Bernardo Monaco

Bernardo Monaco
University of São Paulo | USP · Faculty of Medicine (FM)

MD
Clinical Fellow at Neurological Surgery - Jackson Memorial Hospital/ University of Miami - FL - USA

About

56
Publications
17,132
Reads
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217
Citations
Additional affiliations
September 2016 - April 2021
Brazilian Association for the Welfare of the Handicapped Children
Position
  • Head of Faculty
Description
  • Functional Neurosurgeon head of CDF - Clinica de Dor e Funcional - working with disabled children - spasticity - pain - myelomeningocele - tethered spinal cord - spinal cord injury - brain injury and others. More than 140 selective dorsal rhizotomies (SDR) performed in this institution.
September 2012 - present
University of São Paulo
Position
  • Functional Neurosurgeon
September 2012 - September 2019
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Position
  • Emergency Neurosurgery and Functional Neurosurgery

Publications

Publications (56)
Article
Trigeminal neuralgia (TN) is a facial pain disorder that can be a source of significant disability. Percutaneous balloon compression (PBC) has low cost, high efficacy, and minimal invasiveness. Complications can occur due to the balloon inflation or the needle placement itself. In this paper, we describe for the first time the clinical use of robot...
Article
Full-text available
The large acute component in a chronic subdural hematoma (cSDH) typically requires a craniotomy. Open surgery can be associated with increased morbidity and is not always possible due to systemic conditions. We present the case of a 58-year-old patient who presented with a Glasgow Coma Scale (GCS) of three fixed pupils, but remaining brainstem refl...
Chapter
Neuromodulation techniques for pain treatment have been used since ancient Rome, but knowledge about the interaction of electricity and drugs with the central nervous system (electrical and chemical neuromodulation) was not clear until the middle of the twentieth century. It was only then that the advent of neuromodulatory techniques allowed for mo...
Chapter
Intraventricular pumps can be used to treat severe pain secondary to cancer or spastic dystonia. First reports of the intraventricular route usage for this purpose involved Ommaya reservoirs with single bolus infusions. After favorable initial results, mechanical pumps were coupled to the reservoir for intermittent boluses. With the advancement of...
Book
Neuromodulation implants are currently one of the most successful techniques in the treatment of chronic pain, a condition that affects more and more patients each year, leading to reduced quality of life as well as economic losses. Neuromodulation implants for pain are a relatively new technique and are being increasingly used around the globe. Ho...
Article
Motor cortex stimulation via surgically implanted electrodes has been used as an off-label treatment for chronic neuropathic pain, but its efficacy has not been fully established. We aimed to objectively study the efficacy of motor cortex stimulation and characterize potential predictors of response. In this randomized, double-blind, sham-controlle...
Article
Full-text available
Purpose The current assessment of patients with craniofacial asymmetries is accomplished by physical examination, anamnesis and radiological imaging. We propose a semi-automated, computer-assisted craniofacial evaluation (SymMetric v 1.0) based on orthogonal photography of the patient’s head in 3 positions. The system is simple, low-cost, no-radiat...
Article
Full-text available
Purpose: Brainstem lesions comprise 10-20% of all pediatric brain tumors. Over the past years, the benefits of stereotactic biopsy versus the use alone of MRI features to guide treatment have been controversial. Methods: Retrospective study with pediatric patients submitted to stereotactic brainstem biopsies between 2008 and 2018. Demographic, c...
Preprint
Full-text available
Purpose: The current assessment of patients with craniofacial asymmetries is accomplished by physical examination, anamnesis and radiological imaging. We propose a semi-automated, computer-assisted craniofacial evaluation (SymMetric v 1.0) based on orthogonal photography of the patient's head in 3 positions. The system is simple, low-cost, no-radia...
Article
Full-text available
Since 1967 the treatment of chronic pain has been done through the implantation of medullary electrodes, being used and improved to the present day for many situations. Now we know that there are two clear indications for this procedure: chronic pain syndrome after surgical failure for the treatment of pain and the regional complex pain syndrome. O...
Article
Full-text available
