Peruvian Journal of Neurosurgery最新文献_第3页

Definitive treatment of cerebral aneurysms at the Cayetano Heredia National Hospital in Lima Peru: a case series results 秘鲁利马卡耶塔诺埃雷迪亚国立医院脑动脉瘤的最终治疗:病例系列结果

Peruvian Journal of Neurosurgery Pub Date : 2021-01-01 DOI: 10.53668/2021.pjns31113

Gonzalo Rojas, J. Garay, W. Alaba, C. Rodriguez, Rolando Lovaton, Rélix Huamán

{"title":"Definitive treatment of cerebral aneurysms at the Cayetano Heredia National Hospital in Lima Peru: a case series results","authors":"Gonzalo Rojas, J. Garay, W. Alaba, C. Rodriguez, Rolando Lovaton, Rélix Huamán","doi":"10.53668/2021.pjns31113","DOIUrl":"https://doi.org/10.53668/2021.pjns31113","url":null,"abstract":"Objectives: Subarachnoid hemorrhage (SAH) due to rupture of a cerebral aneurysm continues to be a disease with high morbidity and mortality in our setting, despite advances in microsurgery and endovascular therapy. The objective of the present study was to determine the demography, vascular territory, and complications that occur in the perioperative management of patients with ruptured cerebral aneurysms treated at the Cayetano Heredia Hospital. Methods: An observational descriptive study of patients with cerebral aneurysm undergoing surgical and endovascular treatment was carried out in the Neurosurgery Service of the Cayetano Heredia Hospital from 2016 to 2018. The clinical records and operative reports were reviewed. Results: In a period of 30 months, definitive treatment was performed in 56 patients with a diagnosis of a ruptured cerebral aneurysm, of which 5 received endovascular treatment and 51 treatment by craniotomy and clipping. 62.5% were women, and 50% of the total were between the fifth and sixth decade of life. In more than 50% of cases, treatment was performed within 96 hours of SAH. Regarding the affected arterial territory, 15 patients (27%) had an aneurysm of the territory of the anterior communicating (AComA) and another 15 (27%) in the posterior communicating artery (PComA). Mortality was 17.8%, 70% being due to direct causes such as cerebral infarction and severe vasospasm. Conclusions: The treatment of the aneurysms was mainly by microsurgery, the aneurysms of the AComA, PComA, and middle cerebral (MCA) had a similar proportion and, in more than 50% the treatment was carried out in the first 4 days. More state support is required to increase endovascular therapy and obtain more promising results. Keywords: Intracranial Aneurysm, Microsurgery, Craniotomy, Endovascular Procedures (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122057772","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

Endoscopy-assisted microsurgery in the resection of epidermoid tumor of the pontocerebellar angle 内镜辅助显微手术切除桥小脑角表皮样瘤

Peruvian Journal of Neurosurgery Pub Date : 2020-10-01 DOI: 10.53668/2020.pjns24142

Jerson Flores, Gonzalo Rojas, W. Alaba, Rómulo Rodríguez

{"title":"Endoscopy-assisted microsurgery in the resection of epidermoid tumor of the pontocerebellar angle","authors":"Jerson Flores, Gonzalo Rojas, W. Alaba, Rómulo Rodríguez","doi":"10.53668/2020.pjns24142","DOIUrl":"https://doi.org/10.53668/2020.pjns24142","url":null,"abstract":"Introduction: Intracranial epidermoid tumors are rare, slow-growing, and histologically benign congenital neoplasms. The microsurgical approach with endoscopic assistance is described as a minimally invasive technique that facilitates the work of the neurosurgeon in the complete resection of an epidermoid tumor located in the cerebellopontine angle. Clinical Case: 62-year-old woman, with a 3-year disease characterized by pain on the right side of the face. Symptoms increase in the following 2 years, becoming disabling and only partially improving with pregabalin and oxcarbazepine. Brain MRI showed a hypointense lesion with a cystic appearance at the level of the prepontine cistern with expansion to the right cerebellopontine angle that compressed the right trigeminal nerve (V). Retromastoid craniotomy and a right cerebellopontine angle approach were performed. Under the microscopic vision, the trigeminal nerve was identified which was pulled by the tumor, the cranial nerve complex VII-VIII, and vessels such as the superior petrous vein and the anteroinferior cerebellar artery. With the support of the endoscope, the tumor was better visualized in inaccessible areas, the prepontine cistern was accessed and total resection of the tumor was achieved. The patient evolved favorably with remission of pain on the right side. Conclusion: The microsurgical technique assisted by endoscopy allows safe removal of the tumor, and it is immensely helpful in the resection of tumors from regions not visible under the microscope. Keywords: Brain Neoplasms, Trigeminal Nerve, Endoscopy, Cerebellopontine Angle. (source: MeSH NLM","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121733765","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

