Meningiomas of the basal posterior fossa. Surgical experience in 80 cases

array:22 ["pii" => "S113014730470439X" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70439-X" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70439" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2004" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:525-42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3568 "formatos" => array:3 [ "EPUB" => 22 "HTML" => 1278 "PDF" => 2268 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147304704406" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70440-6" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70440" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:543-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4354 "formatos" => array:3 [ "EPUB" => 24 "HTML" => 1455 "PDF" => 2875 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Empiema epidural espinal. Análisis de 14 casos" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "543" "paginaFinal" => "551" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Spinal epidural empyema. Analysis of 14 cases" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Gelabert-González, J. González-García, J.M. Fernández-Villa, A. GarcíaAllut, R. Martínez-Rumbo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Gelabert-González" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "González-García" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández-Villa" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "GarcíaAllut" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Martínez-Rumbo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704406?idApp=UINPBA00004B" "url" => "/11301473/0000001500000006/v1_201305151229/S1130147304704406/v1_201305151229/es/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "Meningiomas of the basal posterior fossa. Surgical experience in 80 cases" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "525" "paginaFinal" => "542" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R.D. Lobato, P. González, R. Alday, A. Ramos, A. Lagares, J.F. Alen, J.C. Palomino, P. Miranda, A. Perez-Nuñez, I. Arrese" "autores" => array:10 [ 0 => array:3 [ "nombre" => "R.D." "apellidos" => "Lobato" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "P." "apellidos" => "González" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Alday" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Ramos" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Lagares" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Alen" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Palomino" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Miranda" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Perez-Nuñez" ] 9 => array:2 [ "nombre" => "I." "apellidos" => "Arrese" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio Neurocirugía, y Sección de Neurorradiología, Hospital 12 de Octubre. Madrid" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital “12 de Octubre”, Avda Córdoba s/n. 28041 Madrid (Spain)" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Meningiomas basales de la fosa posterior. Experiencia quirúrgica con 80 casos" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-04-24" "fechaAceptado" => "2004-05-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158598" "palabras" => array:8 [ 0 => "Meningioma" 1 => "Clivus" 2 => "Petrous bone" 3 => "Posterior fossa" 4 => "Cranial nerves" 5 => "Skull base tumor" 6 => "Microsurgery" 7 => "Radiosurgery" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158597" "palabras" => array:8 [ 0 => "Meningioma" 1 => "Clivus" 2 => "Petroclival" 3 => "Base craneal" 4 => "Cirugía" 5 => "Nervios craneales" 6 => "Radioterapia" 7 => "Radiocirugía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Summary" "resumen" => "IntroductionDespite recent improvements in microsurgical and radiotherapy techniques, treatment of basal posterior fossa meningiomas still carries an elevated risk of morbidity. We present our results in a series of patients with this type of tumor and review the recent literature looking for the results obtained with different approaches and the new tendencies and algorithms proposed for managing these challenging lesions. Material and MethodsWe analyzed retrospectively the clinical presentation and outcome of 80 patients consecutively operated between 1979 and 2003 for basal posterior fossa meningioma (foramen magnum tumors excluded). All patients had preoperative CT scans and the majority MRI studies. A total of 114 operations were performed including two-stage operations, reoperation for recurrence, CSF diversión, and XII-VII anastomosis. The most commonly used approaches were lateral suboccipital retrosigmoid, subtemporal-transtentorial, frontotemporal pterional and supra-infratentorial presigmoid. Thirteen patients received postoperative radiotherapy. ResultsThere were 59 (73.7%) women and 21 men (mean age = 51.5 years; range = 18–78 yrs). Most common presenting symptoms were cranial nerve dys-function, gait disturbances and intracranial hypertension. The mean duration of symptoms was 2.9 years. 70% of the tumors were over 3cm in size. Fifty patients (62.5%) had a complete resection, 22 (27.5%) subtotal resection (> 90% tumor volume removed), and 8 (10%) only partial resection. Postoperative complications included hematoma, CSF leak, and infection. Fifty four (67.5%) patients developed new or increased cranial nerve déficits and 12.5% somatomotor, somatosensory or cerebellar déficits immediately after surgery with subsequent improvement in most cases. Following initial surgery 67 patients made a good recovery, 10 developed variable degrees of disability and 3 died. Eleven patients died later in the course for tumor recurrence with or without reoperation, malignant meningioma or unrelated causes. There were 9 recurrences in the subgroup of patients having complete resection initially (mean follow-up = 8.6 years). The majority of patients having initial subtotal or partial resections have been managed without reoperation during a mean follow-up period of 6.5 years (radiosurgery and/or observation). Discussion and ConclusiónCurrent microsurgical and radiotherapy techniques allow either a cure or an acceptable control of basal posterior fossa meningiomas. In patients with tumor invasión of the cavernous sinus, extracranial extensión, violation of the arachnoidal membranes in front of the brainstem, or encasement and infiltration of major arteries, a subtotal excisión seems preferable followed by observation and/ or radiosurgical treatment. Apart from the patients age and the clinical presentation (symptomatic or not), the size and secondary extensions of the tumor must be taken into account for planning treatment in the individual patient." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónA pesar de la técnica microquirúrgica y la disponibilidad de la radioterapia estereotáxica, el tratamiento de los meningiomas de la base craneal todavía conlleva un riesgo elevado de morbilidad. Se presenta una serie de pacientes con meningiomas básales de la fosa posterior y se revisa la literatura para establecer una comparación de los resultados obtenidos con diferentes tipos de abordaje terapéutico y detectar las nuevas tendencias para el manejo de estos tumores. Material y métodosSe analizaron de modo retrospectivo la presentación y evolución clínica de 80 pacientes operados consecutivamente entre 1979 y 2003 por vía intradural de meningiomas localizados en la base de la fosa posterior (excluidos los del foramen magno). Se practicó TAC craneal en todos los casos y RM en la mayoría. Se realizaron 114 intervenciones, incluyendo operación en dos estadios, reoperación por recurrencia, derivaciones de LCR y anastomosis VII-XII. Los abordajes más empleados fueron el lateral suboccipital retrosigmoideo, subtemporal-transtentorial, frontotemporal pterional y supra-infratentorial presigmoideo retrolaberíntico. 13 pacientes recibieron además tratamiento radioterápico. ResultadosSe trataron 59 mujeres (73.7%) y 21 hombres (edad media = 51.5 años; rango = 18–78). Los síntomas más frecuentes de presentación (duración media de la historia = 2,9 años) fueron alteraciones de los pares craneales, cefaleas y alteraciones de la marcha. 70% de los tumores tenían un diámetro mayor superior a 3cm. La extirpación fue completa en 50 casos (62.5%), subtotal (resección > 90% del volumen tumoral) en 22 (27.5%) y parcial en 8 (10%). Las complicaciones postoperatorias incluyeron hematoma, fístula LCR, e infección. 54 (67.5%) pacientes desarrollaron incremento, o nueva afectación de pares craneales y un 12.5% déficits de vías largas o cerebelo que mejoraron posteriormente en la gran mayoría. Tras la primera operación 67 pacientes hicieron una buena recuperación, 10 desarrollaron diferentes grados de incapacidad y 3 fallecieron. Once pacientes fallecieron tardíamente durante el curso por recurrencia tumoral con o sin reoperación, meningioma maligno, o causas no relacionadas. Se registraron 9 recurrencias tras resección inicial aparentemente completa (seguimiento medio = 8.6 años). La mayoría de los pacientes con resección subtotal y parcial se han manejado sin reoperación durante un periodo medio de 6.5 años (radiocirugía y/u observación). Discusión y ConclusionesLa técnica microquirúrgica y la radioterapia estereotáxica permiten un control aceptable de estos meningiomas. En los pacientes con invasión del seno cavernoso, extensión extracraneal, transgresión del plano aracnoideo en relación con el tronco cerebral, o adherencia a arterias cerebrales y sus perforantes, la extirpación subtotal parece preferible. En la planificación del tratamiento, se deben considerar además la edad del paciente, la presentación clínica (lesión sintomática o no sintomática), así como el tamaño y la extensión del tumor." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Lobato, R.D.; González, P.; Alday, R.; Ramos, A.; Lagares, A.; Alen, J.F.; Palomino, J.C.; Miranda, P.; Perez-Nuñez, A.; Arrese, L: Meningiomas of the basal posterior fossa. Surgical experience in 80 cases. Neurocirugía 2004; 15: 525–542" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:80 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The recurrence of intracranial meningiomas after surgical treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.B. Adegbite" 1 => "M.I. Khan" 2 => "K.W.E. Paine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1983.58.1.0051" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1983" "volumen" => "58" "paginaInicial" => "51" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6847909" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient-evaluated outcome after surgery for basal meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Akagami" 1 => "M. Napolitano" 2 => "L.N. Sekhar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2002" "volumen" => "50" "paginaInicial" => "941" "paginaFinal" => "949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11950396" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Supraorbital-pterional approach to skull base lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O. Al-Mefty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1987" "volumen" => "21" "paginaInicial" => "474" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3683780" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Petrosal approach for petroclival meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Al-Mefty" 1 => "S.L. Fox" 2 => "R.R. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1988" "volumen" => "22" "paginaInicial" => "510" "paginaFinal" => "517" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3362317" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary meningiomas of the jugular fossa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.I. Arnautovic" 1 => "O. Al-Mefty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neursourg" "fecha" => "2002" "volumen" => "97" "paginaInicial" => "12" "paginaFinal" => "20" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors predicting recurrence in patients operated on for intra cranial meningioma. A multivariate analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Ayerbe" 1 => "R.D. Lobato" 2 => "J. de la Cruz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1999" "volumen" => "141" "paginaInicial" => "921" "paginaFinal" => "932" "itemHostRev" => array:3 [ "pii" => "S1474442208700401" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Petroclival meningiomas: predictive parameters for transpetrosal approaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.M.A. Aziz" 1 => "A. Sanan" 2 => "H.R. van Loveren" 3 => "J.M. Tew" 4 => "J.T. Seller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2000" "volumen" => "47" "paginaInicial" => "139" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10917357" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiation therapy in treatment of partially resected meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.M. Barbaro" 1 => "P.H. Gutin" 2 => "C.B. Wilson" 3 => "G.E. Sheline" 4 => "E.B. Boldrey" 5 => "W.M. Wara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neursourgery" "fecha" => "1987" "volumen" => "20" "paginaInicial" => "525" "paginaFinal" => "528" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.S. Berger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Neurosurgery" "fecha" => "2003" "volumen" => "53" "paginaInicial" => "821" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long term natural history of skull base meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.K. Bindal" 1 => "J.M. Googman" 2 => "B.B. Kuzme" 3 => "A. Kawasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Neurosurgery" "fecha" => "1998" "volumen" => "43" "paginaInicial" => "696" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsurgical removal of petroclival meningiomas: a report of 33 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Bricolo" 1 => "S. Turazzi" 2 => "A. Talacchi" 3 => "L. Cristofori" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1992" "volumen" => "31" "paginaInicial" => "813" "paginaFinal" => "828" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1436406" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors with survival in patients with meningioma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.M. Bridget" 1 => "F.G. Davis" 2 => "S. Freels" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1998.88.5.0831" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1998" "volumen" => "88" "paginaInicial" => "831" "paginaFinal" => "839" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9576250" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of petroclival meningiomas: experience with 16 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Cantare" 1 => "R. Delfini" 2 => "P. Ciappetta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "1994" "volumen" => "42" "paginaInicial" => "105" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8091285" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of computed tomography and magnetic resonance imaging findings on surgical outcome in petroclival meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.A. Carvalho" 1 => "C. Matthies" 2 => "M. Tatagiba" 3 => "R. Eghbal" 4 => "M. Samii" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2000" "volumen" => "47" "paginaInicial" => "1287" "paginaFinal" => "1294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11126899" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas of the posterior fossa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Castellano" 1 => "G. Ruggiero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Radiol" "fecha" => "1953" "volumen" => "104" "numero" => "Suppl" "paginaInicial" => "1" "paginaFinal" => "157" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of cranial base meningiomas with linear accelerator radiosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.D. Chang" 1 => "J.R. Adler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1997" "volumen" => "41" "paginaInicial" => "1019" "paginaFinal" => "1027" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9361055" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnetic resonance imaging and pathological correlates of meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T.C. Chen" 1 => "C.S. Zee" 2 => "C.A. