array:22 [
  "pii" => "S1130147306703517"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(06)70351-7"
  "estado" => "S300"
  "fechaPublicacion" => "2006-01-01"
  "aid" => "70351"
  "copyright" => "Sociedad Española de Neurocirugía"
  "copyrightAnyo" => "2006"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2006;17:105-18"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1633
    "formatos" => array:3 [
      "EPUB" => 18
      "HTML" => 914
      "PDF" => 701
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1130147306703529"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(06)70352-9"
    "estado" => "S300"
    "fechaPublicacion" => "2006-01-01"
    "aid" => "70352"
    "copyright" => "Sociedad Española de Neurocirugía"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2006;17:119-24"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1945
      "formatos" => array:3 [
        "EPUB" => 14
        "HTML" => 1049
        "PDF" => 882
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Delirio postoperatorio en pacientes neuroquirúrgicos: evaluación mediante el Test Mental Abreviado"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "119"
          "paginaFinal" => "124"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Postoperative delirium in patient neurosurgical: evaluation by means of the Abbreviated Mental Test"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:2 [
        0 => array:2 [
          "autoresLista" => "J. Hernández-Palazón, P. Doménech-Asensi, S. Burguillos-López"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J."
              "apellidos" => "Hernández-Palazón"
            ]
            1 => array:2 [
              "nombre" => "P."
              "apellidos" => "Doménech-Asensi"
            ]
            2 => array:2 [
              "nombre" => "S."
              "apellidos" => "Burguillos-López"
            ]
          ]
        ]
        1 => array:2 [
          "autoresLista" => "M.A. Pérez-Espejo, F. López-Hernández, J.F. Martínez-Lage"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M.A."
              "apellidos" => "Pérez-Espejo"
            ]
            1 => array:2 [
              "nombre" => "F."
              "apellidos" => "López-Hernández"
            ]
            2 => array:2 [
              "nombre" => "J.F."
              "apellidos" => "Martínez-Lage"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147306703529?idApp=UINPBA00004B"
    "url" => "/11301473/0000001700000002/v1_201305151252/S1130147306703529/v1_201305151252/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Resonancia magnética en trauma craneal moderado y grave: estudio comparativo de hallazgos en TC y RM. Características relacionadas con la presencia y localización de lesión axonal difusa en RM"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "105"
        "paginaFinal" => "118"
      ]
    ]
    "autores" => array:2 [
      0 => array:4 [
        "autoresLista" => "A. Lagares, R. Alday, A. Pérez-Núñez, I. Arrese, J.F. Alén, B. Pascual, A. Kaen, P.A. Gómez, R.D. Lobato"
        "autores" => array:9 [
          0 => array:3 [
            "nombre" => "A."
            "apellidos" => "Lagares"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Alday"
          ]
          2 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "P&#233;rez-N&#250;&#241;ez"
          ]
          3 => array:2 [
            "nombre" => "I&#46;"
            "apellidos" => "Arrese"
          ]
          4 => array:2 [
            "nombre" => "J&#46;F&#46;"
            "apellidos" => "Al&#233;n"
          ]
          5 => array:2 [
            "nombre" => "B&#46;"
            "apellidos" => "Pascual"
          ]
          6 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Kaen"
          ]
          7 => array:2 [
            "nombre" => "P&#46;A&#46;"
            "apellidos" => "G&#243;mez"
          ]
          8 => array:2 [
            "nombre" => "R&#46;D&#46;"
            "apellidos" => "Lobato"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicios de Neurocirug&#237;a&#46; Hospital 12 de Octubre&#46; Madrid"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia postal&#58; Servicio de Neurocirug&#237;a&#46; Hospital 12 de Octubre&#46; Crta de Andalucia km 5&#44;4&#46; 28041 Madrid&#46;"
          ]
        ]
      ]
      1 => array:3 [
        "autoresLista" => "A&#46; Ramos, F&#46; Ballenilla"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Ramos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Ballenilla"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Servicios de Neurorradiolog&#237;a&#46; Hospital 12 de Octubre&#46; Madrid"
            "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
            "identificador" => "aff0010"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Magnetic Resonance in moderate and severe head injury&#58; comparative study of CT and MR findings&#46; Characteristics related to the presence and location of diffuse axonal injury in MR"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2005-05-12"
    "fechaAceptado" => "2005-05-31"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec159196"
          "palabras" => array:6 [
            0 => "Lesi&#243;n traum&#225;tica cerebral"
            1 => "Trauma craneal"
            2 => "RM"
            3 => "TC"
            4 => "Lesi&#243;n axonal difusa"
            5 => "M&#233;todos de imagen"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec159195"
          "palabras" => array:6 [
            0 => "Traumatic brain injury"
            1 => "Head trauma"
            2 => "MR"
            3 => "CT"
            4 => "Diffuse axonal injury"
            5 => "Imaging methods"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La TC craneal ha sido el m&#233;todo m&#225;s extendido en la evaluaci&#243;n de enfermos que han sufrido trauma craneal&#46; Sin embargo&#44; es poco sensible en la identificaci&#243;n de lesi&#243;n axonal difusa y lesiones en fosa posterior&#46; La RM craneal es una prueba potencialmente m&#225;s sensible pero de dif&#237;cil realizaci&#243;n en estos enfermos&#44; hecho que ha impedido la generalizaci&#243;n de su uso&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparar la capacidad de identificaci&#243;n de lesiones intracraneales postraum&#225;ticas por parte de las dos pruebas diagn&#243;sticas en enfermos con TCE grave y moderado&#44; y determinar qu&#233; caracter&#237;sticas radiol&#243;gicas en la TC se asocian a la presencia de LAD en RM y su gravedad cl&#237;nica&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyen en el estudio 100 enfermos con TCE moderado y grave a los que se ha realizado RM craneal dentro de los primeros 30 d&#237;as tras el trauma craneal&#46; Se recogieron todas las variables cl&#237;nicas potencialmente relacionadas con el pron&#243;stico de los enfermos&#44; as&#237; como los datos del TC inicial seg&#250;n la clasificaci&#243;n de Marshall y cols&#46; La RM fue evaluada de manera ciega por dos neurorradi&#243;logos que ignoraban al resultado de la TC inicial y la situaci&#243;n cl&#237;nica inicial del paciente&#46; Se recogieron todas las lesiones que presentaban&#44; as&#237; como su clasificaci&#243;n seg&#250;n la clasificaci&#243;n de lesiones asociadas con LAD&#44; descrita por Adams&#46; Se compararon los hallazgos en TC y RM&#44; evaluando la sensibilidad de cada prueba con respecto a los diferentes hallazgos&#46; Se estudiaron los hallazgos relacionados con la presencia de LAD en RM&#44; mediante estudio univariable&#44; usando la prueba de &#967;<span class="elsevierStyleSup">2</span> y correlaciones simples&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La RM es m&#225;s sensible que la TC para las lesiones en sustancia blanca cerebral&#44; cuerpo calloso y tronco&#46; Adem&#225;s&#44; detecta mayor n&#250;mero de contusiones&#46; La presencia de lesi&#243;n axonal difusa depende del mecanismo de producci&#243;n del trauma&#44; siendo m&#225;s frecuente en traumas de mayor energ&#237;a&#44; sobre todo en los accidentes de tr&#225;fico&#44; bien sea con autom&#243;vil o moto&#47;bici&#46; En cuanto a las caracter&#237;sticas radiol&#243;gicas asociadas a LAD la m&#225;s claramente relacionada es la hemorragia