PubMed Health⌕ Search

Biomedical subjects

M Gelabert-González

Publications and source records attributed to M Gelabert-González.

At least 19 recordsLinked to original sources
PubMed2006

[Spinal meningiomas].

OBJECTIVE: To present the incidence, clinical presentation, radiological features, localization, surgical techniques, and long term results of surgically treated spinal meningiomas. PATIENTS AND METHODS: We review retrospectively 57 spinal meningiomas in 55 patients operated between January 1980 and June 2004. Age, sex, duration and type of symptoms, radiological and surgical results, histological features and long term outcome are analyzed. RESULTS: Fifty five patients, consisting 46 females and 9 males, with an age range from 12 to 84 years (mean 65.2+/-9.2) were identified. The first symptom was motor deficit (N=34, 61.8%) and the mean duration symptoms were: 6.2 months. Distribution along the spinal axis was 51 thoracic, 5 cervical and 1 lumbar. The most common type was meningothelial (N=31, 54.3%). CONCLUSIONS: Meningiomas account in our experience, the 46% of spinal cord tumours and account the 7.5% of all meningiomas. They are more frequent in females most frequently occur in the thoracic region and have low recurrence rate. Typically, they are located in the intradural extramedullary space, grow slowly, and spread laterally in the subarachnoid space. Finally we concluded that magnetic resonance imaging is the best imaging technique for diagnosis and total tumour resection improved the surgical results of spinal meningiomas.

Adolescent↗
PubMed2005

The Camino intracranial pressure device in clinical practice. Assessment in a 1000 cases.

BACKGROUND: Intracranial pressure (ICP) monitoring has become standard in the management of neurocritical patients. A variety of monitoring techniques and devices are available, each offering advantages and disadvantages. Analysis of large populations has never been performed. PATIENTS AND METHODS: A prospective study was designed to evaluate the Camino fiberoptic intraparenchymal cerebral pressure monitor for complications and accuracy. RESULTS: Between 1992-2004 one thousand consecutive patients had a fiberoptic ICP monitor placed. The most frequent indication for monitoring was severe head injury (697 cases). The average duration of ICP monitoring was 184.6 +/- 94.3 hours; the range was 16-581 hours. Zero drift (range, -17 to 21 mm Hg; mean 7.3 +/- 5.1) was recorded after the devices were removed from 624 patients. Mechanical complications such as: breakage of the optical fiber (n = 17); dislocations of the fixation screw (n = 15) or the probe (n = 13); and failure of ICP recording for unknown reasons (n = 4) were found in 49 Camino devices. CONCLUSIONS: The Camino ICP sensor remains one of the most popular ICP monitoring devices for use in critical neurosurgical patients. The system offers reliable ICP measurements in an acceptable percentage of device complications and the advantage of in vivo recalibration. The incidence of technical complications was low and similar to others devices.

Adolescent↗
PubMed2005

[Simultaneous bilateral epidural haematomas].

INTRODUCTION: Epidural haematomas are one of the most common complications of closed head injuries. Bilateral extradural haematomas are rare, usually acute, and generally associated with severe trauma and a high mortality. OBJECTIVE: The purpose of this paper is to present six cases of bilateral extradural haematomas seen at our service during the last 24 years and found an incidence of 2.5% of all cases of extradural haematomas surgically treated. RESULTS: There were 5 males and 1 female with a mean age of 32.6 years (range 16-55). In 3 cases haematoma was across the midline and in the other 3 cases haematomas was found at different locations on either side. Skull fracture was present in all cases. Surgical approach was the primary treatment in all cases. Mortality in our series was 50%. CONCLUSIONS: Bilateral extradural haematomas is a rare condition and the prognosis is mainly dependent of the pre-operative neurological state.

Adolescent↗
PubMed2004

[Spinal epidural empyema. Analysis of 14 cases].

OBJECTIVE: The goal of this study was to review our series of spinal epidural empyema diagnosed in the last 20 years and review the literature regarding the pathogenesis, diagnosis and treatment of these lesions. PATIENTS AND METHODS: This is a retrospective study over 14 patients diagnosed of spinal epidural empyema. We review the epidemiological data, clinical symptoms, laboratory and imaging data, the treatment regimen and the results. RESULTS: Fourteen patients, 7 males and 7 females, with an age range from 8 to 76 years (mean 48.9) were identified. The first symptom was localized back/ neck pain in 12 patients and the mean duration of symptoms was 9.3 days. Erythrocyte sedimentation rate (ESR) was elevated in all patients; peripheral leukocyte count was elevated in 13 cases (92.9%). Site of spinal epidural empyemas was distributed along the axis but in 11 cases the location was thoracic. Thirteen patients had surgery for debridement and spinal decompression and one patient was treated successfully with antibiotics alone. CONCLUSIONS: Patients with localized back pain and fever who are at risk for developing such empyemas with elevation of white blood cells and increased ESR, should have an immediate magnetic resonance imaging sean. Urgent surgical drainage and antibiotic use are the treatment of choice in order to prevent irreversible neurological deficits. Nonsurgical treatment should be reserved for poor surgical candidates and patients without neurological deficits.