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Neurosurgery" "fecha" => "1992" "volumen" => "31" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Petroclival meningiomas: Surgical experience in 109 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.T. Couldwell" 1 => "T. Fukushima" 2 => "S.L. Giannotta" 3 => "M.H. Weiss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1996.84.1.0020" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1996" "volumen" => "84" "paginaInicial" => "20" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8613831" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posterior fossa meningiomas: Surgical experience in 52 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. Cudlip" 1 => "P.R. Wilkins" 2 => "F.G. Johnston" 3 => "A.J. Moore" 4 => "H.T. Marsh" 5 => "B.A. Bell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1998" "volumen" => "140" "paginaInicial" => "1007" "paginaFinal" => "1012" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome of aggressive removal of cavernous sinus meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. DeMonte" 1 => "H. Smith" 2 => "O. Al-Mefty" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1994.81.2.0245" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1994" "volumen" => "81" "paginaInicial" => "245" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8027808" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas of the cranial base" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Desai" 1 => "J. Bruce" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurooncol" "fecha" => "1999" "volumen" => "20" "paginaInicial" => "255" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7844622" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postoperative irradiation of subtotally resected meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.J. Goldsmith" 1 => "W.M. Wara" 2 => "C.B. Wilson" 3 => "D.A. Larson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1994.80.2.0195" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1994" "volumen" => "80" "paginaInicial" => "195" "paginaFinal" => "201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283256" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stereotactic irradiation of skull base meningiomas with high energy protons" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "O. Gudjonsson" 1 => "E. Blomquist" 2 => "G. Nyberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1999" "volumen" => "141" "paginaInicial" => "933" "paginaFinal" => "940" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Results of linear accelerator-based radiosurgery for intracranial meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Hakim" 1 => "E. Alexander" 2 => "J.S. Loeffler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1998" "volumen" => "42" "paginaInicial" => "446" "paginaFinal" => "454" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9526976" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clivus meningiomas: six cases of total removal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Hakuba" 1 => "S. Nishimura" 2 => "K. Tanaka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurol Med Chir" "fecha" => "1977" "volumen" => "17" "paginaInicial" => "63" "paginaFinal" => "77" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnetic resonance imaging and meningiomas of the posterior cerebral fossa. 31 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "O. Helie" 1 => "D. Soulie" 2 => "J.L. Sarrazin" 3 => "C. Dewrosier" 4 => "Y.S. : Cordoliani" 5 => "G. Cosnard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Neuroradiol" "fecha" => "1995" "volumen" => "22" "paginaInicial" => "252" "paginaFinal" => "270" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8636802" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674909010859" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas involving the cavernous sinus: Valué of imaging for predicting surgical complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.L. Hirsch" 1 => "L.N. Sekhar" 2 => "G. Lanzino" 3 => "S. Pomonis" 4 => "C.N. Sen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.160.5.8470581" "Revista" => array:6 [ "tituloSerie" => "AJR" "fecha" => "1993" "volumen" => "160" "paginaInicial" => "1083" "paginaFinal" => "1088" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8470581" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two-staged gamma knife radiosurgery for the treatment of large petroclival and cavernous sinus meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Iwai" 1 => "K. Yamanaka" 2 => "H. Nakajima" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "308" "paginaFinal" => "314" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11750001" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcome and growth rate of subtotally resected petroclival meningiomas: experience with 38 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.W. Jung" 1 => "H. Yoo" 2 => "S.H. Paek" 3 => "K.S. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2000" "volumen" => "46" "paginaInicial" => "567" "paginaFinal" => "575" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10719852" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors affecting operative and excess long-term mortaliry in 935 patients with intracranial meningioma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Kallio" 1 => "R. Sankila" 2 => "T. Hakulinen" 3 => "J. Jaaskelanen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1992" "volumen" => "31" "paginaInicial" => "2" "paginaFinal" => "12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1641106" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anterior transpetrosal-transtentorial approach for sphenopetroclival meningio mas: surgical method and results in 10 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Kawase" 1 => "R. Shiobara" 2 => "S. Toya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1991" "volumen" => "28" "paginaInicial" => "869" "paginaFinal" => "876" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2067611" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Middle fossa transpetrosal-transtentorial approaches fro petroclival menin giomas: selective pyramid resection and radicality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Kawase" 1 => "R. Shiobara" 2 => "S. Toya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir(Wien)" "fecha" => "1994" "volumen" => "129" "paginaInicial" => "113" "paginaFinal" => "120" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary treatment against petrocli val meningioma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T. Kayama" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "No Shinkei Geka" "fecha" => "1998" "volumen" => "26" "paginaInicial" => "8" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9488986" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674910011280" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contempo rary treatment of skull base meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J. Kokkino" 1 => "K.M.A. Aziz" 2 => "J.M. Tew" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Neurosurg" "fecha" => "2000" "volumen" => "46" "paginaInicial" => "554" "paginaFinal" => "574" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10944701" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome after complex neurosurgery: The caregiver's burden is forgotten" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.A. Lang" 1 => "G. Neil-Dwyer" 2 => "J. Garfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2003.98.2.0359" "Revista" => array:5 [ "tituloSerie" => "J Neurosurg" "fecha" => "1999" "paginaInicial" => "359" "paginaFinal" => "363" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12593623" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Proposed grading system to predict the extent of resection and outcomes for cranial base meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Z.T. Levine" 1 => "R.I. Buchanan" 2 => "L.N. Sekhar" 3 => "C.L. Rosen" 4 => "D.C. Wright" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1999" "volumen" => "45" "paginaInicial" => "221" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10449065" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma knife radiosurgery for large volume tumors: an analysis of acute and chronic toxicity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Linzer" 1 => "S.M. Lung" 2 => "H. Villalobos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Stereotactic Func Neurosurg" "fecha" => "1998" "volumen" => "70" "numero" => "Suppl. 1" "paginaInicial" => "11" "paginaFinal" => "18" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas del alaesfenoidal. Estudio de 90 casos" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R.D. Lobato" 1 => "R. Alday" 2 => "P.A. Gomez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurocirugía" "fecha" => "1999" "volumen" => "10" "paginaInicial" => "13" "paginaFinal" => "26" ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib39" "etiqueta" => "39." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary management of meningiomas: radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.D. Lunsford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1994.80.2.0187" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1994" "volumen" => "80" "paginaInicial" => "187" "paginaFinal" => "190" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283254" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib40" "etiqueta" => "40." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas of the cerebellopontine angle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Mathies" 1 => "G. Carvalho" 2 => "M. Tatagiba" 3 => "M. Lima" 4 => "M. Samii" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1996" "volumen" => "65" "numero" => "Suppl" "paginaInicial" => "86" "paginaFinal" => "91" ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib41" "etiqueta" => "41." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Karlsson: Recurrence of cranial base meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Mathiesen" 1 => "C. Lindquist" 2 => "L. Kihlström" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1996" "volumen" => "39" "paginaInicial" => "2" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8805134" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib42" "etiqueta" => "42." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas of the clivus and apical petrous bone. Report of 35 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.R. Mayberg" 1 => "L. Symon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neursourg" "fecha" => "1986" "volumen" => "65" "paginaInicial" => "160" "paginaFinal" => "167" ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib43" "etiqueta" => "43." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningioma: analysis of recurrence and progression following neurosurgical resection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.O. Mirimanoff" 1 => "D.E. Dosoretz" 2 => "R.M. Linggood" 3 => "R.G. Ojemann" 4 => "R.L. Marruza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1985.62.1.0018" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1985" "volumen" => "62" "paginaInicial" => "18" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3964853" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib44" "etiqueta" => "44." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality of life in patients after meningioma resection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Mohsenipour" 1 => "E. Deusch" 2 => "M. Galb" 3 => "M. Hofer" 4 => "K. Twerdy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2001" "volumen" => "143" "paginaInicial" => "547" "paginaFinal" => "553" ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib45" "etiqueta" => "45." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Morita" 1 => "R.J. Coffey" 2 => "R.L. Foote" 3 => "D. Schiff" 4 => "D. Gorman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1999.90.1.0042" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1999" "volumen" => "90" "paginaInicial" => "42" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10413154" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib46" "etiqueta" => "46." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome from complex neurosurgery: an evidence based approach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Neil-Dwyer" 1 => "D.A. Lang" 2 => "A. Davis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2000" "volumen" => "142" "paginaInicial" => "367" "paginaFinal" => "371" ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib47" "etiqueta" => "47." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas: A quest for the optimum therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.A. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1994.80.2.0191" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1999" "volumen" => "80" "paginaInicial" => "191" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283255" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib48" "etiqueta" => "48." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiosurgical treatment of cavernous sinus meningiomas: experience with 122 treated cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Nicolato" 1 => "R. Foroni" 2 => "F. Alessandrini" 3 => "A. Bricolo" 4 => "M. Gerosa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "1153" "paginaFinal" => "1161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12383360" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib49" "etiqueta" => "49." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma knife radiosurgery in meningiomas of the posterior fossa. Experience with 62 treated lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Nicolato" 1 => "R. Foroni" 2 => "M. Pellegrino" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Minm Invasive Neurosurg" "fecha" => "2001" "volumen" => "44" "paginaInicial" => "211" "paginaFinal" => "217" ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib50" "etiqueta" => "50." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clivus and apicopetroclivus meningiomas: report of 24 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Nishimura" 1 => "A. Hakuba" 2 => "B.J. Jang" 3 => "Y. Inoue" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurol Med Chir (Tokyo)" "fecha" => "1989" "volumen" => "29" "paginaInicial" => "1004" "paginaFinal" => "1111" ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib51" "etiqueta" => "51." