Screening spreading depolarizations during epilepsy surgery.

BACKGROUND: Spreading depolarization (SD) is a fundamental pathophysiological mechanism of both pannecrotic and selective neuronal lesions following deprivation of energy. SD with brain injury has been reported including in one patient during an intracranial operation. However, the incidence of SDs in operative resections is unknown. METHODS: We performed (a) retrospective analysis of intraoperative AC-recordings of 69 patients and (b) a prospective study using intraoperative near-DC recording. All patients had the diagnosis of pharmaco-resistant epilepsy. Both studies were designed to determine the incidence and characteristics of SDs intraoperatively. In the retrospective analysis, we used intraoperative electrocorticography (iECoG) recordings obtained from AC-recording of 69 patients. In the prospective analysis, we used an Octal Bio Amp and Power Lab ECoG recorder with near-DC range. RESULTS: In the retrospective study, we included 69 patients with a mean of 1 h 3 min of iECoG recordings. In the prospective study, we recruited 20 patients with near DC recordings. A total of 35 h 41 min of iECoG recordings with mean of 2 h 32 min/patient were analyzed. We did not find SD in either study. CONCLUSIONS: SDs were not detected during intraoperative recordings of epilepsy surgery using AC- or DC-amplifiers.

A propósito de un caso de desprendimiento seroso de retina en una paciente con preeclampsia severa / Apropos of a case of serous retinal detachment in a patient with severe preeclampsia

Objetivo: Presentar las características clínicas y las secuelas de un caso de desprendimiento de retina (DR) seroso en preeclampsia. Diseño del estudio: Observacional. Material y métodos: Mujer de 17 años, embarazada de 36 semanas, presentó tres días previos a la visita oftalmológica disminución de la agudeza visual de ambos ojos, así como dolor abdominal. A su llegada se diagnosticó preeclampsia con datos de gravedad, por lo que se decidió interrumpir el embarazo. Su agudeza visual de ambos ojos fue contar los dedos a 50 centímetros. El examen de fondo de ojo derecho reveló un DR inferior y temporal, también líquido que se extendía hacia la mácula. El ojo izquierdo se observa con DR superior, nasal y temporal. Se decide iniciar tratamiento con esteroides, presentando mejoría visual y anatómica al tercer día. Conclusiones: El diagnóstico oportuno y seguimiento son el pilar para tener un buen pronóstico visual en pacientes con preeclampsia.

Objective: To present clinical characteristics and the sequelae of a case of serous retinal detachment in preeclampsia. Study design: Observational. Material and methods: We presented a 17-year old, 36-weeks pregnant, female without other ocular history, who reported 3 days previous of the ophthalmologic visit a reduction in visual acuity of both eyes, as well as abdominal pain. Upon arrival, preeclampsia was diagnosed with severity data, so was decided to terminate the pregnancy by cesarean. On examination, her visual acuity of both eyes was counting fingers at 50 centimeters. Fundus examination of the right eye revealed an inferior and temporal retinal detachment, also fluid extending into the macula. The left eye was observed with a superior, nasal and temporal detachment. It was decided to start steroid treatment, presenting visual and anatomical improvement. Conclusions: Timely diagnosis and follow-up are the pillar to have a good visual prognosis in preeclampsia