Spinal cord stimulation (SCS) has been used for the treatment of chronic pain for nearly five decades. With a high degree of efficacy and a low incidence of adverse events, it is now considered to be a suitable therapeutic alternative in most guidelines. Experimental studies suggest that SCS may also be used as a therapy for motor and gait dysfunct...
Article
Dorsal root entry zone (DREZ) lesioning is still used as a choice of treatment for some painful conditions as well as spasticity in selected patients. The most commonly used techniques to perform DREZotomy are the microsurgical one and DREZ radiofrequency (RF) coagulation. The technical difficulties using punctures to perform RF lesions include com...
Conference Paper
To report the efficiency and safety of intraventricular baclofen therapy (IVB) in dystonic-spastic patients. We evaluated efficiency (measured by Modified Ashworth Scale - MAS) and safety (assessed by postoperative complications) of intraventricular infusion in three patients for whom intrathecal therapy was infeasible.
Conference Paper
Spasticity is often refractory in spinal cord injure (SCI) ASIA A patients besides drug therapies and physical rehabilitation. Interventional therapies are also always insufficient to complete alleviate spasticity. For these patients, percutaneous rhizotomy can be a good alternative to intrathecal baclofen pump, selective dorsal rhizotomy, DREZotom...
Conference Paper
Full-text available
The most used intrathecal therapy for spasticity is baclofen one. In Brazil, the public health system does not provide intrathecal baclofen, so, other medications are used intrathecally to promote spasticity improvement, like morphine. We aim to report efficacy and efficiency of intrathecal morphine therapy for spasticity treatment in eleven patien...
Chapter
Neuromodulação invasiva em para tratamento de dores oncológicas
Chapter
Capitulo em português falando sobre neuromodulação para tratamento da dor, desde métodos não invasivos, até os métodos invasivos.
Article
Full-text available
Resumo A espasticidade é uma desordem motora que leva a um quadro de resistência ao movimento articular passivo. A paralisia cerebral é a mais importante causa de espasticidade e pode ser causada por diversos fatores, tais como gestações múltiplas, alcoolismo, infecções, hemorragias, afogamento, lesões cerebrais traumáticas, entre outros. Existem m...
Article
Background: Aspergillosis infection of the central nervous system (CNS) is a rare disease and corticosteroid use has increased the number of cases. It presents a high lethality rate and has to be aggressively treated. Methods: A review of literature was done and 38 cases were identified involving cerebral aneurysms caused by this fungus to date. Co...
Article
Neurogenic Pulmonary Edema (NPE) is defined as the acute onset of dyspnea or a decrease in PaO2/FiO2 ratio, following an acute central nervous system (CNS) insult, in the absence of other obvious causes of lung injury. The most important cause of NPE is subarachnoid hemorrhage (SAH), followed by cerebraltrauma and epilepsy. The incidence of NPE aft...
Article
Background: Motor cortex stimulation (MCS) is routinely used for the treatment of chronic neuropathic pain but its effect on quality of life remains uncertain. Obejctive: To systematically review the published literature on MCS and quality of life and report the effects of this therapy in a series of patients prospectively followed in our center...
Article
Full-text available
There are several unleashing factors associated with spasticity worsening such as infection, pain, immobility, emotional factors, and others. Baclofen pumpis a standard treatment for selected severe spasticity cases. The authors report a case of a suspected baclofen pump malfunctioning in a paraplegic spastic patient secondary to spinal cord injury...
Chapter
En Español - Terapia intratecal para el tratamiento del dolor
Chapter
Chordoma and Chondrosarcoma
Article
Full-text available
Unlabelled: We describe a case of a 30-year-old woman who suffered a traumatic injury of the right brachial plexus, developing severe complex regional pain syndrome type II (CRPS-II). After clinical treatment failure, spinal cord stimulation (SCS) was indicated with initial positive pain control. However, after 2 years her pain progressively retur...
Article
Full-text available
Neurodegeneration with brain iron accumulation type 1 (NBIA-1) is a rare disorder characterized by progressive extrapyramidal dysfunction and dementia. NBIA-1 encompasses typical iron brain accumulation, mostly in the globus pallidus with secondary dementia, spasticity, rigidity, dystonia, and choreoathetosis. Treatment remains mostly symptomatic a...
Article
Full-text available