intraventricular&#46; La presencia de da&#241;o cada vez m&#225;s profundo y mayor puntuaci&#243;n en la escala de Adams se asocia a menor puntuaci&#243;n en la GCS y GCS motora&#44; y por consiguiente peor nivel de conciencia y mayor gravedad del trauma inicial&#44; confirmando el modelo de Ommaya&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cranial CT has been the most extended evaluation means for patients suffering head trauma&#46; However&#44; it has low sensitivity in the identification of diffuse axonal injury and posterior fossa lesions&#46; Cranial MR is a potentially more sensitive test but difficult to perform in these patients&#44; a fact that has hampered its generalised use&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To compare the identification capability of traumatic intracranial lesions by both diagnostic tests in patients with moderate and severe head injury and to determine which radiological characteristics are associated with the presence of diffuse injury in MR and their clinical severity&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">100 patients suffering moderate or severe head injury to whom a MR had been performed in the first 30 days after trauma were included&#46; All clinical variables related to prognosis were registered&#44; as well as the data from the initial CT following Marshall et al&#46;&#44; classification&#46; The MR was blindly evaluated by two neuroradiologists that were not aware of the initial CT results or the clinical situation of the patient&#46; All lesions were registered as well as the classification following the classification of lesions related to DAI described by Adams et al&#46; CT and MR findings were compared evaluating the sensitivities of each test&#46; Factors related to the presence of diffuse injury in MR were studied by univariate analysis using &#967;<span class="elsevierStyleSup">2</span> test and simple correlations&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">MR is more sensitive than CT for lesions in cerebral white matter&#44; corpus callosum and brainstem&#46; It also detects a greater number of cerebral contussions&#46; The presence of diffuse axonal injury depends on the mechanism of the trauma&#44; being more frequent in higher energy trauma&#44; specially in traffic accidents&#46; Among the radiological characteristics associated to DAI the most clearly related is intraventricular haemorrhage&#46; The presence of a deeper injury and a higher score in the scales of Adams is associated with a lower score in the GCS and motor GCS&#44; and so with a worse level of consciousness and bigger severity of injury&#44; confirming Ommaya&#39;s model&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Lagares&#44; A&#46;&#59; Ramos&#44; A&#44;&#59; Alday&#44; R&#46;&#59; Ballenilla&#44; F&#46;&#59; P&#233;rez&#44; A&#44;&#59; Arrese&#44; I&#46;&#59; Fern&#225;ndez-Al&#233;n&#44; J&#46;A&#46;&#59; Pascual&#44; B&#46;&#59; Kaen&#44; A&#46;&#59; G&#243;mez&#44; P&#46;A&#46;&#59; Lobato&#44; R&#46;D&#46;&#58; Resonancia magn&#233;tica en trauma craneal moderado y grave&#58; estudio comparativo de hallazgos en TC y RM&#46; Caracter&#237;sticas relacionadas con la presencia y localizaci&#243;n de lesi&#243;n axonal difusa en RM&#46; Neurocirug&#237;a 2006&#59; 17&#58; 105&#8211;118&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury in head injury&#58; definition&#44; diagnosis and grading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;H&#46; Adams"
                            1 => "D&#46; Doyle"
                            2 => "I&#46; Ford"
                            3 => "T&#46;A&#46; Gennarelli"
                            4 => "D&#46;I&#46; Graham"
                            5 => "D&#46;R&#46; McLellan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Histopathology"
                        "fecha" => "1989"
                        "volumen" => "15"
                        "paginaInicial" => "49"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2767623"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury in non-missile head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;H&#46; Adams"
                            1 => "D&#46;I&#46; Graham"
                            2 => "T&#46;A&#46; Gennarelli"
                            3 => "W&#46;L&#46; Maxwell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1991"
                        "volumen" => "54"
                        "paginaInicial" => "481"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1880506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Brainstem injury diagnosed by MRI&#46; An epidemiologic and prognostic reappraisal&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Aguas"
                            1 => "R&#46; Begue"
                            2 => "J&#46; D&#237;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "14"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Prognostic factors in severe head injury&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;R&#46; Boto"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "C&#46;J&#46; De la"
                            3 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2004"
                        "volumen" => "15"
                        "paginaInicial" => "233"
                        "paginaFinal" => "247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15239010"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Overview of the recent clinical trials in severe head injury and analysis of their therapeutic failure&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;R&#46; Boto"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "C&#46;J&#46; De la"
                            3 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "39"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intraventricular hemorrhage in severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Cordob&#233;s"
                            1 => "M&#46; de la Fuente"
                            2 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.58.2.0217"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "58"
                        "paginaInicial" => "217"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6600274"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-traumatic diffuse axonal brain injury&#46; Analysis of 78 patients studied with computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "F&#46; Cordob&#233;s"
                            1 => "R&#46;D&#46; Lobato"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "A&#46; Cabrera"
                            4 => "M&#46; Sarabia"
                            5 => "S&#46; Castro"
                            6 => "C&#46; Cisneros"
                            7 => "I&#46;D&#46; Torres"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1986"
                        "volumen" => "81"
                        "paginaInicial" => "27"
                        "paginaFinal" => "35"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Initial CT findings in 753 patients with severe head injury&#46; A report from the NIH Traumatic Coma Data Bank"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "H&#46;M&#46; Eisenberg"
                            1 => "H&#46;E&#46; Gary Jr&#46;"
                            2 => "E&#46;F&#46; Aldrich"
                            3 => "C&#46; Saydjari"
                            4 => "B&#46; Turner"
                            5 => "M&#46;A&#46; Foulkes"
                            6 => "J&#46;A&#46; Jane"
                            7 => "A&#46; Marmarou"
                            8 => "L&#46;F&#46; Marshall"
                            9 => "H&#46;F&#46; Young"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1990.73.5.0688"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1990"
                        "volumen" => "73"
                        "paginaInicial" => "688"
                        "paginaFinal" => "698"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2213158"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Animal models of human head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;A&#46; Gennarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.1994.11.357"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "1994"
