Neurocirugia最新文献

{"title":"Posición semisentada en cirugía del ángulo pontocerebeloso: análisis de sus complicaciones y cómo evitarlas","authors":"Pelayo Hevia Rodríguez ,&nbsp;Alejandro Elúa Pinín ,&nbsp;Amaia Larrea Aseguinolaza ,&nbsp;Nicolás Samprón ,&nbsp;Mikel Armendariz Guezala ,&nbsp;Enrique Úrculo Bareño","doi":"10.1016/j.neucir.2023.05.003","DOIUrl":"10.1016/j.neucir.2023.05.003","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the primary complications related to semisitting position in patients undergoing cerebelo-pontine angle surgery.</p></div><div><h3>Methods</h3><p>Retrospective data analysis from patients undergoing elective tumoral cerebelo-pontine angle surgery in a semisitting position. The incidence, severity, occurrence moment, treatment, duration, and outcomes of venous air embolism (VAE), pneumocephalus, postural hypotension, and other complications were recorded. Neurointensive care unit (NICU), length of stay (LOS), hospital LOS, and modified Rankin scale scores were calculated six months after surgery.</p></div><div><h3>Results</h3><p>Fifty patients were operated on. Eleven (22%) presented VAE (mean duration 8 ± 4.5 min): five (10%) during tumor resection, and four (8%) during dural opening. Ten (20%) were resolved by covering the surgical bed, air bubbles aspiration, jugular compression, and one (2%) tilted to a steep Trendelenburg position. One (2%) had intraoperative hemodynamic instability. The only variable associated with VAE was meningioma at histopathology OR = 4.58, <em>P</em> = 0.001. NICU was higher in patients with VAE (5.5 ± 1.06 vs. 1.9 ± 0.20 days, <em>P</em> = 0.01). There were no differences in the Rankin scale. All patients presented postoperative pneumocephalus with a good level of consciousness, except one (2%) who required evacuation. Seven patients (14%) showed postural hypotension, three (6%) after positioning, and one (2%) after developing a VAE; all were reversed with usual vasoactive drugs. No other position-related complications or mortality were registered in this series.</p></div><div><h3>Conclusions</h3><p>The semisitting position is a safe option with the knowledge, prevention, detection, and early solution of all the possible complications. The development of VAE rarely implies hemodynamic instability or greater disability after surgery. Postoperative pneumocephalus is very common and rarely requires evacuation. Excellent cooperation between anesthesia, nursing, neurophysiology, and neurosurgery teams is essential to manage complications.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 18-29"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129705896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of scales for aneurysmal subarachnoid hemorrhage: Report of a reference center in Peru","authors":"Giuseppe Rojas-Panta ,&nbsp;Gian F. Reyes-Narro ,&nbsp;Carlos Toro-Huamanchumo ,&nbsp;Joham Choque-Velasquez ,&nbsp;Giancarlo Saal-Zapata","doi":"10.1016/j.neucir.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.neucir.2023.05.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Multiple scales have been designed to stratify the severity and predict the prognosis in the initial evaluation of patients with aneurysmal subarachnoid hemorrhage (aSAH). Our study aimed to validate the most commonly used prognostic scales for aSAH in our population: Hunt-Hess, modified Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage (PAASH), and Barrow Aneurysm Institute (BAI) scales.</p></div><div><h3>Methods</h3><p>This study includes all aSAH cases treated at our institution between June 2019 and December 2020. We developed a retrospective cohort by reviewing medical records<span> and radiologic images performed during hospitalization. The outcome was evaluated using the modified Rankin scale (mRS). It was defined as a poor outcome (mRS 4–5) and mortality (mRS 6). The ROC curves and the area under the curve (AUC) of each of the prognostic scales were calculated to evaluate their prognostic prediction capacity.</span></p></div><div><h3>Results</h3><p>A total of 142 patients were diagnosed with aSAH. A poor outcome occurred in 52.1% of the patients, whereas mortality was 27.5%. The AUC of the scales studied was similar and no significant difference was found between them for predicting a poor outcome (<em>P</em> = .709) or mortality (<em>P</em> = .715).</p></div><div><h3>Conclusion</h3><p>We determined that the prognostic scales for aSAH had a similar predictive value for poor clinical outcomes and mortality in our institution, with no significant difference. Thus, we recommend the most simple and well-known scale used institutionally.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 1-5"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C1–C2 intraarticular distraction with anterior cervical cages for basilar invagination realignment: Operative technique nuances and review of literature","authors":"Angel G. Chinea,&nbsp;Elliot Pressman,&nbsp;Paul R. Krafft,&nbsp;Puya Alikhani","doi":"10.1016/j.neucir.