Empleo de la biopsia estereotáxica en pacientes con procesos expansivos intracraneales
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Díaz Cascajo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Hernández Vicente" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Morales Ramos" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Maillo Sánchez" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Gómez-Moreta" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Díaz Cascajo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicios de Neurocirugía. Hospital Virgen de la Vega" ] ] ] 1 => array:3 [ "autoresLista" => "A. Santos Briz" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Santos Briz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicios de Anatomía Patológica. Hospital Virgen de la Vega" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec160284" "palabras" => array:4 [ 0 => "Biopsia cerebral" 1 => "Neoplasia cerebral" 2 => "Manejo de los gliomas" 3 => "Cirugía estereotáxica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec160285" "palabras" => array:4 [ 0 => "Brain biopsy" 1 => "Brain neoplasm" 2 => "Glioma management" 3 => "Stereotactic surgery" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pese a los avances de la neurorradiología, el manejo preciso de ciertos enfermos con procesos expansivos intracraneales depende con frecuencia del conocimiento de su diagnóstico histológico. En el presente trabajo, se analiza el empleo de las técnicas estereotáxicas en el diagnóstico y tratamiento de 174 pacientes con este tipo de patología.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El criterio de selección fue valorado mediante los datos de la historia clínica, exploración neurológica, estudios neurorradiológicos y, en el caso de los candidatos a cirugía, se consideró su riesgo vital y funcional. En todos los pacientes fue realizada una biopsia estereotáxica. En el 85,06% de los enfermos fue suficiente un blanco, obteniéndose un diagnóstico histológico positivo en el 92,53% de los casos. En 44, la técnica estereotáxica sirvió no sólo para obtener un diagnóstico citológico, sino también para vaciar una cavidad quística (tumoral o abscesificada) o realizar tratamientos braquiterápicos. La evolución postbiópsica de los pacientes fue excelente en 32 (18,39%) y sin cambios en 136 (78,16%) de los casos. Uno de los pacientes murió, lo que corresponde a una mortalidad del 0,57%. La morbilidad transitoria fue del 2,87% (5 casos). No hemos tenido morbilidad permanente.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Para determinar la eficacia de la metodología estereotáxica, se evaluó la relación entre nuestros diagnósticos de presunción y los resultados histológicos comprobados en 149 casos. Sólo el 58,39% fue diagnosticado correctamente antes de la biopsia. En otro 12,75% hubo diferencias en cuanto al grado de anaplasia tumoral y en el 28,86% restante los diagnósticos fueron incorrectos.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La angiografía nos ha sido muy útil para localizar el blanco y para evitar la hemorragia intraoperatoria. La monitorización de la impedancia tisular ha facilitado una información importante sobre el trayecto y situación de la aguja, de acuerdo con la residencia tisular encontrada y los cortes del TAC.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia, las técnicas estereotáxicas representan un camino racional para obtener diagnósticos más precisos y una alternativa para evitar el manejo a ciegas de una parte importante de la patología intracraneal.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The management of certain intracranial processes still depends upon a histological diagnosis despite advances in neuroradiology. We analyzed the usefulness of the stereotactic technique in the diagnosis and treatment of 174 patients harbouring intracranial processes. The selection criteria was evaluated by history, neurological examination, neuroradiological studies, and in the case of surgical candidates, by their vital and functional risks. In all our patients a stereotactic biopsy was performed. One target was enough in 85,06%, and a positive histological diagnosis was obtained in 92,53%. In 44 out of our 174 cases the stereotactic system was used not only to obtain a cytological diagnosis but also to deflate a cyst cavity (tumoral or abscess) or to insert or remove a radioactive isotope. The patient's postbiopsy course was excellent in 32 (18,39%) and unchanged in 136 (78,16%). One patient died, which corresponds to a mortality rate of 0,57%. The transitory morbidity was 2,87% (5 cases). No permanent morbidity was noted.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To determine the efficiency of our stereotactic methodology we evaluated the relationship between our presumptive diagnosis from the clínical and neuroradiological studies and the final histological results. The presumptive diagnosis was confirmed in 58,39%, in 12,75% the differences were in the degree of tumor anaplasia and in 28,86% our diagnosis was incorrect. Angiography was considered very useful in localizing the target and in avoiding intraoperative haemorrhage. Impedance monitoring gave us important information regarding the trajectory and depth of the target according to the tissue resistance encountered.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">From our experience, we think that stereotactic techniques represent an alternative to blind management of an important part of intracranial pathology, and a rational way to obtain a more accurate diagnosis.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Hernández Vicente J.; Morales Ramos F.; Santos Briz A.; Maillo Sánchez A.; Gómez-Moreta J. A.; Díaz Cascajo P.: Empleo de la biopsia estereotáxica en pacientes con procesos expansivos intracraneales. Neurocirugía, 1991; 2: 87–94.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 4 | 1 | 5 |
| 2018 Febrero | 12 | 5 | 17 |
| 2018 Enero | 12 | 6 | 18 |
| 2017 Diciembre | 12 | 13 | 25 |
| 2017 Noviembre | 47 | 12 | 59 |
| 2017 Octubre | 9 | 8 | 17 |
| 2017 Septiembre | 12 | 7 | 19 |
| 2017 Agosto | 14 | 6 | 20 |
| 2017 Julio | 6 | 5 | 11 |
| 2017 Junio | 18 | 17 | 35 |
| 2017 Mayo | 15 | 7 | 22 |
| 2017 Abril | 6 | 5 | 11 |
| 2017 Marzo | 7 | 10 | 17 |
| 2017 Febrero | 4 | 0 | 4 |
| 2017 Enero | 4 | 6 | 10 |
| 2016 Diciembre | 20 | 15 | 35 |
| 2016 Noviembre | 14 | 6 | 20 |
| 2016 Octubre | 28 | 13 | 41 |
| 2016 Septiembre | 25 | 6 | 31 |
| 2016 Agosto | 30 | 9 | 39 |
| 2016 Julio | 23 | 13 | 36 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Julio | 3 | 0 | 3 |
| 2015 Junio | 13 | 7 | 20 |
| 2015 Mayo | 21 | 18 | 39 |
| 2015 Abril | 17 | 21 | 38 |
| 2015 Marzo | 14 | 35 | 49 |
| 2015 Febrero | 13 | 21 | 34 |
| 2015 Enero | 23 | 15 | 38 |
| 2014 Diciembre | 16 | 17 | 33 |
| 2014 Noviembre | 13 | 14 | 27 |
| 2014 Octubre | 18 | 24 | 42 |
| 2014 Septiembre | 13 | 20 | 33 |
| 2014 Agosto | 14 | 14 | 28 |
| 2014 Julio | 12 | 14 | 26 |
| 2014 Junio | 17 | 32 | 49 |
| 2014 Mayo | 18 | 24 | 42 |
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| 2014 Marzo | 9 | 23 | 32 |
| 2014 Febrero | 16 | 24 | 40 |
| 2014 Enero | 9 | 20 | 29 |
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| 2013 Octubre | 20 | 23 | 43 |
| 2013 Septiembre | 13 | 19 | 32 |
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| 2013 Marzo | 11 | 17 | 28 |
| 2013 Febrero | 9 | 13 | 22 |
| 2013 Enero | 15 | 7 | 22 |
| 2012 Diciembre | 7 | 15 | 22 |
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