Monitorización neurofisiológica intraoperatoria del tronco del encéfalo en un caso de cavernoma en protuberancia
Intraoperative neurophysiological monitoring of brain stem in a case of cavernoma in the pons
R. Rodríguez
, J. Molet, S. de Teresa, P. Treserras, P. Clavel, P. Cano, J. Solivera, F. Muñoz, F. Bartumeus
Servicio de Neurocirugía. Hospital Universitario de la Santa Creu i Sant Pau. Barcelona
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"apellidos" => "Molet" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "de Teresa" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Treserras" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Clavel" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Cano" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Solivera" ] 7 => array:2 [ "nombre" => "F." "apellidos" => "Muñoz" ] 8 => array:2 [ "nombre" => "F." "apellidos" => "Bartumeus" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Universitario de la Santa Creu i Sant Pau. Barcelona" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital Universitario de la Santa Creu i Sant Pau. Sant Antoni María i Claret, 167. 08025 Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intraoperative neurophysiological monitoring of brain stem in a case of cavernoma in the pons" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-09-01" "fechaAceptado" => "2004-11-15" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158805" "palabras" => array:5 [ 0 => "Cirugía del tronco del encéfalo" 1 => "Cavernoma" 2 => "Estimulación cortical intraoperatoria" 3 => "Mapping neurofisiológico" 4 => "Fosa romboidea" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158806" "palabras" => array:5 [ 0 => "Brain stem surgery" 1 => "Cavernous hemangioma" 2 => "Brain mapping" 3 => "Neurophysiological mapping" 4 => "Rhomboid fossa" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La introducción del control neuroflsiológico intraoperatorio ha conseguido minimizar el riesgo funcional quirúrgico en lesiones localizadas en áreas cerebrales funcionales. En la actualidad realizamos control neuroñsiológico intraoperatorio para localizar el área motora o sensitiva y el área del lenguaje mediante estimulación cortical, así como de los pares craneales en cirugía del ángulo ponto cerebeloso. La monitorización neuroñsiológica durante cirugía del tronco del encéfalo y fosa romboidea está menos instaurada.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La cirugía del tronco del encéfalo implica una cuidadosa selección de los pacientes, dado el alto riesgo de morbilidad y mortalidad asociadas. Por esta razón, los cavernomas de esta región suelen ser tratados de manera conservadora cuando se trata de un hallazgo casual o no son sintomáticos. Sin embargo, la presencia de un sangrado o afectación neurológica inducen a tomar una decisión quirúrgica, dada la mala evolución natural.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una mujer de 29 años, diagnosticada de cavernomas múltiples, que ingresó por cuadro de debilidad motora y déficit sensitivo en hemicuerpo izquierdo. Se realizó TC craneal y RM que mostraba hemorragia protuberancial y se practicó una craniectomía infratentorial y resección de la lesión vascular por línea media, con control neurofisiológico intraoperatorio del VII, VIII, X y XII pares craneales con lectura electromiográfica.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El control neurofisiológico ayudó a decidir el punto de acceso a la lesión que no afloraba a la superficie, minimizar las secuelas postoperatorias y pronosticar precozmente los déficits asociados con el fin de iniciar una rehabilitación precoz.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Neurophysiological monitoring during surgery to avoid damaging of eloquent brain áreas is a useful tool. We are performing intraoperative neurophysiological test to lócate motor, sensitive and speech áreas with cortical stimulation and cranial nerves during cerebellopontine cranial base surgery. Neurophysiological monitoring during brain stem surgery has been less described.