                        "volumen" => "11"
                        "paginaInicial" => "357"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7837277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MR imaging of head trauma&#58; review of the distribution and radiopathologic features of traumatic lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;R&#46; Gentry"
                            1 => "J&#46;C&#46; Godersky"
                            2 => "B&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.150.3.663"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1988"
                        "volumen" => "150"
                        "paginaInicial" => "663"
                        "paginaFinal" => "672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3257624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective comparative study of intermediate-field MR and CT in the evaluation of closed head trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;R&#46; Gentry"
                            1 => "J&#46;C&#46; Godersky"
                            2 => "B&#46; Thompson"
                            3 => "V&#46;D&#46; Dunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.150.3.673"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1988"
                        "volumen" => "150"
                        "paginaInicial" => "673"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3257625"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injuries&#58; pathophysiology and imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Hammoud"
                            1 => "B&#46;A&#46; Wasserman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neuroimag Clin N AM"
                        "fecha" => "2002"
                        "volumen" => "12"
                        "paginaInicial" => "205"
                        "paginaFinal" => "216"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Head trauma&#58; comparison of MR and CT--experience in 100 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;B&#46; Kelly"
                            1 => "R&#46;D&#46; Zimmerman"
                            2 => "R&#46;B&#46; Snow"
                            3 => "S&#46;E&#46; Gandy"
                            4 => "L&#46;A&#46; Heier"
                            5 => "M&#46;D&#46; Deck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "1988"
                        "volumen" => "9"
                        "paginaInicial" => "699"
                        "paginaFinal" => "708"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3135716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognosis of severe head injuries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Levati"
                            1 => "M&#46;L&#46; Farina"
                            2 => "G&#46; Vecchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1982.57.6.0779"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1982"
                        "volumen" => "57"
                        "paginaInicial" => "779"
                        "paginaFinal" => "783"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7143060"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of depth of brain lesions to consciousness and outcome after closed head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "H&#46;S&#46; Levin"
                            1 => "D&#46; Williams"
                            2 => "M&#46;J&#46; Crofford"
                            3 => "W&#46;M&#46; High Jr&#46;"
                            4 => "H&#46;M&#46; Eisenberg"
                            5 => "E&#46;G&#46; Amparo"
                            6 => "F&#46;C&#46; Guinto Jr&#46;"
                            7 => "Z&#46; Kalisky"
                            8 => "S&#46;F&#46; Handel"
                            9 => "A&#46;M&#46; Goldman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1988.69.6.0861"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1988"
                        "volumen" => "69"
                        "paginaInicial" => "861"
                        "paginaFinal" => "866"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3193191"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome from severe head injury related to the type of intracranial lesion&#46; A computerized tomography study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "F&#46; Cordob&#233;s"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "F&#46;M&#46; de la"
                            4 => "A&#46; Montero"
                            5 => "A&#46; B&#225;rcena"
                            6 => "C&#46; P&#233;rez"
                            7 => "A&#46; Cabrera"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.59.5.0762"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "59"
                        "paginaInicial" => "762"
                        "paginaFinal" => "774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6619928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sequential computerized tomography changes and related final outcome in severe head injury patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "R&#46; Alday"
                            3 => "J&#46;J&#46; Rivas"
                            4 => "J&#46; Dom&#237;nguez"
                            5 => "A&#46; Cabrera"
                            6 => "F&#46;S&#46; Turanzas"
                            7 => "A&#46; Ben&#237;tez"
                            8 => "B&#46; Rivero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1997"
                        "volumen" => "139"
                        "paginaInicial" => "385"
                        "paginaFinal" => "391"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normal computerized tomography scans in severe head injury&#46; Prognostic and clinical management implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "R&#46; Sarabia"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "F&#46; Cordob&#233;s"
                            4 => "S&#46; Castro"
                            5 => "M&#46;J&#46; Mu&#241;oz"
                            6 => "A&#46; Cabrera"
                            7 => "A&#46; B&#225;rcena"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1986.65.6.0784"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1986"
                        "volumen" => "65"
                        "paginaInicial" => "784"
                        "paginaFinal" => "789"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3772476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new classification of head injury based on computerized tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46;F&#46; Marshall"
                            1 => "M&#46;R&#46; Klauber"
                            2 => "Van Berkum"
                            3 => "M&#46; Clark"
                            4 => "H&#46; Eisenberg"
                            5 => "J&#46;A&#46; Jane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg&#46;"
                        "fecha" => "1991"
                        "volumen" => "75"
                        "numero" => "Suppl"
                        "paginaInicial" => "14"
                        "paginaFinal" => "20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuropsychological outcome in relation to the traumatic coma data bank classification of computed tomography imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "M&#46; Mataro"
                            1 => "M&#46;A&#46; Poca"
                            2 => "J&#46; Sahuquillo"
                            3 => "S&#46; Pedraza"
                            4 => "M&#46; Ariza"
                            5 => "S&#46; Amor&#243;s"
                            6 => "C&#46; Junque"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/089771501750451794"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "2001"
                        "volumen" => "18"
                        "paginaInicial" => "869"
                        "paginaFinal" => "879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11565599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative study of magnetic resonance and CT scan imaging in cases of severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "T&#46; Ogawa"