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiotherapy in the treatment of benign meningioma of the skull base" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Nutting" 1 => "M. Brada" 2 => "L. Brazil" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1999.90.5.0823" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1999" "volumen" => "90" "paginaInicial" => "823" "paginaFinal" => "827" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10223446" "web" => "Medline" ] ] ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib52" "etiqueta" => "52." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The natural history and growth rate of asymptomatic meningiomas. A review of 60 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.C. Olivero" 1 => "J.R. Lister" 2 => "P.W. Elwood" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1995.83.2.0222" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1995" "volumen" => "83" "paginaInicial" => "222" "paginaFinal" => "224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7616265" "web" => "Medline" ] ] ] ] ] ] ] ] 52 => array:3 [ "identificador" => "bib53" "etiqueta" => "53." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The surgical resectability of meningiomas of the cavernous sinus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.G. O'Sullivan" 1 => "H.R. van Loveren" 2 => "J.M. Tew" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1997" "volumen" => "40" "paginaInicial" => "238" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9007855" "web" => "Medline" ] ] ] ] ] ] ] ] 53 => array:3 [ "identificador" => "bib54" "etiqueta" => "54." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Basal meningiomas. A retrospective study of 139 surgical cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Paterniti" 1 => "P. Fiore" 2 => "A. Levila" 3 => "A. La Camera" 4 => "S. Cambria" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J. Neurosurg Sci." "fecha" => "1999" "volumen" => "43" "paginaInicial" => "107" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10735764" "web" => "Medline" ] ] ] ] ] ] ] ] 54 => array:3 [ "identificador" => "bib55" "etiqueta" => "55." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staged radiosurgical treatment for large benign cerebral lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Pendl" 1 => "F. Unger" 2 => "G. Papaefthymiou" 3 => "S. Eustacchio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2000.93.supplement" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2000" "volumen" => "93" "numero" => "Suppl. 3" "paginaInicial" => "107" "paginaFinal" => "112" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11143226" "web" => "Medline" ] ] ] ] ] ] ] ] 55 => array:3 [ "identificador" => "bib56" "etiqueta" => "56." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperostosis associated with meningioma of the cranial base: secondary changes or tumor invasion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.R. Pieper" 1 => "O. Al-Mefty" 2 => "Y. Hanada" 3 => "D. Buechner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1999" "volumen" => "44" "paginaInicial" => "742" "paginaFinal" => "747" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201298" "web" => "Medline" ] ] ] ] ] ] ] ] 56 => array:3 [ "identificador" => "bib57" "etiqueta" => "57." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas petroclivales gigantes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Piquer" 1 => "G. Bataller" 2 => "H. Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurocirugía" "fecha" => "1996" "volumen" => "7" "paginaInicial" => "111" "paginaFinal" => "118" ] ] ] ] ] ] 57 => array:3 [ "identificador" => "bib58" "etiqueta" => "58." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Posterior fossa meningioma: Surgical experience in 161 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Roberti" 1 => "L.N. Sekhar" 2 => "Ch. Kalavakonda" 3 => "D.C. Wright" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Surg Neurol" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "8" "paginaFinal" => "21" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11546562" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673606685425" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 58 => array:3 [ "identificador" => "bib59" "etiqueta" => "59." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma knife radiosurgery in the management of cavernous sinus meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P.H. Roche" 1 => "J. Regis" 2 => "H. Dufour" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2000.93.supplement" "Revista" => array:7 [ "tituloSerie" => "J Neurosurg" "fecha" => "2000" "volumen" => "93" "numero" => "Suppl" "paginaInicial" => "68" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11143266" "web" => "Medline" ] ] ] ] ] ] ] ] 59 => array:3 [ "identificador" => "bib60" "etiqueta" => "60." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome analysis of preoperative embolization in cranial base surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.L. Rosen" 1 => "J.M. Ammerman" 2 => "L.N. Sehkar" 3 => "W.O. Bank" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2002" "volumen" => "144" "paginaInicial" => "1157" "paginaFinal" => "1164" "itemHostRev" => array:3 [ "pii" => "S1474442202001904" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 60 => array:3 [ "identificador" => "bib61" "etiqueta" => "61." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical management of meningiomas originating in Meckel's cave" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Samii" 1 => "G.A. Carvalho" 2 => "M. Tatagiba" 3 => "C. Matthies" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1997" "volumen" => "41" "paginaInicial" => "767" "paginaFinal" => "775" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9316037" "web" => "Medline" ] ] ] ] ] ] ] ] 61 => array:3 [ "identificador" => "bib62" "etiqueta" => "62." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experience witt 36 cases of petroclival meningioma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Samii" 1 => "M. Tatagiba" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1992" "volumen" => "118" "paginaInicial" => "27" "paginaFinal" => "32" "itemHostRev" => array:3 [ "pii" => "S0091674911003757" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 62 => array:3 [ "identificador" => "bib63" "etiqueta" => "63." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retrosigmoid intradural suprameatal approach to Meckel's cave and the middle fossa: surgical technique and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Samii" 1 => "M. Tatagiba" 2 => "G.A. Carvalho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.2000.92.2.0235" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2000" "volumen" => "92" "paginaInicial" => "235" "paginaFinal" => "241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10659009" "web" => "Medline" ] ] ] ] ] ] ] ] 63 => array:3 [ "identificador" => "bib64" "etiqueta" => "64." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conservative (laberinth-preserving) transpetrosal approach to the clivus and pertoclival region-indications, complications, results and lessons learned" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Seifert" 1 => "A. Raabe" 2 => "M. Zimmennann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2003" "volumen" => "145" "paginaInicial" => "631" "paginaFinal" => "642" ] ] ] ] ] ] 64 => array:3 [ "identificador" => "bib65" "etiqueta" => "65." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas involving the clivus: a six year experience with 41 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.N. Sekhar" 1 => "P.J. Jannetta" 2 => "L.E. Burkhart" 3 => "J.E. Janosky" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1990" "volumen" => "27" "paginaInicial" => "764" "paginaFinal" => "781" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2259407" "web" => "Medline" ] ] ] ] ] ] ] ] 65 => array:3 [ "identificador" => "bib66" "etiqueta" => "66." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebellopontine angle meningiomas: microsurgical excision and follow-up results. Reportof 24 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L.N. Sekhar" 1 => "P.J. Jannetta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1988.69.4.0500" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1994" "volumen" => "69" "paginaInicial" => "500" "paginaFinal" => "505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3047341" "web" => "Medline" ] ] ] ] ] ] ] ] 66 => array:3 [ "identificador" => "bib67" "etiqueta" => "67." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical excision of meningiomas involving the clivus: preoperative and intraoperative features as predictors of postoperative functional deterioration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Sekhar" 1 => "N.S. Swamy" 2 => "V. Jaiswal" 3 => "E. Rubinstein" 4 => "W.E. Hirsch" 5 => "D.C. Wright" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1994.81.6.0860" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1994" "volumen" => "81" "paginaInicial" => "860" "paginaFinal" => "868" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7965116" "web" => "Medline" ] ] ] ] ] ] ] ] 67 => array:3 [ "identificador" => "bib68" "etiqueta" => "68." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas involving the cavernous sinus: histological factors affecting the degree of resection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Sen" 1 => "K. Hague" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1997.87.4.0535" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1997" "volumen" => "87" "paginaInicial" => "535" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9322844" "web" => "Medline" ] ] ] ] ] ] ] ] 68 => array:3 [ "identificador" => "bib69" "etiqueta" => "69." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Suprameatal extensión of retrosigmoid approach: microsurgical anatomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Seoane" 1 => "A.L. Rothon Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1999" "volumen" => "44" "paginaInicial" => "553" "paginaFinal" => "560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10069592" "web" => "Medline" ] ] ] ] ] ] ] ] 69 => array:3 [ "identificador" => "bib70" "etiqueta" => "70." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Petroclival meningioma. An attempt to define the role of skull base approaches in their surgical management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Spallone" 1 => "U.B. Makhmudov" 2 => "D.J. Mukhamedjanov" 3 => "V.A. Tcherekajev" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "1999" "volumen" => "51" "paginaInicial" => "412" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10199295" "web" => "Medline" ] ] ] ] ] ] ] ] 70 => array:3 [ "identificador" => "bib71" "etiqueta" => "71." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The combined supra and infratentorial approach for lesions of the petrous and clival regions: experience with 46 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.F. Spetzler" 1 => "C.P. Daspit" 2 => "C.T.E. Pappas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1992.76.4.0588" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1992" "volumen" => "76" "paginaInicial" => "588" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1545251" "web" => "Medline" ] ] ] ] ] ] ] ] 71 => array:3 [ "identificador" => "bib72" "etiqueta" => "72." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of petroclival meningiomas by stereotactic radiosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.R. Subach" 1 => "L.D. Lunsford" 2 => "D. Kondziolka" 3 => "A.D. Maitz" 4 => "J.C. Flickinger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1998" "volumen" => "42" "paginaInicial" => "437" "paginaFinal" => "443" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9526975" "web" => "Medline" ] ] ] ] ] ] ] ] 72 => array:3 [ "identificador" => "bib73" "etiqueta" => "73." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The meningioma controversy: Postopera tive radiation therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.W. Taylor" 1 => "R.B. Marcus" 2 => "W.A. Friedman" 3 => "W.E. Bllinger" 4 => "R.R. Million" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Radiat Oncol Biol Phys" "fecha" => "1988" "volumen" => "15" "paginaInicial" => "299" "paginaFinal" => "304" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3403313" "web" => "Medline" ] ] ] ] ] ] ] ] 73 => array:3 [ "identificador" => "bib74" "etiqueta" => "74." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lateral approaches to petroclival region" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Tedeschi" 1 => "A.L. Rothon Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "1994" "volumen" => "41" "paginaInicial" => "180" "paginaFinal" => "216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8146735" "web" => "Medline" ] ] ] ] ] ] ] ] 74 => array:3 [ "identificador" => "bib75" "etiqueta" => "75." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.T. Trier" 1 => "R.F. Spetzler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Neurosurgery" "fecha" => "2000" "volumen" => "47" "paginaInicial" => "1295" ] ] ] ] ] ] 75 => array:3 [ "identificador" => "bib76" "etiqueta" => "76." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The results of radiosurgical management of 72 middle fossa meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Valentino" 1 => "G. Schinaia" 2 => "J. Raimondi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1993" "volumen" => "122" "paginaInicial" => "60" "paginaFinal" => "70" ] ] ] ] ] ] 76 => array:3 [ "identificador" => "bib77" "etiqueta" => "77." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linac radiosurgery for skull base meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.T. Villavicencio" 1 => "P.M. Black" 2 => "D.C. Shrieve" 3 => "M.P. Fallón" 4 => "E. Alexander" 5 => "J.S. Loeffler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2001" "volumen" => "143" "paginaInicial" => "1141" "paginaFinal" => "1152" ] ] ] ] ] ] 77 => array:3 [ "identificador" => "bib78" "etiqueta" => "78." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history of petroclival meningiomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. van Havenbergh" 1 => "G. Carvalho" 2 => "M. Tatagiba" 3 => "C. Plets" 4 => "M. Samii" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2003" "volumen" => "52" "paginaInicial" => "55" "paginaFinal" => "64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12493101" "web" => "Medline" ] ] ] ] ] ] ] ] 78 => array:3 [ "identificador" => "bib79" "etiqueta" => "79." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meningiomas of basal posterior fossa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.G. Yasargil" 1 => "R.W. Mortara" 2 => "M. Curcic" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Advances and Technical Standards in Neurosurgery" "paginaInicial" => "3" "paginaFinal" => "115" "serieFecha" => "1980" ] ] ] ] ] ] 79 => array:3 [ "identificador" => "bib80" "etiqueta" => "80." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Petroclival meningiomas; Is radical resection always the best option" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Zentner" 1 => "B. Meyer" 2 => "U. Vieweg" 3 => "C. Huberhold" 4 => "J. Schramm" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "1997" "volumen" => "62" "paginaInicial" => "341" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9120445" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/11301473/0000001500000006/v1_201305151229/S113014730470439X/v1_201305151229/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001500000006/v1_201305151229/S113014730470439X/v1_201305151229/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730470439X?idApp=UINPBA00004B"]

