Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
Int J Oral Maxillofac Surg ; 50(12): 1554-1562, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34312041

ABSTRACT

Craniofacial reconstruction represents a major challenge due to the complex anatomical morphology. Although implant production has often been outsourced to external companies, in-house planning and manufacturing has developed in many centres. This note introduces a conceptualized modular mould system to perform any desired craniofacial reconstruction, named 'Cubik', inspired by the famous Rubik's cube. A sophisticated virtual process is described that simulates realistic cranio-orbital resections, and the workflow to create multi-component moulds in order to achieve intraoperatively moulded implants is presented. The description focuses on the appropriate definition of interfaces between the subdivision surfaces of the planned implant, which is the key element to successful design and function of the moulds during surgery and is the peculiarity of the Cubik system. The use of Cubik does not prolong the overall duration of surgery, and it appears to be a very versatile tool, allowing personalized implants with different morphology to be created, which are suitable to cover every potential defect of the skull and the orbital region. This study extends the potential of in-house production, allowing highly accurate implantable craniofacial implants to be fabricated, and in the future this might represent a solution to achieve in-house replacement of other segments of the facial skeleton.


Subject(s)
Dental Implants , Plastic Surgery Procedures , Surgery, Computer-Assisted , Computer-Aided Design , Computers , Humans , Imaging, Three-Dimensional , Skull/surgery
2.
Minim Invasive Neurosurg ; 53(3): 106-11, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20809450

ABSTRACT

BACKGROUND: The aim of this project was to evaluate the efficacy of endoscopic third ventriculostomy (ETV) in the treatment of acute hydrocephalus caused by a haemorrhage or ischaemia in the posterior cranial fossa. METHODS: 21 patients who had acute triventricular hydrocephalus resulting from ischaemia in 8 cases, and from cerebellar haemorrhage in 13 cases were treated with endoscopic third ventriculostomy. This series was compared with a control group of 30 patients, with clinical neuroradiological characteristics comparable to the preceding group (18 acute post-haemorrhage hydrocephalus and 12 post-ischaemia in the posterior cranial fossa), treated by external ventricular drainage (EVD). All patients were monitored clinically and by brain computed axial tomography (CT) to measure the dimensions of the lateral and third ventricles. The criteria used to define efficacy were based on the image of the postoperative cerebral CT scan. RESULTS: No patient suffered haemorrhagic complications from surgical procedures or additional neurological deficits. There was no postoperative mortality or added morbidity. In all cases there was an improvement of intracranial hypertension. Clinical improvement was associated with a reduction of the ventricular dimensions documented by serial CT scans. CONCLUSIONS: We consider that, in selected cases, ETV can be suggested as the first choice treatment instead of the classic EVD. In the overall management of such patients, ETV has no or a very low rate of complications and allows shorter hospitalisation and earlier transfer to rehabilitative structures.


Subject(s)
Brain Ischemia/complications , Endoscopy/methods , Hydrocephalus/surgery , Intracranial Hemorrhages/complications , Third Ventricle/surgery , Ventriculostomy/methods , Adolescent , Adult , Aged , Brain Ischemia/diagnostic imaging , Brain Ischemia/pathology , Case-Control Studies , Child , Child, Preschool , Female , Humans , Hydrocephalus/etiology , Hydrocephalus/physiopathology , Infant , Infant, Newborn , Intracranial Hemorrhages/diagnostic imaging , Intracranial Hemorrhages/pathology , Male , Middle Aged , Radiography , Third Ventricle/anatomy & histology , Third Ventricle/physiopathology , Ventriculostomy/instrumentation , Young Adult
3.
Cephalalgia ; 30(4): 389-98, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19673912

ABSTRACT

Between January 2007 and March 2008, we prospectively studied all patients operated on for intracranial tumours in our Department of Neurosurgery. Preoperatively, all patients were interviewed by a neurologist to collect headache characteristics. Measurements of tumour and oedema volume were made using dedicated software for magnetic resonance imaging studies. Tumour histopathology was established by histological examination postoperatively. If headache improved postoperatively, a diagnosis of 'headache attributed to intracranial neoplasm' was made, according to the 2004 International Classification of Headache Disorders (ICHD-II). A multivariate logistic regression model was used to evaluate the association of headache with potential risk factors. We studied 206 subjects. The prevalence of tumour headache was 47.6%. Intracranial tumour headache was non-specific and in most cases could not be classified by current ICHD-II diagnostic criteria for primary headache syndromes. Its prevalence varied depending on volume, location and type of tumour, as well as on the patient's previous headache history.


