ABSTRACT
Background: A ventriculoatrial shunt (VAS) proves to be an excellent alternative in the treatment of hydrocephalus. Its usage is a viable option when ventriculoperitoneal shunt (VPS) is contraindicated in any age of patients. Case Description: This report highlights a successful case involving a 6-month-old patient who underwent VAS catheter positioning. The child presented with hydrocephalus and biliary atresia, making him a candidate for a liver transplant. Notably, a VPS was considered a relative contraindication in this scenario. Conclusion: The VAS emerges as a viable option for patients in whom a VPS might be contraindicated. This case demonstrates the successful application of a VAS in a pediatric patient.
ABSTRACT
Objetivo. Los tumores del sistema nervioso central producen gran morbimortalidad en nuestra población. Por la escasez de datos epidemiológicos de estas lesiones en Colombia, se decidió revisar y estudiar la serie de tumores del sistema nervioso en uno de los centros de formación de residentes de neurocirugía. El objetivo de este trabajo fue conocer las características demográficas de los pacientes y la histopatología de los tumores cerebrales tratados en la Clínica El Bosque (Bogotá). Materiales y Métodos. Se revisaron los estudios patológicos de tumores del sistema nervioso central realizados en la Clínica del Bosque entre 1 de Agosto de1978 hasta 31 de Agosto del 2008. Resultado. Se encontraron 212 pacientes cuyos estudios patológicos cumplieron con los criterios de inclusión del estudio. El 58.5% de los pacientes pertenecieron al género femenino. Los gliomas fueron los tumores más frecuentes con 71 de los 212 casos estudiados. Conclusiones. En esta serie, los tumores del sistema nervioso central se presentaron más comúnmente en los adultos. Esta población se encontraba en la etapa más productiva de la vida. Esta serie es una de las primeras en evaluar los tumores del sistema nervioso central en Colombia.
Objectives. Tumors of the central nervous system are one of the pathologies with big mobility and mortality in the population. In Colombia there are only few studies that review the characteristics of these lesions. The objective of this research was to study the demographic and histopathological characteristics of patients with brain tumors who were treated in the Clinica el Bosque, Bogotá. Materials and methods. We reviewed the pathological studies of those patients with tumors of the central nervous system who were done in the Clinica el Bosque between August 1, 1978 and August 31, 2008. Results. 212 pathological studies were found from patients who accomplished the inclusion criteria. 58.5% of the patientswere female. Glioma was the most frequent tumor found in 71 cases of the 212. Conclusion. In these series, central nervous system tumors present mostly in adults, the most productive stage of life. These series of central nervous system tumors is one of the first studies that review epidemiological aspects in Colombia.
Subject(s)
Humans , Glioma , Meningioma , NeurosurgeryABSTRACT
Las fracturas de base de cráneo se encuentran entre el 3.5 y el 24 por ciento de los pacientes con trauma craneoencefálico. Las fracturas del clivus, se consideran fracturas de la base craneana posterior y se clasifican en longitudinales, transversas y oblicuas. El diagnóstico de estas fracturas ha aumentado con el uso del TAC de cráneo. Anteriormente su diagnostico se realizaba con mayor frecuencia en autopsias. Las fracturas del clivus con gran frecuencia se asocian a lesión de estructuras neurológicas y vasculares vecinas, tienen un mal pronóstico neurológico aunque se han descrito casos asintomático de fracturas clivales. En este artículo se reportara nuestra experiencia con esta patología traumática y se hará una revisión de la literatura.
Skull base fractures are found in 3.5 to 24 percent of all traumatic brain injury. Clivus fracture is considered a posterior skull base fracture and is classified into longitudinal, transversal and oblique. The finding of these fractures had incremented with the use of CT scans. Previously the diagnosis of clival fractures was made mostly at autopsy studies. Clival fractures are associated with injuries to nervous and vascular structures in its vicinity. These fractures have a bad neurological prognosis although there are cases of asymptomatic patients with clival fractures in the scientific literature. In this article we will repot our experience with this traumatic pathology and we will review the literature.
Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Cranial Fossa, Posterior/injuries , Skull Fracture, Basilar , Tomography, X-Ray Computed , ColombiaABSTRACT
BACKGROUND: Neurotrauma centers have developed management protocols on the basis of evidence obtained from literature analysis and institutional experience. This article reviews our institutional experience in the management of severe traumatic brain injury (TBI) at Simòn Bolivar Hospital, the district trauma center for Bogotá's north zone. METHODS: This is a case control study comparing a group of patients (n: 16) operated for severe TBI between January 2002 and July 2004 according to an institutional management protocol characterized by an early decompressive craniectomy (DC) approach versus a historical control group (n: 20) managed before the implementation of such protocol. Mortality and Glasgow Outcome Score (GOS) at 6 months were used as the main outcome variables. RESULTS: An early DC protocol implemented within 12 hours from injury in 16 patients with severe isolated TBI and a Marshall score between III or IV was associated with a lesser mortality than the conventional approach with ventriculostomy and Intensive Care Unit (ICU) management alone. The GOS was significantly better in the DC group (p=0.0002) than in the control group. CONCLUSION: The use of an early DC protocol for severe TBI patients (Glasgow Coma Scale <9) had a significantly improved outcome compared with the conventional approach with ventriculostomy and ICU management in Simòn Bolivar Hospital in Bogotá, Colombia.
