Coexistencia de neuroblastoma olfatorio y aneurisma de la arteria carótida interna: presentación de un caso / Coexistence of an olfactory neuroblastoma and internal carotid artery aneurism: case report

El neuroblastoma olfatorio es una neoplasia neuroectodérmica maligna rara que afecta a la bóveda nasal y que tiende a invadir las estructuras vecinas, entre estas a la cavidad intracraneal. Su asociación con aneurismas intracraneales nunca ha sido descrita. Presentamos a una paciente con la coexistencia de un aneurisma del segmento oftálmico de la arteria carótida interna y un neuroblastoma olfatorio con invasión intracraneal. La coexistencia entre neoplasias del sistema nervioso central y aneurismas intracraneales es infrecuente. En este artículo analizamos las posibles causas de la asociación entre neoplasias y aneurismas intracraneales.

The olfactory neuroblastoma is a rare malignant neuroectodermal neoplasia of the nasal roof. It has a highly tendency of invades near structures including intracranial compartment. Associations between olfactory neuroblastoma with intracranial aneurysms have been never described. We show a case of a female with coexistence of an internal carotid artery aneurysm and olfactory neuroblastoma. The coexistence between nervous system tumors with intracranial aneurysms is not common. In this paper we analyze the association between intracranial neoplasia and aneurysms.

[Cavernous angioma of the second cranial nerve and chiasmatic apoplexy]. / Angioma cavernoso del segundo nervio craneal y apoplejía quiasmática.

We present the case of a female patient who developed chiasmatic apoplexy and menstrual alterations. CT scanning showed a suprasellar hemorrhage. She underwent surgery with the presumptive diagnosis of pituitary tumor. At surgery, we find a brown-grayish lesion involving left optic nerve and chiasm. Cavernous angioma was diagnosed by histopathology. Cavernous angiomas constitute nearly 15% of all central nervous system vascular malformations. Location at the optic pathway is very rare, but must to be ruled out in the diagnosis of a patient with chiasmatic and/or optic apoplexy. Surgery is useful in preventing worsening of the previous deficit or a new visual defect.

Réplica. Algunas reflexiones sobre la utilidad de la angiografía por resonancia magnética en la cirugía de aneurismas intracraneales rotos / Reply. Some reflections on the value of magnetic resonance angiography in the surgical treatment of ruptured intracranial aneurysms

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[Usefulness of magnetic resonance angiography in surgery of ruptured intracranial aneurysms]. / Utilidad de la angiografía por resonancia magnética en la cirugía de aneurismas intracraneales rotos.

INTRODUCTION: Cerebral angiography (CA) is considered as the gold standard in diagnosis of intracranial aneurysms; nevertheless, the magnetic resonance angiography (MR-angiography) is wide spread used in detection of unruptured aneurysm. For this reason, several authors had proposed that MR-angiography could replace CA in the diagnosis of ruptured aneurysms. AIMS: To asses the efficacy of MR-angiography in diagnosis of ruptured intracranial aneurysms, and in addition to determine the safeness of its surgical management with MR-angiography alone. PATIENTS AND METHODS: We studied prospectively 52 patients with subarachnoid haemorrhage admitted at Teodoro Maldonado Carbo and Alcívar Guayaquil hospitals of Guayaquil, Ecuador, in a 5 years period. We compared the results of MR-angiography with CA and surgical findings in the diagnosis and categorization of intracranial aneurysms. RESULTS: We made diagnosis of 100% of 54 aneurysms with MR-angiography, while 98% with CA. The surgical findings were similar to the characteristics showed by MR-angiography. CONCLUSIONS: MR-angiography is an excellent no invasive method in the diagnosis of ruptured intracranial aneurysms, and could replace CA in selected cases.

Utilidad de la angiografía por resonancia magnética en la cirugía de aneurismas intracraneales rotos / Usefulness of magnetic resonance angiography 1 N surgery of ruptured inracranial aneurysms

Introduction. Cerebral angiography (CA) is considered as the gold standard in diagnosis of intracranial aneurysms; nevertheless, the magnetic resonance angiography (MR-angiography) is wide spread used in detection of unruptured aneurysm. For this reason, several authors had proposed that MR-angiography could replace CA in the diagnosis of ruptured aneurysms. Aims. To asses the efficacy of MR-angiography in diagnosis of ruptured intracranial neurysms, and in addition to determine the safeness of its surgical management with MR-angiography alone. Patients and methods. We studied prospectively 52 patients with subarachnoid haemorrhage admitted at Teodoro Maldonado Carbo and Alcívar Guayaquil hospitals of Guayaquil, Ecuador, in a 5 years period. We compared the results of MR-angiography with CA and surgical findings in the diagnosis and categorization of intracranial aneurysms. Results. We made diagnosis of 100% of 54 aneurysms with MR-angiography, while 98% with CA. The surgical findings were similar to the characteristics showed by MR-angiography. Conclusions. MR-angiography is an excellent no invasive method in the diagnosis of ruptured intracranial aneurysms, and could replace CA in selected cases (AU)

Introducción. La angiografía cerebral (AC) es la técnica de referencia en el diagnóstico de aneurismas intracraneales; no obstante, la angiografía por resonancia magnética (angio-RM) se utiliza con gran efectividad para la detección de aneurismas en pacientes que no han presentado hemorragia subaracnoidea (HSA). Por lo tanto, algunos autores han propuesto que la angio-RM puede suplantar a la AC, incluso en el tratamiento de aneurismas rotos. Objetivos. Valorar la utilidad de la angio-RM comparada con la AC y la observación quirúrgica en el diagnóstico de aneurismas intracraneales rotos, además de determinar la seguridad del tratamiento quirúrgico con angio-RM como único método diagnóstico. Pacientes y métodos. Se estudiaron prospectivamente 52 pacientes con HSA aguda por ruptura de aneurisma en los hospitales Teodoro Maldonado Carbo y Alcívar Guayaquil, de la ciudad de Guayaquil, Ecuador, en un período de 5 años. Comparamos los resultados de la angio-RM con la AC y los hallazgos quirúrgicos en el diagnóstico y caracterización de aneurismas intracraneales. Resultados. Diagnosticamos el 100% de 54 aneurismas intracraneales con angio-RM, mientras que con la AC, el 98%. Los hallazgos quirúrgicos fueron similares a lo mostrado en la angio-RM. Conclusiones. La angio-RM es un método no invasivo y libre de contraste nefrotóxico óptimo en el diagnóstico de aneurismas intracerebrales rotos y puede reemplazar a la AC en casos seleccionados(AU)

Réplica. Histiocitoma fibroso maligno meníngeo / Reply. Malignant fibrous histiocytoma of the meninges

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Histiocitoma fibroso maligno meníngeo. Presentación de un caso / Malignant fibrous histiocytoma of the meninges. A case report

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