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R Hodelín-Tablada

Publications and source records attributed to R Hodelín-Tablada.

13 recordsLinked to original sources
PubMed1997

[Spontaneous intracranial hematomas. A surgical solution?].

INTRODUCTION: Spontaneous intracranial haematomas pose a fundamental question for the neurosurgeon: Should he operate or not? The main objective of this paper is to consider recent ideas on this subject. A detailed review of the literature was carried out and then discussed. DEVELOPMENT: This study has been structured as supratentorial haematomas, infratentorial haematomas (cerebellum and brainstem) and multiple cerebral haematomas. We emphasize the importance of CT scanning to surgical decision-making. In supratentorial haematomas, surgery is considered to be indicated in patients with blood clots of between 2 and 3 cm in diameter, and whose neurological state is starting to deteriorate. Patients with cerebellar haematomas are classified into four groups, depending on the level of consciousness and the diameter of the clot. In these patients surgery is indicated basically in patients, both alert and somnolent, with haematomas greater than 3 cm. Medical treatment is recommended in patients with multiple haematomas and haematomas localized to the brain-stem. It is suggested that the best time to evacuate the haematoma is between 2 and 6 hours after onset. CONCLUSIONS: We consider that with the development of modern neuro-imaging techniques, intensive care units, neurological monitorization, developments in neurosurgical techniques with the use of magnification, the ultrasonic aspirator and stereotactic techniques, there will be more and more patients with spontaneous intracranial haematomas who can be successfully treated surgically in the next few years.

Cerebral Hemorrhage↗
PubMedDate not supplied

[Fractures of the odontoid process. Incidence and treatment in the Neurosurgical Department of a hospital in Maputo (Mozambique)].

INTRODUCTION: Fractures of the odontoid process make up between 10 and 15% of all cervical fractures. The decision as to when to operate on them is still controversial; the dilemma as to whether to use surgical or conservative treatment is still a problem. PATIENTS AND METHODS: We designed a descriptive study, which was prospective and applied to all patients diagnosed as having a fracture of the odontoid process, admitted to the Neurosurgical Department of Maputo Central Hospital (Mozambique) between June 1997 and May 1998. Follow up was rigorously controlled up to May 2000. All were treated conservatively with a cervical plaster collar. RESULTS: Six cases (83.3%), mainly male, were diagnosed. The patients were aged between 17 and 42 years, with an average age of 26.16 years. The commonest aetiology was a traffic accident (66.6%). Type II fractures were the commonest, seen in 4 patients. All patients complained of pain in the back of their necks. Dysparesia and brachial monoparesia were both seen in 33.3% of the patients. In four cases the fracture consolidated in three months, one in two months and the other after four months. Full recovery was made by 66.6%. CONCLUSIONS: Based on their review of the literature and own practical experience, the authors recommend conservative treatment for fractures of types I and II, immediate surgical operation for type IIA and for type II when the following conditions are met: displacement of over 4 mm, age of over 40 years and diagnosis made over a week after the injury had occurred.

Accidents, Traffic↗