Peruvian Journal of Neurosurgery最新文献

{"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}

{"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}

{"title":"ENDOVASCULAR TREATMENT WITH COIL PENUMBRA OF A LARGE ANEURYSM OF THE RIGHT OPHTHALMIC SEGMENT","authors":"Gonzalo Rojas, R. Rodríguez, Walter Durand, R. Vallejos, Dante Valer, Jesus Flores Q, G. Saal-Zapata","doi":"10.53668/2021.pjns11049","DOIUrl":"https://doi.org/10.53668/2021.pjns11049","url":null,"abstract":"Introduction: Coiling is the most common endovascular technique used for the treatment of aneurysms. Different types are available and Penumbra coils are a new option in the endovascular armamentarium. Case report: We report the case of 63year-old female with a ruptured type IA paraclinoid aneurysm according to Barami classification, treated with 3 Penumbra coils successfully. Conclusion: Penumbra coils seems to be an adequate option in cases of large and ruptured aneurysms of anterior circulation. Keywords: Aneurysm Ruptured, Endovascular Procedures, Female (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"1 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":"129936511","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}

{"title":"PROGNOSTIC FACTORS IN THE SURVIVAL OF PATIENTS OPERATED OF ASTROCYTOMA GRADE II","authors":"Jerson Flores, A. Rosell","doi":"10.53668/2021.pjns11065","DOIUrl":"https://doi.org/10.53668/2021.pjns11065","url":null,"abstract":"Introduction: Astrocytoma are the most common tumors of the CNS and constitute 40 to 50% of all brain tumors. Survival depends on several clinical factors and treatment, and the actual survival of patients operated on astrocytoma grade II in our region is unknown, so the objective of the present study was to know the survival of patients operated on astrocytoma grade II as well as determine What is the impact of pre-surgical and post-surgical prognostic factors on the survival of patients with grade II astrocytoma that were operated at the Guillermo Almenara Hospital between 2003 and 2009. Methods: A retrospective, observational and longitudinal study of 38 patients operated on astrocytoma grade II at the Guillermo Almenara Hospital between 2003 and 2009. The data was collected from medical records, operative reports and telephone interviews. The patients were classified according to the histological type of astrocytoma and the variables were analyzed: Group of prognostic risk, type of treatment and extension of the surgery. The SPSS 15.0 was used for the analysis. Results: Of a total of 124 patients with astrocytoma, 30% (38/124) had a grade II astrocytoma, with an average survival of 56.7 months. According to the clinical prognosis group, survival of the low, medium and high-risk groups was 74.8, 46.0 and 31 months respectively. Regarding the type of treatment, the group with the highest survival was radiotherapy + surgery (66.2 months), followed by surgery alone (44.8 months) and the shortest survival time was radiotherapy alone (37.6 months). The longest survival was the total resection group (68.7 months), followed by the single biopsy (39.1 months) and the shortest group survived the partial resection (21.0 months). Conclusions: Survival of patients operated on Astrocytoma grade II in our hospital is 56.7 months, with the factors of better prognosis being the \"low risk\" group and the total resection. Its classification into prognostic risk groups based on pre-surgical clinical data helps us predict survival before surgery. Keywords: Astrocytoma, Prognosis, Brain Neoplasms, Survival, Risk factors (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"3 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":"129558827","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}

{"title":"CEREBROSPINAL FLUID LEAKAGE AND BONE EROSION CAUSED BY CYSTS IN BASAL CYSTERN NEUROCYSTICERCOSIS TREATED BY ENDOSCOPY","authors":"John Malca, J. Flores","doi":"10.53668/2021.pjns11063","DOIUrl":"https://doi.org/10.53668/2021.pjns11063","url":null,"abstract":"Introduction: The extraparenchymal neurocysticercosis and the racemose form are very predisposed to complications. Subarachnoid sellar cysts are rare, are associated with intracranial hypertension and disorders visual fields. Clinical case: A 63-year-old male patient with racemose neurocysticercosis, hydrocephalus and cerebrospinal fluid fistula. He underwent transnasal endoscopy, removal of cysts from the sphenoid sinus, sellar, suprasellar, and prepontine regions, and fistula closure. He also presented erosion in the temporal bone and dural fistula, which were closed through microsurgery and endoscopy. The patient had a favorable initial evolution, with spastic quadriparesis, which improved with rehabilitation. Subsequently he presented episodes of ventriculoperitoneal shunt system dysfunction. Conclusion: Neuroendoscopy is a diagnostic and therapeutic method of various forms of neurocysticercosis. Extraparenchymal neurocysticercosis is able to produce bone and dural erosion, so must be considered in the differential diagnosis of cerebrospinal fluid. Keywords Neurocysticercosis, Fistula, Neuroendoscopy, Sphenoid sinus, Cysts (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"7 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":"126302024","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}

{"title":"FIRST EXPERIENCE USING 5-ALA FOR HIGH GRADE GLIOMAS IN THE ALMENARA HOSPITAL","authors":"J. Vargas, F. Palacios, E. Romero","doi":"10.53668/2021.pjns11057","DOIUrl":"https://doi.org/10.53668/2021.pjns11057","url":null,"abstract":"Introduction: The most frequent brain tumors in adults are high-grade gliomas and meningiomas. Having a discouraging prognosis of high-grade gliomas and knowing that the prognosis improves depending on the degree of tumor resection, is that new therapeutic strategies are sought, one of them is the use of 5-aminolevulinic acid (5-ALA) thanks to the fluorescence it produce in the tumor it allows to improve the rate of tumor resection, finally improving the prognosis of the patients. We presented the first experience in Almenara Hospital of the use of 5-ALA in a patient with a diagnosis of high-grade glioma. Clinical Case: Presents itself the case of a 48-year-old male patient with clinical evidence of motor and sensory deficit contralateral to the lesion, without alteration of the state of consciousness. The magnetic resonance of the encephalon with contrast, a right frontal lesion is evidenced compatible with high-grade glioma. Therefore, it is programmed for guided surgery with fluorescence, where 5-ALA is used, and a total resection of the tumor is performed, obtaining an anaplastic ependymoma as pathological anatomy. The patient presented an increase in the motor deficit, which he later recovered. In the tomographic control with contrast at 4 months, complete tumor resection is evident. Conclusion: 5-aminolevulinic acid is a drug that helps to properly delimit the edges of a high-grade glioma, by using a modified microscope, and thus increases the degree of tumor resection, ultimately improving the prognosis of the disease. Keywords: Glioma, Aminolevulinic acid, Ependymoma, Fluorecense, Prognosis. (source: MeSH NLM)","PeriodicalId":138765,"journal":{"name":"Peruvian Journal of Neurosurgery","volume":"28 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":"133641967","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}

{"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}