A look at Mayan artificial cranial deformation practices: morphological and cultural aspects.

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.

Use of the sole stenting technique for the management of aneurysms in the posterior circulation in a prospective series of 20 patients.

OBJECT: The use of intracranial stents in stent-assisted coil embolization is now a current neurosurgical practice worldwide. The clinical utility of these stents in the sole stenting (SS) technique, however, has not been thoroughly described, and the published reports of this experience are scarce. This study was designed to evaluate SS treatment of dissecting and nondissecting aneurysms of the posterior circulation. METHODS: This prospective and descriptive study was conducted in 20 consecutive patients who harbored single aneurysms of the posterior circulation and who were treated using the SS approach in the last 3 years. The clinical and radiological assessment and follow-up of the patients were evaluated using the modified Rankin scale as well as with computed tomography angiography and digital subtraction angiography at discharge and at 1, 3, 6, and 12 months. RESULTS: Eleven of the 20 patients had subarachnoid hemorrhages, 3 presented with ischemia, 1 presented with brainstem compression, and the remaining 5 patients had incidentally discovered, asymptomatic lesions. Only 1 patient had a complication (occipital infarction) attributable to the SS procedure. One patient died of rebleeding 2 weeks after the procedure. At 1 month, 40% of the patients had a subtotal or total occlusion, which increased to 55% at 3 months and 85% at 6 months, with a final subtotal or total occlusion rate of 80% at 1 year. The SS procedure in 1 case was considered a failure at 6 months because no change had been noted since the 1-month follow-up. One case showed partial occlusion and 1 case showed recanalization. CONCLUSIONS: Use of SS for aneurysms in the posterior circulation complex is a safe and effective technique, demonstrating an occlusion rate of 80% at the 1-year follow up.

Superior cerebellar artery aneurysms treated using the sole stenting approach. Technical note.

Endovascular treatment of intracranial aneurysms has evolved since the introduction of detachable coils. Sole stenting is a brand-new technique that has recently emerged as a definitive treatment for saccular or fusiform aneurysms at particular locations. Superior cerebellar artery aneurysms are rare, and few treated cases have been reported. Most of them have been treated surgically, and endovascular cases usually have been managed with occlusion of the parent vessel. The authors report on the first two endovascularly treated cases with complete cure of the aneurysm as well as preservation of the parent vessel and distal circulation via the sole stenting technique. The results together with several aspects of the technique, such as the correction of the angle of the vessel and modification of the shear stress, are discussed.

Sole stenting bypass for the treatment of vertebral artery aneurysms: technical case report.

OBJECTIVE AND IMPORTANCE: Vertebrobasilar aneurysms have a risk of rupture ranging from 2.5 to 50% (especially those larger than 7 mm) and a repeat bleeding rate of between 30 and 70%. For this reason, patients with aneurysms larger than 7 mm should be treated. Considering the high complexity of surgical approaches in this area, an increasing number of reported cases are being treated with endovascular therapy. The purpose of this article is to determine the effectiveness and safety of sole stenting bypass in the treatment of three consecutive patients with vertebrobasilar aneurysms. CLINICAL PRESENTATION: Three patients (one woman and two men) with vertebrobasilar junction aneurysms were included in this study. Two of the patients presented with subarachnoid hemorrhage. INTERVENTION: An endovascular procedure was performed under general (two patients) or local (one patient) anesthesia and via a right femoral approach. By use of road map guidance, sole Express (one patient) or Express 2 (two patients) coronary stents (Boston Scientific/Scimed, Maple Grove, MN) were deployed on the diseased vessel. When the stent was in place, an immediate partial thrombosis of the aneurysm was observed, related primarily to an intra-aneurysmal flow pattern modification, possibly facilitated by modification of the angle of the parent vessel. Follow-up angiograms showed complete exclusion of the aneurysms within the circulation. Only one patient presented visual deficit as a thrombotic complication, but it disappeared completely 6 months after treatment. CONCLUSION: The sole stenting bypass technique seems to be a good alternative for the treatment of complex vertebral aneurysms by inducing thrombosis of the aneurysm with preservation of the parent vessel lumen.

