Cirurgía estereotáxica no tratamento do abcesso cerebral
Stereotactic surgery for the treatment of cerebral abcess
O.L. Alves, O. Gomes, S. Paranhos
Serviço de Neurocirurgía, Hospital Geral de Santo António
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Acebes, J. Cabiol, L. López-Obarrio, A. Gabarrós, F. Isamat" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "Acebes" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Cabiol" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "López-Obarrio" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Gabarrós" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Isamat" ] ] ] 1 => array:2 [ "autoresLista" => "J.M. Serra" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Serra" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707670?idApp=UINPBA00004B" "url" => "/11301473/0000001000000006/v1_201305151018/S1130147399707670/v1_201305151018/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Cirurgía estereotáxica no tratamento do abcesso cerebral" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "453" "paginaFinal" => "460" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "O.L. Alves, O. Gomes, S. Paranhos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "O.L." "apellidos" => "Alves" ] 1 => array:2 [ "nombre" => "O." "apellidos" => "Gomes" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Paranhos" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Serviço de Neurocirurgía, Hospital Geral de Santo António" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Stereotactic surgery for the treatment of cerebral abcess" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec156824" "palabras" => array:2 [ 0 => "Estereotaxia" 1 => "Abcesso cerebral" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156825" "palabras" => array:2 [ 0 => "Stereotactic surgery" 1 => "Cerebral abscess" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Apesar da redução da mortalidade nos doentes com abcessos cerebrais desde a introdução axial computadorizada (TAC), persiste ainda controvérsia quanto ao melhor método para o tratamento desta patologia. A propósito dos 3 casos que apresentam, os autores fazem também urna revisao da literatura sobre a aplicaão das técnicas estereotáxicas no tratamento dos abcessos cerebrais.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Os tres doentes com abcessos foram submetidos a cirurgia estereotáxica, guiada por TAC, para remoção total ou drenagem de pús e para orientação do tratamento antibiótico apropriado. Todos os abcessos tinham localização supratentorial e nos tres casos o agente patogénico foi identificado. Um excelente resultado clínico foi atingido nos tres doentes.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A cirurgia estereotáxica, urna técnica segura, com grande eficácia e baixo risco, permite a exclusao de neoplasia ou de hematoma em reabsorção, evitando o diagnóstico erróneo e o tratamento empírico de lesoes cerebrais em anel com tradução tomográfica semelhante. Consegue ainda um diagnóstico bacteriológico em 97% dos casos. Verifica-se também a resolução definitiva da doençã, após um único procedimento estereotáxico em pelo menos 72% dos doentes, taxa que sobe para os 93%, se fOr realizada mais do que urna intervenção.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O uso da técnica estereotáxica tem sido descrito com enfase crescente no tratamento dos abcessos cerebrais, dado que representa urna mais valia considerável no objectivo de reduzir a morbilidade e a mortalidade desta doençã, sobretudo nos casos de abcessos múltiplos, historicamente comparável ao produzido pela introdução da tomografia axial computadorizada e da moderna antibioterapia. Com a ilustração de tres casos, os autores realçãm e aconselham o recurso precoce a técnica estereotáxica para drenagem ou remoão em bloco de todos os abcessos cirúrgicos, desde que devidamente complementado com controlo tomográfico apertado de 2 em 2 semanas e antibioterapia prolongada durante 8 semanas.