizadas de 2002 a 2014. RESULTADOS: A decorticação frontal envolve as superfícies lateral, medial e basal, e consiste em 5 passos principais: a) coagulação e secção dos ramos arteriais da superfície lateral do lobo frontal; b) ressecção subpial paramediana do lobo frontal até a localização do joelho do corpo caloso; c) ressecção da substância cinzenta da superfície lateral do lobo frontal sem entrar no corno frontal; d) identificação e preservação do trato olfatório; e) remoção da substância cinzenta da superfície basal do lobo frontal. Esta técnica cirúrgica foi aplicada em 15 casos, em nenhum deles o corno frontal do ventrículo lateral foi aberto, evitando complicações da abertura do mesmo. CONCLUSÃO: A decorticação frontal guiada por parâmetros anatômicos pode ser uma das técnicas cirúrgicas a ser considerada quando há necessidade da ressecação extensa do lobo frontal (especialmente substância cinzenta). A técnica proporciona máxima remoção do lobo frontal, preservação do corno frontal e da área motora suplementar, e redução da perda sanguínea / BACKGROUND: The frontal lobectomy is a frequently performed neurosurgical procedure for treating brain tumors, refractory epilepsy, and other disorders that require extensive removal of the frontal lobe. In spite of being a relatively common procedure, there are only few reports available regarding its surgical technique and little attention has been given to the anatomy relevant to this procedure. OBJECTIVES: The authors present the anatomical landmarks and technical nuances for removing the gray matter of the frontal lobe (frontal lobe decortication) as an alternative to frontal lobectomy. The goals are to maximize the brain removal, minimize the blood loss, and avoid opening the frontal horn of the lateral ventricle. MATERIAL AND METHODS: The anatomical study was performed in 15 adult cadaveric heads. The clinical data are based on 15 frontal resections performed from 2002 to 2014. RESULT: The frontal decortication involves the lateral, medial, and basal surfaces of the frontal lobe, and it consists of 5 main steps: a) coagulation and section of the arterial branches of the lateral surface of the frontal lobe; b) paramedian subpial resection of the frontal lobe until the genu of the corpus callosum is located; c) resection of the gray matter of the lateral surface of the frontal lobe without entering the frontal horn; d) identification and preservation of the olfactory tract; e) removal of the gray matter of the basal surface of the frontal lobe. This surgical technique was applied in 15 cases, and it was possible to preserve the frontal horn in all the patients when following this technique, avoiding complications resulted by its opening. CONCLUSION: The frontal decortication guided by intraoperative anatomical landmarks can be one of the surgical techniques to be considered when an extensive frontal lobe resection (especially gray matter) is needed. It offers maximum frontal lobe removal, preservation of the frontal horn and supplementary motor area, and reduced blood loss

Orientador: Marisa Aparecida Cabrini Gabrielli / Resumo: Complicações precoces e tardias de fraturas do seio frontal não são infrequentes, independentemente da técnica utilizada para tratamento. O objetivo do presente estudo foi avaliar o resultado do tratamento de fraturas da região frontal. Ao todo, 155 pacientes foram incluídos no estudo e avaliados por meio clinicamente e por meio de imagens de tomografia computadorizada. A média de idade foi de 32,86 anos e 88,30% eram do sexo masculino. As três principais etiologias do trauma foram acidente motorciclístico (23,87%), agressão física (20%) e acidente automobilístico (18,70%). O tempo de pós-operatório avaliado variou entre 6 meses a 27 anos (média: 7 anos e meio). Foram tratados por meio de reconstrução do seio frontal, 61,29%; obliteração, 6,45%; cranialização, 21,93% e tratamento não cirúrgico, 10,32%. Vinte e quatro por cento dos pacientes desenvolveram complicações pós-operatórias, tais como sinusite frontal, infecção do tecido mole, osteomielite, dor, mucocele, pneumoencéfalo e irregularidade óssea. As complicações diretamente relacionadas ao tipo de tratamento instituído foi a seguinte: reconstrução do seio frontal 6,3%; obliteração do seio frontal, 75%; cranialização: 2,94% e o tratamento não cirúrgico: 6,25%. Por meio dessa avaliação pode-se concluir que: (1) todas as técnicas de tratamento para fratura do seio frontal desenvolveram complicações pós-operatórias; (2) a obliteração do seio frontal apresentou prevalência para o desenvolvimento de complicações, devendo ser ... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Selective attention involves focusing on one event among many, and is largely responsible for an organism's ability to respond efficiently to the environment. The location at which attention is focused is a function of an ongoing tension between external cues and internal goals. Control over selective attention is often described as an executive process, attributable to the function of the frontal lobes of the brain. The present experiments investigated the role of the frontal cortex in attentional control, through the study of patients with focal cortical lesions and through functional neuroimaging in neurologically normal subjects. It was found that patients with unilateral surgical resections from the frontal cortex were as efficient as patients with temporal-lobe resections and normal controls at attending selectively to a visual stimulus at one location in the presence of irrelevant distracting stimuli. In fact, those patients whose lesions invaded the anterior cingulate gyrus tended to be less reactive to changes in irrelevant stimuli. However, patients with frontal cortex lesions were mildly impaired in a different task in which they used visual cues to direct attention voluntarily to a different location from one trial to the next. In addition, patients with excisions from the right frontal cortex performed less efficiently with increasing time spent on a task, suggesting an important role for this region in sustained attention. These observations prompted a further study of attention using positron emission tomography in normal subjects. This experiment was designed to identify the brain regions that were more active during trials in which cues could be used to direct attention voluntarily, relative to trials in which uninformative cues were presented. The striatum and extrastriate cortex were the only regions in which blood flow correlated positively with the proportion of trials containing informative cues. The present studies indicate that the frontal

