Hemorragia subaracnoidea por rotura de aneurisma especular intracraneal. A propósito de un caso y revisión de la literatura / Subarachnoid haemorrhage from a ruptured intracranial mirror-like aneurysm. A case report and literature review

No disponible

Seguimiento mediante técnicas de neuroimagen de los aneurismas cerebrales tratados por vía endovascular / Neuroimaging follow-up of cerebral aneurysms treated with endovascular techniques

No existen recomendaciones específicas en las guías de práctica clínica sobre el tiempo, prueba de imagen ni intervalo para controlar la evolución de los aneurismas intracraneales tratados por vía endovascular. Hemos revisado la bibliografía existente en las principales bases de datos médicas usando como palabras clave: aneurisma cerebral, espirales, procedimiento endovascular y seguimiento. Nuestro objetivo ha sido, dentro del Grupo de Enfermedades Cerebrovasculares de la Sociedad Española de Neurorradiología, proponer unas recomendaciones y un protocolo orientativo, basados en la evidencia científica, para monitorizar mediante neuroimagen los aneurismas intracraneales tratados por técnicas endovasculares, incluyendo las técnicas de neuroimagen más adecuadas, el intervalo, el tiempo de seguimiento y la mejor forma de definir los hallazgos radiológicos, con el objetivo de mejorar los resultados clínicos y optimizar y racionalizar los recursos disponibles (AU)

There are no specific recommendations in clinical guidelines about the best time, imaging tests, or intervals for following up patients with intracranial aneurysms treated with endovascular techniques. We reviewed the literature, using the following keywords to search in the main medical databases: cerebral aneurysm, coils, endovascular procedure, and follow-up. Within the Cerebrovascular Disease Group of the Spanish Society of Neuroradiology, we aimed to propose recommendations and an orientative protocol based on the scientific evidence for using neuroimaging to monitor intracranial aneurysms that have been treated with endovascular techniques. We aimed to specify the most appropriate neuroimaging techniques, the interval, the time of follow-up, and the best approach to defining the imaging findings, with the ultimate goal of improving clinical outcomes while optimizing and rationalizing the use of available resources (AU)

[Neuroimaging follow-up of cerebral aneurysms treated with endovascular techniques]. / Seguimiento mediante técnicas de neuroimagen de los aneurismas cerebrales tratados por vía endovascular.

There are no specific recommendations in clinical guidelines about the best time, imaging tests, or intervals for following up patients with intracranial aneurysms treated with endovascular techniques. We reviewed the literature, using the following keywords to search in the main medical databases: cerebral aneurysm, coils, endovascular procedure, and follow-up. Within the Cerebrovascular Disease Group of the Spanish Society of Neuroradiology, we aimed to propose recommendations and an orientative protocol based on the scientific evidence for using neuroimaging to monitor intracranial aneurysms that have been treated with endovascular techniques. We aimed to specify the most appropriate neuroimaging techniques, the interval, the time of follow-up, and the best approach to defining the imaging findings, with the ultimate goal of improving clinical outcomes while optimizing and rationalizing the use of available resources.

Ectasia dural y dolor lumbar en pacientes con síndrome de Marfan / Ectasia and lumbar pain associated with marfan syndrome

Objetivo: Evaluar clínica y radiológicamente si la presencia y el volumen de la ectasia dural (ED) se asocia con dolor lumbar en pacientes con Síndrome de Marfan (SM). Material y Método: 92 pacientes diagnosticados de SM según los criterios de Gante fueron estudiados de forma prospectiva durante un año. Se les realizó una historia clínica, pruebas de imagen, incluyendo una resonancia magnética de columna lumbar volumétrica y se les entregaron 3 cuestionarios: SRS 22 (Scoliosis Research Society) y SF 36 v- 2 e Índice de discapacidad de Oswestry en función del que subdividimos la muestra en grupo I (pacientes con dolor lumbar moderado o grave) y grupo II (pacientes sin dolor lumbar). Resultados: Se realizó análisis multivariante de las variables relacionadas con el dolor lumbar, alcanzando la ED significación estadística. Estaba presente en el 75,9% de los pacientes del grupo I, y en el 49,2% del grupo II. La presencia de la ED se asocian con dolor lumbar en pacientes con SM (p= 0,016) y con la presencia de deformidad vertebral (p <0,001). Conclusiones: La presencia y el tamaño de la ED se asocian de forma significativa con dolor lumbar en el SM pero el scalloping no influye en la mayor intensidad del dolor (AU)

Objetive: Evaluate clinically and radiographically whether the presence and size of dural ectasia (ED) is associated with low back pain in patients with Marfan syndrome (MS). Material and method: 92 patients diagnosed with MS according to Ghent criteria were studied prospectively for one year. Underwent a medical history, imaging tests, including a lumbar spine MRI volumetric and 3 questionnaires were given: SRS 22 (Scoliosis Research Society) and SF 36 v-2 and Oswestry Disability Index subdivided according to the sample in group I (patients with moderate lower back pain and / or severe) and group II (patients without pain). Results: Multivariate analysis of variables related to low back pain, the ED reached statistical significance. ED was present in 75.9% of patients in group I, and 49.2% in group II. The presence of ED is associated with low back pain in patients with MS with an OR of 3.24 (1.21 to 8.68) p = 0.016 and the presence of vertebral deformity (scalloping) with an OR of 129, 83 (16.1 to 1047.74) p <0.001. Conclusion: The presence and size of ED was significantly associated with LBP in the SM but the «scalloping» does not affect the increased intensity of pain (AU)

[Treatment in spontaneous intracerebral haemorrhage. Analysis of Spanish clinical series]. / Tratamiento de la hemorragia intracerebral espontánea. Análisis de las series clínicas españolas.

OBJECTIVE: In the spontaneous intracerebral hemorrhage (SICH) there are a small number of unequivocally indicators of surgical or conservative treatment. DEVELOPMENT: An extensive bibliographic revision of studies of patients with spontaneous ICH admitted to Spanish Hospitals has been completed. Later on, studies related to analyses and results of mortality and functional state of surgical and conservative treatments of ICH were gathered. Using the Cochrane Collaboration Manual the methodological quality of the studies has been evaluated. CONCLUSIONS: The chosen studies were 25 clinical series. Only two studies comparing the surgical against the conservative treatment of supratentorial ICH has been found. The intrinsic methodological quality associated to this type of studies does not allow to establish valid conclusions on the efficacy of one treatment over another. Nonetheless it has utility considering that it reveals the chosen treatment and the outcomes in the published studies. We did not found studies evaluating the efficacy of both treatments in Spain with a prospective randomised design, with an adequate size, analysing mortality, dependency and quality of life of the affected patients. Therefore, our final conclusion is that given the importance of the information that could be extracted from these studies in order to design the more efficient treatment of ICH no delay to complete them can be admitted.