Peruvian Journal of Neurosurgery最新文献

Extrapleural transthoracic discectomy without fusion for resection of giant calcified dorsal disc hernia: case report 胸膜外经胸椎间盘不融合切除术治疗巨大钙化腰椎间盘突出1例

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42103

A. Murga, Alfonso Basurco, Eduardo Laos

{"title":"Extrapleural transthoracic discectomy without fusion for resection of giant calcified dorsal disc hernia: case report","authors":"A. Murga, Alfonso Basurco, Eduardo Laos","doi":"10.53668/2022.pjns42103","DOIUrl":"https://doi.org/10.53668/2022.pjns42103","url":null,"abstract":"Introduction: Calcified thoracic disc herniations are rare and their approach represents a surgical challenge when they are giant and symptomatic Surgery is indicated in cases of intractable back pain with medical management persistent intercostal neuralgia or progressive neurological deficit with the transthoracic extrapleural approach being the one of choice because it has advantages regarding the best view of the operative field We present the case of a patient with a giant calcified thoracic hernia who was successfully operated on in our hospital using an extrapleural transthoracic approach. Clinical case: A 53-year-old male with dorsal pain in the medial region radiating to the inframammary region and progressive difficulty walking moderate proximal paraparesis T8 sensory level and urinary retention CT and MRI images showed a large calcified T6-7 disc herniation causing severe compression of the spinal cord The patient underwent a T6-7 extrapleural transthoracic discectomy plus a T6 partial corpectomy without fusion The patient tolerated the procedure well with no complications and the postoperative images one month after surgery demonstrated spinal cord decompression At follow-up irradiated back pain sensory level paraparesis and urinary retention improved. Conclusion: Extrapleural transthoracic discectomy can be considered a safe approach in the case of giant calcified thoracic hernias since it allows resection of the calcified disc fragment and decompression of the spinal cord. Keywords: Intervertebral Disc Displacement, Diskectomy, Spinal Cord, Decompression (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"abs/1907.05251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133138135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ancient thoracic schwannoma: a rare etiology of spinal cord compression. case report 古代胸椎神经鞘瘤:一种罕见的脊髓压迫病因。病例报告

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42110

J. Vargas, José Luis Urquizo, Alfonso Basurco

引用次数: 0

Spinal tuberculosis: a diagnostic challenge. case report and literature review 脊柱结核:一个诊断挑战。病例报告及文献复习

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42097

Zindya Barrientos, Alfonso Basurco, Elar Cari, Eduardo Laos

{"title":"Spinal tuberculosis: a diagnostic challenge. case report and literature review","authors":"Zindya Barrientos, Alfonso Basurco, Elar Cari, Eduardo Laos","doi":"10.53668/2022.pjns42097","DOIUrl":"https://doi.org/10.53668/2022.pjns42097","url":null,"abstract":"Introduction: Spinal tuberculosis TB represents 1% of all TB cases and 50 - 60 of osteoarticular TB cases.1 Certain atypical clinical and radiological presentations of spinal tuberculosis are described infrequently. 2 The lack of recognition of these presentations can lead to a delay in diagnosis and the initiation of treatment. 3 We present the case of a patient with atypical vertebral tuberculosis operated on in our hospital. Clinical case: A 56-year-old male with a history of diabetes mellitus and no history of tuberculosis contact with a 3-year history of moderate low back pain without sciatic pain that did not improve with physical therapy. The general and systemic physical examination was normal. The tests showed PCR 9.8 ESR 24 BK in the sputum brucellosis test, and ELISA and chest X-ray were normal. A tomography and magnetic resonance imaging of the lumbosacral spine showed an osteolytic lesion involving L2 L3, isointense on T1, with regular punched-out borders sparing the L2 L3 intervertebral disc suggestive of vertebral tuberculosis. He received standard tuberculosis treatment for 24 months with no improvement. A new open biopsy revealed Mycobacterium tuberculosis GenXpert. Conclusion: Spinal tuberculosis continues to be a global health problem. Diagnosing atypical spinal tuberculosis remains difficult, which could lead to inappropriate treatment, especially regarding the choice of treatment regimens and surgical options. Histopathological confirmation is essential for time management. Keywords: Tuberculosis, Spinal, Mycobacterium tuberculosis, Lumbar Vertebrae, Biopsy (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"155 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124341435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combined treatment “microsurgery-arthrodesis”: total resection of dorsal schwannoma plus dorsal arthrodesis “显微手术-关节融合术”联合治疗:背神经鞘瘤全切除加背关节融合术