Subject(s)
Brain Neoplasms/epidemiology , Brain Neoplasms/pathology , Headache/epidemiology , Headache/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Female , Headache/classification , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multivariate Analysis , Prevalence , Prospective Studies , Risk Factors , Young Adult
5.
Cephalalgia ; 27(10): 1171-3, 2007 Oct.
Article in English | MEDLINE | ID: mdl-17655718

ABSTRACT

Thunderclap headache is well known to be a presenting feature of a variety of causal events. Indeed, a primary form is considered in the International Classification of Headache Disorders-II, but such diagnosis must be made only after exclusion of a possible secondary cause. We report a case of late-onset idiopathic aqueductal stenosis presenting with thunderclap headache, in the absence of abnormal neurological findings or indirect signs of raised intracranial pressure. The patient recovered completely after endoscopic third ventriculostomy. This case indicates primary aqueduct stenosis as a possible, never previously reported, cause of thunderclap headache.


Subject(s)
Cerebral Aqueduct/pathology , Headache Disorders, Primary/etiology , Hydrocephalus/complications , Adult , Cerebral Aqueduct/surgery , Constriction, Pathologic/complications , Female , Headache Disorders, Primary/surgery , Humans , Hydrocephalus/surgery , Magnetic Resonance Imaging , Third Ventricle/pathology , Third Ventricle/surgery , Ventriculostomy
6.
Rev. chil. neurocir ; 21: 59-63, 2003. tab
Article in Spanish | LILACS | ID: lil-416804

ABSTRACT

En los EE.UU., el traumatísmo craneoencefálico (TCE) es la principal causa mortis entre individuos de 10 a 44 años y constituye por más del 50 por ciento de los órbitos por trauma alcanzado, por lo tanto, una importante parcela económicamente activa de la población. El uso de vehículos de dos ruedas, sea como medio de transporte, recreación o para la práctica de deportes, no está exento de accidentes, siendo el TCE relevante consecuencia de esa práctica y la principal causa de muerte e invalidez. Se realizó un estudio prospectivo de 20 pacientes atendidos en el Hospital Universitario Vírgen de la Arrixaca, Murcia, España, con diagnóstico de TCE por caída de vehículo de dos ruedas, en el período de enero a junio de 2002, utilizando un protocolo patrón, el cual fue rellenado por el autor o por el equipo del hospital. En nuestra muestra, hubo una nítida predominancia del sexo masculino (95 por ciento de los casos), siendo el grupo más afectado el de los jóvenes de 11 a 20 años, con el 65 por ciento de los casos. Hubo 17 accidentes por motocicleta y tres por bicicleta. En el primer grupo, siete (41,2 por ciento) usaban casco y entre los usuarios de bicicleta, dos (67 por ciento). En todo el muestreo, el uso de casco fue relatado por el 45 por ciento de los pacientes. La tomografía computarizada (TC) fue el método de elección para la evaluación de esos pacientes, pues es un método rápido que tiene la posibilidad de reconocer a los pacientes que necesitan intervención quirúrgica. En cuanto a las lesiones encontradas en las imágenes por TAC, el 85 por ciento del muestreo evidenció la presencia de lesiones intracraneales, siendo el hematoma subdural la más frecuente, seguido de la hemorragia subaracnoidea, la contusión cerebral y el edema cerebral. El tratamiento instituído fue conservador en la mayoría de los casos, siendo en apenas 5 pacientes (25 por ciento) necesaria la cirugía. El tiempo medio de internación fue significativamente más alto en los pacientes sometidos a tratamiento quirúrgico en relación al grupo sometido a tratamiento conservador (26,6 días y 15,3 días, respectivamente). La mortalidad fue de 10 por ciento (2 pacientes). La atención en el lugar del accidente es de importancia fundamental para reducir el número de óbitos y secuelas después del traumatísmo en general y el TEC en particular.


Subject(s)
Humans , Craniocerebral Trauma , Motor Vehicles , Tomography, Emission-Computed , Spain
SELECTION OF CITATIONS
SEARCH DETAIL
...