                            1 => "H&#46; Sekino"
                            2 => "M&#46; Uzura"
                            3 => "T&#46; Sakamoto"
                            4 => "Y&#46; Taguchi"
                            5 => "Y&#46; Yamaguchi"
                            6 => "T&#46; Hayashi"
                            7 => "I&#46; Yamanaka"
                            8 => "N&#46; Oohama"
                            9 => "S&#46; Imaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir Suppl &#40;Wien&#41;"
                        "fecha" => "1992"
                        "volumen" => "55"
                        "paginaInicial" => "8"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral concussion and traumatic unconsciousness&#46; Correlation of experimental and clinical observations of blunt head injuries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;K&#46; Ommaya"
                            1 => "T&#46;A&#46; Gennarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain"
                        "fecha" => "1974"
                        "volumen" => "97"
                        "paginaInicial" => "633"
                        "paginaFinal" => "654"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4215541"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging findings in diffuse axonal injury after closed head trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "P&#46;M&#46; Parizel"
                            1 => "Ozsarlak"
                            2 => "J&#46;W&#46; Van Goethem"
                            3 => "H&#46;L&#46; Van Den"
                            4 => "C&#46; Dillen"
                            5 => "J&#46; Verlooy"
                            6 => "P&#46; Cosyns"
                            7 => "A&#46;M&#46; De Schepper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "1998"
                        "volumen" => "8"
                        "paginaInicial" => "960"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9683701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pathobiology of traumatically induced axonal injury in animals and humans&#58; a review of current thoughts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;T&#46; Povlishock"
                            1 => "C&#46;W&#46; Christman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.1995.12.555"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "1995"
                        "volumen" => "12"
                        "paginaInicial" => "555"
                        "paginaFinal" => "564"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8683606"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury after head trauma&#46; A review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Sahuquillo"
                            1 => "M&#46;A&#46; Poca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Tech Stand Neurosurg"
                        "fecha" => "2002"
                        "volumen" => "27"
                        "paginaInicial" => "23"
                        "paginaFinal" => "86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11887581"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury after severe head trauma&#46; A clinico-pathological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Sahuquillo"
                            1 => "J&#46; Vilalta-Cast&#225;n"
                            2 => "J&#46; Lamarca"
                            3 => "E&#46; Rubio"
                            4 => "M&#46; Rodr&#237;guez-Pazos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1989"
                        "volumen" => "101"
                        "paginaInicial" => "762"
                        "paginaFinal" => "774"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse degeneration of cerebral white matter in severe dementia following head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Strich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1956"
                        "volumen" => "19"
                        "paginaInicial" => "163"
                        "paginaFinal" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13357957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of traumatic intracranial hematoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Teasdale"
                            1 => "S&#46; Galbraith"
                            2 => "L&#46;S&#46; Murray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1983"
                        "volumen" => "285"
                        "paginaInicial" => "1695"
                        "paginaFinal" => "1697"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6816334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traumatismos craneoencef&#225;licos graves sin lesiones significativas en la TAC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Vilalta-Cast&#225;n"
                            1 => "J&#46; Sahuquillo"
                            2 => "E&#46; Rubio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Revista de Neurolog&#237;a"
                        "fecha" => "1984"
                        "volumen" => "57"
                        "paginaInicial" => "133"
                        "paginaFinal" => "140"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Magnetic resonance imaging in cases of severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Wilberger"
                            1 => "Z&#46; Deeb"
                            2 => "W&#46; Rothfus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1987"
                        "volumen" => "20"
                        "paginaInicial" => "571"
                        "paginaFinal" => "576"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3587549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Head injury&#58; early results of comparing CT and high-field MR"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;A&#46; Zimmerman"
                            1 => "L&#46;T&#46; Bilaniuk"
                            2 => "D&#46;B&#46; Hackney"
                            3 => "H&#46;I&#46; Goldberg"
                            4 => "R&#46;I&#46; Grossman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.147.6.1215"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1986"
                        "volumen" => "147"
                        "paginaInicial" => "1215"
                        "paginaFinal" => "1222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3490757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11301473/0000001700000002/v1_201305151252/S1130147306703517/v1_201305151252/es/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001700000002/v1_201305151252/S1130147306703517/v1_201305151252/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147306703517?idApp=UINPBA00004B"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Resonancia magnética en trauma craneal moderado y grave: estudio comparativo de hallazgos en TC y RM. Características relacionadas con la presencia y localización de lesión axonal difusa en RM
Magnetic Resonance in moderate and severe head injury: comparative study of CT and MR findings. Characteristics related to the presence and location of diffuse axonal injury in MR
A. Lagares
, R. Alday, A. Pérez-Núñez, I. Arrese, J.F. Alén, B. Pascual, A. Kaen, P.A. Gómez, R.D. Lobato
Servicios de Neurocirugía. Hospital 12 de Octubre. Madrid
A. Ramos*, F. Ballenilla*
* Servicios de Neurorradiología. Hospital 12 de Octubre. Madrid
Leído
1619
Veces
se ha leído el artículo
702
Total PDF
917
Total HTML
Compartir estadísticas
 array:22 [
  "pii" => "S1130147306703517"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(06)70351-7"
  "estado" => "S300"
  "fechaPublicacion" => "2006-01-01"
  "aid" => "70351"
  "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
  "copyrightAnyo" => "2006"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2006;17:105-18"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1633
    "formatos" => array:3 [
      "EPUB" => 18
      "HTML" => 914
      "PDF" => 701
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1130147306703529"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(06)70352-9"
