Guilherme Machado

Publications (2)4.51 Total impact

• Article: Cloverleaf skull deformity and hydrocephalus.

  Guilherme Machado, Federico Di Rocco, Christian Sainte-Rose, Philippe Meyer, Daniel Marchac, Gaëlle Macquet-Nouvion, Eric Arnaud, Dominique Renier
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  ABSTRACT: This article describes the clinical aspects for both operated and non-operated patients with a cloverleaf skull deformity treated in our service, focusing on hydrocephalus. We describe 13 cases of cloverleaf skull deformity treated in our services between 1977 and 2008. Among them, ten were operated (9 out of 13 for the craniofacial stenosis and 7 out of 13 for hydrocephalus). Hydrocephalus was present in all patients with bilateral lambdoid stenosis. There was no case of hydrocephalus among the patients with unilateral or absent lambdoid stenosis. Associated malformations and severe faciostenosis were associated with higher mortality and morbidity. The development of hydrocephalus seems to be closely related to a bilateral lambdoid stenosis. The optimal treatment must be tailored individually considering the degree of the malformation and the presence of complications and comorbidities.
  Child s Nervous System 10/2011; 27(10):1683-91. · 1.54 Impact Factor
• Article: Stereotactic biopsy of diffuse pontine lesions in children.

  Thomas Roujeau, Guilherme Machado, Matthew R Garnett, Catherine Miquel, Stephanie Puget, Birgit Geoerger, Jacques Grill, Nathalie Boddaert, Federico Di Rocco, Michel Zerah, Christian Sainte-Rose
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  ABSTRACT: Empirical radiotherapy is the current treatment for children with diffuse pontine lesions that have imaging characteristics of an infiltrative malignant astrocytoma. The use of chemotherapeutic agents is, however, currently under investigation in the treatment of these tumors. To be included into a trial, patients need a definitive histological diagnosis. The authors present their prospective study of the stereotactic biopsy of these lesions during a 4-year period. A suboccipital, transcerebellar approach was used to obtain biopsy samples in 24 children. Two patients suffered deficits. Both had a transient (< 2 months) new cranial nerve palsy; one of these patients also experienced an exacerbation of a preoperative hemiparesis. No patient died during the perioperative period. A histological diagnosis was made in all 24 patients as follows: 22 had a malignant infiltrative astrocytoma, one had a low-grade astrocytoma, and one had a pilocytic astrocytoma. The diagnosis of the latter two patients affected the initial treatment after the biopsy. The findings of this study imply that stereotactic biopsy sampling of a diffuse pontine tumor is a safe procedure, is associated with minimal morbidity, and has a high diagnostic yield. A nonmalignant tumor was identified in two of the 24 patients in whom the imaging findings were characteristic of a malignant infiltrative astrocytoma. With the advent of new treatment protocols, stereotactic biopsy sampling, which would allow specific tumor characterization of diffuse pontine lesions, may become standard.
  Journal of Neurosurgery 08/2007; 107(1 Suppl):1-4. · 2.96 Impact Factor