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array:22 [ "pii" => "S1130147304704649" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70464-9" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70464" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2004" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:484-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2766 "formatos" => array:3 [ "EPUB" => 23 "HTML" => 1170 "PDF" => 1573 ] ] "itemAnterior" => array:18 [ "pii" => "S1130147304704637" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70463-7" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70463" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:480-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2740 "formatos" => array:3 [ "EPUB" => 18 "HTML" => 925 "PDF" => 1797 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Seno dérmico occipital asociado a absceso cerebeloso. Caso clínico" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "480" "paginaFinal" => "483" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Occipital dermal sinus associated to a cerebellar abscess. Case" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "J.M. Costa, A. Guillen, E. Claramunt" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Costa" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Guillen" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Claramunt" ] ] ] 1 => array:2 [ "autoresLista" => "L. de Reina" "autores" => array:1 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "de Reina" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704637?idApp=UINPBA00004B" "url" => "/11301473/0000001500000005/v1_201305151227/S1130147304704637/v1_201305151227/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Hernia medular espontánea" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "484" "paginaFinal" => "489" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.J. Rivas, A. de la Lama, P. González, A. Ramos, M. Zurdo, R. Alday" "autores" => array:6 [ 0 => array:3 [ "nombre" => "J.J." "apellidos" => "Rivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "de la Lama" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "González" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Ramos" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Zurdo" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Alday" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital 12 de Octubre. Madrid" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital 12 de Octubre. Carretera Andalucía Km 5,400. 28041 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Spontaneous spinal cord herniation" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-10-05" "fechaAceptado" => "2003-10-28" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158585" "palabras" => array:5 [ 0 => "Hernia medular espontánea" 1 => "Mielopatía" 2 => "Síndrome de Brown-Sèquard" 3 => "Defecto dural" 4 => "Resonancia magnética" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158586" "palabras" => array:5 [ 0 => "Spontaneous spinal cord herniation" 1 => "Myelopathy" 2 => "Brown-Sèquard syndrome" 3 => "Dural defect" 4 => "Magnetic resonance imaging" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La herniación espontánea o idiopática de la médula espinal, a través de un defecto dural, es una entidad clínica muy rara, aunque su frecuencia ha sido quizás infravalorada antes del advenimiento de los estudios de imagen modernos.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un varón de 49 años de edad con una mielopatía progresiva, consistente con un síndrome de Brown-Sèquard. En el estudio de RM y mielo-TC se pudo apreciar un desplazamiento llamativo de la médula, anterior y lateral, a nivel de D6-D7, con aumento del espacio subaracnoideo posterior, compatible con el diagnóstico de hernia medular. El enfermo fue intervenido a través de una laminectomía y la hernia medular fue recolocada en el espacio intradural, siendo el defecto dural reparado con una plastia de duramadre lioñlizada. El paciente mejoró de su defecto motor pero no del sensitivo.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Debe considerarse el diagnóstico de hernia medular espontánea en enfermos de edad media con mielopatía progresiva, en los que no se aprecian causas de compresión medular, y que muestran los hallazgos típicos en los estudios de imagen. El tratamiento quirúrgico consigue la mejoría clínica en muchos casos o al menos la detención en la progresión de la enfermedad.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Spontaneous spinal cord herniation through a dural defect is an unusual condition. This entity has been pro-bably underestimated before the introduction of MRI.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We report a case of a 49-year-old man with a progressive Brown-Sèquard syndrome. MRI and CT myelogram showed a ventrally displaced spinal cord at level T6–T7 and expansion of the posterior subarach-noid space. Through a laminectomy, a spinal cord herniation was identifled and reduced. The anterior dural defect was repaired with a patch of lyophilized dura. The patient recovered muscle power but there was no improvement of the sensory disturbance.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The diagnosis of spontaneous spinal cord herniation must be considered when progressive myelopathy occurs in middle-aged patients, without signs of spinal cord compression and typical radiological findings. Surgical treatment may halt the progressive deficits and even yield improvement in many cases.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Rivas, J.J.; de la Lama, A., González, R; Ramos, A., Zurdo, M., Alday, R.: Hernia medular espontánea. Neurocirugía 2004; 15: 484–489.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:42 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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