Examinando por Materia "Neurosurgery"

Mostrando 1 - 4 de 4
  • Publicación
    Acceso abierto
    Diseño de una Lista de Chequeo Para el Alistamiento Pre Quirúrgico en Procedimientos de Reparación de Aneurisma Cerebral con el uso del Dispositivo Coils
    (Universidad de Santander, 2023-02-24) Hernandez-Reyes, Janeth Sthephany; Contreras-Jaimes, Maria Paula; Gelves-Rodríguez, María Paula; Acevedo-Supelano, Adriana Lucia; Vargas-Rodriguez, Mónica; Pérez-Rodríguez, Angie Paola
    El presente proyecto cuyo propósito principal es, diseñar una lista de chequeo para ofrecer seguridad en el alistamiento previo de una intervención quirúrgica por aneurisma cerebral con dispositivo Coils, tiene como finalidad llevar el control sobre un protocolo quirúrgico para cirugía endovascular. Es importante saber que un aneurisma cerebral es el ensanchamiento anormal de un vaso sanguíneo ubicado en el cerebro, el cual puede desarrollarse por diferentes problemas de salud como un proceso de infección, debilitamiento en la pared vascular, entre otros. Las aneurismas cerebrales se clasifican en Aneurisma sacular, Aneurisma fusiforme y Aneurisma disecante. Las aneurismas cerebrales tienden a causar una ruptura de un vaso sanguíneo, generando complicaciones como un accidente cerebro vascular hemorrágico. El sangrado es un factor de riesgo de alta gravedad, por ende, se recomienda tratarse de forma endovascular con dispositivos como el coils, el cual fue diseñado y aplicado en 1991 por Guglielmi cuyo tratamiento puede ser utilizado en intervenciones de aneurismas rotos y no rotos. El uso de la técnica con coils le brinda al paciente una cirugía de menor traumatismo y menor manipulación de las estructuras. Es importante realizar una intervención quirúrgica oportuna enfatizando en la etapa de planificación realizada por el profesional en instrumentación quirúrgica previo a la cirugía. Para lograr este objetivo se diseñó un instrumento de medición teniendo como base las características de los protocolos pre quirúrgicos existentes, basándose en 4 preguntas principales las cuales recopilaron información acerca del procedimiento quirúrgico sobre aneurisma cerebral por parte de profesionales expertos en el tema. Posteriormente se diseñó la lista de chequeo con las respuestas del cuestionario, finalmente la lista de chequeo fue creada teniendo en cuenta la similitud de elementos que respondieron los participantes y clasificando estos según corresponde.
  • Publicación
    Acceso abierto
    Evidences in Neurological Surgery and a Cutting Edge Classification of the Trigeminocardiac Reflex : A Systematic Review
    (2018-08) Leon Ariza, Daniel S.; Leon Ariza, Juan S.; Nangiana, Jasvinder; Vargas Grau, Gabriel; Leon Sarmiento, Fidias E.; Quiñones Hinojosa, Alfredo
    The trigeminocardiac reflex (TCR) is characterized by bradycardia, decrease of mean arterial blood pressure, and sometimes, asystole during surgery. We critically reviewed TCR studies and devised a novel classification scheme for assessing the reflex. Methods A comprehensive systematic literature review was performed using PubMed, MEDLINE, Web of Science, EMBASE, and Scielo databases. Eligible studies were extracted based on stringent inclusion and exclusion criteria. Statistical analyses were used to assess cardiovascular variables. TCR was classified according to morphophysiologic aspects involved with reflex elicitation. Results A total of 575 patients were included in this study. TCR was found in 8.9% of patients. The reflex was more often triggered by interventions made within the anterior cranial fossa. The maxillary branch (type II in the new classification) was the most prevalent nerve branch found to trigger the TCR. Heart rate and mean arterial blood pressure were similarly altered (P = 0.06; F = 0.3912809), covaried with age (P = 0.012; F = 9.302), and inversely correlated to each other (r = −0.27). Conclusions TCR is a critical cardiovascular phenomenon that must be quickly identified and efficiently classified and should trigger vigilance. Prompt therapeutic measures during neurosurgical procedures should be carefully addressed to avoid unwanted complications. Accurate categorization using the new classification scheme will help to improve understanding and guide the management of TCR in the perioperative period.
  • Publicación
    Acceso abierto
    Histopathological and immunohistochemical profile in anaplastic gangliogliomas
    (2013-11) Romero Rojas, Alfredo E.; Diaz Perez, Julio A.; Chinchilla Olaya, Sandra I.; Amaro, Deirdre E.; Lozano Castillo, Alfonso; Restrepo Escobar, Ligia I.
    The anaplastic ganglioglioma (AG) is the high-grade counterpart of ganglioglioma, a rare mixed tumor composed of neuronal/ganglion and glial cells. Materials and methods We describe the histopathology and immunohistochemistry in 7 cases of AG and correlate them with the clinical and radiological features. Results Our AG patients correspond to 2.5% of the central nervous system tumor patients evaluated in our institution. The mean age at presentation was 25.7 years, with a male predominance. The most common clinical presentation was generalized tonic–clonic seizures (3/7 cases), in correlation with frequent cortical/subcortical location (6/7 cases). Histopathologically, all our cases showed high-grade features in glial (glial fibrillary acid protein-positive) and neuron-ganglion cells (synaptophysin, PGP-9.5, neurofilament, NSE and CD56-positive), as well as moderate cellularity, frequent mitotic figures and a Ki-67 labeling index >5%. All our patients had poor survival. Conclusion We found that a typical histopathological and immunohistochemical profile is constant and can be useful in early diagnosis of these aggressive neoplasms.
  • Publicación
    Acceso abierto
    Primary gliosarcoma of the brain : Radiologic and histopathologic features
    (2013) Romero Rojas, Alfredo E.; Diaz Perez, Julio A.; Ariza Serrano, Lina María; Amaro, Deirdre E.; Lozano Castillo, Alfonso
    Gliosarcoma is a rare central nervous system (CNS) neoplasm with biphasic glial and non-glial malignant components. Here we describe the radiologic and histopathologic features observed in five cases of primary gliosarcoma. The mean age at diagnosis in the studied patients was 54.2 years; these patients were predominantly males (male: female ratio = 4:1). At diagnosis all patients had several clinical deterioration. The most common symptoms of presentation were: headache (5/5 cases), seizures (4/5 cases) and hemiparesis (1/5 cases). All the tumors were large (mean major diameter= 4.12±1.64 cm) at diagnosis as evidenced in computer tomography (CT) scans and magnetic resonance images (MRIs), with preferential involvement of the temporal lobe and frequent associated deviation of the midline structures. Other common characteristics identified on CT scans and MRIs were partial contrast medium uptake with annular pattern (5/5 cases), peripheral edema (5/5 cases), and central calcification (3/5 cases). In additional a peak of dye uptake was observed (4/5 cases) on MRI spectrometry. In the histopathology, the glial component showed malignant astrocytes, with high Ki67 (>60%) and p53 positivity; the sarcomatous components displayed pleomorphic spindle cells similarly with p53 positivity and high Ki67 (75-90%) in all cases. Dedifferentiation to pleomorphic sarcoma (two cases), fibrosarcoma (one case), leiomyosarcoma (one case) and MPNST (one case) were documented. All patients received radiotherapy/chemotherapy and had a median overall survival of ten months. The study of radiologic and histopathologic features in primary gliosarcomas of the brain is a priority to achieve early diagnosis that can be translated to better outcomes. Here we describe the radiologic and histopathologic features observed in a group of gliosarcoma patients with variable histopathologic dedifferentiation.