Background: Implantable pumps for intrathecal opioid therapy in the last decades emerged as one of the most effective treatment for chronic non-malignant pain (CNMP) in selected patients. This study analyses reliability of intrathecal infusion morphine therapy for chronic and refractory pain not related to malignancy using an implantable constant f...
Article
Full-text available
The treatment of uncomplicated osteoma consists of an en bloc resection, or curettage, of the tumor, followed by cranioplasty. Here, we present a case report of a patient treated for a parietal osteoma, followed by a calcium phosphate cranioplasty, with early resorption after 3 months, which was presented by a sinking flap above the resection area....
Article
Full-text available
Optimal treatment of oncologic pain is a challenge to all professionals who deal with cancer and its complications. The management of upper abdominal pain is usually difficult and it is often refractory to conservative therapies. In this context, celiac plexus neurolysis (CPN) appears to be an important and indispensable tool because it alleviates...
Article
Full-text available
The authors provide a review of brain arteriovenous malformations, initially reviewing epidemiological and etiological aspects in addition to the pathophysiology and risk factors associated with bleeding. The emphasis of this review is directed to the clinical and care should be taken since the diagnosis of this pathology, intraoperative management...
Article
Full-text available
Rev Med (São Paulo). 2012;91(ed. esp.):54-5. ISSN 1679-9836
Article
Full-text available
Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. An exposure of all distal elements of lumbar plexus was possible, but a cranial...
Article
Full-text available
Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4% of all head injuries. Transorbital penetrating brain injury is an unusual occurrence in emergency practice and presents with controversial management. We report the case of a 10-year-old boy who fell forward on a bamboo stick while playing with other c...
Article
Full-text available
Wellingson Silva Paiva, Bernardo Monaco, Marcelo Prudente, Matheus Schimidt Soares, Robson Luis Oliveira de Amorim, Almir Ferreira de Andrade, Manoel Jacobsen TeixeiraDivision of Neurosurgery, Hospital Das Clinicas University of Sao Paulo Medical School, Sao Paulo, BrazilAbstract: Penetrating injury of the skull and brain are relatively uncommon ev...
Article
Full-text available
Fusiform and dolichoectatic aneurysms are challenging lesions to treat with direct clipping. Treatment of these aneurysms often requires alternative surgical strategies, including extracranial-intracranial bypass, wrapping, or clip-wrap techniques. Nonetheless, these alternatives methods of treatment have been underused and frequently overlooked. T...
Article
Full-text available
To evaluate the effectiveness of acute ischemic preconditioning (IP), based on somatosensory evoked potentials (SSEP) monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aorta cross-clamping. In...
Article
Full-text available
OBJECTIVES: To evaluate the effectiveness of acute ischemic preconditioning (IP), based on somatosensory evoked potentials (SSEP) monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS: Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aort...
Article
Full-text available
OBJETIVO: Este estudo compara os efeitos do pré-condicionamento isquêmico imediato, baseado na monitorização do potencial evocado somatossensitivo (PESS), com aqueles da drenagem do líquido cefalorraquidiano, em um modelo de oclusão da aorta torácica descendente em cães. MÉTODO: Dezoito cães foram submetidos à isquemia medular induzida pela oclusão...
Article
Full-text available
This study compares the effects of immediate ischemic preconditioning based on somatosensory evoked potential (SSEP) monitoring with those of cerebrospinal fluid drainage in a model of descending thoracic aorta occlusion in dogs. Eighteen dogs were submitted to spinal cord ischemia induced by descending thoracic aortic cross-clamping for 60 minutes...
Article
OBJECTIve: Delayed ischemic preconditioning has demonstrated neuroprotective effects in spinal cord ischemia. We investigated the effects of immediate ischemic preconditioning based on somatosensory evoked potentials monitoring in a model of spinal cord injury due descending thoracic aorta occlusion in dogs. Twenty-one dogs were submitted to spinal...
Article
Full-text available
Resumo Objetivo: Este estudo compara os efeitos do pré- condicionamento isquêmico imediato, baseado na monitorização do potencial evocado somatossensitivo (PESS), com aqueles da drenagem do líquido cefalorraquidiano, em um modelo de oclusão da aorta torácica descendente em cães. Método: Dezoito cães foram submetidos à isquemia medular induzida pela...

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