ABSTRACT
Los quistes coloides son lesiones intracraneales benignas localizadas mayoritariamente en el III ventrículo en la región de los agujeros de Monro. La mayoría se presentan entre la tercera y cuartas décadas de la vida, y son poco frecuentes por debajo de los 10 años. Presentamos el caso de una niña de 2,5 años que presentaba un quiste coloide incidental que fue seguido de manera conservadora, observándose en los estudios de resonancia magnética una progresiva regresión en su tamaño. Realizamos una revisión de los 4 casos similares publicados con anterioridad (AU)
Colloid cyst are benign intracranial lesions located in the III ventricle in the region of the foramen of Monro. The majority present in the third and fourth decades of life and are rare under the age of ten. We report a case of an incidentally colloid cyst presented in a 2.5 -years-old girl who was managed conservatively; follow-up with MRI showed a progressive reduction in size. We review the four similar case previously reported (AU)
Subject(s)
Humans , Female , Child, Preschool , Remission, Spontaneous , Colloid Cysts/diagnostic imaging , Third Ventricle/diagnostic imaging , Magnetic Resonance ImagingABSTRACT
El neumoencéfalo a tensión es una complicación extremadamente rara en el uso de la ventilación a presión positiva en el neonato, cuyo diagnóstico requiere un alto grado de sospecha clínica. Presentamos el caso de un recién nacido prematuro, que recibió oxígeno a través de cánulas nasales de alto flujo debido a enfermedad de membrana hialina, propia de su prematuridad, y que desarrolló signos clínicos de hipertensión intracraneal. La ecografía transfontanelar y la TAC craneal pusieron de manifiesto un importante neumoencéfalo a tensión que fue evacuado a través de punción directa a través de la fontanela anterior (AU)
Tension pneumocephalus is an extremely rare complication of positive-pressure ventilation in neonates, the diagnosis of which requires a high degree of clinical suspicion. We present the case of a preterm newborn, who received high-flow nasal cannula oxygen therapy because of hyaline membrane disease, due to his prematurity, and developed clinical signs of intracranial hypertension. Transfontanellar ultrasound and cranial CT scan revealed significant tension pneumocephalus, which was evacuated with direct needle puncture through the anterior fontanelle (AU)
Subject(s)
Humans , Female , Infant, Newborn , Infant, Premature , Intracranial Hypertension/etiology , Pneumocephalus/diagnostic imaging , Pneumocephalus/etiology , Continuous Positive Airway Pressure/adverse effects , Tomography, X-Ray Computed , Postoperative ComplicationsABSTRACT
Tension pneumocephalus is an extremely rare complication of positive-pressure ventilation in neonates, the diagnosis of which requires a high degree of clinical suspicion. We present the case of a preterm newborn, who received high-flow nasal cannula oxygen therapy because of hyaline membrane disease, due to his prematurity, and developed clinical signs of intracranial hypertension. Transfontanellar ultrasound and cranial CT scan revealed significant tension pneumocephalus, which was evacuated with direct needle puncture through the anterior fontanelle.
Subject(s)
Intracranial Hypertension , Pneumocephalus , Humans , Infant, Newborn , Oxygen , Pneumocephalus/diagnostic imaging , Pneumocephalus/etiology , Pneumocephalus/therapy , Postoperative Complications , Tomography, X-Ray ComputedABSTRACT
Colloid cyst are benign intracranial lesions located in the III ventricle in the region of the foramen of Monro. The majority present in the third and fourth decades of life and are rare under the age of ten. We report a case of an incidentally colloid cyst presented in a 2.5 -years-old girl who was managed conservatively; follow-up with MRI showed a progressive reduction in size. We review the four similar case previously reported.