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Despite a reduction in the mortality of patients with cerebral abscess since the introduction of computerized tomography (CT) and modern antibiotherapy, controversy persists as to the preferred method of treatment for this condition. The authors report three cases and review the Iiterature concerning the impact of stereotactic techniques on the treatment of this disease.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Three patients with cerebral abscess were treated by CT guided stereotactic surgery, for total removal or drainage of pus, and appropriate antibiotic therapy. All abscesses were supratentorial and in the three cases a pathogen was identified. A good outcome was achieved in all patients.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Being a safe and reliable technique, stereotactic surgery easily permits the exclusion of neoplasm or reabsorbing hematoma, thus avoiding the erroneous treatment of ring-enhancing lesions on the CT scan. Moreover, it aHows the bacteriological diagnosis in 97% of cases and the cure of the disease in 72% of patients with a single procedure, that rises to 93% if more than one intervention is performed.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The use of stereotactic techniques represents a most valuable tool in the reduction of morbidity and mortality of this disease, namely in multiple abscess, only comparable to the introduction of CT scan and modern antibiotics.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Through the illustration of three cases, the authors strongly advise the early use of stereotactic technique for drainage or “en bloc” removal of surgical abscess, complemented with a close radiological follow-up, with a 2 weeks interval CT scan, and long-term antibiotherapy.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Alves, O.L.; Gomes, O.; Paranhos, S.: Cirurgía estereotáxica no tratamento do abcesso cerebral. 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| 2023 Marzo | 1 | 1 | 2 |
| 2018 Febrero | 17 | 6 | 23 |
| 2018 Enero | 17 | 46 | 63 |
| 2017 Diciembre | 14 | 22 | 36 |
| 2017 Noviembre | 16 | 26 | 42 |
| 2017 Octubre | 11 | 23 | 34 |
| 2017 Septiembre | 15 | 9 | 24 |
| 2017 Agosto | 27 | 14 | 41 |
| 2017 Julio | 17 | 26 | 43 |
| 2017 Junio | 21 | 18 | 39 |
| 2017 Mayo | 15 | 15 | 30 |
| 2017 Abril | 14 | 19 | 33 |
| 2017 Marzo | 15 | 2 | 17 |
| 2017 Febrero | 11 | 19 | 30 |
| 2017 Enero | 23 | 10 | 33 |
| 2016 Diciembre | 20 | 12 | 32 |
| 2016 Noviembre | 27 | 11 | 38 |
| 2016 Octubre | 35 | 16 | 51 |
| 2016 Septiembre | 47 | 46 | 93 |
| 2016 Agosto | 59 | 39 | 98 |
| 2016 Julio | 36 | 36 | 72 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Julio | 5 | 6 | 11 |
| 2015 Junio | 20 | 19 | 39 |
| 2015 Mayo | 14 | 23 | 37 |
| 2015 Abril | 21 | 36 | 57 |
| 2015 Marzo | 28 | 24 | 52 |
| 2015 Febrero | 13 | 32 | 45 |
| 2015 Enero | 21 | 35 | 56 |
| 2014 Diciembre | 14 | 34 | 48 |
| 2014 Noviembre | 16 | 20 | 36 |
| 2014 Octubre | 24 | 53 | 77 |
| 2014 Septiembre | 18 | 55 | 73 |
| 2014 Agosto | 12 | 74 | 86 |
| 2014 Julio | 12 | 41 | 53 |
| 2014 Junio | 30 | 38 | 68 |
| 2014 Mayo | 28 | 52 | 80 |
| 2014 Abril | 29 | 38 | 67 |
| 2014 Marzo | 11 | 37 | 48 |
| 2014 Febrero | 16 | 49 | 65 |
| 2014 Enero | 11 | 30 | 41 |
| 2013 Diciembre | 19 | 29 | 48 |
| 2013 Noviembre | 22 | 44 | 66 |
| 2013 Octubre | 25 | 34 | 59 |
| 2013 Septiembre | 25 | 45 | 70 |
| 2013 Agosto | 36 | 54 | 90 |
| 2013 Julio | 20 | 65 | 85 |
| 2013 Junio | 19 | 38 | 57 |
| 2013 Mayo | 20 | 60 | 80 |
| 2013 Abril | 15 | 36 | 51 |
| 2013 Marzo | 9 | 38 | 47 |
| 2013 Febrero | 6 | 25 | 31 |
| 2013 Enero | 10 | 13 | 23 |
| 2012 Diciembre | 9 | 34 | 43 |
| 2012 Noviembre | 0 | 17 | 17 |
| 2012 Octubre | 0 | 5 | 5 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 11 | 0 | 11 |
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