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S Vega-Basulto

Publications and source records attributed to S Vega-Basulto.

10 recordsLinked to original sources
PubMedDate not supplied

[Simultaneous cephalic migration of a ventriculoperitoneal shunt into the intraventricular and subdural spaces. A case report].

INTRODUCTION: Hydrocephaly is defined as a hemodynamic disorder in which the production, circulation or reabsorption of cerebrospinal fluid is involved. Migration, in a cephalic direction, into the subdural and intraventricular spaces of the proximal ends (shunt malfunction), is very unusual and perhaps not yet reported. It probably involves movement of the craniospinal region of the patient which leads to a follow on effect due to an underlying disorder. CLINICAL CASE: We report the case of a polytraumatized baby (non hospital birth, subarachnoid hemorrhage, porencephaly and subsequent hydrocephaly), who had had multiple shunts inserted. On her most recent admission the shunt was not working properly, as confirmed on plain radiological examination. This showed migration of the catheter, in cephalic direction, into the intraventricular and subdural space. CONCLUSIONS: In order that such migration could occur, conditioning factors would be necessary: such as detachment of the shunt at the distal end (technical fault), underlying disease (porencephaly), dynamic factors causing expulsion (abdominal peristaltic movements) dynamic translocation factor (neck movements), dynamic attraction factor (increased CSF reabsorption) and unishunt catheter (offering no resistance to passage through the trepanation orifice).

Cerebral Ventricles↗
PubMedDate not supplied

[Hemangioblastomas of the central nervous system in Camagüey (Cuba)].

INTRODUCTION AND OBJECTIVE: Hemangioblastomas of the central nervous system are the most frequent vascular tumours. They are 1 2% of primary nervous system tumours and 8 12% of the posterior fossa neoplasms. The objective is to analize clinical behaviour and long term results of sporadic and Von Hippel Lindau linked hemangioblastomas. PATIENTS AND METHODS: It was searched the vacular Neurosurgical Data Bank at Manuel Ascunce Dom nech Hospital between January 1981 and January 2001 to select patients harvoring central nervous system hemangioblastomas histological confirmed. Melmo and Rosen criteria were utilized in Von Hippel Lindau syndrome. We performed a twenty years follow up of this patients. RESULTS: There were 12 patients with central nervous system hemangioblastomas. Average age of presentation was 41 years old. The first case had twenty years since the operation and the last, eight months. 83% were cystic and 17% were solids. There was not surgical mortality. One patient died of renal carcinoma 15 years after the operation on craneal fossa. CONCLUSION: Central nervous system hemangioblastomas are a cluster of challenge tumours. They are intraxial benign tumours with potential good outcome. We observed sporadic and Von Hippel Lindau linked hemangioblastomas. Patients with this syndrome need clinico imagenological screening to identify new associated lesions.

Adult↗
PubMedDate not supplied

[Multiple intracranial aneurysms in Camagüey, Cuba].

INTRODUCTION: It is considered multiple intracranial aneurysms when a patient harbors two or more intracranial aneurysms. OBJECTIVE: To analyze clinical characteristic and microneurosurgical results of patients with multiple intracranial aneurysms attended in Camagüey. PATIENTS AND METHODS: Between 524 patients operated on to clip aneurysms, we searched 113 patients with multiple intracranial aneurysms. Patients were operated on by microneurosurgical methods and specialized neuroanesthesia. We performed one or two stage operations. Patients were evaluated three month later with Glasgow Outcome scale. RESULTS: There were 21.5% of multiple aneurysms. Age average was 46 years. There were 85 (75%) women and 28 (25%) men. Associated diseases were high blood pressure, carotid fibromuscular dysplasia and familiar aneurysms. There were 264 aneurysms: 252 at the carotid system and 12 at the vertebrobasilar circulation. Sacs average per patients was 2.3. There were 36% of bilateral aneurysms and 30% of symmetric or mirror sacs. Nehls algorithm permitted to localize symptomatic lesions at: posterior communicating region, anterior cerebral anterior communicating artery, basilar bifurcation, ophthalmic region, and middle cerebral artery. We utilized 128 surgical procedures and two stage operations were applied in 15 patients. 90% of aneurysms were clipped. Ninety patients (79%) obtained complete recuperation, 15 (12%) partial incapacity; 3 (4%) severe incapacity and there were not vegetative patients. Five patients died and the mortality rate was 4.4%. CONCLUSION: Multiple intracranial aneurysms are complex lesions but each one has a similar behavior to sporadic aneurysms. Association to different medical conditions is frequent and microneurosurgery offers good results.