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42115

Lizert Aquino-Fabian

{"title":"Combined treatment “microsurgery-arthrodesis”: total resection of dorsal schwannoma plus dorsal arthrodesis","authors":"Lizert Aquino-Fabian","doi":"10.53668/2022.pjns42115","DOIUrl":"https://doi.org/10.53668/2022.pjns42115","url":null,"abstract":"Introduction: Schwannomas are benign, unusual, and slow-growing tumors originating in Schwann cells, they constitute 30% of spinal tumors and are more common in women between the fifth and sixth decade. The symptoms depend on the location, degree of spinal cord compression, vertebral erosion, and tumor size. The diagnosis is clinical and imaging. The gold standard of treatment is total excision, to avoid recurrence. Surgical planning must be holistic, and the surgical field must be wide to allow complete excision. Clinical case: A 65-year-old woman with symptoms of axial pain, with an imaging diagnosis of a spinal tumor, is presented. Total resection of the tumor was performed by means of a hemilaminectomy plus dorsal arthrodesis. The pathology result was spinal schwannoma. The patient evolved favorably without presenting a neurological deficit. Conclusion: Hemilaminectomy plus posterior arthrodesis with facetectomy constitutes an effective way for total resection of extramedullary intradural tumors at the dorsal level, as was the case we performed in our patient. This allows for a larger operating field and optimizes the surgical approach. Keywords: Spinal Cord Neoplasms, Neurilemmoma, Laminectomy, Arthrodesis. (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116539066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Experience in lumbar microdiscectomy at the Guillermo Almenara Irigoyen Hospital 2018 -2021 2018 -2021年Guillermo Almenara Irigoyen医院腰椎微椎间盘切除术经验

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42109

J. Vargas, R. Martínez, Eduardo Laos, Alfonso Basurco

{"title":"Experience in lumbar microdiscectomy at the Guillermo Almenara Irigoyen Hospital 2018 -2021","authors":"J. Vargas, R. Martínez, Eduardo Laos, Alfonso Basurco","doi":"10.53668/2022.pjns42109","DOIUrl":"https://doi.org/10.53668/2022.pjns42109","url":null,"abstract":"Objective: Herniation of the nucleus pulposus (HNP) is the leading cause of sciatica. The standard diagnostic test is magnetic resonance imaging, and treatment can be conservative or surgical. The most common surgical technique is lumbar microdiscectomy. The objective of the study was to know the epidemiological and clinical profile, as well as the surgical results of patients undergoing lumbar microdiscectomy at the Almenara Hospital from January 2018 to August 2021. Methods: Descriptive, retrospective, and cross-sectional epidemiological study. We found 82 patients who underwent lumbar microdiscectomy with complete data in the clinical history. The data was collected from the clinical history of hospitalization and outpatient consultation. Proportions were applied for qualitative variables and mean with confidence interval in quantitative variables. Results: Of the total number of patients, 69.51% were male, the most frequent age group was 31-50 years, and most came from Lima. The most frequently operated anatomical levels were L4 and L5. Regarding the clinic, 95.12% presented positive Lasegue. The mean preoperative VAS decreased from 7.83 to 2.00. Recurrence was 4.88%, and the most frequent complication was inadvertent durotomy. Conclusions: HNP is the most common cause of sciatica. The most frequent surgical management is lumbar microdiscectomy, which has good clinical results as well as a low rate of complications and recurrence. Keywords: Spine, Sciatica, Nucleus Pulposus, Diskectomy, Neurosurgical Procedures. (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128641505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beginnings of endoscopy spine surgery in Peru 秘鲁内窥镜脊柱手术的开始

Peruvian Journal of Neurosurgery Pub Date : 2022-04-01 DOI: 10.53668/2022.pjns42117

