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array:22 [ "pii" => "S1130147397707280" "issn" => "11301473" "doi" => "10.1016/S1130-1473(97)70728-0" "estado" => "S300" "fechaPublicacion" => "1997-01-01" "aid" => "70728" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "1997" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1997;8:260-83" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6672 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 1785 "PDF" => 4874 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147397707292" "issn" => "11301473" "doi" => "10.1016/S1130-1473(97)70729-2" "estado" => "S300" "fechaPublicacion" => "1997-01-01" "aid" => "70729" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1997;8:284-93" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1668 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 909 "PDF" => 748 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Enfermedad de Creutzfeldt-Jakob en Neurocirugía: una revisión de riesgos y medidas de prevención" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "284" "paginaFinal" => "293" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Creutzfeldt-Jakob disease in neurosurgery: a review of risks and prevention measures" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "J.E. Martínez-Lage, M. Poza" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J.E." "apellidos" => "Martínez-Lage" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Poza" ] ] ] 1 => array:2 [ "autoresLista" => "P. Brown, L. Cervenáková, A. Ruiz Bremón, J. de Pedro" "autores" => array:4 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Brown" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Cervenáková" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Ruiz Bremón" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "de Pedro" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147397707292?idApp=UINPBA00004B" "url" => "/11301473/0000000800000004/v1_201305151505/S1130147397707292/v1_201305151505/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Actualizaciones en la fisiopatología y monitorización de los traumatismos craneoencefálicos graves" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "260" "paginaFinal" => "283" ] ] "autores" => array:2 [ 0 => array:3 [ "autoresLista" => "J. Sahuquillo, M.A. Poca" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Sahuquillo" ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Poca" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía Unidad de Neurotraumatología. Hospitales Universitarios Vall d’Hebrón. Barcelona" ] ] ] 1 => array:3 [ "autoresLista" => "S. Pedraza, X. Munar" "autores" => array:2 [ 0 => array:3 [ "nombre" => "S." "apellidos" => "Pedraza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "X." "apellidos" => "Munar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Diagnóstico por la Imagen. Hospitales Universitarios Vall d’Hebrón. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Servicio de Anestesiología y Reanimación. Hospitales Universitarios Vall d’Hebrón. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Advances in the management of severe head injury patients" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec163199" "palabras" => array:4 [ 0 => "Traumatismo craneoencefálico" 1 => "Fisiopatología" 2 => "Presión intracraneal" 3 => "Revisión" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abreviaturas" "identificador" => "xpalclavsec163200" "palabras" => array:18 [ 0 => "TCE" 1 => "TCEG" 2 => "TC" 3 => "FSC" 4 => "PIC" 5 => "PPC" 6 => "TAM" 7 => "CMRO<span class="elsevierStyleInf">2</span>" 8 => "RL" 9 => "RLO" 10 => "BHE" 11 => "TCDB" 12 => "PET" 13 => "SPECT" 14 => "AVDO<span class="elsevierStyleInf">2</span>" 15 => "CEO<span class="elsevierStyleInf">2</span>" 16 => "SjO<span class="elsevierStyleInf">2</span>" 17 => "DTC" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec163198" "palabras" => array:4 [ 0 => "Head injury" 1 => "Physiopathology" 2 => "Intracranial pressure" 3 => "Review" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los traumatismos craneoencefálicos (TCE) representan la primera causa de muerte en la población por debajo de los 45 años de edad. En la última década se han producido avances significativos tanto en el conocimiento de los mecanismos básicos de los traumatismos como en su fisiopatología. Aunque una parte considerable de las lesiones se producen de forma inmediata al impacto (lesiones primarias), muchas de ellas aparecen un período variable de tiempo después del traumatismo (lesiones secundarias). La isquemia cerebral, causada por hipertensión intracraneal, por una reducción en la presión de perfusión cerebral o secundaria a insultos sistémicos en la fase prehospitalaria (hipoxia, hipotensión o anemia) es la lesión secundaria de mayor prevalencia en los traumatismos craneoencefálicos graves (TCEG). El hecho de que las lesiones secundarias originan a su vez, importantes cascadas metabólicas, que son la causa más importante de alteraciones celulares y de lesiones estructurales irreversibles, ha sido el avance fisiopatológico más significativo en el conocimiento de los TCE. Este mejor conocimiento de su fisiopatología ha permitido mejorar la monitorización e incrementar de forma significativa la asistencia ofrecida a estos pacientes. En la primera parte de este trabajo, revisamos los conceptos fundamentales en los mecanismos etiopatogénicos implicados en los TCE, en su fisiopatología y en las cascadas metabólicas implicadas. Revisamos también los principios básicos en la monitorización de estos pacientes.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Head injury is the leading cause of death amog people under the age of 45. In the last decade significant advances in the understanding of the basic mechanisms of injury and its physiopathology have been made. Although major damage to the brain is often produced inmediately on impact (primary damage), many lesions appear a variable period of time after injury (secondary lesions). Ischemic damage related to high intracranial pressure, low cerebral perfusion pressure or prehospitalary systemic insults (hypoxia, hypotension or anemia), is the most important secondary lesion found after severe head injury. The fact that secondary lesions induce important metabolic cascades which are the leading cause of cellular disorders and structural damage to the brain after severe head injury, has been the main advance in physiopathological knowledge. A better understanding of the pathophysiology of head injury has allowed a better monitoring and an improvement in the standard of care offered to these patients. In the first part of this work, we review the current concepts in basic mechanisms involved in head injury, the pathophysiology of these lesions and the metabolic cascades involved. The accepted standards of monitoring in the management of these patients are also reviewed.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Sahuquillo, J.; Poca, M.A.; Pedraza, S.; Munar, X.: Actualizaciones en la fisiopatología y monitorización de los traumatismos craneoencefálicos graves. Neurocirugía 1997; 8: 260–283.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:145 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries" "autores" => array:1 [ 0 => array:2 [ …2] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1982.57.6.0769" "Revista" => array:6 [ "tituloSerie" => "J. Neurosurg." 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