Adult↗
PubMedDate not supplied

[Retrograde suction decompression technique for paraclinoidal aneurysms].

INTRODUCTION: Paraclinoidal carotid artery aneurysms pose technical surgical problems with regard to acquisition of the proximal control and safe intracranial exposure due to brisk retrograde flow through the ophthalmic artery and cavernous branches. Simple trapping of the aneurysm by cervical internal carotid artery clamping and intracranial clipping may not adequately soften the lesion. PATIENTS AND METHODS: Fifteen patients with giant and complexes large paraclinoidal aneurysms were operated on. We utilized microneurosurgical techniques, specialized neuroanesthesia, mild hypothermia, barbiturical brain protection, electroencephalographic monitoring and retrograde suction decompression technique described by Batjer et al. Patients were followed at Intensive Care Unit and were evaluated three months later. RESULTS: . 74% were female and there was a 14% of multiplicity. There was not intraoperative aneurysmal rupture and all aneurysms were clipped. We obtained 67% of good recovery, 27% of partial recovery, and no patient died. CONCLUSION: Retrograde suction decompression technique was useful for surgical treatment of paraclinoidal aneurysms. We introduced three technical modifications to the original procedure: intraoperative mild hypothermia, heparin utilization for endovascular procedure and intraoperative surgical evaluation of the vascular anatomical wall to select optimal area for angiocatheter insertion and temporary clipping. Modifications improve results.

Combined Modality Therapy↗
PubMedDate not supplied

[Combined supra and infratentorial presigmoideo approach for lesions of the petrous and clival regions].

INTRODUCTION: Petrous and petroclival lesions may be surgically treated with combinations of suprainfratentorial presigmoideo approach and microsurgical techniques. OBJECTIVE: To demonstrate the utility and to present our surgical experiences with this approach. PATIENTS AND METHODS: Thirteen patients with lesions of the clival, petrous region and of the cerebellopontine angle with extension toward the anterior portion of brainstem were taken to the operative room. There were nine women and four men. Eleven were adults and two children. The main clinical manifestations were headache (100%), dysfunction of cranial nerves (90%), ataxia (90%) hemiparesis (75%). There was papiledema in 45%. Petroclival meningiomas and schwannomas were the more frequent lesions. There were three patients with intraxial brainstem tumors and two arteriovenous malformations. There were not aneurysms. We performed nine retrolaberintic, three translaberintic and one transcochlear approach. RESULTS: There was not severe incapacity, vegetative or dead patients. The surgical complications were facial nerve paresis (31%), cerebrospinal fluid leak (23%), decreased gag reflex (15%), abducens nerve paresis, hemiparesis and Claude Bernard Horner syndrome (8%). 50% of these complications disappeared three months later. CONCLUSIONS: The suprainfratentorial presigmoidal approach and their surgical variations could be utilized to obtaining a low morbimortality, in the treatment of different neoplasm and vascular diseases of the petrous and petroclival region.

Adult↗
PubMedDate not supplied

[Cerebral dissecting aneurysms].

INTRODUCTION: Blood stream penetrates through the lacerations of the arterial layers determining dissecting aneurysms. Each intramural clot localization determines different clinical form. OBJECTIVE: We present the clinical observations carried out in two patients with vertebrobasilar dissecting aneurysms and we review the state of the art of this process to remark the early identification of these unusual lesions. CASE REPORTS: Two cases of vertebrobasilar dissecting aneurysms were described. They were young patients that debuted, one as posteroinferior artery brain steam infarction and the other one as a subarachnoid hemorrhage caused by a right posterior cerebral artery dissecting aneurysms. Lesions were confirmed by helicoidal cerebral angiotomographic and angiograms. This patient was operated on and we clipped the posterior communicating that irrigated dissecting segment. We carry out an anatomical and hemodynamic analysis of that lesion. Both patients had a satisfactory clinical evolution. CONCLUSIONS: Dissecting intramural hematomas of the vertebrobasilar territory are frequent cause of young people ictus. It has been suggested that the ictus may happen after minor head trauma and pain, main symptom, always precedes neurological dysfunction signs. Hemorrhagic presentation has a high incidence of rebleeding and elevated mortality. It always requires, as soon as possible, direct microsurgical treatment or endovascular methods (coils). Most useful microsurgical procedure, until today, is parent artery clipping. This technique has a low index of isquemic and neural postoperative damage.

Adult↗