Estadísticas

Meningiomas basales de la fosa posterior. Experiencia quirúrgica con 80 casos

R.D. Lobato

, P. González, R. Alday, A. Ramos, A. Lagares, J.F. Alen, J.C. Palomino, P. Miranda, A. Perez-Nuñez, I. Arrese

Servicio Neurocirugía, y Sección de Neurorradiología, Hospital 12 de Octubre. Madrid

Leído

3551

Veces
se ha leído el artículo

2272

Total PDF

1279

Total HTML

Compartir estadísticas

 array:22 [
  "pii" => "S113014730470439X"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(04)70439-X"
  "estado" => "S300"
  "fechaPublicacion" => "2004-01-01"
  "aid" => "70439"
  "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
  "copyrightAnyo" => "2004"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2004;15:525-42"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3568
    "formatos" => array:3 [
      "EPUB" => 22
      "HTML" => 1278
      "PDF" => 2268
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1130147304704406"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(04)70440-6"
    "estado" => "S300"
    "fechaPublicacion" => "2004-01-01"
    "aid" => "70440"
    "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2004;15:543-51"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 4354
      "formatos" => array:3 [
        "EPUB" => 24
        "HTML" => 1455
        "PDF" => 2875
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Empiema epidural espinal&#46; An&#225;lisis de 14 casos"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "543"
          "paginaFinal" => "551"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Spinal epidural empyema&#46; Analysis of 14 cases"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Gelabert-Gonz&#225;lez, J&#46; Gonz&#225;lez-Garc&#237;a, J&#46;M&#46; Fern&#225;ndez-Villa, A&#46; Garc&#237;aAllut, R&#46; Mart&#237;nez-Rumbo"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Gelabert-Gonz&#225;lez"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Gonz&#225;lez-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Fern&#225;ndez-Villa"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Garc&#237;aAllut"
            ]
            4 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Mart&#237;nez-Rumbo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704406?idApp=UINPBA00004B"
    "url" => "/11301473/0000001500000006/v1_201305151229/S1130147304704406/v1_201305151229/es/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Meningiomas of the basal posterior fossa&#46; Surgical experience in 80 cases"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "525"
        "paginaFinal" => "542"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "R&#46;D&#46; Lobato, P&#46; Gonz&#225;lez, R&#46; Alday, A&#46; Ramos, A&#46; Lagares, J&#46;F&#46; Alen, J&#46;C&#46; Palomino, P&#46; Miranda, A&#46; Perez-Nu&#241;ez, I&#46; Arrese"
        "autores" => array:10 [
          0 => array:3 [
            "nombre" => "R&#46;D&#46;"
            "apellidos" => "Lobato"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Gonz&#225;lez"
          ]
          2 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Alday"
          ]
          3 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Ramos"
          ]
          4 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Lagares"
          ]
          5 => array:2 [
            "nombre" => "J&#46;F&#46;"
            "apellidos" => "Alen"
          ]
          6 => array:2 [
            "nombre" => "J&#46;C&#46;"
            "apellidos" => "Palomino"
          ]
          7 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Miranda"
          ]
          8 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Perez-Nu&#241;ez"
          ]
          9 => array:2 [
            "nombre" => "I&#46;"
            "apellidos" => "Arrese"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Servicio Neurocirug&#237;a&#44; y Secci&#243;n de Neurorradiolog&#237;a&#44; Hospital 12 de Octubre&#46; Madrid"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia postal&#58; Servicio de Neurocirug&#237;a&#46; Hospital &#8220;12 de Octubre&#8221;&#44; Avda C&#243;rdoba s&#47;n&#46; 28041 Madrid &#40;Spain&#41;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Meningiomas basales de la fosa posterior&#46; Experiencia quir&#250;rgica con 80 casos"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2004-04-24"
    "fechaAceptado" => "2004-05-08"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec158598"
          "palabras" => array:8 [
            0 => "Meningioma"
            1 => "Clivus"
            2 => "Petrous bone"
            3 => "Posterior fossa"
            4 => "Cranial nerves"
            5 => "Skull base tumor"
            6 => "Microsurgery"
            7 => "Radiosurgery"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec158597"
          "palabras" => array:8 [
            0 => "Meningioma"
            1 => "Clivus"
            2 => "Petroclival"
            3 => "Base craneal"
            4 => "Cirug&#237;a"
            5 => "Nervios craneales"
            6 => "Radioterapia"
            7 => "Radiocirug&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite recent improvements in microsurgical and radiotherapy techniques&#44; treatment of basal posterior fossa meningiomas still carries an elevated risk of morbidity&#46; We present our results in a series of patients with this type of tumor and review the recent literature looking for the results obtained with different approaches and the new tendencies and algorithms proposed for managing these challenging lesions&#46;</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We analyzed retrospectively the clinical presentation and outcome of 80 patients consecutively operated between 1979 and 2003 for basal posterior fossa meningioma &#40;foramen magnum tumors excluded&#41;&#46; All patients had preoperative CT scans and the majority MRI studies&#46; A total of 114 operations were performed including two-stage operations&#44; reoperation for recurrence&#44; CSF diversi&#243;n&#44; and XII-VII anastomosis&#46; The most commonly used approaches were lateral suboccipital retrosigmoid&#44; subtemporal-transtentorial&#44; frontotemporal pterional and supra-infratentorial presigmoid&#46; Thirteen patients received postoperative radiotherapy&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There were 59 &#40;73&#46;7&#37;&#41; women and 21 men &#40;mean age &#61; 51&#46;5 years&#59; range &#61; 18&#8211;78 yrs&#41;&#46; Most common presenting symptoms were cranial nerve dys-function&#44; gait disturbances and intracranial hypertension&#46; The mean duration of symptoms was 2&#46;9 years&#46; 70&#37; of the tumors were over 3<span class="elsevierStyleHsp" style=""></span>cm in size&#46; Fifty patients &#40;62&#46;5&#37;&#41; had a complete resection&#44; 22 &#40;27&#46;5&#37;&#41; subtotal resection &#40;&#62; 90&#37; tumor volume removed&#41;&#44; and 8 &#40;10&#37;&#41; only partial resection&#46; Postoperative complications included hematoma&#44; CSF leak&#44; and infection&#46; Fifty four &#40;67&#46;5&#37;&#41; patients developed new or increased cranial nerve d&#233;ficits and 12&#46;5&#37; somatomotor&#44; somatosensory or cerebellar d&#233;ficits immediately after surgery with subsequent improvement in most cases&#46; Following initial surgery 67 patients made a good recovery&#44; 10 developed variable degrees of disability and 3 died&#46; Eleven patients died later in the course for tumor recurrence with or without reoperation&#44; malignant meningioma or unrelated causes&#46; There were 9 recurrences in the subgroup of patients having complete resection initially &#40;mean follow-up &#61; 8&#46;6 years&#41;&#46; The majority of patients having initial subtotal or partial resections have been managed without reoperation during a mean follow-up period of 6&#46;5 years &#40;radiosurgery and&#47;or observation&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Discussion and Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Current microsurgical and radiotherapy techniques allow either a cure or an acceptable control of basal posterior fossa meningiomas&#46; In patients with tumor invasi&#243;n of the cavernous sinus&#44; extracranial extensi&#243;n&#44; violation of the arachnoidal membranes in front of the brainstem&#44; or encasement and infiltration of major arteries&#44; a subtotal excisi&#243;n seems preferable followed by observation and&#47; or radiosurgical treatment&#46; Apart from the patients age and the clinical presentation &#40;symptomatic or not&#41;&#44; the size and secondary extensions of the tumor must be taken into account for planning treatment in the individual patient&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pesar de la t&#233;cnica microquir&#250;rgica y la disponibilidad de la radioterapia estereot&#225;xica&#44; el tratamiento de los meningiomas de la base craneal todav&#237;a conlleva un riesgo elevado de morbilidad&#46; Se presenta una serie de pacientes con meningiomas b&#225;sales de la fosa posterior y se revisa la literatura para establecer una comparaci&#243;n de los resultados obtenidos con diferentes tipos de abordaje terap&#233;utico y detectar las nuevas tendencias para el manejo de estos tumores&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se analizaron de modo retrospectivo la presentaci&#243;n y evoluci&#243;n cl&#237;nica de 80 pacientes operados consecutivamente entre 1979 y 2003 por v&#237;a intradural de meningiomas localizados en la base de la fosa posterior &#40;excluidos los del foramen magno&#41;&#46; Se practic&#243; TAC craneal en todos los casos y RM en la mayor&#237;a&#46; Se realizaron 114 intervenciones&#44; incluyendo operaci&#243;n en dos estadios&#44; reoperaci&#243;n por recurrencia&#44; derivaciones de LCR y anastomosis VII-XII&#46; Los abordajes m&#225;s empleados fueron el lateral suboccipital retrosigmoideo&#44; subtemporal-transtentorial&#44; frontotemporal pterional y supra-infratentorial presigmoideo retrolaber&#237;ntico&#46; 13 pacientes recibieron adem&#225;s tratamiento radioter&#225;pico&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se trataron 59 mujeres &#40;73&#46;7&#37;&#41; y 21 hombres &#40;edad media &#61; 51&#46;5 a&#241;os&#59; rango &#61; 18&#8211;78&#41;&#46; Los s&#237;ntomas m&#225;s frecuentes de presentaci&#243;n &#40;duraci&#243;n media de la historia &#61; 2&#44;9 a&#241;os&#41; fueron alteraciones de los pares craneales&#44; cefaleas y alteraciones de la marcha&#46; 70&#37; de los tumores ten&#237;an un di&#225;metro mayor superior a 3<span class="elsevierStyleHsp" style=""></span>cm&#46; La extirpaci&#243;n fue completa en 50 casos &#40;62&#46;5&#37;&#41;&#44; subtotal &#40;resecci&#243;n &#62; 90&#37; del volumen tumoral&#41; en 22 &#40;27&#46;5&#37;&#41; y parcial en 8 &#40;10&#37;&#41;&#46; Las complicaciones postoperatorias incluyeron hematoma&#44; f&#237;stula LCR&#44; e infecci&#243;n&#46; 54 &#40;67&#46;5&#37;&#41; pacientes desarrollaron incremento&#44; o nueva afectaci&#243;n de pares craneales y un 12&#46;5&#37; d&#233;ficits de v&#237;as largas o cerebelo que mejoraron posteriormente en la gran mayor&#237;a&#46; Tras la primera operaci&#243;n 67 pacientes hicieron una buena recuperaci&#243;n&#44; 10 desarrollaron diferentes grados de incapacidad y 3 fallecieron&#46; Once pacientes fallecieron tard&#237;amente durante el curso por recurrencia tumoral con o sin reoperaci&#243;n&#44; meningioma maligno&#44; o causas no relacionadas&#46; Se registraron 9 recurrencias tras resecci&#243;n inicial aparentemente completa &#40;seguimiento medio &#61; 8&#46;6 a&#241;os&#41;&#46; La mayor&#237;a de los pacientes con resecci&#243;n subtotal y parcial se han manejado sin reoperaci&#243;n durante un periodo medio de 6&#46;5 a&#241;os &#40;radiocirug&#237;a y&#47;u observaci&#243;n&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Discusi&#243;n y Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La t&#233;cnica microquir&#250;rgica y la radioterapia estereot&#225;xica permiten un control aceptable de estos meningiomas&#46; En los pacientes con invasi&#243;n del seno cavernoso&#44; extensi&#243;n extracraneal&#44; transgresi&#243;n del plano aracnoideo en relaci&#243;n con el tronco cerebral&#44; o adherencia a arterias cerebrales y sus perforantes&#44; la extirpaci&#243;n subtotal parece preferible&#46; En la planificaci&#243;n del tratamiento&#44; se deben considerar adem&#225;s la edad del paciente&#44; la presentaci&#243;n cl&#237;nica &#40;lesi&#243;n sintom&#225;tica o no sintom&#225;tica&#41;&#44; as&#237; como el tama&#241;o y la extensi&#243;n del tumor&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Lobato&#44; R&#46;D&#46;&#59; Gonz&#225;lez&#44; P&#46;&#59; Alday&#44; R&#46;&#59; Ramos&#44; A&#46;&#59; Lagares&#44; A&#46;&#59; Alen&#44; J&#46;F&#46;&#59; Palomino&#44; J&#46;C&#46;&#59; Miranda&#44; P&#46;&#59; Perez-Nu&#241;ez&#44; A&#46;&#59; Arrese&#44; L&#58; Meningiomas of the basal posterior fossa&#46; Surgical experience in 80 cases&#46; Neurocirug&#237;a 2004&#59; 15&#58; 525&#8211;542</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:80 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The recurrence of intracranial meningiomas after surgical treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;B&#46; Adegbite"
                            1 => "M&#46;I&#46; Khan"
                            2 => "K&#46;W&#46;E&#46; Paine"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.58.1.0051"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "58"
                        "paginaInicial" => "51"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6847909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-evaluated outcome after surgery for basal meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Akagami"
                            1 => "M&#46; Napolitano"
                            2 => "L&#46;N&#46; Sekhar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2002"
                        "volumen" => "50"
                        "paginaInicial" => "941"
                        "paginaFinal" => "949"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11950396"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Supraorbital-pterional approach to skull base lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "O&#46; Al-Mefty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1987"
                        "volumen" => "21"
                        "paginaInicial" => "474"
                        "paginaFinal" => "477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3683780"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petrosal approach for petroclival meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Al-Mefty"
                            1 => "S&#46;L&#46; Fox"
                            2 => "R&#46;R&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1988"
                        "volumen" => "22"
                        "paginaInicial" => "510"
                        "paginaFinal" => "517"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3362317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary meningiomas of the jugular fossa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;I&#46; Arnautovic"