Jerson Flores

{"title":"Beginnings of endoscopy spine surgery in Peru","authors":"Jerson Flores","doi":"10.53668/2022.pjns42117","DOIUrl":"https://doi.org/10.53668/2022.pjns42117","url":null,"abstract":"In recent years, spinal endoscopy has become increasingly common in our setting; however, its use is not recent. The first reported cases date back to the early 2010s by a team from the Cayetano Heredia Hospital in charge of Drs. Wesley Alaba and Jerson Flores. Although other minimally invasive procedures such as nucleoplasty, nucleolysis, or percutaneous rhizotomies had already been used since the 2000s, it was not until 2011 that endoscopy was used for the first time in a standardized manner in spinal surgery with the endoscope as the only element of vision, successfully resecting a vertebral lesion. The first cases of vertebral pathology in which endoscopic surgery was used were the resection of a synovial cyst and a tuberculous abscess, followed by the resection of herniated discs at the L5-S1 level and later at the L3-L4 and L4-L5 levels. The first approach was the tubular interlaminar posterior approach, followed by the transforaminal endoscopic approach and the percutaneous posterior interlaminar approach. In the following years, endoscopy has been used not only in resecting herniated discs but also in treating central and lateral canal stenosis, reaching significant experience in this technique. The development of spinal endoscopy and its increasingly widespread use by neurosurgeons and traumatologists from different hospitals in the country represents an important advance in spinal surgery in Peru, which brings greater benefit to patients. Keywords: Endoscopy, Intervertebral Disc Displacement, Endoscopes, Neurosurgeons (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"3 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132329949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Glioma of the optic pathway and hypothalamus in a child: a case report 儿童视神经通路及下丘脑胶质瘤1例报告

Peruvian Journal of Neurosurgery Pub Date : 2022-01-01 DOI: 10.53668/2022.pjns41045

J. Vargas, Manuel Lazón

{"title":"Glioma of the optic pathway and hypothalamus in a child: a case report","authors":"J. Vargas, Manuel Lazón","doi":"10.53668/2022.pjns41045","DOIUrl":"https://doi.org/10.53668/2022.pjns41045","url":null,"abstract":"Introduction: Gliomas of the optic nerve, visual pathway, and hypothalamus are treated as a single entity, being considered benign neoplasms in pediatric age, grade I according to the WHO. 25% of them are confined to the optic nerve, 40-75% involve the optic chiasm, and 33-60% are posterior lesions. Most do not present symptoms, but in the case of presenting, the most frequent is loss of vision. The gold standard for diagnosis is magnetic resonance imaging (MRI) with contrast. The first line of treatment is chemotherapy, with surgery used for nerve decompression, if necessary. Clinical case: A 4-year-old woman with a 3-month illness characterized by headache, vomiting, and seizures. The MRI showed a heterogeneous, solid cystic tumor with a solid component that captures contrast. A craniotomy and partial tumor resection were performed, finding both nerves and the optic chiasm thickened. Pathology was reported as pilomyxoid astrocytoma. The patient presented a favorable evolution and was discharged on postoperative day 9. Conclusion: Gliomas of the optic pathway and hypothalamus are tumors with a benign course in childhood, and their main form of treatment is chemotherapy. Surgery only plays an important role if decompression is required to preserve the patient's visual function. Keywords: Astrocytoma, Optic Chiasm, Decompression, Craniotomy, Visual Pathways. (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134570609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant occipital encephalocele in a newborn; surgical treatment. Case report 新生儿巨大枕脑膨出1例;外科处置病例报告

Peruvian Journal of Neurosurgery Pub Date : 2022-01-01 DOI: 10.53668/2022.pjns41073

G. Espín, Alicia Torres, J. R. Bernal, J. Castro, A. Paez, Byron Sanunga, C. Morales, E. Castro

{"title":"Giant occipital encephalocele in a newborn; surgical treatment. Case report","authors":"G. Espín, Alicia Torres, J. R. Bernal, J. Castro, A. Paez, Byron Sanunga, C. Morales, E. Castro","doi":"10.53668/2022.pjns41073","DOIUrl":"https://doi.org/10.53668/2022.pjns41073","url":null,"abstract":"Introduction: Neural tube defects (NTD) are congenital malformations that are caused by the lack of fusion of the neural tube during the embryonic period, exposing the nervous tissue to the outside. There are different types, and they can be cranial (anencephaly and encephalocele) and spinal (spina bifida). The encephalocele is a protrusion or herniation of the intracranial content, through the bony defect of the skull. In this article, we report the case of a patient diagnosed with occipital encephalocele, while reviewing the neurosurgical treatment performed in our hospital. Clinical Case: We present the case of an 8-day-old male neonate, the son of a 36-year-old diabetic mother, with a prenatal ultrasound diagnosis of occipital encephalocele, evidenced at 16 weeks of gestational age. The patient underwent surgery, performing a plasty of the occipital encephalocele; he presented as a mediate complication infection of the surgical wound that was resolved with antibiotic treatment, later presenting a favorable evolution. Conclusion: The extension and nature of the hernial content of the encephalocele determine its prognosis, as well as immediate treatment, which can reduce postoperative complications. Keywords: Encephalocele, Neural Tube, Spinal Dysraphism, Nerve Tissue (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128208168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Esthesioneuroblastoma with intracranial invasion, surgical management by double approach: craniotomy and craniofacial. case report 侵袭颅内的神经母细胞瘤，双入路手术治疗:开颅和颅面。病例报告