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.neucir.2023.03.001","url":null,"abstract":"<div><p><span>Neurosurgical management of basilar invagination<span> (BI) has traditionally been aimed at direct cervicomedullary decompression through transoral dens resection or suboccipital decompression with supplemental instrumented fixation. Dr. Goel introduced chronic atlantoaxial dislocation (AAD) as the etiology in most cases of BI and described a technique for distracting the C1–C2 joint with interfacet spacers to achieve reduction and anatomic realignment. We present our modification to Goel’s surgical technique, in which we utilize anterior </span></span>cervical discectomy<span> (ACD) cages as C1–C2 interfacet implants. A young adult male presented to our institution with BI, cervicomedullary compression, occipitalization of C1, and Chiari 1 malformation<span>. There was AAD of C1 over the C2 lateral masses. This reduced some with preoperative traction. He underwent successful C1–C2 interfacet joint reduction and arthrodesis<span> with anterior cervical discectomy (ACD) cages and concomittant occiput to C2 instrumented fusion. BI can be effectively treated through reduction of AAD and by utilizing ACD cages as interfacet spacers.</span></span></span></p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 51-56"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La mujer en neurocirugía en el Perú: situación y representación en la actualidad","authors":"Martha I. Vilca-Salas ,&nbsp;Adriam M. Castilla-Encinas ,&nbsp;Marycielo Victoria Mamani-Leiva ,&nbsp;Thalia Samira Pinazo-Rios","doi":"10.1016/j.neucir.2023.07.005","DOIUrl":"10.1016/j.neucir.2023.07.005","url":null,"abstract":"<div><p>The participation of women in neurosurgery in Peru began in 1974 with the first Peruvian female neurosurgeon, who was accepted into a residency program with the condition of not getting married during her training. Nowadays, the conditions are more just, and there is greater equality of opportunities between men and women, but the numbers show that the differences have not yet been fully equalized. As evidence of this, it has been observed that only 17% of the residency positions offered in 2022 were filled by women, and there has been reduced participation of female neurosurgeons in the Peruvian Society of Neurosurgery. This article discusses the importance of tracking and promoting stories of Peruvian female neurosurgeons and calls for research in the area of women in neurosurgery in Latin countries, like Peru.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 41-44"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135349185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisión sistemática de las aplicaciones y límites de la impresión 3D en la cirugía de raquis","authors":"José Vicente Martínez Quiñones ,&nbsp;Javier Orduna Martínez ,&nbsp;David Pinilla Arias ,&nbsp;Manuel Bernal Lecina ,&nbsp;Fabián Consolini Rossi ,&nbsp;Ricardo Arregui Calvo","doi":"10.1016/j.neucir.2023.06.001","DOIUrl":"10.1016/j.neucir.2023.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>The main objective of this study has been to demonstrate why additive printing allows to make complex surgical pathological processes that affect the spine more visible and understandable, increasing precision, safety and reliability of the surgical procedure.</p></div><div><h3>Methods</h3><p>A systematic review of the articles published in the last 10 years on 3D printing-assisted spinal surgery was carried out, in accordance with PRISMA 2020 declaration. Keywords «3D printing» and «spine surgery» were searched in <em>Pubmed, Embase, Cochrane Database of Systematic Reviews, Google Scholar</em> and <em>Opengrey</em> databases, which was completed with a manual search through the list of bibliographic references of the articles that were selected following the defined inclusion and exclusion criteria.</p></div><div><h3>Results</h3><p>From the analysis of the 38 selected studies, it results that 3D printing is useful in surgical planning, medical teaching, doctor–patient relationship, design of navigation templates and spinal implants, and research, optimizing the surgical process by focusing on the patient, offering magnificent support during the surgical procedure.</p></div><div><h3>Conclusions</h3><p>The use of three-dimensional printing biomodels allows: making complex surgical pathological processes that affect the spine more visible and understandable; increase the accuracy, precision and safety of the surgical procedure, and open up the possibility of implementing personalized treatments, mainly in tumor surgery.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 30-40"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131287654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entrenamiento microneuroquirúrgico en el espécimen anatómico. Propuesta de un plan estructurado de disección endoscópica y microquirúrgica basicraneal durante la residencia","authors":"Mario Gomar-Alba ,&nbsp;Pablo González-López ,&nbsp;Javier Abarca-Olivas ,&nbsp;Carlos Martorell-Llobregat ,&nbsp;Cristina Gómez-Revuelta ,&nbsp;José Masegosa-González","doi":"10.1016/j.neucir.2023.05.002","DOIUrl":"10.1016/j.neucir.2023.05.002","url":null,"abstract":"<div><h3>Background and objective</h3><p>The development of a high level of competence and technical proficiency is one of the main objectives of any neurosurgical training program. Due to many factors, this progressive skill development can be complex during the residency. Despite its high cost and infrastructure requirements, there is renewed interest regarding the role of anatomy labs. The study and dissection of the human cadaver has been the environment where many surgeons have developed the necessary skills for microneurosurgery. We propose a structured endoscopic and microsurgical training dissection program to enable residents to maximize the benefits of their training in the lab.