Lesión traumática del tronco cerebral diagnosticada por resonancia magnética. Reconsideración epidemiológica y pronostica
Brainstem injury diagnosed by MRI. An epidemiologic and prognostic reappraisal
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"apellidos" => "Cabezudo-Artero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305704292?idApp=UINPBA00004B" "url" => "/11301473/0000001600000001/v1_201305151233/S1130147305704292/v1_201305151233/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1130147305704279" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70427-9" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70427" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Neurocirugia. 2005;16:12-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1487 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 901 "PDF" => 569 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Comentario al trabajo <span class="elsevierStyleItalic">Comparación de la eficacia del pentobarbital y el tiopental en el control de la hipertensión intracraneal refractaria. 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Reconsideración epidemiológica y pronostica" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "14" "paginaFinal" => "20" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "J. Aguas" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Aguas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neurocirugía. Hospital Universitari Arnau de Vilanova. Lleida" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital Universitari Arnau de Vilanova de Lleida. Avenida Rovira Roure, 80. 25198 Lleida." ] ] ] 1 => array:3 [ "autoresLista" => "R. Begué, J. Diez" "autores" => array:2 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Begué" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Diez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Instituí de diagnostic per l’imatge. Hospital Universitari Arnau de Vilanova. Lleida" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Brainstem injury diagnosed by MRI. An epidemiologic and prognostic reappraisal" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-01-26" "fechaAceptado" => "2004-04-16" "PalabrasClave" => array:2 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158709" "palabras" => array:5 [ 0 => "Tronco cerebral" 1 => "Traumatismo craneal" 2 => "Resonancia magnética" 3 => "Secuencia FLAIR" 4 => "Lesión axonal difusa" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abreviaturas" "identificador" => "xpalclavsec158710" "palabras" => array:8 [ 0 => "DP" 1 => "FLAIR" 2 => "GCS" 3 => "LAD" 4 => "LED" 5 => "RM" 6 => "TAC" 7 => "TCE" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec158711" "palabras" => array:5 [ 0 => "Brainstem" 1 => "Head injury" 2 => "Magnetic Resonance imaging" 3 => "FLAIR sequence" 4 => "Diffuse axonal injury" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción y Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La TAC craneal permite la evaluación quirúrgica urgente de un TCE, pero no supone una evaluación completa de las lesiones encefálicas producidas. La resonancia magnética (RM) puede complementar la evaluación del TCE, especialmente a nivel de tronco cerebral. Utilizando la secuencia FLAIR pretendemos obtener una estimación de la frecuencia de lesión primaria traumática de tronco cerebral.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se presenta una serie prospectiva de 30 casos con TCE moderado o grave (GCS≤13) a los que se les realizó RM en un intervalo menor a dos semanas tras el traumatismo. En la serie se incluyeron exclusivamente pacientes jóvenes (entre 16 y 40 años), con objeto de excluir lesiones previas de tipo isquémico no relacionadas con el traumatismo. Quedaron fuera los pacientes con cirugía craneal para excluir lesiones yatrogénicas.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En base a estudios previos, se utilizó la secuencia FLAIR (Fluid Attenuated Inversión Recovery 8000/ 120/ T. Inversión 2200mseg) para la detección óptima de lesiones de tronco cerebral.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En un 26,6% de los casos se apreciaron lesiones en tronco cerebral confirmadas por dos radiólogos independientes. De ellas, seis casos correspondían a lesiones hiperintensas compatibles con lesión axonal difusa y dos casos a lesión hemorrágica. La supervivencia de la serie fue del 100%, si bien este dato está sesgado por la selección exclusiva de pacientes que en un plazo inferior a dos semanas habían salido de cuidados intensivos. En cuatro casos pudo establecerse una relación directa entre lesión y focalidad neurológica. En el resto, la lesión fue relacionada con trastornos inespecíficos del nivel de consciencia.