                            1 => "O&#46; Al-Mefty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neursourg"
                        "fecha" => "2002"
                        "volumen" => "97"
                        "paginaInicial" => "12"
                        "paginaFinal" => "20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors predicting recurrence in patients operated on for intra cranial meningioma&#46; A multivariate analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Ayerbe"
                            1 => "R&#46;D&#46; Lobato"
                            2 => "J&#46; de la Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1999"
                        "volumen" => "141"
                        "paginaInicial" => "921"
                        "paginaFinal" => "932"
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442208700401"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petroclival meningiomas&#58; predictive parameters for transpetrosal approaches"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;M&#46;A&#46; Aziz"
                            1 => "A&#46; Sanan"
                            2 => "H&#46;R&#46; van Loveren"
                            3 => "J&#46;M&#46; Tew"
                            4 => "J&#46;T&#46; Seller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "47"
                        "paginaInicial" => "139"
                        "paginaFinal" => "150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10917357"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiation therapy in treatment of partially resected meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;M&#46; Barbaro"
                            1 => "P&#46;H&#46; Gutin"
                            2 => "C&#46;B&#46; Wilson"
                            3 => "G&#46;E&#46; Sheline"
                            4 => "E&#46;B&#46; Boldrey"
                            5 => "W&#46;M&#46; Wara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neursourgery"
                        "fecha" => "1987"
                        "volumen" => "20"
                        "paginaInicial" => "525"
                        "paginaFinal" => "528"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;S&#46; Berger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2003"
                        "volumen" => "53"
                        "paginaInicial" => "821"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long term natural history of skull base meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;K&#46; Bindal"
                            1 => "J&#46;M&#46; Googman"
                            2 => "B&#46;B&#46; Kuzme"
                            3 => "A&#46; Kawasaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1998"
                        "volumen" => "43"
                        "paginaInicial" => "696"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microsurgical removal of petroclival meningiomas&#58; a report of 33 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Bricolo"
                            1 => "S&#46; Turazzi"
                            2 => "A&#46; Talacchi"
                            3 => "L&#46; Cristofori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1992"
                        "volumen" => "31"
                        "paginaInicial" => "813"
                        "paginaFinal" => "828"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1436406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors with survival in patients with meningioma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Bridget"
                            1 => "F&#46;G&#46; Davis"
                            2 => "S&#46; Freels"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1998.88.5.0831"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1998"
                        "volumen" => "88"
                        "paginaInicial" => "831"
                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9576250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical treatment of petroclival meningiomas&#58; experience with 16 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Cantare"
                            1 => "R&#46; Delfini"
                            2 => "P&#46; Ciappetta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1994"
                        "volumen" => "42"
                        "paginaInicial" => "105"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8091285"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of computed tomography and magnetic resonance imaging findings on surgical outcome in petroclival meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;A&#46; Carvalho"
                            1 => "C&#46; Matthies"
                            2 => "M&#46; Tatagiba"
                            3 => "R&#46; Eghbal"
                            4 => "M&#46; Samii"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "47"
                        "paginaInicial" => "1287"
                        "paginaFinal" => "1294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11126899"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas of the posterior fossa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46; Castellano"
                            1 => "G&#46; Ruggiero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Radiol"
                        "fecha" => "1953"
                        "volumen" => "104"
                        "numero" => "Suppl"
                        "paginaInicial" => "1"
                        "paginaFinal" => "157"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of cranial base meningiomas with linear accelerator radiosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;D&#46; Chang"
                            1 => "J&#46;R&#46; Adler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1997"
                        "volumen" => "41"
                        "paginaInicial" => "1019"
                        "paginaFinal" => "1027"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9361055"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Magnetic resonance imaging and pathological correlates of meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;C&#46; Chen"
                            1 => "C&#46;S&#46; Zee"
                            2 => "C&#46;A&#46; Miller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1992"
                        "volumen" => "31"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petroclival meningiomas&#58; Surgical experience in 109 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;T&#46; Couldwell"
                            1 => "T&#46; Fukushima"
                            2 => "S&#46;L&#46; Giannotta"
                            3 => "M&#46;H&#46; Weiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1996.84.1.0020"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1996"
                        "volumen" => "84"
                        "paginaInicial" => "20"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8613831"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Posterior fossa meningiomas&#58; Surgical experience in 52 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; Cudlip"
                            1 => "P&#46;R&#46; Wilkins"
                            2 => "F&#46;G&#46; Johnston"
                            3 => "A&#46;J&#46; Moore"
                            4 => "H&#46;T&#46; Marsh"
                            5 => "B&#46;A&#46; Bell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1998"
                        "volumen" => "140"
                        "paginaInicial" => "1007"
                        "paginaFinal" => "1012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of aggressive removal of cavernous sinus meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; DeMonte"
                            1 => "H&#46; Smith"
                            2 => "O&#46; Al-Mefty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.81.2.0245"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "81"
                        "paginaInicial" => "245"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8027808"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas of the cranial base"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Desai"
                            1 => "J&#46; Bruce"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurooncol"
                        "fecha" => "1999"
                        "volumen" => "20"
                        "paginaInicial" => "255"
                        "paginaFinal" => "279"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7844622"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative irradiation of subtotally resected meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;J&#46; Goldsmith"
                            1 => "W&#46;M&#46; Wara"
                            2 => "C&#46;B&#46; Wilson"
                            3 => "D&#46;A&#46; Larson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.80.2.0195"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "80"
                        "paginaInicial" => "195"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283256"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stereotactic irradiation of skull base meningiomas with high energy protons"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Gudjonsson"
                            1 => "E&#46; Blomquist"
                            2 => "G&#46; Nyberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1999"
                        "volumen" => "141"
                        "paginaInicial" => "933"
                        "paginaFinal" => "940"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Results of linear accelerator-based radiosurgery for intracranial meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Hakim"
                            1 => "E&#46; Alexander"
                            2 => "J&#46;S&#46; Loeffler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1998"
                        "volumen" => "42"
                        "paginaInicial" => "446"
                        "paginaFinal" => "454"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9526976"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clivus meningiomas&#58; six cases of total removal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Hakuba"
                            1 => "S&#46; Nishimura"
                            2 => "K&#46; Tanaka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurol Med Chir"
                        "fecha" => "1977"
                        "volumen" => "17"
                        "paginaInicial" => "63"
                        "paginaFinal" => "77"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Magnetic resonance imaging and meningiomas of the posterior cerebral fossa&#46; 31 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O&#46; Helie"
                            1 => "D&#46; Soulie"
                            2 => "J&#46;L&#46; Sarrazin"
                            3 => "C&#46; Dewrosier"
                            4 => "Y&#46;S&#46; &#58; Cordoliani"
                            5 => "G&#46; Cosnard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neuroradiol"
                        "fecha" => "1995"
                        "volumen" => "22"
                        "paginaInicial" => "252"
                        "paginaFinal" => "270"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8636802"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674909010859"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas involving the cavernous sinus&#58; Valu&#233; of imaging for predicting surgical complications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46;L&#46; Hirsch"
                            1 => "L&#46;N&#46; Sekhar"
                            2 => "G&#46; Lanzino"
                            3 => "S&#46; Pomonis"
                            4 => "C&#46;N&#46; Sen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.160.5.8470581"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR"
                        "fecha" => "1993"
                        "volumen" => "160"
                        "paginaInicial" => "1083"
                        "paginaFinal" => "1088"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8470581"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two-staged gamma knife radiosurgery for the treatment of large petroclival and cavernous sinus meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46; Iwai"
                            1 => "K&#46; Yamanaka"
                            2 => "H&#46; Nakajima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "308"
                        "paginaFinal" => "314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11750001"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcome and growth rate of subtotally resected petroclival meningiomas&#58; experience with 38 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;W&#46; Jung"
                            1 => "H&#46; Yoo"
                            2 => "S&#46;H&#46; Paek"
                            3 => "K&#46;S&#46; Choi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "567"
                        "paginaFinal" => "575"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10719852"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors affecting operative and excess long-term mortaliry in 935 patients with intracranial meningioma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kallio"
                            1 => "R&#46; Sankila"
                            2 => "T&#46; Hakulinen"
                            3 => "J&#46; Jaaskelanen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1992"
                        "volumen" => "31"
                        "paginaInicial" => "2"
                        "paginaFinal" => "12"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1641106"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anterior transpetrosal-transtentorial approach for sphenopetroclival meningio mas&#58; surgical method and results in 10 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Kawase"
                            1 => "R&#46; Shiobara"
                            2 => "S&#46; Toya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1991"
                        "volumen" => "28"
                        "paginaInicial" => "869"
                        "paginaFinal" => "876"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2067611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Middle fossa transpetrosal-transtentorial approaches fro petroclival menin giomas&#58; selective pyramid resection and radicality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Kawase"
                            1 => "R&#46; Shiobara"
                            2 => "S&#46; Toya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir&#40;Wien&#41;"
