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array:22 [ "pii" => "S1130147399707979" "issn" => "11301473" "doi" => "10.1016/S1130-1473(99)70797-9" "estado" => "S300" "fechaPublicacion" => "1999-01-01" "aid" => "70797" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "1999" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1999;10:185-209" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4715 "formatos" => array:3 [ "EPUB" => 15 "HTML" => 1485 "PDF" => 3215 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147399707980" "issn" => "11301473" "doi" => "10.1016/S1130-1473(99)70798-0" "estado" => "S300" "fechaPublicacion" => "1999-01-01" "aid" => "70798" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 1999;10:210-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3107 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 1204 "PDF" => 1886 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Abordaje infratemporal preauricular a los tumores de la base del cráneo: Nuestra experiencia clínica" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "210" "paginaFinal" => "218" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infratemporal preauricular approach to skull base tumors" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Romance, G. Sánchez Aniceto, R. Gutiérrez, R.D. Lobato, R. Alday, A. De La Lama, R. de la Mata" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Romance" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Sánchez Aniceto" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Gutiérrez" ] 3 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Alday" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "De La Lama" ] 6 => array:2 [ "nombre" => "R." "apellidos" => "de la Mata" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707980?idApp=UINPBA00004B" "url" => "/11301473/0000001000000003/v1_201305151012/S1130147399707980/v1_201305151012/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Avances en el tratamiento de los traumatismos craneoencefálicos graves" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "185" "paginaFinal" => "209" ] ] "autores" => array:2 [ 0 => array:3 [ "autoresLista" => "J. Sahuquillo, M.A. Poca, E. Rubio" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Sahuquillo" ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Poca" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Rubio" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía, Hospitales Universitarios Vall d’Hebron. Barcelona" ] ] ] 1 => array:3 [ "autoresLista" => "F. Munar" "autores" => array:1 [ 0 => array:3 [ "nombre" => "F." "apellidos" => "Munar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Neurotraumatología, Hospitales Universitarios Vall d’Hebron. Barcelona" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Advances in the management of severe head injury" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec156683" "palabras" => array:6 [ 0 => "Traumatismos craneoencefálicos" 1 => "Revisión" 2 => "Estrategias terapéuticas" 3 => "Corticosteroides" 4 => "Hiperventilación" 5 => "Medicina basada en la evidencia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156684" "palabras" => array:6 [ 0 => "Head injury" 1 => "Review" 2 => "Management strategies" 3 => "Steroids" 4 => "Hyperventilation" 5 => "Evidence-based medicine" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los fundamentos teóricos para el tratamiento de los pacientes con un traumatismo craneoencefálico (TCE) grave se derivan del concepto de lesión secundaria. En este trabajo actualizamos las pautas de tratamiento seguidas en el traumatismo craneoencefálico y de aquel subgrupo de pacientes que presentan hipertensión intracraneaI. Introducimos el nuevo paradigma denominado medicina basada en la evidencia haciendo énfasis en sus implicaciones presentes y futuras en el tratamiento de los traumatismos craneoencefálicoso Presentamos una revisión de las recomendaciones sugeridas por las Guías de práctica clínica recientemente publicadas bajo los auspicios de la Brain Trauma Foundation. En este artículo revisamos también los grupos específicos de drogas utilizados en el tratamiento de estos pacientes y que incluyen entre otras: Sedantes y analgésicos, bloqueantes musculares, barbitúricos, corticosteroides y soluciones hiperosmolares. Planteamos las controversias existentes en el uso de algunos tratamientos tales como el aumento de la presión de perfusión cerebral mediante drogas vasoactivas, la hiperventilación o el uso de drogas tales como la dihidroergotamina y la indometacina. También presentamos una revisión histórica y las controversias existentes sobre el uso de corticosteroides y se discuten los fundamentos y la potencial utilidad de ciertas drogas dirigidas a bloquear las cascadas neuroquímicas anómalas que se han demostrado en estos pacientes. Presentamos y discutimos también las bases teóricas sobre la utilización de los 21-aminoesteroides (Lazaroides), los antagonistas del calcio, algunos fármacos potenciales protectores de membrana y los inhibidores del glutamato en el tratamiento de estos pacientes.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The theoretical basis for treatment of severe head injury derives from the concept of secondary damage to the brain. This paper provides an overview of the current therapeutic approaches used in treating severe head injury and in particular those patients who develop high intracranial pressure. Special emphasis is given to the new paradigm of so-called evidence-based medicine and its influence on the present and future management of severe head injuries. A review of the recommendations suggested by the <span class="elsevierStyleItalic">Guidelines for the Treatment of Severe Head Injury</span>, recently published by the Brain Trauma Foundation are presented. Specific types of drugs covered in this review include sedatives, analgesics, paralytic agents, barbiturates, steroids and hyperosmolar solutions. The controversies surrounding certain treatments such as the increase of cerebral perfusion pressure with vasoactive drugs, hyperventilation, indomethacine or dihydroergotamine are outlined. We also review the historical background and the controversies over the use of steroids in these patients. The recentiy developed drugs capable of blocking the damaging neurochemical cascades identified in severe head injury are discussed. Finally, the rationale for using 21-aminosteroids (Lazaroids), calcium-antagonists, potential membrane-protectors and the different types of glutamate receptors is also presented.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Sahuquillo, J.; Poca, M.A.; Munar, F.; Rubio, E.: Avances en el tratamiento de los traumatismos craneoencefálicos graves. Neurocirugía 1999; 10: 185–209.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:184 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emergency drug therapy of closed head injury" "autores" => array:1 [ 0 => array:2 [ …2] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "CNS Drugs" "fecha" => "1995" "volumen" => "3" "paginaInicial" => "337" "paginaFinal" => "350" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Molecular biology of the cell" "autores" => array:1 [ 0 => array:2 [ …2] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1989" "editorial" => "Garlan Publishing, lnc" "editorialLocalizacion" => "New York & London" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subtemporal decompression: radiological observations and current surgical experience" "autores" => array:1 [ 0 => array:2 [ …2] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Brit. 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