ABSTRACT
No disponible
Subject(s)
Humans , Meningioma/etiology , Syringomyelia/complications , Spinal Cord NeoplasmsABSTRACT
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Subject(s)
Humans , Arachnoid Cysts/etiology , Arachnoid Cysts/surgery , Neurosurgery/methods , Arachnoid Cysts/complications , Spinal Cord Neoplasms/surgery , Paraparesis/complicationsABSTRACT
Introducción: La espasticidad representa un problema médico cuya incidencia está aumentando debido a enfermedades como parálisis cerebral, ictus, esclerosis múltiple, traumatismos o encefalopatías, afectando tanto a adultos como a niños. Los tratamientos incluyen rehabilitación, farmacoterapia y cirugía, entre las cuales destacamos las bombas de baclofeno intratecal. Material y métodos: Seleccionamos a los pacientes portadores de bomba de baclofeno intratecal implantada en el Hospital Clínico de Santiago de Compostela entre 2005-2018 y analizamos retrospectivamente los resultados mediante escalas de valoración de espasticidad, como la de Ashworth, así como las complicaciones observadas. Resultados: Se implantaron bombas de baclofeno a 17 pacientes, obteniendo una mejoría de 2 puntos en la escala de Ashworth en el 88,2% y de 1 punto en la escala de Penn en el 94%. Se observaron complicaciones en 3 pacientes. Conclusiones: El tratamiento con baclofeno intratecal es una técnica sencilla con resultados muy positivos para mejorar la calidad de vida de pacientes con espasticidad
Introduction: Spasticity represents a medical problem whose incidence is increasing during the last years due to pathologies such as cerebral palsy, stroke, multiple sclerosis, trauma or encephalopathy, affecting both adults and children. The treatments include rehabilitation, pharmacotherapy and surgery, among which we highlight intrathecal baclofen infusion devices. Material and methods: Intrathecal baclofen devices implanted patients in Clinical Hospital of Santiago de Compostela from 2005 to 2018 were selected for retrospective analysis using assessment of spasticity scales, such as Ashworth scale. Complications are described. Results: Surgery was performed in 17 patients for baclofen pump implant, achieving an improvement of 2 points on the Ashworth Scale in 88,2% of the patients and of 1 point on the Penn Scale in 94%. Complications were seen in 3 patients. Conclusions: Intrathecal baclofen is a simple technique with good results for improving the quality of life of patients with spasticity
Subject(s)
Humans , Male , Female , Adult , Baclofen/administration & dosage , Muscle Spasticity/drug therapy , Retrospective Studies , Muscle Spasticity/complications , Multiple Sclerosis/etiology , NeurophysiologyABSTRACT
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Subject(s)
Humans , Male , Female , Aged , Central Nervous System Cysts/complications , Central Nervous System Cysts/diagnostic imaging , Cranial Nerves/diagnostic imaging , Cranial Nerves/pathology , Cerebral Palsy/etiology , Tomography, X-Ray Computed , Magnetic Resonance ImagingABSTRACT
INTRODUCTION: Spasticity represents a medical problem whose incidence is increasing during the last years due to pathologies such as cerebral palsy, stroke, multiple sclerosis, trauma or encephalopathy, affecting both adults and children. The treatments include rehabilitation, pharmacotherapy and surgery, among which we highlight intrathecal baclofen infusion devices. MATERIAL AND METHODS: Intrathecal baclofen devices implanted patients in Clinical Hospital of Santiago de Compostela from 2005 to 2018 were selected for retrospective analysis using assessment of spasticity scales, such as Ashworth scale. Complications are described. RESULTS: Surgery was performed in 17 patients for baclofen pump implant, achieving an improvement of 2 points on the Ashworth Scale in 88,2% of the patients and of 1 point on the Penn Scale in 94%. Complications were seen in 3 patients. CONCLUSIONS: Intrathecal baclofen is a simple technique with good results for improving the quality of life of patients with spasticity.
Subject(s)
Baclofen/administration & dosage , Infusion Pumps, Implantable , Muscle Relaxants, Central/administration & dosage , Muscle Spasticity/drug therapy , Adolescent , Adult , Aged , Child , Female , Humans , Infusion Pumps, Implantable/adverse effects , Injections, Spinal , Male , Middle Aged , Muscle Spasticity/etiology , Retrospective Studies , Young AdultABSTRACT
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Subject(s)
Humans , Subdural Effusion/diagnosis , Subdural Effusion/therapy , Arachnoid Cysts/complications , Arachnoid Cysts/etiology , Subdural Effusion/complicationsSubject(s)
Arachnoid Cysts , Subdural Effusion , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Cerebral Palsy/diagnostic imaging , Head Injuries, Penetrating/diagnostic imaging , Tegmentum Mesencephali/diagnostic imaging , Tegmentum Mesencephali/injuries , Head Injuries, Penetrating/complications , Coma/complications , Glasgow Coma Scale , Corpus Callosum/diagnostic imaging , Corpus Callosum/injuries , Oculomotor Nerve Injuries/complicationsSubject(s)
Hematoma, Subdural, Chronic , Aged, 80 and over , Humans , Postoperative Complications , RecurrenceABSTRACT
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Subject(s)
Humans , Female , Aged , Accidental Falls , Craniocerebral Trauma/complications , Abducens Nerve Injury/diagnosis , Ophthalmoplegia/diagnosisSubject(s)
Abducens Nerve Injury/etiology , Nystagmus, Pathologic/etiology , Ocular Motility Disorders/etiology , Pons/injuries , Abducens Nerve Injury/diagnostic imaging , Abducens Nerve Injury/physiopathology , Accidental Falls , Aged , Cerebral Hemorrhage, Traumatic/diagnostic imaging , Cerebral Hemorrhage, Traumatic/etiology , Dizziness/etiology , Female , Humans , Magnetic Resonance Imaging , Neuroimaging , Nystagmus, Pathologic/physiopathology , Ocular Motility Disorders/physiopathology , Pons/diagnostic imaging , Pons/physiopathology , SyndromeABSTRACT