Adolescent↗
PubMed2004

[Acute spontaneous subdural haematoma of arterial origin].

INTRODUCTION: An acute subdural hematoma is often regarded as a complication of head trauma. Occasionally subdural bleeding from the rupture of a cerebral aneurysm or an arteriovenous malformations is described. Spontaneous subdural hematoma is, however, very rare and it commonly has an arterial origin and their aetiology is still a matter of controversy. OBJECTIVE: The purpose of this paper is to present eight cases of spontaneous subdural hematoma seen at our department during the last 19 years. The etiological possibilities of spontaneous subdural hematoma are discussed. PATIENTS AND METHODS: We analyzed 8 cases of acute spontaneous subdural hematoma among a total number of 321 patients with subdural hematoma is presented. RESULTS: There were six males and 2 females with a mean age of 52 years (range 20-66). All patients developed progressive neurological deficits, until become comatose. All eight patients were operated on and surgical mortality was 25%. CONCLUSIONS: Spontaneous subdural hematoma is a rare condition and the prognosis is mainly dependent on the pre-operative neurological state regardless of its origin or cause.

Adult↗
PubMed2003

[Malignant fibrous histiocytoma of the duramater].

Malignant fibrous histiocytoma is the most common soft tissue sarcoma in adults with the majority of cases that occur in patients between 50-70 years and most of cases occurs in male. Seventy percent originate from extremities. Primary MFH involving the central nervous system is a rare occurrence with most cases originating from the dura or leptomeninges. A case of primary intracranial malignant fibrous histiocytoma in a 60-year-old man is presented. The tumor was successfully excised and the patient remained well at follow-up of 12 months. The clinical features of this case and the therapeutic prognosis of 24 cases reported previously in the literature were reviewed.

Brain Neoplasms↗
PubMed2003

[Orbital meningocystocele].

Encephalocele is defined as a protrusion of cranial contents beyond the normal confines of the skull. Encephaloceles occur with an incidence of approximately 1 in 3,000-10,000 births and are categorized based on location in the skull. Orbital meningoencephalocele is a rare congenital abnormality caused by a defect of the cranio-orbital bones that usually manifests soon after birth as a soft mass associated with exophthalmos. We present a case of a giant orbital meningocele presenting as an orbital mass in a 15 months-old girl. Preoperative diagnosis was confirmed by CT-scan and magnetic resonance imaging.

Female↗
PubMed2002

Intra-operative monitoring of brain tissue O2 (PtiO2) during aneurysm surgery.

BACKGROUND: Regional cerebral blood flow may be compromised during aneurysm surgery. This may occur during vessel occlusion by temporary cliping or result from the malposition of an aneurysm clip. In this report we monitored intra-operatively the brain tissue oxygen concentration (PtiO2) to visualize regional ischaemic events. METHOD: During surgery of 10 intracranial aneurysms, monitoring of PtiO2 was performed using a polarographic microcatheter (Licox, GMS-Kiel-Germany), which was placed in the vascular territory of the artery harboring the aneurysm. FINDINGS: No complications were observed after implantation of Licox electrodes. In 6 patients PtiO2 decreased during transient clipping. In two patients PtiO2 decreased below 2 mmHg without morphological or clinical signs cerebral ischemia. In four patients, without incidence during surgery, only minor oscillations were observed. CONCLUSION: Intra-operative monitoring of PtiO2 is a complimentary procedure to monitor cerebral perfusion and detect episodes of ischaemia. Given the rapid detection of these events, therapeutic intervention may be initiated before irreversible neuronal damage occurs.

Adult↗
PubMed2002

[Epidermoid cyst of the third ventricle].

Intracranial epidermoid tumours are very rare lesions of ectodermal origin that account for 1% of all intracranial tumours. The favourite sites affected by these tumours are the cerebellopontine angle and the chiasmal region. They also appear in the cerebral hemisphere and the intraventricular cavities. We report a case of epidermoid tumour of the third ventricle. The patient was a 68 year-old woman admitted in our service with a 7-days history of headaches and intermittent nausea and vomiting. A CT scan of the brain revealed a large hypodense mass in the third ventricle associated with hydrocephalus. An MRI was performed and revealed, on T1-weighted image, an irregular nonhomogeneous lower signal in relation with CSF. This tumour showed a very bright signal intensity on T2-weighted images. A transcallosal approach of the tumour mass was performed via a right frontal craniotomy. Using an ultrasonic aspirator, the tumour was removed. In a review of the literature, we found only 8 reported cases.

Aged↗
PubMed2002

[Cemento-ossifying fibroma of the skull].

Cemento-ossifying fibroma (cementoma) is benign fibro-osseous lesion of bone that generally is first seen during childhood or young adulthood as asymptomatic or painful intraosseous mass that commonly involved the maxilla. This paper describes the case of a young boy with a cemento-ossifying fibroma of the skull.

Adolescent↗
PubMed2001

Spinal arachnoid cyst without neural tube defect.