</p></div><div><h3>Material and methods</h3><p>During the months of September, October and November 2021, a stay was done at the Microneurosurgery and Skull Base Laboratory of the Miguel Hernández University of Alicante. A total of 2 specimens were used. The first specimen underwent a first endoscopic endonasal dissection phase. After completing the endonasal part, a set of incisions were made to perform the transcranial part. In the second specimen, the transcranial part was performed first, leaving the endonasal endoscopic work for the last phase.</p></div><div><h3>Results</h3><p>The results of the dissection program are presented. During the endonasal endoscopic phase, the transsphenoidal approach to the sella was simulated while focusing on the extended approaches in the sagittal plane. During the transcranial phase, right and left anterolateral approaches, a left anterior transcallosal interhemispheric approach, a left transcondylar posterolateral approach and a combined right lateral approach were performed.</p></div><div><h3>Conclusions</h3><p>The structured dissection of the specimen allowed both endonasal endoscopic and transcranial microsurgical training in the same specimen. This design facilitated the realization of the core skull base approaches in the same specimen. According to our initial experience, we believe that developing common dissection programs is a powerful tool to maximize the results of our residents’ laboratory training.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 1","pages":"Pages 6-17"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134473005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculoperitoneal shunt migration into the pulmonary artery: Case report and literature review","authors":"Marta González-Pombo,&nbsp;Juan Alberto Torri,&nbsp;Magdalena Olivares Blanco","doi":"10.1016/j.neucir.2022.08.002","DOIUrl":"https://doi.org/10.1016/j.neucir.2022.08.002","url":null,"abstract":"<div><p>Cerebrospinal fluid (CSF) shunt placement is a commonly performed procedure for patients with hydrocephalus of various etiologies.</p><p><span><span>We present the case of a 68-year-old male patient treated with a ventriculoperitoneal shunt for obstructive hydrocephalus management. Eight years later, a computed tomography (CT) scan detected migration of distal catheter into the </span>pulmonary artery. We conducted a </span>systematic review in Medline database using PubMed search engine to identify previous cases and their management. Our literature review identified eighteen single case reports describing this complication and different strategies to attempt catheter retrieval. To the best authors’ knowledge, this is the first case where conservative management was chosen.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"34 6","pages":"Pages 321-325"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consenso sobre el tratamiento neuroquirúrgico de las metástasis intracraneales elaborado por el Grupo de Trabajo de Neurooncología (GTNO) de la Sociedad Española de Neurocirugía","authors":"Sonia Tejada Solís ,&nbsp;Irene Iglesias Lozano ,&nbsp;Leonor Meana Carballo ,&nbsp;Manuela Mollejo Villanueva ,&nbsp;Ricardo Díez Valle ,&nbsp;Josep González Sánchez ,&nbsp;Alejandro Fernández Coello ,&nbsp;Rajab Al Ghanem ,&nbsp;Sara García Duque ,&nbsp;Gonzalo Olivares Granados ,&nbsp;Gerard Plans Ahicart ,&nbsp;Cristina Hostalot Panisello ,&nbsp;Juan Carlos García Romero ,&nbsp;José Luis Narros Giménez ,&nbsp;Grupo de trabajo de la SENEC","doi":"10.1016/j.neucir.2023.07.003","DOIUrl":"https://doi.org/10.1016/j.neucir.2023.07.003","url":null,"abstract":"<div><p>Brain metastases are tumors that arise from a tumor cell originated in another organ reaching the brain through the blood. In the brain this tumor cell is capable of growing and invading neighboring tissues, such as the meninges and bone.</p><p>In most patients a known tumor is present when the brain lesion is diagnosed, although it is possible that the first diagnose is the brain tumor before there is evidence of cancer elsewhere in the body.</p><p>For this reason, the neurosurgeon must know the management that has shown the greatest benefit for brain metastasis patients, so treatments can be streamlined and optimized.</p><p>Specifically, in this document, the following topics will be developed: selection of the cancer patient candidate for surgical resection and the role of the neurosurgeon in the multidisciplinary team, the importance of immunohistological and molecular diagnosis, surgical techniques, radiotherapy techniques, treatment updates of chemotherapy and immunotherapy and management algorithms in brain metastases.