Consenso sobre guías de tratamiento de gliomas de bajo grado elaborado por el grupo de tumores de la SENEC / Low grade gliomas guide-lines elaborated by the tumor section of Spanish Society of Neurosurgery

Los gliomas de bajo grado (Low Grade Gliomas, LGG) del adulto son tumores que se originan a partir de las células gliales del cerebro y cuyo manejo implica gran controversia a día de hoy, comenzando desde el diagnóstico, hasta el tratamiento y seguimiento posterior de estos pacientes. Es por ello que el grupo de tumores de la Sociedad Española de Neurocirugía (GT-SENEC) ha llevado a cabo una reunión de consenso, en la que se han debatido las cuestiones neuroquirúrgicas más relevantes, llegando a recomendaciones basadas en la mejor evidencia científica. Con el fin de obtener el máximo beneficio a estos tratamientos se debe hacer una valoración individualizada de cada paciente por un equipo multidisciplinar, constituido por aquellas especialidades involucradas tanto en el diagnóstico como en el tratamiento. El objetivo de este trabajo es elaborar unas recomendaciones de tratamiento para los pacientes con LGG, para lo cual un experto en cada campo ha descrito lo más relevante de dicha área basado tanto en su experiencia como en la literatura. Se han desarrollado los apartados más relevantes en el manejo de los LGG basados en la mejor evidencia publicada. A pesar de que existe controversia en algunos aspectos del manejo de los LGG, cada vez hay más datos para poder hacer recomendaciones de tratamiento consensuadas. El neurocirujano debe conocer las distintas opciones de tratamientos, sus indicaciones y riesgos para poder participar activamente en la toma de decisiones y poder ofrecer un tratamiento neuroquirúrgico oportuno a cada situación (AU)

Adult low-grade gliomas (Low Grade Gliomas, LGG) are tumors that originate from the glial cells of the brain and whose management involves great controversy, starting from the diagnosis, to the treatment and subsequent follow-up. For this reason, the Tumor Group of the Spanish Society of Neurosurgery (GT-SENEC) has held a consensus meeting, in which the most relevant neurosurgical issues have been discussed, reaching recommendations based on the best scientific evidence. In order to obtain the maximum benefit from these treatments, an individualized assessment of each patient should be made by a multidisciplinary team. Experts in each LGG treatment field have briefly described it based in their experience and the reviewed of the literature. Each area has been summarized and focused on the best published evidence. LGG have been surrounded by treatment controversy, although during the last years more accurate data has been published in order to reach treatment consensus. Neurosurgeons must know treatment options, indications and risks to participate actively in the decision making and to offer the best surgical treatment in every case (AU)

Low grade gliomas guide-lines elaborated by the tumor section of Spanish Society of Neurosurgery.

Adult low-grade gliomas (Low Grade Gliomas, LGG) are tumors that originate from the glial cells of the brain and whose management involves great controversy, starting from the diagnosis, to the treatment and subsequent follow-up. For this reason, the Tumor Group of the Spanish Society of Neurosurgery (GT-SENEC) has held a consensus meeting, in which the most relevant neurosurgical issues have been discussed, reaching recommendations based on the best scientific evidence. In order to obtain the maximum benefit from these treatments, an individualised assessment of each patient should be made by a multidisciplinary team. Experts in each LGG treatment field have briefly described it based in their experience and the reviewed of the literature. Each area has been summarized and focused on the best published evidence. LGG have been surrounded by treatment controversy, although during the last years more accurate data has been published in order to reach treatment consensus. Neurosurgeons must know treatment options, indications and risks to participate actively in the decision making and to offer the best surgical treatment in every case.

«El convento de las monjas torcidas». Síndrome de Pisa y camptocormia inducido por antipsicóticos / “The bent nuns convent”. Antipsycotic-induced Pisa Syndrome and Camptocormia

La camptocormia y el sídrome de Pisa (pleurothotonus) se caracteriza por una postura anormal en el tronco, con una flexión de la columna toracolumbar de entre 15-45° durante la bipedestación y la marcha que se corrige completamente con el decúbito supino. Se asocia a la enfermedad de Parkinson y a otras enfermedades neurodegenerativas, siendo su fisiopatología incierta. Se presentan 3 casos de camptocormia secundaria a antipsicóticos atípicos (AU)

Camptocormia is an involuntary flexion between 15-45° of the thoracolumbar spine when standing, walking or sitting, which disappears completely in the supine position. Is associated to Parkinson's disease and other neurodegenerative conditions, being its physiopatology unknown. We report three cases of atypical anti-psychotic induced camptocormia (AU)

"The bent nuns convent". Antipsycotic-induced Pisa Syndrome and Camptocormia. / «El convento de las monjas torcidas¼. Síndrome de Pisa y camptocormia inducido por antipsicóticos.

