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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." "apellidos" => "Alday" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Pérez-Núñez" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Arrese" ] 4 => array:2 [ "nombre" => "J.F." "apellidos" => "Alén" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Pascual" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Kaen" ] 7 => array:2 [ "nombre" => "P.A." "apellidos" => "Gómez" ] 8 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicios de Neurocirugía. Hospital 12 de Octubre. Madrid" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital 12 de Octubre. Crta de Andalucia km 5,4. 28041 Madrid." ] ] ] 1 => array:3 [ "autoresLista" => "A. Ramos, F. Ballenilla" "autores" => array:2 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Ramos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Ballenilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicios de Neurorradiología. Hospital 12 de Octubre. Madrid" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "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" ] ] "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 => "Lesión traumática cerebral" 1 => "Trauma craneal" 2 => "RM" 3 => "TC" 4 => "Lesión axonal difusa" 5 => "Métodos 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">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La TC craneal ha sido el método más extendido en la evaluación de enfermos que han sufrido trauma craneal. Sin embargo, es poco sensible en la identificación de lesión axonal difusa y lesiones en fosa posterior. La RM craneal es una prueba potencialmente más sensible pero de difícil realización en estos enfermos, hecho que ha impedido la generalización de su uso.</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparar la capacidad de identificación de lesiones intracraneales postraumáticas por parte de las dos pruebas diagnósticas en enfermos con TCE grave y moderado, y determinar qué características radiológicas en la TC se asocian a la presencia de LAD en RM y su gravedad clínica.</p> <span class="elsevierStyleSectionTitle">Material y métodos</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 días tras el trauma craneal. Se recogieron todas las variables clínicas potencialmente relacionadas con el pronóstico de los enfermos, así como los datos del TC inicial según la clasificación de Marshall y cols. La RM fue evaluada de manera ciega por dos neurorradiólogos que ignoraban al resultado de la TC inicial y la situación clínica inicial del paciente. Se recogieron todas las lesiones que presentaban, así como su clasificación según la clasificación de lesiones asociadas con LAD, descrita por Adams. Se compararon los hallazgos en TC y RM, evaluando la sensibilidad de cada prueba con respecto a los diferentes hallazgos. Se estudiaron los hallazgos relacionados con la presencia de LAD en RM, mediante estudio univariable, usando la prueba de χ<span class="elsevierStyleSup">2</span> y correlaciones simples.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La RM es más sensible que la TC para las lesiones en sustancia blanca cerebral, cuerpo calloso y tronco. Además, detecta mayor número de contusiones. La presencia de lesión axonal difusa depende del mecanismo de producción del trauma, siendo más frecuente en traumas de mayor energía, sobre todo en los accidentes de tráfico, bien sea con automóvil o moto/bici. En cuanto a las características radiológicas asociadas a LAD la más claramente relacionada es la hemorragia intraventricular. La presencia de daño cada vez más profundo y mayor puntuación en la escala de Adams se asocia a menor puntuación en la GCS y GCS motora, y por consiguiente peor nivel de conciencia y mayor gravedad del trauma inicial, confirmando el modelo de Ommaya.</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. However, it has low sensitivity in the identification of diffuse axonal injury and posterior fossa lesions. Cranial MR is a potentially more sensitive test but difficult to perform in these patients, a fact that has hampered its generalised use.</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.</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. All clinical variables related to prognosis were registered, as well as the data from the initial CT following Marshall et al., classification. The MR was blindly evaluated by two neuroradiologists that were not aware of the initial CT results or the clinical situation of the patient. All lesions were registered as well as the classification following the classification of lesions related to DAI described by Adams et al. CT and MR findings were compared evaluating the sensitivities of each test. Factors related to the presence of diffuse injury in MR were studied by univariate analysis using χ<span class="elsevierStyleSup">2</span> test and simple correlations.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">MR is more sensitive than CT for lesions in cerebral white matter, corpus callosum and brainstem. It also detects a greater number of cerebral contussions. The presence of diffuse axonal injury depends on the mechanism of the trauma, being more frequent in higher energy trauma, specially in traffic accidents. Among the radiological characteristics associated to DAI the most clearly related is intraventricular haemorrhage. 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, and so with a worse level of consciousness and bigger severity of injury, confirming Ommaya's model.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Lagares, A.; Ramos, A,; Alday, R.; Ballenilla, F.; Pérez, A,; Arrese, I.; Fernández-Alén, J.A.; Pascual, B.; Kaen, A.; Gómez, P.A.; Lobato, R.D.: 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. Neurocirugía 2006; 17: 105–118.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffuse axonal injury in head injury: definition, diagnosis and grading" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.H. Adams" 1 => "D. Doyle" 2 => "I. Ford" 3 => "T.A. Gennarelli" 4 => "D.I. Graham" 5 => "D.R. 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." 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