    "estado" => "S300"
    "fechaPublicacion" => "2006-01-01"
    "aid" => "70352"
    "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2006;17:119-24"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1945
      "formatos" => array:3 [
        "EPUB" => 14
        "HTML" => 1049
        "PDF" => 882
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Delirio postoperatorio en pacientes neuroquir&#250;rgicos&#58; evaluaci&#243;n mediante el Test Mental Abreviado"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "119"
          "paginaFinal" => "124"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Postoperative delirium in patient neurosurgical&#58; evaluation by means of the Abbreviated Mental Test"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:2 [
        0 => array:2 [
          "autoresLista" => "J&#46; Hern&#225;ndez-Palaz&#243;n, P&#46; Dom&#233;nech-Asensi, S&#46; Burguillos-L&#243;pez"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Hern&#225;ndez-Palaz&#243;n"
            ]
            1 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Dom&#233;nech-Asensi"
            ]
            2 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Burguillos-L&#243;pez"
            ]
          ]
        ]
        1 => array:2 [
          "autoresLista" => "M&#46;A&#46; P&#233;rez-Espejo, F&#46; L&#243;pez-Hern&#225;ndez, J&#46;F&#46; Mart&#237;nez-Lage"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;A&#46;"
              "apellidos" => "P&#233;rez-Espejo"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "L&#243;pez-Hern&#225;ndez"
            ]
            2 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Mart&#237;nez-Lage"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147306703529?idApp=UINPBA00004B"
    "url" => "/11301473/0000001700000002/v1_201305151252/S1130147306703529/v1_201305151252/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Resonancia magn&#233;tica en trauma craneal moderado y grave&#58; estudio comparativo de hallazgos en TC y RM&#46; Caracter&#237;sticas relacionadas con la presencia y localizaci&#243;n de lesi&#243;n axonal difusa en RM"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "105"
        "paginaFinal" => "118"
      ]
    ]
    "autores" => array:2 [
      0 => array:4 [
        "autoresLista" => "A&#46; Lagares, R&#46; Alday, A&#46; P&#233;rez-N&#250;&#241;ez, I&#46; Arrese, J&#46;F&#46; Al&#233;n, B&#46; Pascual, A&#46; Kaen, P&#46;A&#46; G&#243;mez, R&#46;D&#46; Lobato"
        "autores" => array:9 [
          0 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Lagares"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Alday"
          ]
          2 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "P&#233;rez-N&#250;&#241;ez"
          ]
          3 => array:2 [
            "nombre" => "I&#46;"
            "apellidos" => "Arrese"
          ]
          4 => array:2 [
            "nombre" => "J&#46;F&#46;"
            "apellidos" => "Al&#233;n"
          ]
          5 => array:2 [
            "nombre" => "B&#46;"
            "apellidos" => "Pascual"
          ]
          6 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Kaen"
          ]
          7 => array:2 [
            "nombre" => "P&#46;A&#46;"
            "apellidos" => "G&#243;mez"
          ]
          8 => array:2 [
            "nombre" => "R&#46;D&#46;"
            "apellidos" => "Lobato"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicios de Neurocirug&#237;a&#46; Hospital 12 de Octubre&#46; Madrid"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia postal&#58; Servicio de Neurocirug&#237;a&#46; Hospital 12 de Octubre&#46; Crta de Andalucia km 5&#44;4&#46; 28041 Madrid&#46;"
          ]
        ]
      ]
      1 => array:3 [
        "autoresLista" => "A&#46; Ramos, F&#46; Ballenilla"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Ramos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Ballenilla"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Servicios de Neurorradiolog&#237;a&#46; Hospital 12 de Octubre&#46; Madrid"
            "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
            "identificador" => "aff0010"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Magnetic Resonance in moderate and severe head injury&#58; comparative study of CT and MR findings&#46; Characteristics related to the presence and location of diffuse axonal injury in MR"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2005-05-12"
    "fechaAceptado" => "2005-05-31"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec159196"
          "palabras" => array:6 [
            0 => "Lesi&#243;n traum&#225;tica cerebral"
            1 => "Trauma craneal"
            2 => "RM"
            3 => "TC"
            4 => "Lesi&#243;n axonal difusa"
            5 => "M&#233;todos de imagen"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec159195"
          "palabras" => array:6 [
            0 => "Traumatic brain injury"
            1 => "Head trauma"
            2 => "MR"
            3 => "CT"
            4 => "Diffuse axonal injury"
            5 => "Imaging methods"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La TC craneal ha sido el m&#233;todo m&#225;s extendido en la evaluaci&#243;n de enfermos que han sufrido trauma craneal&#46; Sin embargo&#44; es poco sensible en la identificaci&#243;n de lesi&#243;n axonal difusa y lesiones en fosa posterior&#46; La RM craneal es una prueba potencialmente m&#225;s sensible pero de dif&#237;cil realizaci&#243;n en estos enfermos&#44; hecho que ha impedido la generalizaci&#243;n de su uso&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparar la capacidad de identificaci&#243;n de lesiones intracraneales postraum&#225;ticas por parte de las dos pruebas diagn&#243;sticas en enfermos con TCE grave y moderado&#44; y determinar qu&#233; caracter&#237;sticas radiol&#243;gicas en la TC se asocian a la presencia de LAD en RM y su gravedad cl&#237;nica&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyen en el estudio 100 enfermos con TCE moderado y grave a los que se ha realizado RM craneal dentro de los primeros 30 d&#237;as tras el trauma craneal&#46; Se recogieron todas las variables cl&#237;nicas potencialmente relacionadas con el pron&#243;stico de los enfermos&#44; as&#237; como los datos del TC inicial seg&#250;n la clasificaci&#243;n de Marshall y cols&#46; La RM fue evaluada de manera ciega por dos neurorradi&#243;logos que ignoraban al resultado de la TC inicial y la situaci&#243;n cl&#237;nica inicial del paciente&#46; Se recogieron todas las lesiones que presentaban&#44; as&#237; como su clasificaci&#243;n seg&#250;n la clasificaci&#243;n de lesiones asociadas con LAD&#44; descrita por Adams&#46; Se compararon los hallazgos en TC y RM&#44; evaluando la sensibilidad de cada prueba con respecto a los diferentes hallazgos&#46; Se estudiaron los hallazgos relacionados con la presencia de LAD en RM&#44; mediante estudio univariable&#44; usando la prueba de &#967;<span class="elsevierStyleSup">2</span> y correlaciones simples&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La RM es m&#225;s sensible que la TC para las lesiones en sustancia blanca cerebral&#44; cuerpo calloso y tronco&#46; Adem&#225;s&#44; detecta mayor n&#250;mero de contusiones&#46; La presencia de lesi&#243;n axonal difusa depende del mecanismo de producci&#243;n del trauma&#44; siendo m&#225;s frecuente en traumas de mayor energ&#237;a&#44; sobre todo en los accidentes de tr&#225;fico&#44; bien sea con autom&#243;vil o moto&#47;bici&#46; En cuanto a las caracter&#237;sticas radiol&#243;gicas asociadas a LAD la m&#225;s claramente relacionada es la hemorragia intraventricular&#46; La presencia de da&#241;o cada vez m&#225;s profundo y mayor puntuaci&#243;n en la escala de Adams se asocia a menor puntuaci&#243;n en la GCS y GCS motora&#44; y por consiguiente peor nivel de conciencia y mayor gravedad del trauma inicial&#44; confirmando el modelo de Ommaya&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cranial CT has been the most extended evaluation means for patients suffering head trauma&#46; However&#44; it has low sensitivity in the identification of diffuse axonal injury and