                        "fecha" => "1994"
                        "volumen" => "129"
                        "paginaInicial" => "113"
                        "paginaFinal" => "120"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contemporary treatment against petrocli val meningioma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Kayama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "No Shinkei Geka"
                        "fecha" => "1998"
                        "volumen" => "26"
                        "paginaInicial" => "8"
                        "paginaFinal" => "17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9488986"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674910011280"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contempo rary treatment of skull base meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;J&#46; Kokkino"
                            1 => "K&#46;M&#46;A&#46; Aziz"
                            2 => "J&#46;M&#46; Tew"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Neurosurg"
                        "fecha" => "2000"
                        "volumen" => "46"
                        "paginaInicial" => "554"
                        "paginaFinal" => "574"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10944701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome after complex neurosurgery&#58; The caregiver&#39;s burden is forgotten"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;A&#46; Lang"
                            1 => "G&#46; Neil-Dwyer"
                            2 => "J&#46; Garfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2003.98.2.0359"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1999"
                        "paginaInicial" => "359"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12593623"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proposed grading system to predict the extent of resection and outcomes for cranial base meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Z&#46;T&#46; Levine"
                            1 => "R&#46;I&#46; Buchanan"
                            2 => "L&#46;N&#46; Sekhar"
                            3 => "C&#46;L&#46; Rosen"
                            4 => "D&#46;C&#46; Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1999"
                        "volumen" => "45"
                        "paginaInicial" => "221"
                        "paginaFinal" => "230"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10449065"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gamma knife radiosurgery for large volume tumors&#58; an analysis of acute and chronic toxicity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Linzer"
                            1 => "S&#46;M&#46; Lung"
                            2 => "H&#46; Villalobos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stereotactic Func Neurosurg"
                        "fecha" => "1998"
                        "volumen" => "70"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "11"
                        "paginaFinal" => "18"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas del alaesfenoidal&#46; Estudio de 90 casos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "R&#46; Alday"
                            2 => "P&#46;A&#46; Gomez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurocirug&#237;a"
                        "fecha" => "1999"
                        "volumen" => "10"
                        "paginaInicial" => "13"
                        "paginaFinal" => "26"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contemporary management of meningiomas&#58; radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;D&#46; Lunsford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.80.2.0187"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "80"
                        "paginaInicial" => "187"
                        "paginaFinal" => "190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283254"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas of the cerebellopontine angle"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Mathies"
                            1 => "G&#46; Carvalho"
                            2 => "M&#46; Tatagiba"
                            3 => "M&#46; Lima"
                            4 => "M&#46; Samii"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1996"
                        "volumen" => "65"
                        "numero" => "Suppl"
                        "paginaInicial" => "86"
                        "paginaFinal" => "91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Karlsson&#58; Recurrence of cranial base meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Mathiesen"
                            1 => "C&#46; Lindquist"
                            2 => "L&#46; Kihlstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1996"
                        "volumen" => "39"
                        "paginaInicial" => "2"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8805134"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas of the clivus and apical petrous bone&#46; Report of 35 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;R&#46; Mayberg"
                            1 => "L&#46; Symon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neursourg"
                        "fecha" => "1986"
                        "volumen" => "65"
                        "paginaInicial" => "160"
                        "paginaFinal" => "167"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningioma&#58; analysis of recurrence and progression following neurosurgical resection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;O&#46; Mirimanoff"
                            1 => "D&#46;E&#46; Dosoretz"
                            2 => "R&#46;M&#46; Linggood"
                            3 => "R&#46;G&#46; Ojemann"
                            4 => "R&#46;L&#46; Marruza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1985.62.1.0018"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1985"
                        "volumen" => "62"
                        "paginaInicial" => "18"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3964853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quality of life in patients after meningioma resection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Mohsenipour"
                            1 => "E&#46; Deusch"
                            2 => "M&#46; Galb"
                            3 => "M&#46; Hofer"
                            4 => "K&#46; Twerdy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2001"
                        "volumen" => "143"
                        "paginaInicial" => "547"
                        "paginaFinal" => "553"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas&#58; experience in 88 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Morita"
                            1 => "R&#46;J&#46; Coffey"
                            2 => "R&#46;L&#46; Foote"
                            3 => "D&#46; Schiff"
                            4 => "D&#46; Gorman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1999.90.1.0042"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "42"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10413154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome from complex neurosurgery&#58; an evidence based approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Neil-Dwyer"
                            1 => "D&#46;A&#46; Lang"
                            2 => "A&#46; Davis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2000"
                        "volumen" => "142"
                        "paginaInicial" => "367"
                        "paginaFinal" => "371"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas&#58; A quest for the optimum therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;A&#46; Newman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.80.2.0191"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1999"
                        "volumen" => "80"
                        "paginaInicial" => "191"
                        "paginaFinal" => "194"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8283255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiosurgical treatment of cavernous sinus meningiomas&#58; experience with 122 treated cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Nicolato"
                            1 => "R&#46; Foroni"
                            2 => "F&#46; Alessandrini"
                            3 => "A&#46; Bricolo"
                            4 => "M&#46; Gerosa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2002"
                        "volumen" => "51"
                        "paginaInicial" => "1153"
                        "paginaFinal" => "1161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12383360"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gamma knife radiosurgery in meningiomas of the posterior fossa&#46; Experience with 62 treated lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Nicolato"
                            1 => "R&#46; Foroni"
                            2 => "M&#46; Pellegrino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Minm Invasive Neurosurg"
                        "fecha" => "2001"
                        "volumen" => "44"
                        "paginaInicial" => "211"
                        "paginaFinal" => "217"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clivus and apicopetroclivus meningiomas&#58; report of 24 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Nishimura"
                            1 => "A&#46; Hakuba"
                            2 => "B&#46;J&#46; Jang"
                            3 => "Y&#46; Inoue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurol Med Chir &#40;Tokyo&#41;"
                        "fecha" => "1989"
                        "volumen" => "29"
                        "paginaInicial" => "1004"
                        "paginaFinal" => "1111"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radiotherapy in the treatment of benign meningioma of the skull base"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Nutting"
                            1 => "M&#46; Brada"
                            2 => "L&#46; Brazil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1999.90.5.0823"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "823"
                        "paginaFinal" => "827"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10223446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The natural history and growth rate of asymptomatic meningiomas&#46; A review of 60 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46;C&#46; Olivero"
                            1 => "J&#46;R&#46; Lister"
                            2 => "P&#46;W&#46; Elwood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1995.83.2.0222"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1995"
                        "volumen" => "83"
                        "paginaInicial" => "222"
                        "paginaFinal" => "224"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7616265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The surgical resectability of meningiomas of the cavernous sinus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;G&#46; O&#39;Sullivan"
                            1 => "H&#46;R&#46; van Loveren"
                            2 => "J&#46;M&#46; Tew"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1997"
                        "volumen" => "40"
                        "paginaInicial" => "238"
                        "paginaFinal" => "247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9007855"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal meningiomas&#46; A retrospective study of 139 surgical cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Paterniti"
                            1 => "P&#46; Fiore"
                            2 => "A&#46; Levila"
                            3 => "A&#46; La Camera"
                            4 => "S&#46; Cambria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg Sci&#46;"
                        "fecha" => "1999"
                        "volumen" => "43"
                        "paginaInicial" => "107"
                        "paginaFinal" => "113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10735764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Staged radiosurgical treatment for large benign cerebral lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Pendl"
                            1 => "F&#46; Unger"
                            2 => "G&#46; Papaefthymiou"
                            3 => "S&#46; Eustacchio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2000.93.supplement"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2000"
                        "volumen" => "93"
                        "numero" => "Suppl&#46; 3"
                        "paginaInicial" => "107"
                        "paginaFinal" => "112"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11143226"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hyperostosis associated with meningioma of the cranial base&#58; secondary changes or tumor invasion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;R&#46; Pieper"
                            1 => "O&#46; Al-Mefty"
                            2 => "Y&#46; Hanada"
                            3 => "D&#46; Buechner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1999"
                        "volumen" => "44"
                        "paginaInicial" => "742"
                        "paginaFinal" => "747"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201298"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas petroclivales gigantes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Piquer"
                            1 => "G&#46; Bataller"
                            2 => "H&#46; P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurocirug&#237;a"
                        "fecha" => "1996"
                        "volumen" => "7"
                        "paginaInicial" => "111"
                        "paginaFinal" => "118"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib58"
              "etiqueta" => "58&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Posterior fossa meningioma&#58; Surgical experience in 161 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46; Roberti"
                            1 => "L&#46;N&#46; Sekhar"
                            2 => "Ch&#46; Kalavakonda"
                            3 => "D&#46;C&#46; Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "8"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11546562"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673606685425"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib59"
              "etiqueta" => "59&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gamma knife radiosurgery in the management of cavernous sinus meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;H&#46; Roche"
                            1 => "J&#46; Regis"
