[Complications of stereotaxic surgery for cerebral tumors. Minimal access neurosurgery]. / Complicaciones de la cirugía estereotáxica de los tumores cerebrales. Neurocirugía de mínimo acceso.

INTRODUCTION: Complications of neurosurgery include the clinical, neurological and neurosurgical aspects. Their prevention and correction depend on satisfactory preoperative assessment and close postoperative follow-up. Although minimum access neurosurgery reduces some problems, the complexity and depth of many cerebral lesions cause problems. Therefore it is important to adhere to the above principles to obtain good results. OBJECTIVES: To determine the clinical complications, their early detection and course to be followed when they occur. PATIENTS AND METHODS: We studied 29 patients with intracranial tumors operated on using stereotaxic surgery during a period of two years. They were evaluated before and after surgery and the complications recorded. RESULTS: We discuss the most significant clinical aspects of peri-operative management. The main complications found were lower respiratory tract infection and hyperglycemia. CONCLUSIONS: These results show the need for suitable management, even in minimum access surgery, in patients with cerebral tumors operated on using stereotaxis and underline the most significant complications.

[Sepsis and antibiotic prophylaxis in stereotaxic neurosurgery]. / Sepsis y profilaxis antibiótica en neurocirugía estereotáxica.

INTRODUCTION: Stereotaxic surgery is becoming increasingly important because of the possibility of approaching the deep zones of the brain with less risk. It is in daily use in cerebral tumours and in the functional surgery of Parkinson's disease. The use of antibiotic prophylaxis in neurosurgery is controversial, although in many centres, including ours, all patients receive it. OBJECTIVE: To study the pre-operative clinical characteristics analysing the antibiotic prophylaxis used, septic complications seen and their management. PATIENTS AND METHODS: In this study we included 93 patients with neurosurgical disorders operated on using a stereotaxic approach in the Neurosurgical Department of the Centro Internacional de Restauración Neurologica (Cuba) during 1997 and 1998, in which antibiotic prophylaxis was used and septic patients detected. The variables studied included age, sex, neurological disorders, surgical operations done and the antibiotic used for prophylaxis. We analysed the test of clinical criteria for sepsis in all patients. RESULTS: We found that a greater number of patients operated on had had functional surgery, which showed its importance as an alternative surgical method in Parkinson's disease. There was satisfactory use of antibiotic prophylaxis with a reduction in the rate of nosocomial infection; most infections were seen in the lower respiratory tract. CONCLUSION: These results support the hypothesis of use of antibiotic prophylaxis in stereotaxic surgery to achieve a reduction in intra-hospital infections in surgical patients.