Thesis (PhD) - Swinburne University of Technology, School of Biophysical Sciences and Electrical Engineering, 2004. / A thesis submitted for the degree of Doctor of Philosophy, School of Biophysical Sciences and Electrical Engineering, Swinburne University of Technology - 2004. Typescript. Includes bibliographical references (p. 259-287).

A lobectomia frontal é um procedimento neurocirúrgico frequentemente realizado para o tratamento de tumores cerebrais, epilepsia refratária, e outras patologias que requerem remoção extensa do lobo frontal. Embora seja um procedimento relativamente comum, foram encontrados apenas alguns relatos na literatura acerca da técnica cirúrgica, com pouca consideração acerca da anatomia relevante para esse procedimento. OBJETIVOS: O principal objetivo desta tese é apresentar parâmetros anatômicos e considerações técnicas para a remoção da substância cinzenta do lobo frontal (decorticação do lobo frontal) como uma alternativa a lobectomia frontal. A finalidade deste estudo é a maximização da remoção cerebral, diminuindo a perda sanguínea, e evitando a abertura do corno frontal do ventrículo lateral. MATERIAIS E MÉTODOS: O estudo anatômico foi realizado em 15 cabeças cadavéricas adultas. Os dados clínicos foram baseados em 15 decorticações frontais realizadas de 2002 a 2014. RESULTADOS: A decorticação frontal envolve as superfícies lateral, medial e basal, e consiste em 5 passos principais: a) coagulação e secção dos ramos arteriais da superfície lateral do lobo frontal; b) ressecção subpial paramediana do lobo frontal até a localização do joelho do corpo caloso; c) ressecção da substância cinzenta da superfície lateral do lobo frontal sem entrar no corno frontal; d) identificação e preservação do trato olfatório; e) remoção da substância cinzenta da superfície basal do lobo frontal. Esta técnica cirúrgica foi aplicada em 15 casos, em nenhum deles o corno frontal do ventrículo lateral foi aberto, evitando complicações da abertura do mesmo. CONCLUSÃO: A decorticação frontal guiada por parâmetros anatômicos pode ser uma das técnicas cirúrgicas a ser considerada quando há necessidade da ressecação extensa do lobo frontal (especialmente substância cinzenta). A técnica proporciona máxima remoção do lobo frontal, preservação do corno frontal e da área motora suplementar, e redução da perda sanguínea / BACKGROUND: The frontal lobectomy is a frequently performed neurosurgical procedure for treating brain tumors, refractory epilepsy, and other disorders that require extensive removal of the frontal lobe. In spite of being a relatively common procedure, there are only few reports available regarding its surgical technique and little attention has been given to the anatomy relevant to this procedure. OBJECTIVES: The authors present the anatomical landmarks and technical nuances for removing the gray matter of the frontal lobe (frontal lobe decortication) as an alternative to frontal lobectomy. The goals are to maximize the brain removal, minimize the blood loss, and avoid opening the frontal horn of the lateral ventricle. MATERIAL AND METHODS: The anatomical study was performed in 15 adult cadaveric heads. The clinical data are based on 15 frontal resections performed from 2002 to 2014. RESULT: The frontal decortication involves the lateral, medial, and basal surfaces of the frontal lobe, and it consists of 5 main steps: a) coagulation and section of the arterial branches of the lateral surface of the frontal lobe; b) paramedian subpial resection of the frontal lobe until the genu of the corpus callosum is located; c) resection of the gray matter of the lateral surface of the frontal lobe without entering the frontal horn; d) identification and preservation of the olfactory tract; e) removal of the gray matter of the basal surface of the frontal lobe. This surgical technique was applied in 15 cases, and it was possible to preserve the frontal horn in all the patients when following this technique, avoiding complications resulted by its opening. CONCLUSION: The frontal decortication guided by intraoperative anatomical landmarks can be one of the surgical techniques to be considered when an extensive frontal lobe resection (especially gray matter) is needed. It offers maximum frontal lobe removal, preservation of the frontal horn and supplementary motor area, and reduced blood loss