Peruvian Journal of Neurosurgery Pub Date : 2022-01-01 DOI: 10.53668/2022.pjns41051

Giuseppe Rojas, Manuel Lazón

{"title":"Esthesioneuroblastoma with intracranial invasion, surgical management by double approach: craniotomy and craniofacial. case report","authors":"Giuseppe Rojas, Manuel Lazón","doi":"10.53668/2022.pjns41051","DOIUrl":"https://doi.org/10.53668/2022.pjns41051","url":null,"abstract":"Introduction: Esthesioneuroblastoma, or olfactory neuroblastoma, is a rare malignant neoplasm of the sinonasal tract that originates in the olfactory neuroepithelium with neuroblastic differentiation. It occurs most frequently in the upper nasal cavity. It is a locally aggressive neoplasm and metastasizes both hematogenously and lymphatic. A multimodal approach, which can combine surgery, chemotherapy, and radiotherapy, is essential for the management of these tumors. Clinical Case: A 56-year-old female patient with an 18-month illness, characterized by loss of smell, shortness of breath, and frontal headache. Brain tomography showed an extensive tumor in the nasopharynx with intracranial involvement and destruction of the anterior skull base. She was diagnosed with Esthesioneuroblastoma by endonasal endoscopic biopsy. A combined approach was planned first by Neurosurgery, through a bifrontal craniotomy in which the resection of the intracranial portion and the reconstruction of the skull base were achieved. Then, Head and Neck Surgery perform the resection of the tumor in the nasal cavity through right lateral rhinotomy. The patient evolved favorably in the postoperative period without presenting neurological deficit, so she was discharged in the following days after the removal of the tracheostomy cannula. She subsequently received adjuvant chemotherapy and radiation therapy. Conclusion: In an Esthesioneuroblastoma, obtaining an extensive resection, total, if possible, is a very important factor in the prognosis of a patient, so it is recommended to use the combination of several surgical techniques to achieve this goal. Keywords: Esthesioneuroblastoma, Olfactory, Craniotomy, Nasal Cavity, Skull Base (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132584228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High-definition three-dimensional exoscopy-guided exeresis of a ruptured supratentorial cavernous angioma. Initial experience at the Dos de Mayo National Hospital 高清三维外窥镜引导下的幕上海绵状血管瘤破裂术。在多斯·德·梅奥国家医院的初步经验

Peruvian Journal of Neurosurgery Pub Date : 2022-01-01 DOI: 10.53668/2022.pjns41049

J. L. Acha, L. Contreras, M. Azurín, Manuel Cueva, Adriana Bellido, S. Contreras

{"title":"High-definition three-dimensional exoscopy-guided exeresis of a ruptured supratentorial cavernous angioma. Initial experience at the Dos de Mayo National Hospital","authors":"J. L. Acha, L. Contreras, M. Azurín, Manuel Cueva, Adriana Bellido, S. Contreras","doi":"10.53668/2022.pjns41049","DOIUrl":"https://doi.org/10.53668/2022.pjns41049","url":null,"abstract":"Introduction: We report the exeresis of a cerebral cavernoma, by using the extracorporeal telescope (\"exoscope\") operating system integrated into the Kinevo 900 microscope. The objective of this study was to evaluate the surgical potential of this novel high-speed 3D exoscope system. definition (4K-HD) for the removal of a brain cavernoma. Clinical Case: A 47-year-old female patient was admitted to the emergency room for having presented intense headache with occipital predominance, the tomography showed a right occipital hematoma, the presence of a ruptured cerebral cavernoma was confirmed, so surgery was decided. The exoscope allowed good maneuverability of the instruments, without visual obstruction. The large 4K monitor made for an immersive surgical experience, giving multiple team members the same high-quality 3D view as the primary operator. It was also ergonomically favorable, allowing the surgeon to be in a neutral position regardless of the operative angle. Conclusion: The novel system provided excellent visualization, ergonomics, and favorable maneuverability, the shared surgical vision of the exoscope with 3D lenses provided educational advantages for our residents. More cases are justified to validate this initial experience. Keywords: Hemangioma, Cavernous, Central Nervous System, Telescopes, Ergonomics, Brain. (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116320829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0