Intracerebral hematoma caused by Moyamoya disease: a case report 烟雾病致脑内血肿1例

Peruvian Journal of Neurosurgery Pub Date : 2020-10-01 DOI: 10.53668/2020.pjns24165

J. Vargas, Giancarlo Saal, F. Palacios

{"title":"Intracerebral hematoma caused by Moyamoya disease: a case report","authors":"J. Vargas, Giancarlo Saal, F. Palacios","doi":"10.53668/2020.pjns24165","DOIUrl":"https://doi.org/10.53668/2020.pjns24165","url":null,"abstract":"Introduction: Moyamoya disease is a chronic occlusive cerebrovascular disease of unknown etiology, characterized by bilateral stenotic and occlusive changes in the terminal portion of the internal carotid, as well as the presence of an abnormal vascular network at the base of the brain. The diagnosis is made with magnetic resonance (MRI) and digital subtraction angiography (DSA), SPECT is useful in the therapeutic decision. The surgical treatment of choice is revascularization. Clinical Case: A 50-year-old female patient from China, with the Glasgow Coma Scale (GCS) of 9, and a clinical picture of stroke. An admission brain tomography (CT) revealed a right temporal hematoma. Surgical evacuation of the intracerebral hematoma was performed. Cerebral angiography revealed distal stenosis of the internal carotid artery and its branches, being diagnosed with Moyamoya disease. The evolution was favorable, neither a motor deficit nor a decreased level of consciousness (GCS:15) was observed at the time of discharge. A subsequent revascularization surgery was indicated. Conclusion: Moyamoya disease is a rare cause of intracerebral hematoma but should be suspected in adults of Asian descent. MRI and angiography are the diagnostic methods of choice. Surgical treatment is revascularization, which improves the prognosis. Keywords: Moyamoya Disease, Cerebral Hemorrhage, Stroke, Cerebral Angiography (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"262 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114374302","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

Tension pneumocephalus after surgical evacuation of chronic subdural hematoma: case report and pathophysiological mechanism 慢性硬膜下血肿手术后张力性脑气:1例报告及病理生理机制

Peruvian Journal of Neurosurgery Pub Date : 2020-10-01 DOI: 10.53668/2020.pjns24151

F. Celi, Giancarlo Saal

引用次数: 1

Extramedullary intradural capillary hemangioma in a patient of 03 months of life: a case report 3个月生的髓外硬膜内毛细血管瘤1例

Peruvian Journal of Neurosurgery Pub Date : 2020-10-01 DOI: 10.53668/2020.pjns24188

José Luis Urquizo, Alfonso Basurco, William Anicama, Rocío Torres

{"title":"Extramedullary intradural capillary hemangioma in a patient of 03 months of life: a case report","authors":"José Luis Urquizo, Alfonso Basurco, William Anicama, Rocío Torres","doi":"10.53668/2020.pjns24188","DOIUrl":"https://doi.org/10.53668/2020.pjns24188","url":null,"abstract":"Introduction: Capillary hemangioma is an extremely rare endothelial cell neoplasm as an extramedullary intradural tumor. Its presentation in infants is anecdotal and only 2 cases have been previously reported in the literature. Clinical case: a 03-month-old infant with severe abrupt-onset paraparesis. Spinal magnetic resonance imaging (MRI) showed an intraspinal tumor at the T7, T8, and T9 levels, which captures contrast. A T7-T9 laminectomy and microsurgical resection of the extramedullary spinal tumor were performed. The pathology was reported as lobulated angiomatous proliferation with focal vascular thrombus, with positive immunohistochemistry for CD 31 and 34, compatible with capillary hemangioma. The neurological evolution was favorable. Post-surgical MRI and spinal angiography showed little residual tumor and hydrosyringomyelia in remission. Conclusion: Capillary hemangioma is a rare pathology in infants, this case being the 3rd case reported. Its diagnosis and surgical resection are important since most patients present an improvement in the neurological deficit after surgery. Surgical treatment avoids the risk of acute bleeding Keywords: Hemangioma, Capillary, Spinal Cord Neoplasms, Infant, Laminectomy. (Source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134406896","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