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Consideramos que la RM en secuencia FLAIR nos permite visualizar un tipo de lesión traumática de tronco cerebral (posiblemente lesión axonal) que presenta mayor frecuencia y menor gravedad pronostica que aquellas otras descritas clásicamente en estudios realizados mediante TAC.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction and Objectives</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">CT-scan allows emer-gency surgical evaluation of head injury lesions, but does not offer a comprehensive diagnosis of the resulting brain injuries. Magnetic Resonance Imaging (MRI) can complete the evaluation of head injury, par-ticularly in the brain stem. We attempted to estímate the frequency of traumatic primary brain stem injuries by using the FLAIR (Fluid Attenuated Inversión Recovery) sequence.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Thirty patients with modérate or severe head injury (GCS≤13) underwent a MRI study during the first two weeks after trauma. In order to exelude oíd patients with previous ischemic lesions unrelated to the head trauma, only young patients (16–40 years-old) were included. Patients with cranial surgery were also eliminated from the study. Based on previous studies, the FLAIR (8000/120/T. Inversión 2200mseg) sequence was selected.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Brain stem injuries were detected in 26.6% of the patients; this was confirmed by two independent radiologists. Six patients had hyperintense lesions compatible with diffuse axonal damage, and two others showed hemorrhagic lesions. These flndings were directly related to a specific neurological déficit in four patients; while in the remaining, unspecific conscious-ness disturbances were noted.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">We believe that the FLAIR sequence demónstrate a type of traumatic brain stem injury (probably corresponding to diffuse axonal injury) that is more frequent and less severe in terms of prognosis than those classically described in previous CT sean studies.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Aguas J.; Begué R.; Diez J.: Lesión traumática de tronco cerebral diagnosticada por resonancia magnética. Reconsideración epidemiológica y pronostica. Neurocirugía 2005; 16: 14–20.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI of head injury using FLAIR" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Ashikaga" 1 => "Y. Araki" 2 => "O. Ishida" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neuroradiology" "fecha" => "1997" "volumen" => "39" "paginaInicial" => "239" "paginaFinal" => "242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9144669" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 1 | 2 |
| 2020 Octubre | 0 | 2 | 2 |
| 2018 Septiembre | 1 | 0 | 1 |
| 2018 Marzo | 6 | 0 | 6 |
| 2018 Febrero | 29 | 2 | 31 |
| 2018 Enero | 41 | 9 | 50 |
| 2017 Diciembre | 27 | 16 | 43 |
| 2017 Noviembre | 52 | 36 | 88 |
| 2017 Octubre | 27 | 11 | 38 |
| 2017 Septiembre | 32 | 14 | 46 |
| 2017 Agosto | 47 | 6 | 53 |
| 2017 Julio | 49 | 3 | 52 |
| 2017 Junio | 49 | 6 | 55 |
| 2017 Mayo | 41 | 10 | 51 |
| 2017 Abril | 36 | 8 | 44 |
| 2017 Marzo | 28 | 5 | 33 |
| 2017 Febrero | 25 | 3 | 28 |
| 2017 Enero | 31 | 13 | 44 |
| 2016 Diciembre | 54 | 12 | 66 |
| 2016 Noviembre | 76 | 15 | 91 |
| 2016 Octubre | 74 | 34 | 108 |
| 2016 Septiembre | 81 | 13 | 94 |
| 2016 Agosto | 69 | 8 | 77 |
| 2016 Julio | 45 | 19 | 64 |
| 2016 Junio | 2 | 0 | 2 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 1 | 0 | 1 |
| 2016 Febrero | 6 | 0 | 6 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Julio | 2 | 11 | 13 |
| 2015 Junio | 21 | 5 | 26 |
| 2015 Mayo | 22 | 11 | 33 |
| 2015 Abril | 18 | 11 | 29 |
| 2015 Marzo | 21 | 12 | 33 |
| 2015 Febrero | 19 | 11 | 30 |
| 2015 Enero | 32 | 15 | 47 |
| 2014 Diciembre | 15 | 10 | 25 |
| 2014 Noviembre | 21 | 12 | 33 |
| 2014 Octubre | 27 | 18 | 45 |
| 2014 Septiembre | 21 | 16 | 37 |
| 2014 Agosto | 31 | 19 | 50 |
| 2014 Julio | 25 | 14 | 39 |
| 2014 Junio | 28 | 22 | 50 |
| 2014 Mayo | 33 | 24 | 57 |
| 2014 Abril | 34 | 15 | 49 |
| 2014 Marzo | 31 | 30 | 61 |
| 2014 Febrero | 23 | 22 | 45 |
| 2014 Enero | 18 | 18 | 36 |
| 2013 Diciembre | 26 | 16 | 42 |
| 2013 Noviembre | 27 | 26 | 53 |
| 2013 Octubre | 24 | 16 | 40 |
| 2013 Septiembre | 27 | 34 | 61 |
| 2013 Agosto | 30 | 25 | 55 |
| 2013 Julio | 33 | 21 | 54 |
| 2013 Junio | 25 | 25 | 50 |
| 2013 Mayo | 21 | 20 | 41 |
| 2013 Abril | 24 | 24 | 48 |
| 2013 Marzo | 21 | 27 | 48 |
| 2013 Febrero | 10 | 16 | 26 |
| 2013 Enero | 18 | 13 | 31 |
| 2012 Diciembre | 13 | 22 | 35 |
| 2012 Noviembre | 0 | 12 | 12 |
| 2012 Octubre | 0 | 4 | 4 |
| 2012 Septiembre | 0 | 1 | 1 |
| 2012 Enero | 23 | 0 | 23 |
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