                            2 => "H&#46; Dufour"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2000.93.supplement"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2000"
                        "volumen" => "93"
                        "numero" => "Suppl"
                        "paginaInicial" => "68"
                        "paginaFinal" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11143266"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome analysis of preoperative embolization in cranial base surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;L&#46; Rosen"
                            1 => "J&#46;M&#46; Ammerman"
                            2 => "L&#46;N&#46; Sehkar"
                            3 => "W&#46;O&#46; Bank"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2002"
                        "volumen" => "144"
                        "paginaInicial" => "1157"
                        "paginaFinal" => "1164"
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442202001904"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib61"
              "etiqueta" => "61&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical management of meningiomas originating in Meckel&#39;s cave"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Samii"
                            1 => "G&#46;A&#46; Carvalho"
                            2 => "M&#46; Tatagiba"
                            3 => "C&#46; Matthies"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1997"
                        "volumen" => "41"
                        "paginaInicial" => "767"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9316037"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib62"
              "etiqueta" => "62&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Experience witt 36 cases of petroclival meningioma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Samii"
                            1 => "M&#46; Tatagiba"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1992"
                        "volumen" => "118"
                        "paginaInicial" => "27"
                        "paginaFinal" => "32"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674911003757"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib63"
              "etiqueta" => "63&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retrosigmoid intradural suprameatal approach to Meckel&#39;s cave and the middle fossa&#58; surgical technique and outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Samii"
                            1 => "M&#46; Tatagiba"
                            2 => "G&#46;A&#46; Carvalho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2000.92.2.0235"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2000"
                        "volumen" => "92"
                        "paginaInicial" => "235"
                        "paginaFinal" => "241"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10659009"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib64"
              "etiqueta" => "64&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Conservative &#40;laberinth-preserving&#41; transpetrosal approach to the clivus and pertoclival region-indications&#44; complications&#44; results and lessons learned"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Seifert"
                            1 => "A&#46; Raabe"
                            2 => "M&#46; Zimmennann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2003"
                        "volumen" => "145"
                        "paginaInicial" => "631"
                        "paginaFinal" => "642"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib65"
              "etiqueta" => "65&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas involving the clivus&#58; a six year experience with 41 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;N&#46; Sekhar"
                            1 => "P&#46;J&#46; Jannetta"
                            2 => "L&#46;E&#46; Burkhart"
                            3 => "J&#46;E&#46; Janosky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1990"
                        "volumen" => "27"
                        "paginaInicial" => "764"
                        "paginaFinal" => "781"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2259407"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib66"
              "etiqueta" => "66&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebellopontine angle meningiomas&#58; microsurgical excision and follow-up results&#46; Reportof 24 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;N&#46; Sekhar"
                            1 => "P&#46;J&#46; Jannetta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1988.69.4.0500"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "69"
                        "paginaInicial" => "500"
                        "paginaFinal" => "505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3047341"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib67"
              "etiqueta" => "67&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical excision of meningiomas involving the clivus&#58; preoperative and intraoperative features as predictors of postoperative functional deterioration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Sekhar"
                            1 => "N&#46;S&#46; Swamy"
                            2 => "V&#46; Jaiswal"
                            3 => "E&#46; Rubinstein"
                            4 => "W&#46;E&#46; Hirsch"
                            5 => "D&#46;C&#46; Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.81.6.0860"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "81"
                        "paginaInicial" => "860"
                        "paginaFinal" => "868"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7965116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib68"
              "etiqueta" => "68&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas involving the cavernous sinus&#58; histological factors affecting the degree of resection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Sen"
                            1 => "K&#46; Hague"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1997.87.4.0535"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1997"
                        "volumen" => "87"
                        "paginaInicial" => "535"
                        "paginaFinal" => "543"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9322844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib69"
              "etiqueta" => "69&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Suprameatal extensi&#243;n of retrosigmoid approach&#58; microsurgical anatomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Seoane"
                            1 => "A&#46;L&#46; Rothon Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1999"
                        "volumen" => "44"
                        "paginaInicial" => "553"
                        "paginaFinal" => "560"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10069592"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib70"
              "etiqueta" => "70&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petroclival meningioma&#46; An attempt to define the role of skull base approaches in their surgical management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Spallone"
                            1 => "U&#46;B&#46; Makhmudov"
                            2 => "D&#46;J&#46; Mukhamedjanov"
                            3 => "V&#46;A&#46; Tcherekajev"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1999"
                        "volumen" => "51"
                        "paginaInicial" => "412"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10199295"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib71"
              "etiqueta" => "71&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The combined supra and infratentorial approach for lesions of the petrous and clival regions&#58; experience with 46 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;F&#46; Spetzler"
                            1 => "C&#46;P&#46; Daspit"
                            2 => "C&#46;T&#46;E&#46; Pappas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1992.76.4.0588"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1992"
                        "volumen" => "76"
                        "paginaInicial" => "588"
                        "paginaFinal" => "599"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1545251"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib72"
              "etiqueta" => "72&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of petroclival meningiomas by stereotactic radiosurgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;R&#46; Subach"
                            1 => "L&#46;D&#46; Lunsford"
                            2 => "D&#46; Kondziolka"
                            3 => "A&#46;D&#46; Maitz"
                            4 => "J&#46;C&#46; Flickinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1998"
                        "volumen" => "42"
                        "paginaInicial" => "437"
                        "paginaFinal" => "443"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9526975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            72 => array:3 [
              "identificador" => "bib73"
              "etiqueta" => "73&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The meningioma controversy&#58; Postopera tive radiation therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;W&#46; Taylor"
                            1 => "R&#46;B&#46; Marcus"
                            2 => "W&#46;A&#46; Friedman"
                            3 => "W&#46;E&#46; Bllinger"
                            4 => "R&#46;R&#46; Million"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Radiat Oncol Biol Phys"
                        "fecha" => "1988"
                        "volumen" => "15"
                        "paginaInicial" => "299"
                        "paginaFinal" => "304"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3403313"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            73 => array:3 [
              "identificador" => "bib74"
              "etiqueta" => "74&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lateral approaches to petroclival region"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Tedeschi"
                            1 => "A&#46;L&#46; Rothon Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1994"
                        "volumen" => "41"
                        "paginaInicial" => "180"
                        "paginaFinal" => "216"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8146735"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            74 => array:3 [
              "identificador" => "bib75"
              "etiqueta" => "75&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;T&#46; Trier"
                            1 => "R&#46;F&#46; Spetzler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2000"
                        "volumen" => "47"
                        "paginaInicial" => "1295"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            75 => array:3 [
              "identificador" => "bib76"
              "etiqueta" => "76&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The results of radiosurgical management of 72 middle fossa meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Valentino"
                            1 => "G&#46; Schinaia"
                            2 => "J&#46; Raimondi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1993"
                        "volumen" => "122"
                        "paginaInicial" => "60"
                        "paginaFinal" => "70"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            76 => array:3 [
              "identificador" => "bib77"
              "etiqueta" => "77&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Linac radiosurgery for skull base meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;T&#46; Villavicencio"
                            1 => "P&#46;M&#46; Black"
                            2 => "D&#46;C&#46; Shrieve"
                            3 => "M&#46;P&#46; Fall&#243;n"
                            4 => "E&#46; Alexander"
                            5 => "J&#46;S&#46; Loeffler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "2001"
                        "volumen" => "143"
                        "paginaInicial" => "1141"
                        "paginaFinal" => "1152"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            77 => array:3 [
              "identificador" => "bib78"
              "etiqueta" => "78&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural history of petroclival meningiomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; van Havenbergh"
                            1 => "G&#46; Carvalho"
                            2 => "M&#46; Tatagiba"
                            3 => "C&#46; Plets"
                            4 => "M&#46; Samii"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2003"
                        "volumen" => "52"
                        "paginaInicial" => "55"
                        "paginaFinal" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12493101"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            78 => array:3 [
              "identificador" => "bib79"
              "etiqueta" => "79&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meningiomas of basal posterior fossa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;G&#46; Yasargil"
                            1 => "R&#46;W&#46; Mortara"
                            2 => "M&#46; Curcic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Advances and Technical Standards in Neurosurgery"
                        "paginaInicial" => "3"
                        "paginaFinal" => "115"
                        "serieFecha" => "1980"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            79 => array:3 [
              "identificador" => "bib80"
              "etiqueta" => "80&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Petroclival meningiomas&#59; Is radical resection always the best option"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Zentner"
                            1 => "B&#46; Meyer"
                            2 => "U&#46; Vieweg"
                            3 => "C&#46; Huberhold"
                            4 => "J&#46; Schramm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1997"
                        "volumen" => "62"
                        "paginaInicial" => "341"
                        "paginaFinal" => "345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9120445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/11301473/0000001500000006/v1_201305151229/S113014730470439X/v1_201305151229/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001500000006/v1_201305151229/S113014730470439X/v1_201305151229/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730470439X?idApp=UINPBA00004B"
]

