Empleo de la biopsia estereotáxica en pacientes con procesos expansivos intracraneales
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Díaz Cascajo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Hernández Vicente" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Morales Ramos" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Maillo Sánchez" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Gómez-Moreta" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Díaz Cascajo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicios de Neurocirugía. Hospital Virgen de la Vega" ] ] ] 1 => array:3 [ "autoresLista" => "A. Santos Briz" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Santos Briz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicios de Anatomía Patológica. Hospital Virgen de la Vega" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec160284" "palabras" => array:4 [ 0 => "Biopsia cerebral" 1 => "Neoplasia cerebral" 2 => "Manejo de los gliomas" 3 => "Cirugía estereotáxica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec160285" "palabras" => array:4 [ 0 => "Brain biopsy" 1 => "Brain neoplasm" 2 => "Glioma management" 3 => "Stereotactic surgery" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pese a los avances de la neurorradiología, el manejo preciso de ciertos enfermos con procesos expansivos intracraneales depende con frecuencia del conocimiento de su diagnóstico histológico. En el presente trabajo, se analiza el empleo de las técnicas estereotáxicas en el diagnóstico y tratamiento de 174 pacientes con este tipo de patología.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El criterio de selección fue valorado mediante los datos de la historia clínica, exploración neurológica, estudios neurorradiológicos y, en el caso de los candidatos a cirugía, se consideró su riesgo vital y funcional. En todos los pacientes fue realizada una biopsia estereotáxica. En el 85,06% de los enfermos fue suficiente un blanco, obteniéndose un diagnóstico histológico positivo en el 92,53% de los casos. En 44, la técnica estereotáxica sirvió no sólo para obtener un diagnóstico citológico, sino también para vaciar una cavidad quística (tumoral o abscesificada) o realizar tratamientos braquiterápicos. La evolución postbiópsica de los pacientes fue excelente en 32 (18,39%) y sin cambios en 136 (78,16%) de los casos. Uno de los pacientes murió, lo que corresponde a una mortalidad del 0,57%. La morbilidad transitoria fue del 2,87% (5 casos). No hemos tenido morbilidad permanente.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Para determinar la eficacia de la metodología estereotáxica, se evaluó la relación entre nuestros diagnósticos de presunción y los resultados histológicos comprobados en 149 casos. Sólo el 58,39% fue diagnosticado correctamente antes de la biopsia. En otro 12,75% hubo diferencias en cuanto al grado de anaplasia tumoral y en el 28,86% restante los diagnósticos fueron incorrectos.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La angiografía nos ha sido muy útil para localizar el blanco y para evitar la hemorragia intraoperatoria. La monitorización de la impedancia tisular ha facilitado una información importante sobre el trayecto y situación de la aguja, de acuerdo con la residencia tisular encontrada y los cortes del TAC.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia, las técnicas estereotáxicas representan un camino racional para obtener diagnósticos más precisos y una alternativa para evitar el manejo a ciegas de una parte importante de la patología intracraneal.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The management of certain intracranial processes still depends upon a histological diagnosis despite advances in neuroradiology. We analyzed the usefulness of the stereotactic technique in the diagnosis and treatment of 174 patients harbouring intracranial processes. The selection criteria was evaluated by history, neurological examination, neuroradiological studies, and in the case of surgical candidates, by their vital and functional risks. In all our patients a stereotactic biopsy was performed. One target was enough in 85,06%, and a positive histological diagnosis was obtained in 92,53%. In 44 out of our 174 cases the stereotactic system was used not only to obtain a cytological diagnosis but also to deflate a cyst cavity (tumoral or abscess) or to insert or remove a radioactive isotope. The patient's postbiopsy course was excellent in 32 (18,39%) and unchanged in 136 (78,16%). One patient died, which corresponds to a mortality rate of 0,57%. The transitory morbidity was 2,87% (5 cases). No permanent morbidity was noted.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To determine the efficiency of our stereotactic methodology we evaluated the relationship between our presumptive diagnosis from the clínical and neuroradiological studies and the final histological results. The presumptive diagnosis was confirmed in 58,39%, in 12,75% the differences were in the degree of tumor anaplasia and in 28,86% our diagnosis was incorrect. Angiography was considered very useful in localizing the target and in avoiding intraoperative haemorrhage. Impedance monitoring gave us important information regarding the trajectory and depth of the target according to the tissue resistance encountered.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">From our experience, we think that stereotactic techniques represent an alternative to blind management of an important part of intracranial pathology, and a rational way to obtain a more accurate diagnosis.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Hernández Vicente J.; Morales Ramos F.; Santos Briz A.; Maillo Sánchez A.; Gómez-Moreta J. A.; Díaz Cascajo P.: Empleo de la biopsia estereotáxica en pacientes con procesos expansivos intracraneales. Neurocirugía, 1991; 2: 87–94.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 4 | 1 | 5 |
| 2018 February | 12 | 5 | 17 |
| 2018 January | 12 | 6 | 18 |
| 2017 December | 12 | 13 | 25 |
| 2017 November | 47 | 12 | 59 |
| 2017 October | 9 | 8 | 17 |
| 2017 September | 12 | 7 | 19 |
| 2017 August | 14 | 6 | 20 |
| 2017 July | 6 | 5 | 11 |
| 2017 June | 18 | 17 | 35 |
| 2017 May | 15 | 7 | 22 |
| 2017 April | 6 | 5 | 11 |
| 2017 March | 7 | 10 | 17 |
| 2017 February | 4 | 0 | 4 |
| 2017 January | 4 | 6 | 10 |
| 2016 December | 20 | 15 | 35 |
| 2016 November | 14 | 6 | 20 |
| 2016 October | 28 | 13 | 41 |
| 2016 September | 25 | 6 | 31 |
| 2016 August | 30 | 9 | 39 |
| 2016 July | 23 | 13 | 36 |
| 2015 December | 2 | 0 | 2 |
| 2015 July | 3 | 0 | 3 |
| 2015 June | 13 | 7 | 20 |
| 2015 May | 21 | 18 | 39 |
| 2015 April | 17 | 21 | 38 |
| 2015 March | 14 | 35 | 49 |
| 2015 February | 13 | 21 | 34 |
| 2015 January | 23 | 15 | 38 |
| 2014 December | 16 | 17 | 33 |
| 2014 November | 13 | 14 | 27 |
| 2014 October | 18 | 24 | 42 |
| 2014 September | 13 | 20 | 33 |
| 2014 August | 14 | 14 | 28 |
| 2014 July | 12 | 14 | 26 |
| 2014 June | 17 | 32 | 49 |
| 2014 May | 18 | 24 | 42 |
| 2014 April | 11 | 19 | 30 |
| 2014 March | 9 | 23 | 32 |
| 2014 February | 16 | 24 | 40 |
| 2014 January | 9 | 20 | 29 |
| 2013 December | 13 | 24 | 37 |
| 2013 November | 12 | 16 | 28 |
| 2013 October | 20 | 23 | 43 |
| 2013 September | 13 | 19 | 32 |
| 2013 August | 19 | 28 | 47 |
| 2013 July | 13 | 37 | 50 |
| 2013 June | 17 | 25 | 42 |
| 2013 May | 8 | 17 | 25 |
| 2013 April | 11 | 15 | 26 |
| 2013 March | 11 | 17 | 28 |
| 2013 February | 9 | 13 | 22 |
| 2013 January | 15 | 7 | 22 |
| 2012 December | 7 | 15 | 22 |
| 2012 November | 1 | 8 | 9 |
| 2012 October | 0 | 1 | 1 |
| 2012 September | 0 | 2 | 2 |
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