Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
1.
Rev. chil. neurocir ; 43(1): 74-82, July 2017. ilus
Article in English | LILACS | ID: biblio-869782

ABSTRACT

Introducción: A hemisferectomía es un procedimiento valioso en el tratamiento de trastornos convulsivos causados por desordenes hemisféricos unilaterales. El hemisferectomía anatómica se ha utilizado para este fin desde 1938, sin embargo, se abandonó este procedimiento después de informes de complicaciones postoperatorias causadas por hemosiderosis superficial, ependimitis e hidrocefalia obstructiva. Así que, se ha mostrado en la literatura modificaciones en las indicaciones y técnicas de hemisferectomía anatómica cuya finalidad es la de reducir la incidencia de esta complicación sin dejar de lograr control de las convulsiones. Sobre la base de la literatura, la hemisferectomía mejora la calidad de vida de los pacientes que tiene la indicación para realizar este procedimiento, ya que permite reducir la frecuencia de las convulsiones, si tónica o átona, tónico-clónicas Objetivo: El objetivo de esta revisión de la literatura es discutir los detalles técnicos, modalidades, riesgos, complicaciones, resultados y de pronóstico de hemisferectomía basado en la revisión crítica de la literatura. Casuística y Métodos: Se realizó la consulta bibliográfica, utilizando la base de datos MEDLINE, LILACS, SciELO, que utiliza el lenguaje como criterios de selección, la elección de los artículos recientes preferiblemente en portugués, español o inglés. Conclusión: Según las referencias, hemisferectomía es un procedimiento con buen resultado para las personas con convulsiones derivadas cuando está indicado para casos seleccionados y la tasa de éxito no es proporcional a la extensión de la resección del tejido neuronal. A mayor resección puede o no reducir la frecuencia de las crisis, sin embargo, la incidencia de la morbilidad puede ser mayor.


Background: The hemispherectomy is a valuable procedure in the management of seizure disorders caused by unilateral hemispheric disease. The anatomical hemispherectomy has been used for this purpose since 1938, however, it was abandoned after reports of postoperative complications caused by superficial hemosiderosis, ependymitis and obstructive hydrocephalus. So that, it has been showed modifications in the techniques of hemispherectomy whose the purpose is reduce the incidence of this complications while still achieving seizure control. Based on literature, the hemispherectomy improves the quality of life of patients that has the indication to perform this procedure because it allows reducing the frequency of seizures, whether tonic or atonic, tonic-clonic. Aim: The aim of this literature review is discuss the indications, technical details, modalities, risks, complications, results as well de prognosis of callosotomy based on critical literature review and the authors experience. Casuistry and Methods: It was performed bibliographical consultation, using the databases MEDLINE, LILACS, SciELO, utilizing language as selection criteria, choosing preferably recent articles in Portuguese, Spanish or English. Conclusion: According to references, the functional hemispherectomy has a good outocome for those with seizures arisin when indicated to selected cases and the success rate is not proportional to the extent of neuronal tissue resection. So that, a greater resection cannot necessarily reduce the seizure frequency, however the morbidity may also be larger.


Subject(s)
Humans , Cerebrum/surgery , Cerebrum/physiopathology , Seizures/surgery , Epilepsy/surgery , Hemispherectomy/adverse effects , Hemispherectomy/methods , Hemispherectomy/mortality , Cerebral Ventricles/surgery , Cranial Nerves , Hemosiderosis , Prognosis
2.
Acta méd. peru ; 31(4): 199-212, oct.-dic. 2014. ilus, tab
Article in Spanish | LILACS, LIPECS | ID: lil-735439

ABSTRACT

La epilepsia tiene una incidencia de 1 % en la población, de los cuales un tercio no responde al tratamiento farmacológico, que conlleva a discapacidad y morbilidad secundaria. Los pacientes con epilepsia refractaria requieren un estudio multidisciplinario para el origen de la epilepsia y realizar la resección quirúrgica. En cinco pacientes del Hospital Almenara hicimos la evaluación clínica, neuropsicológica, estudio estructural con resonancia magnética, PET y SPECT y videoelectroencefalografía de cuero cabelludo e intracraneal, con lo que realizamos la cirugía resectiva correspondiente. En 71 % de los pacientes se logró la supresión completa de las crisis epilépticas y en 29 % restantes, la disminución de la frecuencia en 75 %. La morbilidad adicional en los pacientes operados fue leve y manejable. El manejo multidisciplinario y tratamiento quirúrgico de la epilepsia refractaria en el hospital Almenara es altamente eficaz y se requiere la implementación de una unidad de Cirugía de Epilepsia.


Epilepsy has 1 % prevalence, until one third are refractory to pharmacological treatment, so it produces disability, morbidity and mortality. These patients requires multidisciplinary diagnostic approach to localize the origin and ideally resect it. In Almenara Hospital, seven patients has been studied clinically, neuropsychologically, brain imaging: structure magnetic resonance and functional with positron emission tomography and single photon emission computed tomography and video electroencephalography non invasive initially and electrocorticography. After the study we decided and performed respective surgery. In 71 % of patients we have got complete suppression of seizures and in the remain 29 %, more than 75 % in seizure frequency. The side effects were mild and possible to treat. The multidisciplinary approach and surgical treatment of refractory epilepsy in the Almenara Hospital is highly efficient and it is needed to install an Specialized Unit.


Subject(s)
Humans , Male , Female , Electroencephalography , Epilepsy , Epilepsy/surgery , Neuropsychological Tests
3.
J. epilepsy clin. neurophysiol ; 17(3): 93-99, 2011. ilus
Article in English | LILACS | ID: lil-610923

ABSTRACT

Catastrophic epileptic encephalopathies in children comprise devastating conditions that features cerebral dysfunction in association with refractory epileptic seizures. The diagnosis is based on the clinical findings, on magnetic resonance imaging (MRI) of the brain and on electroencephalographic findings. For these conditions, surgery remains essential for attaining seizure control. We report two cases of 5-year-old girls. The first one had a diagnosis of Rasmussen’s syndrome. The second one had a large porencephalic cyst secondary to perinatal cerebral ischemia. Despite trials of anticonvulsants, both patients deteriorated, and a functional hemispherectomy guided by neuronavigation was indicated and performed, with low morbidity and excellent seizure control. The neuronavigation proved to be a valuable guidance tool in performing the functional hemispherectomy, making the disconnections more accurate, and thus decreasing the surgical time and blood loss.


Aplicabilidade da neuronavegação em hemisferectomia funcional As encefalopatias epilépticas catastróficas da infância compreendem condições graves que associam disfunção cerebral e crises epilépticas refratárias. Seu diagnóstico é firmado com base nos dados clínicos e nos achados de ressonância magnética e eletrencefalográficos. Para algumas destas condições o tratamento cirúrgico continua sendo essencial para o controle das crises. Relatamos dois casos de pacientes de 5 anos. A primeira teve diagnóstico de síndrome de Rasmussen. A segunda tinha antecedentes de encefalopatia hipóxico-isquêmica perinatal. Ambas apresentaram epilepsia parcial refratária em associação com rápida deterioração neurológica, e foram submetidas à hemisferectomia funcional com auxílio da neuronavegação, com baixa morbidade e excelente controle das crises. A neuronavegação se mostrou como uma valiosa ferramenta na realização da hemisferectomia funcional, possibilitando desconexões mais precisas, menor tempo de cirurgia e menor perda sanguínea.


Subject(s)
Humans , Neuronavigation , Hemispherectomy , Encephalitis , Epilepsy/surgery
SELECTION OF CITATIONS
SEARCH DETAIL