posterior fossa lesions&#46; Cranial MR is a potentially more sensitive test but difficult to perform in these patients&#44; a fact that has hampered its generalised use&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To compare the identification capability of traumatic intracranial lesions by both diagnostic tests in patients with moderate and severe head injury and to determine which radiological characteristics are associated with the presence of diffuse injury in MR and their clinical severity&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">100 patients suffering moderate or severe head injury to whom a MR had been performed in the first 30 days after trauma were included&#46; All clinical variables related to prognosis were registered&#44; as well as the data from the initial CT following Marshall et al&#46;&#44; classification&#46; The MR was blindly evaluated by two neuroradiologists that were not aware of the initial CT results or the clinical situation of the patient&#46; All lesions were registered as well as the classification following the classification of lesions related to DAI described by Adams et al&#46; CT and MR findings were compared evaluating the sensitivities of each test&#46; Factors related to the presence of diffuse injury in MR were studied by univariate analysis using &#967;<span class="elsevierStyleSup">2</span> test and simple correlations&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">MR is more sensitive than CT for lesions in cerebral white matter&#44; corpus callosum and brainstem&#46; It also detects a greater number of cerebral contussions&#46; The presence of diffuse axonal injury depends on the mechanism of the trauma&#44; being more frequent in higher energy trauma&#44; specially in traffic accidents&#46; Among the radiological characteristics associated to DAI the most clearly related is intraventricular haemorrhage&#46; The presence of a deeper injury and a higher score in the scales of Adams is associated with a lower score in the GCS and motor GCS&#44; and so with a worse level of consciousness and bigger severity of injury&#44; confirming Ommaya&#39;s model&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Lagares&#44; A&#46;&#59; Ramos&#44; A&#44;&#59; Alday&#44; R&#46;&#59; Ballenilla&#44; F&#46;&#59; P&#233;rez&#44; A&#44;&#59; Arrese&#44; I&#46;&#59; Fern&#225;ndez-Al&#233;n&#44; J&#46;A&#46;&#59; Pascual&#44; B&#46;&#59; Kaen&#44; A&#46;&#59; G&#243;mez&#44; P&#46;A&#46;&#59; Lobato&#44; R&#46;D&#46;&#58; Resonancia magn&#233;tica en trauma craneal moderado y grave&#58; estudio comparativo de hallazgos en TC y RM&#46; Caracter&#237;sticas relacionadas con la presencia y localizaci&#243;n de lesi&#243;n axonal difusa en RM&#46; Neurocirug&#237;a 2006&#59; 17&#58; 105&#8211;118&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury in head injury&#58; definition&#44; diagnosis and grading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;H&#46; Adams"
                            1 => "D&#46; Doyle"
                            2 => "I&#46; Ford"
                            3 => "T&#46;A&#46; Gennarelli"
                            4 => "D&#46;I&#46; Graham"
                            5 => "D&#46;R&#46; McLellan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Histopathology"
                        "fecha" => "1989"
                        "volumen" => "15"
                        "paginaInicial" => "49"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2767623"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury in non-missile head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;H&#46; Adams"
                            1 => "D&#46;I&#46; Graham"
                            2 => "T&#46;A&#46; Gennarelli"
                            3 => "W&#46;L&#46; Maxwell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1991"
                        "volumen" => "54"
                        "paginaInicial" => "481"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1880506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Brainstem injury diagnosed by MRI&#46; An epidemiologic and prognostic reappraisal&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Aguas"
                            1 => "R&#46; Begue"
                            2 => "J&#46; D&#237;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "14"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756406"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Prognostic factors in severe head injury&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;R&#46; Boto"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "C&#46;J&#46; De la"
                            3 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2004"
                        "volumen" => "15"
                        "paginaInicial" => "233"
                        "paginaFinal" => "247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15239010"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Overview of the recent clinical trials in severe head injury and analysis of their therapeutic failure&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;R&#46; Boto"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "C&#46;J&#46; De la"
                            3 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "39"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intraventricular hemorrhage in severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Cordob&#233;s"
                            1 => "M&#46; de la Fuente"
                            2 => "R&#46;D&#46; Lobato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.58.2.0217"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "58"
                        "paginaInicial" => "217"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6600274"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-traumatic diffuse axonal brain injury&#46; Analysis of 78 patients studied with computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "F&#46; Cordob&#233;s"
                            1 => "R&#46;D&#46; Lobato"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "A&#46; Cabrera"
                            4 => "M&#46; Sarabia"
                            5 => "S&#46; Castro"
                            6 => "C&#46; Cisneros"
                            7 => "I&#46;D&#46; Torres"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1986"
                        "volumen" => "81"
                        "paginaInicial" => "27"
                        "paginaFinal" => "35"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Initial CT findings in 753 patients with severe head injury&#46; A report from the NIH Traumatic Coma Data Bank"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "H&#46;M&#46; Eisenberg"
                            1 => "H&#46;E&#46; Gary Jr&#46;"
                            2 => "E&#46;F&#46; Aldrich"
                            3 => "C&#46; Saydjari"
                            4 => "B&#46; Turner"
                            5 => "M&#46;A&#46; Foulkes"
                            6 => "J&#46;A&#46; Jane"
                            7 => "A&#46; Marmarou"
                            8 => "L&#46;F&#46; Marshall"
                            9 => "H&#46;F&#46; Young"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1990.73.5.0688"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1990"
                        "volumen" => "73"
                        "paginaInicial" => "688"
                        "paginaFinal" => "698"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2213158"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Animal models of human head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;A&#46; Gennarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.1994.11.357"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "1994"
                        "volumen" => "11"
                        "paginaInicial" => "357"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7837277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MR imaging of head trauma&#58; review of the distribution and radiopathologic features of traumatic lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;R&#46; Gentry"
