ABSTRACT
Resumen: La anestesiología cuenta con una nueva generación de monitores de la profundidad anestésica como Narcotrend, SedLine y el índice biespectral; con un procesador del electroencefalograma llamado espectrograma o espectrografía. Tras la obtención del electroencefalograma, se procesa para graficar en tres dimensiones: la frecuencia, el tiempo y la potencia en una escala de colores, con lo que se obtiene la matriz de densidad espectral (DSA, por sus siglas en inglés). El objetivo de esta revisión narrativa es ilustrar los efectos de los anestésicos más comunes en el espectrograma y hacer una breve revisión de su huella en el electroencefalograma.
Abstract: Anesthesiology has a new generation of anesthetic depth monitors such as Narcotrend, SedLine and Bispectral Index; with an electroencephalogram processor called a spectrogram or spectrograph. After obtaining the electroencephalogram, it is processed to graph three dimensions: frequency, time, and power on a color scale, obtaining the DSA (density spectral array). The objective of this narrative review is to illustrate the effects of the most common anesthetics on the spectrogram and to briefly review their signature on the electroencephalogram.
ABSTRACT
The incidence of primary brain tumors during pregnancy is uncommon. The etiology of these can range from different genetic syndromes such as Li Fraumeni, neurofibromatosis type I, and hormonal associated tumors. The number of meningiomas gradually tends to increase during pregnancy, suggesting a relationship between non-malignant meningiomas and hormonal changes. Clinical features are non specific or can be misinterpreted with pregnancy symptoms such as headache, vomiting and dizziness. It is worth mentioning that the symptoms due to intracranial tumors are no different in pregnant compared with non pregnant patients. However, retrospective studies in glioma behavior suggested that both tumor volume and growth, increased during pregnancy. These changes were correlated with clinical worsening and increased frequency of seizures. The diagnosis requires a proper neurologic exploration and the support of imaging studies. Treatment of tumors is very controversial since we look for the preservation of both mother and fetus. In theory, the best therapy for the mother will also be the best therapy for the fetus. During pregnancy, ideally the treatment is symptomatic, to preserve the fetus, and definite treatment may be performed after birth; the latter is not always accomplished since patients may present with impending herniation or a malignant tumor for which immediate management is necessary. We intend to give an updated review in the literature on the adequate treatment of brain tumors during pregnancy and the anesthetic management during the definite treatment. Literature data was obtained from Pubmed using the search terms: "Pregnancy", "Brain", "Tumors". A total of forty-three articles were selected.