Camptocormia is an involuntary flexion between 15-45° of the thoracolumbar spine when standing, walking or sitting, which disappears completely in the supine position. Is associated to Parkinson's disease and other neurodegenerative conditions, being its physiopatology unknown. We report three cases of atypical anti-psychotic induced camptocormia.

Craneofaringioma ectópico y síndrome de Gardner: a propósito de un caso y revisión de la literatura / Ectopic craniopharyngioma and Gardner's syndrome: Case report and literature review

Introducción: El craneofaringioma representa alrededor del 3% de todos los tumores primarios del sistema nervioso central. Por lo general, se localiza en la región supraselar, sin embargo, puede tener una localización atípica. Caso clínico: Presentamos el caso de un varón de 29 años de edad que fue intervenido de un osteoma de mandíbula a los 19 años de edad, y a quien posteriormente se le diagnosticó síndrome de Gardner. Ingresó en nuestro hospital con una paresia facial derecha de un día de evolución acompañada de diplopía. La exploración neurológica confirmó la existencia de una paresia leve del VI y VII pares craneales derechos. La resonancia magnética cerebral mostró una lesión sólido-quística, redondeada, de contorno bien definido, de unos 2cm de diámetro que ocupaba el cuarto ventrículo. El paciente fue intervenido mediante una craneotomía fosa posterior, abordaje telovelar y extirpación completa del tumor implantado a nivel del techo del cuarto ventrículo. El estudio anatomopatológico definitivo informó de un craneofaringioma adamantinomatoso. Conclusión: El craneofaringioma es un tumor que puede aparecer en otra localización diferente de la región selar-supraselar, y por mecanismos etiopatogénicos hasta ahora desconocidos su localización atípica puede guardar relación con alguna forma de poliposis adenomatosa familiar como el síndrome de Gardner

Introduction: Craniopharyngioma accounts for around 3% of all primary tumours of the central nervous system. It is usually located in the suprasellar region, although it may also have an ectopic location. Case report: The case is presented on 29 year-old male who underwent surgery for a jaw osteoma when he was 19 years old and was subsequently diagnosed with Gardner's syndrome. He was admitted in our Hospital with right facial paresis and diplopia of one day onset. The examination showed mild right VII and VI cranial nerves paresis. Magnetic resonance imaging of the brain demonstrated a rounded solid and cystic lesion with well-defined contours of about 2cm in diameter filling the fourth ventricle. The patient underwent a posterior fossa craniotomy using a telovelar approach with complete removal of the tumour implanted at roof level of the fourth ventricle. The final histology of the tumour was reported as adamantinomatous craniopharyngioma. Conclusion: Craniopharyngioma may appear in another location other than the suprasellar region. Its atypical location may be related to Gardner syndrome by still unknown pathogenic mechanisms

[Ectopic craniopharyngioma and Gardner's syndrome: Case report and literature review]. / Craneofaringioma ectópico y síndrome de Gardner: a propósito de un caso y revisión de la literatura.

INTRODUCTION: Craniopharyngioma accounts for around 3% of all primary tumours of the central nervous system. It is usually located in the suprasellar region, although it may also have an ectopic location. CASE REPORT: The case is presented on 29 year-old male who underwent surgery for a jaw osteoma when he was 19 years old and was subsequently diagnosed with Gardner's syndrome. He was admitted in our Hospital with right facial paresis and diplopia of one day onset. The examination showed mild right VII and VI cranial nerves paresis. Magnetic resonance imaging of the brain demonstrated a rounded solid and cystic lesion with well-defined contours of about 2cm in diameter filling the fourth ventricle. The patient underwent a posterior fossa craniotomy using a telovelar approach with complete removal of the tumour implanted at roof level of the fourth ventricle. The final histology of the tumour was reported as adamantinomatous craniopharyngioma. CONCLUSION: Craniopharyngioma may appear in another location other than the suprasellar region. Its atypical location may be related to Gardner syndrome by still unknown pathogenic mechanisms.