                            1 => "J&#46;C&#46; Godersky"
                            2 => "B&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.150.3.663"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1988"
                        "volumen" => "150"
                        "paginaInicial" => "663"
                        "paginaFinal" => "672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3257624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective comparative study of intermediate-field MR and CT in the evaluation of closed head trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;R&#46; Gentry"
                            1 => "J&#46;C&#46; Godersky"
                            2 => "B&#46; Thompson"
                            3 => "V&#46;D&#46; Dunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.150.3.673"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1988"
                        "volumen" => "150"
                        "paginaInicial" => "673"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3257625"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injuries&#58; pathophysiology and imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Hammoud"
                            1 => "B&#46;A&#46; Wasserman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neuroimag Clin N AM"
                        "fecha" => "2002"
                        "volumen" => "12"
                        "paginaInicial" => "205"
                        "paginaFinal" => "216"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Head trauma&#58; comparison of MR and CT--experience in 100 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;B&#46; Kelly"
                            1 => "R&#46;D&#46; Zimmerman"
                            2 => "R&#46;B&#46; Snow"
                            3 => "S&#46;E&#46; Gandy"
                            4 => "L&#46;A&#46; Heier"
                            5 => "M&#46;D&#46; Deck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "1988"
                        "volumen" => "9"
                        "paginaInicial" => "699"
                        "paginaFinal" => "708"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3135716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognosis of severe head injuries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Levati"
                            1 => "M&#46;L&#46; Farina"
                            2 => "G&#46; Vecchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1982.57.6.0779"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1982"
                        "volumen" => "57"
                        "paginaInicial" => "779"
                        "paginaFinal" => "783"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7143060"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of depth of brain lesions to consciousness and outcome after closed head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "H&#46;S&#46; Levin"
                            1 => "D&#46; Williams"
                            2 => "M&#46;J&#46; Crofford"
                            3 => "W&#46;M&#46; High Jr&#46;"
                            4 => "H&#46;M&#46; Eisenberg"
                            5 => "E&#46;G&#46; Amparo"
                            6 => "F&#46;C&#46; Guinto Jr&#46;"
                            7 => "Z&#46; Kalisky"
                            8 => "S&#46;F&#46; Handel"
                            9 => "A&#46;M&#46; Goldman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1988.69.6.0861"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1988"
                        "volumen" => "69"
                        "paginaInicial" => "861"
                        "paginaFinal" => "866"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3193191"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome from severe head injury related to the type of intracranial lesion&#46; A computerized tomography study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "F&#46; Cordob&#233;s"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "F&#46;M&#46; de la"
                            4 => "A&#46; Montero"
                            5 => "A&#46; B&#225;rcena"
                            6 => "C&#46; P&#233;rez"
                            7 => "A&#46; Cabrera"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.59.5.0762"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "59"
                        "paginaInicial" => "762"
                        "paginaFinal" => "774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6619928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sequential computerized tomography changes and related final outcome in severe head injury patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "P&#46;A&#46; G&#243;mez"
                            2 => "R&#46; Alday"
                            3 => "J&#46;J&#46; Rivas"
                            4 => "J&#46; Dom&#237;nguez"
                            5 => "A&#46; Cabrera"
                            6 => "F&#46;S&#46; Turanzas"
                            7 => "A&#46; Ben&#237;tez"
                            8 => "B&#46; Rivero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1997"
                        "volumen" => "139"
                        "paginaInicial" => "385"
                        "paginaFinal" => "391"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normal computerized tomography scans in severe head injury&#46; Prognostic and clinical management implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:9 [
                            0 => "R&#46;D&#46; Lobato"
                            1 => "R&#46; Sarabia"
                            2 => "J&#46;J&#46; Rivas"
                            3 => "F&#46; Cordob&#233;s"
                            4 => "S&#46; Castro"
                            5 => "M&#46;J&#46; Mu&#241;oz"
                            6 => "A&#46; Cabrera"
                            7 => "A&#46; B&#225;rcena"
                            8 => "E&#46; Lamas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1986.65.6.0784"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1986"
                        "volumen" => "65"
                        "paginaInicial" => "784"
                        "paginaFinal" => "789"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3772476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new classification of head injury based on computerized tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46;F&#46; Marshall"
                            1 => "M&#46;R&#46; Klauber"
                            2 => "Van Berkum"
                            3 => "M&#46; Clark"
                            4 => "H&#46; Eisenberg"
                            5 => "J&#46;A&#46; Jane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg&#46;"
                        "fecha" => "1991"
                        "volumen" => "75"
                        "numero" => "Suppl"
                        "paginaInicial" => "14"
                        "paginaFinal" => "20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuropsychological outcome in relation to the traumatic coma data bank classification of computed tomography imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "M&#46; Mataro"
                            1 => "M&#46;A&#46; Poca"
                            2 => "J&#46; Sahuquillo"
                            3 => "S&#46; Pedraza"
                            4 => "M&#46; Ariza"
                            5 => "S&#46; Amor&#243;s"
                            6 => "C&#46; Junque"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/089771501750451794"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "2001"
                        "volumen" => "18"
                        "paginaInicial" => "869"
                        "paginaFinal" => "879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11565599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative study of magnetic resonance and CT scan imaging in cases of severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:10 [
                            0 => "T&#46; Ogawa"
                            1 => "H&#46; Sekino"
