Meningiomas quisticos: presentacion de 3 casos / Cystic meningiomas: report of three cases

Objective: to describe 3 cases of intracranial cystic meningioma. Description: Case 1 (male, 24 years old), with headache, vomits, right homonymous hemianopsia and conductal disorder, in the last 2 months. MRI: left parieto - occipital cystic tumor. Case 2 (male, 56 years old) with generalized siezure, in the last month. MRI. left parietal cystic tumor. In the three cases, the suspected diagnose was glioma. Intervention: in the 3 cases a craniotomy was perfomed, with total (cases 2 and 3) or partial resection of the tumor (case 1). The cysts were intratumoral (case 2) and extratumoral (cases 1 and 3). Pathology informed meningioma. The outcome was favorable, with no complications. Conclusion: It is very difficult to make a diagnosis of cystic meningioma before surgery procedure and pathological analysis. During surgery they behave as solid meningiomas

Glioblastoma multiforme de fosa posterior. Presentacion de un caso / Posterior fosa multiform glioblastoma

Objective: to report a case of glioblastoma multiforme (GBM) of the posterior fossa. Description: male, 53 years old, with a clinical presentation of dizziness and diplopia. MRI: posterior fossa tumor in the left cerebellar hemisphere, with an extension to the peduncle, brain stem and cerebellopontine angle. Intervention: a subtotal ressection was performed through a suboccipital craniotomy. Pathology informed GBM. After surgery the patient completed the treatment with radiotherapy (60Gy). The outcome was favorable. Conclusion: the preoperative diagnosis of a posterior fossa GBM is difficult because its a extremely rare localization, nevertheless it must be suspected

Hematoma subdural subagudo y cronico: tratamiento quirurgico en 176 pacientes. Nuestra experiencia / Subacute and chronic subdural hematomas: surgical treatment in 176 patients. Our experience

Objective: to describe our surgical experience in suvacute and chronic subdural hematomas. Method: 176 patients with subacute or chronic subdural hematomas were operated between June 1998 and May 2003. Hospital records were used to ascertain data. We did a comparative analysis of the different types of surgical procedures performed. Results: the surgical procedure commonly performed was a burrhole craniostomy with subdural closed - system drainage (66 por ciento). This procedure was associated with a low rate of complications and reoperations, in comparison with the burr hole craniostomy or the craniostomy without subdural closed-system drainge. Global recurrence rate was 13 por ciento and 20,4 por ciento of the cases required reoperation. Clinical improvement rate was 72,3 por ciento. Conclusion: In our cases, burr hole craniostomy with closed-system drainge was the method of choice for the initial treatment in subacute and chronic subdural hematomas. Craniotomy should be reserved for those cases of recurrence or residual hematoma