This investigation addresses the thermal characteristics of the major oceanic frontal systems in the Southern Ocean south of Africa based on data collected to a depth of 500 m on forty-three cruises during a fifteen year period. The width of the Agulhas Front has been shown to vary considerably in both its sea surface and sub-surface thermal manifestation as a result of mesoscale turbulence. Its mean sea surface width of 84 km has a standard deviation of 53 km, and the mean subsurface width of 37 km has a standard deviation of 33 km. The Agulhas Front. has been found to be a separate front north of the Subtropical Convergence in 56 % of the cruises investigated. It has only been observed from 18,2°E to 24,7°E, with a mean sea and subsurface temperature gradient across the Agulhas Front of 0,05 °C/km and 0, 13 °C/km respectively. It has a mean sea surface middle temperature of 17, 8° C and a mean subsurface middle temperature of 12,6° C. The mean sea and sub-surface geographic positions of the thermal expression of the Agulhas Front are 39,3° S; 22,7° E aild 39,1° S; 22,7° E. The Subtropical Convergence at surface has been found to be a single, broad frontal zone across the Central/South East Atlantic Ocean, that does not bifurcate. It has a mean sea surface middle temperature of ·14,3° C and a mean sub-surface middle temperature of 8,4° C. The mean sea and sub-surface temperature gradients across the Subtropical Convergence are O, 03 °C/km and O, 05 °C/km respectively. The mean sea and sub-surface geographic positions of the· thermal expression of the Subtropical Convergence are 41, 8° S; 21, 9° E and 41, 7° S; 22, 0° E. The Subtropical Convergence has a mean sea surface width of 146 km and a mean sub-surface width of 79 km. The Sub-antarctic Front is pressed northward from 45° S to 43° S by the Mid-Ocean Ridge in the South West Indian Ocean sector, after which it converges · with the Subtropical Convergence at approximately 60° E to form a united STC/SAF at subsurface. This united STC/SAF does not however form a "Crozet Front" by joining the Agulhas Front between 52° E and 65° E. It has a mean sea surface middle temperature of 4,4° C and a mean sub-surface middle temperature of 4,0° C. The mean sea and subsurface temperature gradients across the Sub-antarctic Front are 0,02 °C/km. The mean sea and sub-surface geographic positions of the thermal expression of the Sub-antarctic Front are 48,7° S; 18,9° E and 46,8° S; 19,9° E. The Sub-antarctic Front has a mean sea surface width of 73 km and a mean sub-surface width of 77 km. In 30 % of the sections investigated the- Antarctic Polar Front consisted of a primary and secondary front. The Antarctic Polar Front does not join the Sub-antarctic Front east of · 40° E at sub-surface and subsequently no quadruple front is formed. It has a mean sea surface middle temperature of 2, 1 ° C and a mean sub-surface middle temperature of 2,3° C. The mean sea and sub-surface temperature gradients across the Antarctic Polar Front are 0,01 °C/km and 0,02 °C/km respectively. The mean sea and sub-surface geographic position of the thermal expression of the Antarctic Polar Front are 52, 7° S; 14,9° E and 49,2° S; 20,8° E. The Antarctic Polar Front has a mean sea surface width of 66 km and a mean sub-surface width of 74 km.

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