                            2 => "M&#46; Uzura"
                            3 => "T&#46; Sakamoto"
                            4 => "Y&#46; Taguchi"
                            5 => "Y&#46; Yamaguchi"
                            6 => "T&#46; Hayashi"
                            7 => "I&#46; Yamanaka"
                            8 => "N&#46; Oohama"
                            9 => "S&#46; Imaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir Suppl &#40;Wien&#41;"
                        "fecha" => "1992"
                        "volumen" => "55"
                        "paginaInicial" => "8"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral concussion and traumatic unconsciousness&#46; Correlation of experimental and clinical observations of blunt head injuries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;K&#46; Ommaya"
                            1 => "T&#46;A&#46; Gennarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain"
                        "fecha" => "1974"
                        "volumen" => "97"
                        "paginaInicial" => "633"
                        "paginaFinal" => "654"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4215541"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging findings in diffuse axonal injury after closed head trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:8 [
                            0 => "P&#46;M&#46; Parizel"
                            1 => "Ozsarlak"
                            2 => "J&#46;W&#46; Van Goethem"
                            3 => "H&#46;L&#46; Van Den"
                            4 => "C&#46; Dillen"
                            5 => "J&#46; Verlooy"
                            6 => "P&#46; Cosyns"
                            7 => "A&#46;M&#46; De Schepper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "1998"
                        "volumen" => "8"
                        "paginaInicial" => "960"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9683701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pathobiology of traumatically induced axonal injury in animals and humans&#58; a review of current thoughts"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;T&#46; Povlishock"
                            1 => "C&#46;W&#46; Christman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.1995.12.555"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma"
                        "fecha" => "1995"
                        "volumen" => "12"
                        "paginaInicial" => "555"
                        "paginaFinal" => "564"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8683606"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury after head trauma&#46; A review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Sahuquillo"
                            1 => "M&#46;A&#46; Poca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Tech Stand Neurosurg"
                        "fecha" => "2002"
                        "volumen" => "27"
                        "paginaInicial" => "23"
                        "paginaFinal" => "86"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11887581"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse axonal injury after severe head trauma&#46; A clinico-pathological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Sahuquillo"
                            1 => "J&#46; Vilalta-Cast&#225;n"
                            2 => "J&#46; Lamarca"
                            3 => "E&#46; Rubio"
                            4 => "M&#46; Rodr&#237;guez-Pazos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1989"
                        "volumen" => "101"
                        "paginaInicial" => "762"
                        "paginaFinal" => "774"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse degeneration of cerebral white matter in severe dementia following head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Strich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "1956"
                        "volumen" => "19"
                        "paginaInicial" => "163"
                        "paginaFinal" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13357957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of traumatic intracranial hematoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Teasdale"
                            1 => "S&#46; Galbraith"
                            2 => "L&#46;S&#46; Murray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1983"
                        "volumen" => "285"
                        "paginaInicial" => "1695"
                        "paginaFinal" => "1697"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6816334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traumatismos craneoencef&#225;licos graves sin lesiones significativas en la TAC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Vilalta-Cast&#225;n"
                            1 => "J&#46; Sahuquillo"
                            2 => "E&#46; Rubio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Revista de Neurolog&#237;a"
                        "fecha" => "1984"
                        "volumen" => "57"
                        "paginaInicial" => "133"
                        "paginaFinal" => "140"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Magnetic resonance imaging in cases of severe head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Wilberger"
                            1 => "Z&#46; Deeb"
                            2 => "W&#46; Rothfus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1987"
                        "volumen" => "20"
                        "paginaInicial" => "571"
                        "paginaFinal" => "576"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3587549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Head injury&#58; early results of comparing CT and high-field MR"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;A&#46; Zimmerman"
                            1 => "L&#46;T&#46; Bilaniuk"
                            2 => "D&#46;B&#46; Hackney"
                            3 => "H&#46;I&#46; Goldberg"
                            4 => "R&#46;I&#46; Grossman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.147.6.1215"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1986"
                        "volumen" => "147"
                        "paginaInicial" => "1215"
                        "paginaFinal" => "1222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3490757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11301473/0000001700000002/v1_201305151252/S1130147306703517/v1_201305151252/es/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001700000002/v1_201305151252/S1130147306703517/v1_201305151252/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147306703517?idApp=UINPBA00004B"
]
Información del artículo
ISSN: 11301473
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2023 Marzo 3 1 4
2018 Febrero 10 3 13
2018 Enero 16 5 21
2017 Diciembre 14 5 19
2017 Noviembre 21 13 34
2017 Octubre 16 8 24
2017 Septiembre 11 8 19
2017 Agosto 11 6 17
2017 Julio 19 7 26
2017 Junio 21 5 26
2017 Mayo 21 7 28
2017 Abril 8 10 18
2017 Marzo 13 4 17
2017 Febrero 6 2 8
2017 Enero 8 7 15
2016 Diciembre 27 11 38
2016 Noviembre 18 8 26
2016 Octubre 26 16 42
2016 Septiembre 30 10 40
2016 Agosto 40 22 62
2016 Julio 31 21 52
2015 Diciembre 2 0 2
2015 Julio 1 4 5
2015 Junio 18 9 27
2015 Mayo 24 15 39
2015 Abril 13 11 24
2015 Marzo 18 8 26
2015 Febrero 22 12 34
2015 Enero 16 11 27
2014 Diciembre 11 16 27
2014 Noviembre 13 13 26
2014 Octubre 15 22 37
2014 Septiembre 13 18 31
2014 Agosto 13 14 27
2014 Julio 16 20 36
2014 Junio 22 23 45
2014 Mayo 19 20 39
2014 Abril 15 13 28
2014 Marzo 21 14 35
2014 Febrero 17 21 38
2014 Enero 23 19 42
2013 Diciembre 16 21 37
2013 Noviembre 13 27 40
2013 Octubre 20 19 39
2013 Septiembre 21 21 42
2013 Agosto 28 21 49
2013 Julio 15 16 31
2013 Junio 13 15 28
2013 Mayo 19 16 35
2013 Abril 17 20 37
2013 Marzo 23 19 42
2013 Febrero 11 11 22
2013 Enero 17 7 24
2012 Diciembre 9 15 24
2012 Noviembre 1 9 10
2012 Octubre 0 1 1
2012 Septiembre 0 2 2
2012 Enero 12 0 12
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Neurocirugía
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?