Introducción. El hematoma subdural crónico (HSC) es una patología frecuente en los servicios de neurocirugía, y especialmente prevalente entre los pacientes de edad avanzada. El objetivo de este estudio es analizar las características demográficas, clínicas y radiológicas en una serie de pacientes mayores de 85 años afectados de un HSC. Pacientes y métodos. Realizamos un estudio retrospectivo sobre una serie de pacientes mayores de 85 años entre abril de 1986 y noviembre de 2015. Se recogieron las características clínicas (edad, sexo, comorbilidades, factores de riesgo, características radiológicas) y los resultados quirúrgicos (complicaciones fundamentalmente centradas en las recidivas y mortalidad). Analizamos las particularidades de este grupo de edad y su relación entre edad, sexo, grado clínico, tratamiento antiagregante o anticoagulante, arquitectura del hematoma, desplazamiento de la línea media y número de trépanos realizados con la mortalidad y recidiva del hematoma. Resultados. Analizamos 200 pacientes con una edad media de 88,5 años (rango 85-104), con una relación varón:mujer de 1:1,1. Se recogió antecedente traumático en 114 casos (57%) y estaban sometidos a terapia anticoagulante o antiagregante 71 pacientes (35,5%). Al ingreso, 114 pacientes (57%) tenían un buen estado clínico (grado 0-2 de Markwalder). El principal síntoma fue el deterioro cognitivo en 82 casos (41%). El HSC estaba localizado en el hemisferio izquierdo en 89 (44,5%), derecho en 78 casos (39%) y bilateral en los restantes 33 (16,5%). Se presentaron 59 complicaciones en 59 casos (29 recidivas) y el grado clínico de Markwalder se relacionó con unos mayores índices de complicaciones y mortalidad (p<0,0001). Conclusiones. El HSC es una patología frecuente en los pacientes muy ancianos. Clínicamente se manifiesta con deterioro cognitivo y déficit neurológico. La situación clínica al ingreso representó en nuestra serie un importante factor predictivo tanto de complicaciones como de mortalidad (AU)
Introduction. Chronic subdural haematoma (CSDH) is one of the most common neurosurgical conditions and is especially prevalent among elderly individuals. The objective of this study was to analyse the demographic, clinical and radiological findings, and surgical outcomes in a series of chronic subdural haematoma in patients older than 85 years. Patients and methods. A review was carried out on all patients over 85 years with CSDH treated in our neurosurgical service from April 1986 to November 2015. A record was made of the baseline patient characteristics (age, sex, comorbidities, known risk factors, imaging characteristics, and number of burr-holes) and surgical outcomes (complications, especially recurrences and mortality). An analysis was carried out on the special characteristics of these patients, as well as the relationships between gender, clinical grade, anti-platelet or anticoagulant therapy, internal architecture of the haematoma, and midline shift, with mortality and recurrence of the haematoma. Results. A total of 200 patients were included, with a mean age of 88.5 (range 85-104) years, and the male: female sex ratio was 1:1.1. History of injury was reported in 114 (57%) cases. Anti-platelet or anticoagulant therapy was being used by 71 (35.5%) patients. On admission, 114 patients (57%) were in satisfactory condition (Markwalder grades 0-2). The main symptom was behavioural disturbance in 82 (41%) cases. CSDH was left-sided in 89 (44.5%) patients, right-sided in 78 (39%) cases (39%), and bilateral in the remaining 33 (16.5%) cases). Postoperative complications were observed in 59 cases (29 recurrences). Preoperative Markwalder grade correlated significantly with recurrence rate and mortality (P<.0001). Conclusions. CSDH was a very common disease in very elderly patients. Behavioural disturbance and neurological deficits are the most common first symptom. Preoperative neurological status at admission is the most important factor in recurrences and mortality (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Hematoma, Subdural, Chronic/diagnosis , Hematoma, Subdural, Chronic/therapy , Anticoagulants/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Hematoma, Subdural/surgery , Retrospective Studies , Risk Factors , Tomography, Emission-Computed/methodsABSTRACT
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Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Meningioma/complications , Meningioma/epidemiology , Neurosurgery/methods , Craniotomy/methods , Craniotomy , Prognosis , Radiosurgery/methods , Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Survivorship/physiology , Neoplasm Recurrence, Local/epidemiologyABSTRACT
La apoplejía pituitaria es normalmente el resultado de un infarto hemorrágico que acontece a un adenoma hipofisario. La presentación clínica comprende un espectro muy amplio e incluye desde casos asintomáticos, el cuadro clínico clásico e incluso muerte súbita. La isquemia cerebral tras una apoplejía pituitaria ocurre muy raras veces. Se postulan como mecanismos etiopatogénicos el vasoespasmo y/o la compresión vascular arterial provocada por el propio tumor. En el presente artículo describimos un caso de apoplejía pituitaria asociada a infarto cerebral y discutimos la relación entre ambos eventos
Pituitary apoplexy is usually the result of haemorrhagic infarction in a pituitary adenoma. The clinical presentation varies widely and includes asymptomatic cases, classical pituitary apoplexy and even sudden death. Cerebral ischemia due to pituitary apoplexy is very rare. It may be caused by vasospasm or direct compression of cerebral vessels by the tumor. We report a case of pituitary apoplexy associated with cerebral infarction and discuss the relationship between the two events