Symptomatic arachnoid cysts of the spine are rare lesions in the pediatric age group. Although most commonly occurring in association with neural tube defects, such as myelomeningocele and diastematomyelia, in some cases the cysts appear in children without spinal anomalies. We describe a 12-month-old girl with lumbar intradural arachnoid cyst with progressive weakness of the lower limbs. There was full recovery after fenestration of the cyst.

Arachnoid Cysts↗
PubMed2001

Double ependymoma of the filum terminale.

Myxopapillary ependymoma of the filum terminale and conus medullaris are relatively common spinal intradural neoplasms in adults, only 8-14% affecting children. We describe a case of a 15-year-old girl with two myxopapillary ependymomas of the filum terminale. Although cases of two such tumours have been described in adults, we have not found any similar paediatric cases in the literature.

Adolescent↗
PubMed2001

Mutism after posterior fossa surgery. Review of the literature.

Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks. A review of the literature disclosed 157 patients with this condition. The anatomical structures thought to be involved are the connections between the cerebella dentate nucleous, the ventrolateral nucleous of the contalateral thalamus and the supplementary motor area. We reviewed 157 of cerebellar mutism; however several reports did not give sufficient information about the patients and 134 cases were selected for this study. The ages of the patients ranged from 2 to 61 years and the vermisat was the site of the tumour in 89% of the cases. All tumours were considered to be large or very large. The mutism lasted from 4 days to 52 months and was transient in all cases.

Adolescent↗
PubMed2001

[Chronic subdural hematoma in patients over 80 years of age].

INTRODUCTION: Chronic subdural hematoma (CSH) represents one of the most frequent types of intracranial hemorrhage. Most occur in elderly patients causing a variety of therapeutic problems associated to systemic diseases. PATIENTS AND METHODS: A retrospective study of 90 patients older than 80 years of age with chronic subdural hematoma treated in the last 15 years was undertaken. For clinical evaluation on admission and at discharge we used the classification of Markwalder. Surgical treatment was performed in all patients and a burr hole craniostomy with closed drainage system was used. RESULTS: On admission, 73 patients (80%) were in satisfactory condition (grades 0-2); 17 (20%) were grade 3 or 4. Seven (7.7%) patients died but none due to surgery. In 6 (6.6%) of the patients, surgical reintervention was required to remove a recurring CSH. In 76.6% of the patients, the results achieved were graded 0 or 1. CONCLUSIONS: In our experience CSH in elderly patients should be treated with minimal surgery with a simple drainage of the subdural space. The good results suggest that the procedure could be considered as a first procedure in these patients and that age or concomitant diseases do not appear to be poor prognostic factors.

Aged↗
PubMed1999

Spinal cord compression caused by adjacent adenocystic carcinoma of the skin.

Adenocystic carcinomas are malignant tumours that arise from the major accessory salivary glands. Cutaneous involvement can result from direct extension from a salivary gland neoplasm. Cutaneous adenocystic carcinomas remote from adjacent salivary tissue are rare. We present the case of an elderly patient with primary cutaneous adenoid cystic carcinoma causing spinal cord compression at the L1-L2 level. The patient was operated on and the tumour totally removed. No similar cases have been found in our review of the literature.

Aged↗
PubMed1999

Intradural cervical chordoma. Case report.

We describe a rare case of an intradural spinal chordoma. Only two cases have been previously reported and it is the second case diagnosed with MRI. A 65-year-old man presented with progressive disturbance of gait and weakness in the lower extremities. MRI revealed a intradural C6-C7 isointense mass, on T1- and T2-weighted images. The lesion enhanced after injection of gadolinium. The lesion was totally removed without difficulty by a C6-D1 laminectomy. Microscopic examination of the tumor revealed a chordoma. This is the third case in the literature of an intradural spinal chordoma. The appearance of this tumor with MRI may be similar to the chordomas of other locations.

Aged↗
PubMed1998

[Intracranial epidermoid and dermoid cysts].

INTRODUCTION: Dermoid and epidermoid cysts are dysembryogenic tumors representing 1% of all intracranial tumors. They are characterized by slow growth, localization to the middle in relation to the basal cisterns and their benign course. OBJECTIVES: To analyze the clinical and radiological characteristics, and the results of surgical treatment of intracranial dermoid and epidermoid cysts. PATIENTS AND METHODS: We reviewed 18 cases of epidermoid and 3 dermoid intracranial cysts which had been diagnosed and treated during a period of 18 years. All patients were diagnosed by computerized tomography (CT) and the last 15 cases by magnetic resonance (MR). RESULTS: The commonest site was the temporal lobe with 7 cases, followed by the suprasellar region with 4 cases. All patients had peculiar imaging characteristics both on CT (hypodense and with no contrast silhouetted) and on MR (hypointensity in T1 and in T2). They were completely resected in 16 cases. There were 3 episodes of aseptic meningitis and 2 deaths. CONCLUSIONS: Dermoid and epidermoid cysts are characterized by long term clinical symptoms. The commonest site is supratentorial in the midline or in the temporosylvian region. The diagnostic investigation of choice is MR. Treatment is surgical, preferably complete resection. However, after sub-total resection there is a prolonged period of remission.

Adolescent↗