[Primary prophylaxis of early seizures after surgery of cerebral supratentorial tumors: Group for the Study of Functional-Sterotactic Neurosurgery of The Spain Society of Neurosurgery recommendations]. / Control de las crisis epilépticas durante el postoperatorio inmediato de los tumores cerebrales supratentoriales: recomendaciones del Grupo de Neurocirugía Funcional y Estereotáctica de la Sociedad Española de Neurocirugía.

Our review of the literature is basically focused on the primary prophylaxis of early seizures after surgery of cerebral supratentorial tumors, with the aim of suggesting several recommendations in medical antiepileptic treatment to avoid this kind of seizures which occur immediately after surgery. In conclusion, it is recommended to provide criteria for prophylaxis of early seizures after surgery of cerebral supratentorial tumors. It́s recommended a one week treatment with antiepileptic drugs in patients who didnt have seizures jet, starting immediately after the surgical treatment. If seizures appear during progress of the disease, a large period treatment will be needed. Preferred antiepileptic treatment is intravenous and with a low interactions profile. Levetiracetam, followed by valproic acid seem to be most appropriated drugs due to their properties and protective effects, particularly for our patients requirements. These recommendations are considered a general proposal to effective clinical management of early seizures after surgery, not taking into account the single circumstances of our patients. Always, clinical features of the patients could modify even significantly these guides in the benefit of each patient.

[Perioperative considerations in vagal nerve stimulator implantation]. / Aspectos perioperatorios de la implantación de un estimulador vagal.

Vagal nerve stimulation has become an a important tool in the treatment of refractory epilepsy, which continues to be the main indication for this technique. Other therapeutic indications are emerging, however, and vagal nerve stimulation has now been approved for major depression. Additional possible uses under study include morbid obesity, Alzheimer disease, chronic pain syndromes, and certain neuropsychologic disorders. This review considers perioperative aspects relevant to using this therapeutic procedure with a view to facilitating better and more integrated management of its application.

[Neuronal tumors: gangliocytoma]. / Tumores neuronales: gangliocitoma.

INTRODUCTION: Gangliocytomas are neuronal tumors of the central nervous system. They tend to appear in children and young adults. These tumors usually appear in the supratentorial compartment in the temporal lobe. Their clinical presentation is frequently as refractory epilepsy. CASE REPORTS: Three gangliocytoma cases in different locations are presented and a review is made. CONCLUSIONS: Immunochemistry is of great value in the pathological study of these lesions, using neuronal markers for the diagnosis. They are usually benign lesions. Therefore, surgical complete removal is the goal to pursue.

Tumores neuronales: gangliocitoma / Neuronal tumors: gangliocytoma

Los gangliocitomas son tumores de estirpe neuronal que se presentan en individuos jóvenes y niños.Su localización más habitual es supratentorial (lóbulo temporal...). La presentación más habitual es en forma de epilepsia refractaria. Casos clínicos. Se presentan tres casos clínicos en diferentes localizaciones. Conclusiones. La anatomía patológica se ayuda de la inmunohistoquímica para enfocar el diagnóstico, utilizando marcadores neuronales. Son lesiones de naturaleza habitualmente benigna que requieren extirpación lo más completa posible

Gangliocytomas are neuronal tumors of the central nervous system. They tend to appear in childrenand young adults. These tumors usually appear in the supratentorial compartment in the temporal lobe. Their clinical presentation is frequently as refractory epilepsy. Case reports. Three gangliocytoma cases in different locations are presentedand a review is made. Conclusions. Immunochemistry is of great value in the pathological study of these lesions, using neuronal markers for the diagnosis. They are usually benign lesions. Therefore, surgical complete removal is the goal to pursue

[Chronic subdural haematoma. Presentation and therapeutic attitudes]. / Hematoma subdural crónico. Presentación y actitudes terapéuticas.

INTRODUCTION: The chronic subdural haematoma (CSH) is a present pathology in the day by day of any Neurosurgical Department, and even in the beginning of the xxi century, the different therapeutic options are of current debate. OBJECTIVE: To compare retrospectively the results obtained by different types of surgical techniques, different modalities of drainage systems, and the application or not of perioperative intrathecal solutions. PATIENTS AND METHODS: The data have been obtained by the review of 109 clinical cases treated of CSH between 1996 and 2000 in the Department of Neurosurgery of the Hospital de Cruces (Bilbao). We have analysed the age, sex, background, presenting symptomatology, type of treatment, evolution and mean hospital stay. RESULTS: The report is centred in the analysis of the recurrence rate of the CSH, its principal feature, and so, according to the type of evacuation technique, a burr hole presents 17,2% recurrences, two burr holes 31%, a small craniotomy 50%, and an ordinary craniotomy 66%. According to the drainage system, the subgaleal shunt presents 33,3% recurrences, the subdural 24,5%, and the subdural subgaleal 15,4%. The intrathecal solutions present 37% recurrences. CONCLUSION: After studying all the data, we can conclude that for the treatment of the CSH, the choice of a burr hole and subdural subgaleal shunt and intrathecal solution, can result beneficial in relation to other techniques, although with a minimum difference over the subdural shunt.

Hematoma subdural crónico. Presentación y actitudes terapéuticas / Chronic subdural haematoma. Presentation and therapeutic attitudes

Introducción. El hematoma subdural crónico (HSC) es una entidad presente en el día a día de cualquier servicio de Neurocirugía, y, a inicios del siglo XXI, todavía son de actual debate las distintas opciones terapéuticas. Objetivo. Comparar retrospectivamente los resultados obtenidos a partir de la realización de diversos tipos de técnicas quirúrgicas, diferentes modalidades de sistemas de drenaje, y la aplicación o no de soluciones intratecales perioperatorias. Pacientes y métodos. Los datos se han obtenido mediante la revisión de 109 casos clínicos tratados de HSC, entre 1996 y 2000, en el Servicio de Neurocirugía del Hospital de Cruces (Bilbao). Se han analizado: la edad, el sexo, los antecedentes, la clínica de presentación, el tipo de tratamiento, la evolución y la estancia media hospitalaria. Resultados. El trabajo se ha centrado en el análisis de la tasa de recidiva del HSC, característica principal, y así, según el tipo de técnica evacuadora, un agujero de trépano presenta el 17,2 por ciento de reacúmulos, dos trépanos el 31 por ciento, una trefina el 50 por ciento, y una craneotomía el 66 por ciento. Según el sistema de drenaje, el subgaleal presenta el 33,3 por ciento de recidivas, el subdural un 24,5 por ciento, y el subdurosubgaleal el 15,4 por ciento. Las soluciones intratecales presentan un 37 por ciento de reacúmulos. Conclusión. Tras el estudio de todos los datos, se puede concluir que para el tratamiento del HSC, la elección de un agujero de trépano más drenaje subdurosubgaleal y solución intratecal, puede resultar beneficiosa respecto a otras técnicas, aunque con una mínima diferencia sobre el drenaje subdural (AU)