Intracranial aneurysms associated with unsuspected aortic coarctation.

Intracranial aneurysms (IAs) are found more often in patients with aortic coarctation (AC) than in the general population and aneurysm rupture occurs much earlier in the lives of these patients when there is coexistent AC. The diagnosis of AC is frequently made only after a serious cerebrovascular complication has developed. The aim of this paper is to call attention to AC in patients presenting with aneurysmal subarachnoid hemorrhage. The literature is reviewed, the key clinical features are highlighted, and the proposed pathogenesis of this association is discussed. The authors present clinical information and imaging data obtained in three young patients with ruptured IAs that were associated with initially unnoticed AC. Abnormal results of cardiovascular examinations led the authors to consider an underlying AC, which was later confirmed by aortography. These aneurysms were successfully treated prior to correction of the ACs. The diagnosis of AC should be considered in adolescent and young adult patients presenting with IAs.

Efecto del tratamiento quirúrgico de los adenomas de la hipófisis sobre la función visual / Results of surgical treatment of pituitary adenomas with compression of optic pathway

Uno de los síntomas más importantes producidos por el crecimiento de los tumores de la hipófisis es la afección de las vías ópticas. El diagnóstico temprano y la descompresión dependerá el resultado terapéutico. Se analizan 49 casos tratados quirúrgicamente por vía transcraneal y transesfenoidal, y el efecto del tratamiento en la función visual; así como, la necesidad de seguimiento de estos tumores.

Tiempo de consolidación en las fracturas diafisarias del húmero tratadas con injerto óseo autólogo y placas A / Bone-union span in fractures of the humeral shaft treated by screw-plating and autologous bone grafting

Se trataron 40 pacientes con fractura diafisaria del húmero mediante osteosíntesis con placa de compresión DCP y aplicación de injerto autógeno mediante un abordaje posterior. Su edad promedio fue de 34.5 años. El 40 por ciento (16 casos) tenían lesión del nervio radial, que se reparó en el mismo tiempo operatorio. Se aplicó una férula posterior en pinza de azúcar como protección complementaria. Se obtuvo consolidación primaria en 39 de los 40 casos (97.5 por ciento) en un promedio de 12 semanas (9 a 19). Persistieron datos de lesión del nervio radial solamente en 2 de los 16 casos referidos después de un seguimiento promedio de 9 meses (6 a 18). Solamente un caso con alfojamiento del implante requirió ser reintervenido para una segunda osteosíntesis y aplicación de injerto óseo autólogo. Hubo 2 casos con necrosis superficial de la herida

Tratamiento del hematoma subdural crónico con tres técnicas quirúrgicas, coagulación y fibrinolisis / Treatment of chronic subdural hematomo with three different techniques coagulation and fibrinolysis

El hematoma subdural continua siendo un grave problema quirúrgico tanto por su frecuencia como por el gran número de pacientes que requieren tratamiento para esta condición. Diversas técnicas han sido empleadas a través de los años para mejorar esta condición se considera importante evaluar tres técnicas quirúrgicas en el manejo de esta entidad

RM de teratoma supraselar del adulto: informe de un enfermo / Suprasellar teratoma in the adulthood: magnetic resonance review of one case

Se informa historia de un paciente adulto con un teratoma supraselar , que es el primero estudiado con Resonancia Magnética (RM) y Tomografía Computada (TC). El estudio histopatologíco de la pieza confirmó el diagnóstico quirúrgico.

Abordaje transorofaríngeo para la sección del nervio glosofaríngeo: presentación de dos casos tratados por neuralgia / Transoro pharyngeal approach for section of glossopharyngeal nerve: report of the cases treated by neuralgia

Se presentan dos casos de neuralgía primaria del glosofaríngeo. Se puntualiza la técnica quirúrgica del abordaje transorofaríngeo y la utilidad de usar el microscopio operatorio en la localización y sección del nervio