Asunto(s)
Neoplasias Encefálicas/patología , Recurrencia Local de Neoplasia/patología , Glándula Pineal/patología , Pinealoma/patología , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/terapia , Terapia Combinada , Humanos , Hidrocefalia/etiología , Hidrocefalia/cirugía , Inmunohistoquímica , Masculino , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/terapia , Procedimientos Neuroquirúrgicos , Pinealoma/metabolismo , Pinealoma/terapia , Radioterapia , Derivación Ventriculoperitoneal , Adulto JovenRESUMEN
We present an integrated imaging system which enables CT and MRI data to blend with angiographic or ventriculographic films obtained by teleradiography and digitized. From all the data fed to the calculator, orthogonal, frontal, lateral, simple or double-obliquity trajectories can be determined easily and rapidly.
Asunto(s)
Diagnóstico por Imagen/estadística & datos numéricos , Técnicas Estereotáxicas/estadística & datos numéricos , Angiografía/estadística & datos numéricos , Mapeo Encefálico , Diagnóstico por Computador , Diagnóstico por Imagen/instrumentación , Diagnóstico por Imagen/métodos , Humanos , Aumento de la Imagen , Imagen por Resonancia Magnética/estadística & datos numéricos , Radiocirugia , Técnicas Estereotáxicas/instrumentación , Telerradiología , Tomografía Computarizada por Rayos X/estadística & datos numéricosAsunto(s)
Neoplasias Encefálicas/cirugía , Hemangioblastoma/cirugía , Neoplasias de la Médula Espinal/cirugía , Enfermedad de von Hippel-Lindau/cirugía , Biomarcadores de Tumor/análisis , Encéfalo/patología , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patología , Diagnóstico por Imagen , Hemangioblastoma/diagnóstico , Hemangioblastoma/genética , Hemangioblastoma/patología , Humanos , Complicaciones Posoperatorias/etiología , Pronóstico , Médula Espinal/patología , Neoplasias de la Médula Espinal/diagnóstico , Neoplasias de la Médula Espinal/genética , Neoplasias de la Médula Espinal/patología , Enfermedad de von Hippel-Lindau/diagnóstico , Enfermedad de von Hippel-Lindau/genética , Enfermedad de von Hippel-Lindau/patologíaRESUMEN
An overview of recent studies concerning opioids and their pharmacokinetics is presented. In the light of these findings it is shown that intracerebral administration may be justified. The authors experience with 63 cases is detailed: all cancer patients in the final stage. Initial dosage by the intraventricular route was 500 to 700 microgram-day but in one case twice daily injections of 1.200 microgram were needed. The dosage needed doubled over the observation period of 2 to 3 months. The mean length of survival was 75 days. Among complications nausea and vomiting were observed in 15 to 35% of the cases, sweating and pruritus in 15%, urinary retention in 15 to 20%. In some cases euphoria, motor excitement and hallucinations occurred. Chronic constipation was present in all cases. Two cases of meningitis were successfully treated by antibiotics. Pain relief was judged excellent or good in 75% of the cases. In 20% other analgesics had to be added to the treatment. In 5% the method failed.
Asunto(s)
Morfina/administración & dosificación , Neoplasias/fisiopatología , Dolor/tratamiento farmacológico , Humanos , Inyecciones Intraventriculares , Dolor/etiologíaRESUMEN
Pain is as old as mankind. It has a threshold beyond which nobody can escape it. Pain is a biological and physiological phenomenon, an integrated part of our body and ego. Will all our efforts eventually make it disappear? Is its disappearance desirable? Pain is one of the major expressions of sensation. It is integrated by the central structures and expressed as a behavior of avoidance or attenuation of the effects produced by the cause of pain. The study of this behavior and of the transmission of the pain message corresponds to the study of how to fight against this message, which means that it should logically lead to the treatment of pain.
Asunto(s)
Dolor/fisiopatología , Analgesia/métodos , Humanos , Fibras Nerviosas/fisiología , Inhibición Neural , Nociceptores/fisiología , Manejo del Dolor , Técnicas Estereotáxicas , Estimulación Eléctrica Transcutánea del NervioRESUMEN
Five patients were treated after a period varying between 6 weeks and 18 months following original injury. The five lesions were similar in that they could not be reduced by conventional orthopedic measures and that they were fixed during dynamic review examinations using a brilliance amplifier.
Asunto(s)
Callo Óseo/diagnóstico por imagen , Vértebras Cervicales/lesiones , Luxaciones Articulares/diagnóstico por imagen , Vértebras Torácicas/lesiones , Adulto , Vértebras Cervicales/cirugía , Niño , Femenino , Humanos , Luxaciones Articulares/fisiopatología , Luxaciones Articulares/cirugía , Masculino , Persona de Mediana Edad , Radiografía , Columna Vertebral/diagnóstico por imagen , Vértebras Torácicas/cirugíaRESUMEN
The legitimacy of osteosynthesis for the treatment of spinal injuries in children is analyzed as a function of results in 10 cases, 7 affecting the cervical, 2 the thoracic and one the lumbar region, six of the children being under 10 years of age. Five of these children had serious neurologic disorders, including 4 with high tetraplegia. Technical difficulties of osteosynthesis were not made easier by the poorly adapted nature of the material for infantile statures. Indications for this surgery were not only those cases not improved by orthopedic therapy: instability of lesions, the child's condition and deterioration in the neurologic state can also require initial treatment by osteosynthesis. The principal complication is postoperative cervical kyphosis, but this can be prevented by early active reeducation, the stability of the fixation dispensing with the need for external contention.
Asunto(s)
Fijación Interna de Fracturas , Traumatismos Vertebrales/cirugía , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Cifosis/etiología , Cifosis/prevención & control , Masculino , Complicaciones PosoperatoriasRESUMEN
Based on their personal experience of the use of arteriography in 11 patients, the authors describe the angiographic appearances of both benign and malignant peripheral nerve tumours. They emphasise the reasons for errors, and the criteria enabling the precise nature of the lesion to be determined pre-operatively in the majority of cases. Other contributions supplied by angiography are discussed.