Tumores y otros procesos de la parte anterior del III ventrículo
Tumors and other space occupying lesions oí the anterior part of the third ventricle
P. Albert Lasierra
Hospital Universitario “Virgen del Rocío”. Instituto de Especialidades Neuroquirúrgicas. Sevilla
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"apellidos" => "Ramos" ] 6 => array:2 [ "nombre" => "P." "apellidos" => "González" ] 7 => array:2 [ "nombre" => "B." "apellidos" => "Rivero" ] 8 => array:2 [ "nombre" => "C." "apellidos" => "Rodríguez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399709851?idApp=UINPBA00004B" "url" => "/11301473/0000001000000001/v1_201305151005/S1130147399709851/v1_201305151005/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Tumores y otros procesos de la parte anterior del III ventrículo" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "27" "paginaFinal" => "41" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. Albert Lasierra" "autores" => array:1 [ 0 => array:3 [ "nombre" => "P." "apellidos" => "Albert Lasierra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Hospital Universitario “Virgen del Rocío”. Instituto de Especialidades Neuroquirúrgicas. Sevilla" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Antiguo Jefe del Departamento de Neurocirugía." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Tumors and other space occupying lesions oí the anterior part of the third ventricle" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras Clave" "identificador" => "xpalclavsec156597" "palabras" => array:3 [ 0 => "Tumores intracraneales" 1 => "Tercer ventrículo" 2 => "Tratamiento quirúrgico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec156598" "palabras" => array:3 [ 0 => "Intracranial tumor" 1 => "Third ventricle" 2 => "Surgical treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El presente estudio se basa en la experiencia neuroquirúrgica del autor en el tratamiento de 55 pacientes afectos de tumores y otros procesos de la parte anterior del III ventrículo, operados casi todos en el período 1977–86 y con un seguimiento mínimo de 6 años en su evolución. Sin excepción fueron operados por vía transcallosa transforaminal frontal que permitió en todos los casos una adecuada exposición de la lesión haciendo posible su exéresis radical; una vez más hemos comprobado la ausencia de secuelas neuropsicológicas o de otro tipo atribuibles a esta vía de abordaje. Hemos considerado innecesario el empleo de las otras vías por ser técnicamente más complejas, susceptibles de producir secuelas y por no estar avaladas, en nuestro conocimiento por casuísticas clínicas amplias.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Nuestro aporte fundamental al estudio de esta patología es demostrar que el techo de la parte anterior del III ventrículo es una región con características embriológicas, anatómicas e histopatológicas propias que a pesar de ser una zona tan limitada es asiento de procesos expansivos muy variados de origen disembriogénico o glial pero con tamaño y forma similares, mayoritariamente benignos independientemente de su naturaleza.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">También se puede explicar que clínicamente se manifiestan casi siempre por un síndrome de HIC y no por alteraciones endocrinas o neurovegetativas en relación con las funciones vitales de la región; se originan en el fórnix, tienen un área de implantación limitada no infiltrante, con un crecimiento sesil intraventricular. Todo ello unido a su benignidad histológica condiciona su operabilidad con baja mortalidad y alto porcentaje de curaciones. Estas consideraciones son aplicables a todos los tumores y procesos menos a los craneofaringiomas; cuando ocupan la parte anterior del III ventrículo deben considerarse en principio como tumores paraventriculares originados en la región selar o supraselar; los raros casos de localización primariamente intraventricular no se implantan como los otros procesos, en la región del fórnix sino en el suelo e infundíbulo comportando una elevada mortalidad postoperatoria (40% en nuestra serie) frente al 8,8% del resto de los procesos de la región.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The present clinical study is based on the author's neurosurgical experience after the treatment of 55 patients with tumors and other lesions of the anterior part of the III ventricle. Most of them were surgically treated between 1977–1986 and were followed for at least six years after operative treatment. All of them were operated through a frontal transcallosal-transforaminal approach. This approach enables an appropriate visualization of the lesions and their radical removal. Once more we have proved the absence of neuropsychological deficits, or any other type of neurological impairment related to this surgical approach. We have considered unnecessary any other operative approaches because of their technical complexity and the fact that they are more liable to cause neurological damages.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our main contribution to the study of this pathology is to prove that the roof of the anterior part of the III ventricle is an area with individual characteristics (anatomical, embriological, pathological) which despite of being limited in extension gives rise to a variety of pathological processes such as glial, vascular or disembriogenic tumors, with similar shapes and sizes, the mayority of which are benign.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">First clinical symptoms caused by lesions in this area are usually related to intracranial hypertension and rarely to endocrinologic abnormalities. They originate in the anterior part of the fornix with a limited zone of implantation which does not go beyond the subependymal glial layer. Their growing is pediculated and intraventricular and is clinically silent until they cause compromise of the foramen of Monro. All the previous characteristics, together with its histological benignity make possible their surgical excision with low mortality and morbility rates and a high percentage of definitive recoveries.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">These considerations should not be applied to the craniopharyngiomas. Most commonly these tumors have their origin aboye the sella and develop upwards lifting the ventricular floor; they have to be considered paraventricular tumors. The much unusual cases with primitive intraventricular origin, do not implant in the fornix but in the floor, which associates with a high operative mortality (40% in our experience) in oposition to an 8,8% mortality registered with the rest of tumors.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Albert Lasierra, P.: Tumores y otros procesos de la parte anterior del III ventrículo. Neurocirugía 1999; 10: 27–41.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The study of Gnosis, Praxis and Language. Following Section of the corpus callosum on anterior comisure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.J. 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