</p><p>With this consensus manuscript, the tumor group of the Spanish Society of Neurosurgery (GT-SENEC) exposes the most relevant neurosurgical issues and the fundamental aspects to harmonize multidisciplinary treatment, especially with the medical specialties that are treating or will treat these patients.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"34 6","pages":"Pages 308-320"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 20% mannitol and 3% hypertonic saline for intraoperative brain relaxation during supratentorial brain tumour craniotomy in patients with a midline shift","authors":"Joaquín Hernández-Palazón ,&nbsp;Paloma Doménech-Asensi ,&nbsp;Diego Fuentes-García ,&nbsp;Sebastián Burguillos-López ,&nbsp;Claudio Piqueras-Pérez ,&nbsp;Carlos García-Palenciano","doi":"10.1016/j.neucir.2022.10.002","DOIUrl":"https://doi.org/10.1016/j.neucir.2022.10.002","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>A prospective, randomized, double-blind study was designed to assess differences in brain relaxation between 20% mannitol and 3% hypertonic saline (HS) during elective supratentorial brain tumour surgery in patients with midline shift.</p></div><div><h3>Material and methods</h3><p>Sixty patients undergoing supratentorial craniotomy for tumour resection were enrolled to receive either 5<!--> <!-->mL/kg of 20% mannitol (<em>n</em> <!-->=<!--> <!-->30) or 3% HS (<em>n</em> <!-->=<!--> <!-->30) administered at skin incision. <em>P</em>_CO2 in arterial blood was maintained within 35–40<!--> <!-->mmHg and arterial blood pressure was controlled within baseline values ±20%. The primary outcome was the proportion of satisfactory brain relaxation. The surgeon assessed brain relaxation on a four-point scale (1<!--> <!-->=<!--> <!-->excellent with no swelling, 2<!--> <!-->=<!--> <!-->minimal swelling, 3<!--> <!-->=<!--> <!-->serious swelling not requiring treatment, 4<!--> <!-->=<!--> <!-->severe swelling requiring treatment). Postsurgical intracranial changes determined by imaging techniques, postoperative complications, PACU and hospital stay, and mortality at 30 days were also recorded. Appropriate statistical tests were used for comparison; <em>P</em> <!-->&lt;<!--> <!-->0.05 was considered as significant. This trial was registered in Eudract.ema.europa.eu (#2021-006290-40).</p></div><div><h3>Results</h3><p>There was no difference in brain relaxation: 2.00 [1.00–2.00] and 2.00 [1.75–3.00] for patients in mannitol and HS groups, respectively (<em>P</em> <!-->=<!--> <!-->0.804). Tumour size (OR: 0.99, 95% CI: 0.99–1.01; <em>P</em> <!-->=<!--> <!-->0.371), peritumoral oedema classification (OR: 0.57, 95% CI: 0.11–2.84; <em>P</em> <!-->=<!--> <!-->0.493), mass effect (OR: 0.86, 95% CI: 0.16–4.87; <em>P</em> <!-->=<!--> <!-->0.864), anaesthesia (OR: 4.88, 95% CI: 0.82–28.96; <em>P</em> <!-->=<!--> <!-->0.081) and midline shift (OR: 5.00, 95% CI: 0.84–29.70; <em>P</em> <!-->=<!--> <!-->0.077) did not have a significant influence on brain swelling in patients treated with either mannitol or HS. No significant differences in perioperative outcomes, mortality and length of PACU and hospital stay were observed.</p></div><div><h3>Conclusions</h3><p>5<!--> <!-->mL/kg of 20% mannitol or 3% HS result in similar brain relaxation scores in patients undergoing craniotomy for supratentorial brain tumour with midline shift.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"34 6","pages":"Pages 273-282"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resumen ejecutivo del documento de consenso de expertos de la Sociedad Española de Neurocirugía y de la Sociedad Española de Endocrinología y Nutrición sobre: recomendaciones clínicas en el manejo perioperatorio de los tumores hipofisarios","authors":"Marta Araujo-Castro ,&nbsp;Víctor Rodríguez-Berrocal ,&nbsp;Elena Dios ,&nbsp;Ramon Serramito ,&nbsp;Betina Biagetti ,&nbsp;Ignacio Bernabeu","doi":"10.1016/j.neucir.2023.07.002","DOIUrl":"https://doi.org/10.1016/j.neucir.2023.07.002","url":null,"abstract":"<div><p>Pituitary tumors (PT) account for 15% of intracranial tumors affect 10.7 to 14.4% of the population although the incidence of clinically relevant PT is 5.1 cases/100,000 inhabitants. Surgical treatment is indicated in PTs with hormone hypersecretion (except for prolactin-producing PTs) and those with local compressive or global neurological symptoms. Multidisciplinary care, is essential for patients with PTs, preferably delivered in a center of excellence and based on a well-defined care protocol. In order to facilitate and standardize the clinical procedures for this type of tumor, this document gathers the positioning of the Neuroendocrinology Knowledge Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Society of Neurosurgery (SENEC) on the management of patients with PTs and their preoperative, surgical and postoperative follow-up.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"34 6","pages":"Pages 292-307"},"PeriodicalIF":0.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}