Microsurgical resection of a pontine cavernoma through a far lateral infratentorial supracerebellar approach 经远侧幕下小脑上入路显微外科切除脑桥海绵瘤

Peruvian Journal of Neurosurgery Pub Date : 2020-10-01 DOI: 10.53668/2020.pjns24148

C. Vasquez, Gonzalo Rojas, J. Calderón, Yelimer Caucha

{"title":"Microsurgical resection of a pontine cavernoma through a far lateral infratentorial supracerebellar approach","authors":"C. Vasquez, Gonzalo Rojas, J. Calderón, Yelimer Caucha","doi":"10.53668/2020.pjns24148","DOIUrl":"https://doi.org/10.53668/2020.pjns24148","url":null,"abstract":"Introduction: Cavernomas on the posterolateral pontomesencephalic surface can be approached from an extreme lateral supracerebellar infratentorial corridor, although the theory is scarce. The brainstem has a dense concentration of nuclei and fibers that are responsible for a high rate of morbidity when treating brainstem lesions. The objective of this work is to demonstrate the safe microsurgical resection technique for the complete removal of a pontine cavernoma. Clinical Case: 27-year-old woman with a 5-month history of disease; characterized by headache, left facial paresis and right half body paresis. Magnetic resonance imaging (MRI) showed a hemorrhage in the middle cerebellar peduncle compatible with a ruptured cavernoma, initially receiving medical treatment. Subsequently, due to an increase in the motor deficit and the presence of keratopathy in the left eye, surgery was decided. A retromastoid craniotomy and an extreme lateral supracerebellar infratentorial approach were performed. A safe entry zone was identified and the cavernoma was completely excised. In the postoperative period, she did not present additional neurological deficit, being extubated at 24 hours, with a score on the Glasgow scale of 15 points. Postoperative brain tomography (CT) showed the absence of the cavernoma. Conclusion: The far lateral supracerebellar infratentorial approach is safe for the excision of cavernomas with a middle cerebellar peduncle. When combined with the significant reverse Trendelenburg position it results in minimal cerebellar retraction as the cerebellum descends with gravity. Keywords: Hemangioma, Cavernous, Pons, Middle Cerebellar Peduncle, Craniotomy (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123721895","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

AESTHETIC AND PSYCHOLOGICAL OUTCOMES OF CRANIOPLASTY, POLYMETHYL METHACRYLATE VERSUS TITANIUM MESH 聚甲基丙烯酸甲酯与钛网在颅骨成形术中的美学和心理效果

Peruvian Journal of Neurosurgery Pub Date : 2019-01-01 DOI: 10.53668/2021.pjns11153

Essam Youssef, Dina Seleem, Mohamed Yahia

{"title":"AESTHETIC AND PSYCHOLOGICAL OUTCOMES OF CRANIOPLASTY, POLYMETHYL METHACRYLATE VERSUS TITANIUM MESH","authors":"Essam Youssef, Dina Seleem, Mohamed Yahia","doi":"10.53668/2021.pjns11153","DOIUrl":"https://doi.org/10.53668/2021.pjns11153","url":null,"abstract":"Introduction: Problems with appearance may negatively affect the mental health of individuals with disfigurement so, cranioplasty has an important role in improving the physical appearance of patients as well as their psychological symptoms. Objective: This study aims to highlight the aesthetic as well as the psychological outcomes of cranioplasty using the two most widely used synthetic graft materials; polymethyl methacrylate (PMMA) and titanium mesh. Methods: This is a prospective study conducted on patients with apparent skull deformity who underwent cranioplasty using PMMA or titanium mesh from April 2016 to April 2017 and were followed up for one year. Patients were assessed preoperatively, at three months, and one year postoperatively using the Derriford Appearance Scale 24 (DAS 24) and the Hospital Anxiety and Depression scale (HADS). Results: 42 patients; 25 males and 17 females were recruited. PMMA was used in 23 patients while titanium mesh was used in 19 patients. There were no significant differences regarding early and late complications between both groups. Revision surgery was necessary in only four cases having equal rates between both groups. There was a marked reduction in DAS 24 and HADS scores postoperatively with better scores in the PMMA group especially at three months after cranioplasty. Conclusion: Cranioplasty had positive effects on patients' distress regarding their appearance and their psychological symptoms. PMMA had better parameters than titanium mesh. Both PMMA and titanium mesh had comparable aesthetic outcomes with no statistically significant difference regarding the complication rates. Keywords: Cranioplasty, Polymethyl methacrylate, Titanium, Physical Appearance, Body, Depression (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126827166","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