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Hospital de Órbigo, Spain

Objective: To describe the microsurgical anatomy and approaches to the mesial temporal region (MTR), in relation with cavernomas. Methods: Five adult cadaveric heads, fixed in formol and injected with colored silicon were studied. Since January 2007 and June 2014, the author operated 7 patients with cavernomas located in the MTR. Results: Anatomy: The MTR was divided in 3 portions: Anterior, middle and posterior. Patients: The author operated 7 patients with MTR cavernomas. Four cavernomas were located in the anterior portion, 2 were located in the middle portion, and 1 cavernoma was located in the posterior portion. The transsylvian-transinsular approach was used for the anterior portion of the MTR; the transtemporal approach (anterior temporal lobectomy) was used for the middle portion of the MTR; and the supracerebellar-transtentorial approach was used for the posterior portion of the MTR. Conclusion: The idea of divide the MTR in 3 portions help to select the correct approach.

Boto G.R.,Servicio de Neurocirugia
Anales de la Real Academia Nacional de Farmacia | Year: 2013

This review article carries out, first and foremost, a presentation of the Neurosurgery, as surgical speciality. The main pathologies related to the Neurosurgery are exposed, both cranium-brain (injuries, tumours, hydrocephalus and vascular disease, mainly) and spine-spinal cord (degenerative disease, injuries and tumours). Moreover, this paper alludes to the neurosurgical malformations in the Central Nervous System and to the functional Neurosurgery. Finally, some considerations regarding the neurosurgical pathology of the Peripheral and Autonomic Nervous System are included.

Vega-Sosa A.,Servicio de Neurocirugia | Obieta-Cruz E.D.,Instituto Nacional Of Pediatria | Hernandez-Rojas M.A.,Residente de Tercer Ano de Cirugia General
Cirugia y Cirujanos | Year: 2010

Background: Arachnoid cysts contain a liquid similar to cerebrospinal fluid. Some communicate with the subarachnoid space and others do not. These cysts are reported to account for at least 1% of all intracranial mass lesions. Most patients present during the first two decades of life; however, presentation during adulthood is not uncommon. discussion: A literature review to identify studies relating to pathogenesis, epidemiology, genetics, presentation, radiology and treatment of arachnoid cysts was conducted and indicated that symptoms depend on size and location. When arachnoid cysts are symptomatic, they must be treated surgically. Surgical treatment of arachnoid cysts can be accomplished by cystoperitoneal shunting, fenestration of the cyst either by craniotomy or endoscopic techniques. Conclusions: Currently, appropriate treatment is still controversial regarding which is the best technique. Expectative treatment should be considered in lower volume cysts and, even more, in asymptomatic patients diagnosed by other studies.

Garcia-Cosamalon J.,Servicio de Neurocirugia | del Valle M.E.,University of Oviedo | Calavia M.G.,University of Oviedo | Garcia-Suarez O.,University of Oviedo | And 3 more authors.
Journal of Anatomy | Year: 2010

The normal intervertebral disc (IVD) is a poorly innervated organ supplied only by sensory (mainly nociceptive) and postganglionic sympathetic (vasomotor efferents) nerve fibers. Interestingly, upon degeneration, the IVD becomes densely innervated even in regions that in normal conditions lack innervation. This increased innervation has been associated with pain of IVD origin. The mechanisms responsible for nerve growth and hyperinnervation of pathological IVDs have not been fully elucidated. Among the molecules that are presumably involved in this process are some members of the family of neurotrophins (NTs), which are known to have both neurotrophic and neurotropic properties and regulate the density and distribution of nerve fibers in peripheral tissues. NTs and their receptors are expressed in healthy IVDs but much higher levels have been observed in pathological IVDs, thus suggesting a correlation between levels of expression of NTs and density of innervation in IVDs. In addition, NTs also play a role in inflammatory responses and pain transmission by increasing the expression of pain-related peptides and modulating synapses of nociceptive neurons at the spinal cord. This article reviews current knowledge about the innervation of IVDs, NTs and NT receptors, expression of NTs and their receptors in IVDs as well as in the sensory neurons innervating the IVDs, the proinflammatory role of NTs, NTs as nociception regulators, and the potential network of discogenic pain involving NTs. © 2010 The Authors. Journal compilation © 2010 Anatomical Society of Great Britain and Ireland.

Avecillas-Chasin J.M.,Servicio de Neurocirugia | Matias-Guiu J.A.,Institute Neurociencias | Bautista-Balbas L.,Servicio de Neurocirugia
Revista de Neurologia | Year: 2015

Introduction. Posterior reversible encephalopathy (PRE) is a clinical and radiological entity that is typically characterized by headache, visual disturbances and seizures associated with cortical and subcortical reversible vasogenic edema in neuroimaging. Aim. To present a review of the pathophysiology of this entity, and also the associations of the PRE described in the literature. Development. Given its clinical presentation, often nonspecific and variable, magnetic resonance imaging is essential for diagnosis. There are a number of well-known triggers, such as hypertensive crisis, eclampsia or certain drugs. The description of increasingly atypical cases from clinical and radiological point of view, and possible new triggers, requires a redefinition of this entity. Conclusions. The PRE is a set of clinical and radiological manifestations that may not be framed within the word ‘syndrome’. Although, the PRE has been reported in some cases irreversible, reversibility concept should be maintained in the definition of this entity, since in most cases the rapid control of the triggering condition allows reversibility of the lesions. © 2015 Revista de Neurología.

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