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Brain stem surgery implies a careful selección of patients for surgery given the high risk of morbidity and mortality. For this reason, conservative treatment is usually indicated when an asymptomatic cavernoma is incidentally found. Instead, when bleeding or neurological deficit appear, operative treatment may be indicated and then the goal of surgery is to avoid the disability linked to the natural history.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We present the case of a 29 years oíd woman with diagnosis of múltiple cavernomas. She was admitted at our hospital because she presented weakness and sensitive disturbance of left limbs and dizziness. The CT sean and MRI showed a pontine haemorrhage caused by a cavernous hemangioma. We operated her on using neurophysiological monitoring of VII, VIII, X and XII cranial nerves with electromyographic recordings.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Postoperative disability could be reduced with a better knowledge of entry zone into the brain stem and early physiotherapy.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Rodríguez, R.; Molet, J.; de Teresa, S.; Treserras, P.; Clavel, P.; Cano, P.; Solivera, J.; Muñoz, F.; Bartumeus, F.: Monitorización neurofisiológica intraoperatoria del tronco del encéfalo en un caso de cavernoma en protuberancia. Neurocirugía 2005; 16: 117–123.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:44 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history of intracranial cavernous malformations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Alba" 1 => "R. Tanaka" 2 => "T. Koike" 3 => "S. Kameyama" 4 => "N. Takeda" 5 => "T. Komata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1995.83.1.0056" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "1995" "volumen" => "83" "paginaInicial" => "56" "paginaFinal" => "59" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7782850" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 5 | 2 | 7 |
| 2018 Febrero | 11 | 6 | 17 |
| 2018 Enero | 17 | 11 | 28 |
| 2017 Diciembre | 14 | 9 | 23 |
| 2017 Noviembre | 49 | 13 | 62 |
| 2017 Octubre | 13 | 9 | 22 |
| 2017 Septiembre | 12 | 21 | 33 |
| 2017 Agosto | 11 | 9 | 20 |
| 2017 Julio | 14 | 9 | 23 |
| 2017 Junio | 18 | 18 | 36 |
| 2017 Mayo | 23 | 11 | 34 |
| 2017 Abril | 15 | 45 | 60 |
| 2017 Marzo | 13 | 8 | 21 |
| 2017 Febrero | 11 | 10 | 21 |
| 2017 Enero | 8 | 10 | 18 |
| 2016 Diciembre | 38 | 16 | 54 |
| 2016 Noviembre | 30 | 14 | 44 |
| 2016 Octubre | 43 | 15 | 58 |
| 2016 Septiembre | 46 | 28 | 74 |
| 2016 Agosto | 46 | 23 | 69 |
| 2016 Julio | 33 | 31 | 64 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Junio | 14 | 6 | 20 |
| 2015 Mayo | 21 | 20 | 41 |
| 2015 Abril | 13 | 11 | 24 |
| 2015 Marzo | 19 | 18 | 37 |
| 2015 Febrero | 6 | 16 | 22 |
| 2015 Enero | 13 | 16 | 29 |
| 2014 Diciembre | 15 | 12 | 27 |
| 2014 Noviembre | 14 | 15 | 29 |
| 2014 Octubre | 22 | 17 | 39 |
| 2014 Septiembre | 12 | 14 | 26 |
| 2014 Agosto | 12 | 9 | 21 |
| 2014 Julio | 12 | 16 | 28 |
| 2014 Junio | 30 | 19 | 49 |
| 2014 Mayo | 17 | 16 | 33 |
| 2014 Abril | 19 | 13 | 32 |
| 2014 Marzo | 19 | 15 | 34 |
| 2014 Febrero | 18 | 21 | 39 |
| 2014 Enero | 15 | 29 | 44 |
| 2013 Diciembre | 17 | 17 | 34 |
| 2013 Noviembre | 19 | 19 | 38 |
| 2013 Octubre | 17 | 28 | 45 |
| 2013 Septiembre | 20 | 26 | 46 |
| 2013 Agosto | 23 | 24 | 47 |
| 2013 Julio | 29 | 20 | 49 |
| 2013 Junio | 11 | 26 | 37 |
| 2013 Mayo | 13 | 25 | 38 |
| 2013 Abril | 9 | 30 | 39 |
| 2013 Marzo | 15 | 35 | 50 |
| 2013 Febrero | 13 | 34 | 47 |
| 2013 Enero | 12 | 16 | 28 |
| 2012 Diciembre | 10 | 11 | 21 |
| 2012 Noviembre | 1 | 11 | 12 |
| 2012 Octubre | 0 | 2 | 2 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 8 | 0 | 8 |
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