Información del artículo

ISSN: 11301473
Idioma original: Inglés

DOI:10.1016/S1130-1473(04)70439-X

Datos actualizados diariamente

año/Mes	Html	Pdf	Total

2023 Marzo	1	4	5
2018 Febrero	11	18	29
2018 Enero	16	14	30
2017 Diciembre	8	17	25
2017 Noviembre	36	28	64
2017 Octubre	10	19	29
2017 Septiembre	14	25	39
2017 Agosto	11	22	33
2017 Julio	18	23	41
2017 Junio	16	27	43
2017 Mayo	19	24	43
2017 Abril	12	28	40
2017 Marzo	21	37	58
2017 Febrero	13	41	54
2017 Enero	10	19	29
2016 Diciembre	44	19	63
2016 Noviembre	34	26	60
2016 Octubre	47	46	93
2016 Septiembre	25	43	68
2016 Agosto	0	33	33
2016 Julio	0	20	20
2015 Diciembre	2	0	2
2015 Julio	0	10	10
2015 Junio	18	42	60
2015 Mayo	30	50	80
2015 Abril	22	51	73
2015 Marzo	27	55	82
2015 Febrero	16	80	96
2015 Enero	32	109	141
2014 Diciembre	21	45	66
2014 Noviembre	18	70	88
2014 Octubre	30	73	103
2014 Septiembre	20	53	73
2014 Agosto	22	45	67
2014 Julio	18	72	90
2014 Junio	35	50	85
2014 Mayo	36	57	93
2014 Abril	26	29	55
2014 Marzo	36	49	85
2014 Febrero	32	33	65
2014 Enero	27	33	60
2013 Diciembre	25	37	62
2013 Noviembre	20	46	66
2013 Octubre	33	59	92
2013 Septiembre	34	49	83
2013 Agosto	42	43	85
2013 Julio	47	56	103
2013 Junio	38	60	98
2013 Mayo	32	69	101
2013 Abril	36	66	102
2013 Marzo	30	75	105
2013 Febrero	27	55	82
2013 Enero	48	71	119
2012 Diciembre	25	36	61
2012 Noviembre	1	10	11
2012 Septiembre	0	1	1
2012 Enero	7	0	7

Mostrar todo

Indexada en:

Síguenos:

Suscribirse:

Estadísticas

Indexada en:

Síguenos:

Suscribirse:

Estadísticas

Suscríbase a la newsletter