Spontaneous convexity subarachnoid haemorrhage: Clinical series of 3 patients with associated cerebral amyloid angiopathy. / Hemorragia subaracnoidea espontánea de la convexidad cerebral: una serie clínica de 3 pacientes asociada con angiopatía amiloide cerebral.

INTRODUCTION: Convexity subarachnoid haemorrhage (cSAH) is a rare type of spontaneous, non-traumatic, and nonaneurysmal SAH characterised by blood collections in one or more cortical sulci in the convexity of the brain; the aetiology varies. We report a clinical case series of 3 patients with cSAH associated with probable cerebral amyloid angiopathy (CAA) who presented with focal sensory seizures and responded well to corticosteroid treatment. PATIENTS: Case 1 was a 67-year-old man reporting right-sided paroxysmal sensory episodes with Jacksonian progression, cheiro-oral symptoms, and motor dysphasia. Case 2 was a 79-year-old man reporting left-sided paroxysmal episodes with cheiro-oral signs and dysarthria. Case 3 was a 71-year-old woman also reporting recurrent left cheiro-oral signs and dysarthria. None of the patients had headache or clinical dementia. Aneurysms were ruled out using MR angiography. RESULTS: Brain CT scan detected an isolated hyperintensity in a sulcus of the frontal convexity; brain gradient echo T2-weighted MRI sequences showed meningeal haemosiderosis and microbleeds. However, no atrophy was identified in medial temporal lobes including the hippocampal formation. All patients had low levels of beta-amyloid in CSF, low values on the Hulstaert index and high levels of phosphorylated tau protein. Patients were initially treated with prednisone and levetiracetam, but symptoms recurred in 2 patients after prednisone was discontinued. CONCLUSIONS: We present a series of 3 patients with cSAH associated with CAA, characterised by a stereotypical syndrome responding well to corticoid treatment; there were no cases of headache or clinical dementia.

Factores pronósticos e imagen funcional del cáncer de recto / The outcome of treatment for rectal cancer in recent years has been improved by diverse advances in the field of surgery and in neoadjuvant oncologic therapies. Heald's introduction of the concept of the mesorectum as an anatomical unit (total mesorectal excision) in 1982 and the generalization of preoperative radiochemotherapy have improved the prognosis in a significant number of patients. Owing to these advances, it has become necessary for imaging studies to define a series of prognostic factors for tumors, both before and after neoadjuvant treatment, to make it possible to tailor treatment for individual patients with rectal tumors

La evolución del tratamiento de cáncer de recto durante los últimos años ha estado condicionada por diversos avances en el campo de la cirugía y terapias oncológicas neoadyuvantes. La introducción por Heald en 1982 del concepto del mesorrecto como unidad anatómica (escisión mesorrectal total) y la generalización de la radioquimioterapia preoperatoria, han determinado una mejoría del pronóstico en un número significativo de pacientes. Debido a estos avances, ha surgido la necesidad de que la imagen defina una serie de factores pronósticos del tumor, tanto antes como después del tratamiento neoadyuvante, que permitan individualizar el manejo del paciente con neoplasia de recto. Por otra parte, la irrupción de las técnicas de imagen funcional y molecular permite abrir una vía de estudio in vivo de una serie de características tumorales distintivas como la angiogénesis, el metabolismo o la celularidad en las neoplasias de recto con una aportación creciente en la determinación del pronóstico, la estadificación, la planificación terapéutica y la evaluación de la respuesta al tratamiento en pacientes con cáncer de recto (AU)

The outcome of treatment for rectal cancer in recent years has been improved by diverse advances in the field of surgery and in neoadjuvant oncologic therapies. Heald's introduction of the concept of the mesorectum as an anatomical unit (total mesorectal excision) in 1982 and the generalization of preoperative radiochemotherapy have improved the prognosis in a significant number of patients. Owing to these advances, it has become necessary for imaging studies to define a series of prognostic factors for tumors, both before and after neoadjuvant treatment, to make it possible to tailor treatment for individual patients with rectal tumors. On the other hand, the advent of functional and molecular imaging techniques has provided a way to study a series of distinctive tumor characteristics in vivo, including the angiogenesis, metabolism, or cellularity of rectal tumors, and these techniques are making a growing contribution to the prognosis, staging, treatment planning, and evaluation of the response to therapy in patients with rectal cancer (AU)

[Prognostic factors and functional imaging in rectal cancer]. / Factores pronósticos e imagen funcional del cáncer de recto.

The outcome of treatment for rectal cancer in recent years has been improved by diverse advances in the field of surgery and in neoadjuvant oncologic therapies. Heald's introduction of the concept of the mesorectum as an anatomical unit (total mesorectal excision) in 1982 and the generalization of preoperative radiochemotherapy have improved the prognosis in a significant number of patients. Owing to these advances, it has become necessary for imaging studies to define a series of prognostic factors for tumors, both before and after neoadjuvant treatment, to make it possible to tailor treatment for individual patients with rectal tumors. On the other hand, the advent of functional and molecular imaging techniques has provided a way to study a series of distinctive tumor characteristics in vivo, including the angiogenesis, metabolism, or cellularity of rectal tumors, and these techniques are making a growing contribution to the prognosis, staging, treatment planning, and evaluation of the response to therapy in patients with rectal cancer.

Vascular reconstruction of a fusiform basilar aneurysm with the Silk embolization system.

We present the case of a 47-year-old man with a fusiform aneurysm of the basilar cerebral artery, who was successfully treated with the placement of a novel flow diverter system (Silk stent).