Evaluación del sistema asistencial uruguayo en el tratamiento del traumatizado grave de cráneo / Evaluation of the assistance system of Uruguay in the treatment of acute brain injuries

En este trabajo retrospectivo se señala la importancia de los accidentes de tránsito y de su consecuencia más severa: el traumatismo grave de cráneo. Se analiza una casuística nacional (que recoge la experiencia de la mayoría de los centros asistenciales del país, públicos y privados) y las deficiencias y errores cometidos en nuestro sistema asistencial actual y su directa vinculación en muertes evitables y potencialmente evitables. Se esquematizan las condiciones básicas para mejorar la atención del traumatizado grave de cráneo

[Tumors of the sellar region and the cavernous sinus. Evaluation of diagnostic procedures and therapeutic orientation]. / Tumores de la región selar y del seno cavernoso. Valoración de la conducta diagnóstica y orientación terapéutica.

Two cases of infrequently seen tumors of the cavernous sinus and the clivus regions are presented. One of them was a chordoma and the other, a myeloma, and both were approached by the transphenoidal route. The clinical picture and the diagnostic procedures are reviewed, and the several surgical approaches to these regions are discussed. These regional processes should be submitted to a precise radiological evaluation: plain skull films, conventional tomography, arteriography, and computerized tomography scan, in order to establish their origin and their extension, and also to determine the proper approach. The authors conclude that all these regional tumors must be operated on, and that the transphenoidal approach is the most effective. This approach is extradural, well known through the experience brought about by the pituitary surgery, and with a low morbi-mortality rate.

Cerebral hematomas.

One hundred patients with primary cerebral hemorrhage were studied to evaluate previously established guidelines for surgical treatment. Sixty two patients were not operated upon and 38 were. The mortality in the 100 cases was 51%. It appears that the mortality can be lowered if a careful selection of surgical cases is made.

[Cauda equina syndrome caused by vertebral disk hernia]. / Síndromes de cola de caballo por hernia discal.

Thirteen cases of cauda equina syndrome of discal ethiology are analyzed. The clinical characteristics and course are studied. The factors which influence the prognosis and the possibilities of treatment are analyzed.

[Pott's disease of cervical topography. Apropos of a case]. / Mal de Pott de topografía cervical. A propósito de una observación.

The authors present a case of cervical Pott's disease with severe neurological impairment and with a favourable course with medical and surgical treatment. The diagnostic difficulties and the possibilities of treatment at the present stage are discussed.