Ten-year follow-up of giant basilar aneurysm treated by sole stenting technique: a case report.

INTRODUCTION: The sole stenting technique has emerged as a new tool for the management of intracranial aneurysms. However, several concerns have emerged about the long-term behavior of intracranial stents, particularly their safety and efficacy. CASE PRESENTATION: We present the first case of an intracranial aneurysm intentionally treated with the sole stenting technique. After ten years of clinical and imaging follow-up, the lesion has healed and no intrastent stenosis is observed.Several issues concerning this technique are discussed. For instance, the modification of the angle and intra-aneurysmal thrombosis may account as positive effects; negative outcomes include in-stent thrombosis or stenosis. CONCLUSIONS: This case report, involving a long clinical and imaging follow-up, provides an example of the effectiveness, safety, durability and simplicity of the sole stenting technique in the management of intracranial aneurysms.

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

Presentamos el caso de una paciente que presentó un cuadro de apoplejía quiasmática asociada a alteraciones menstruales cuya tomografía computarizada de cráneo mostró hemorragia supraselar. Fue intervenida con el diagnostico de tumor hipofisiario, pero presentó una lesión hemorrágica en quiasma y la porción proximal del nervio óptico izquierdo. El diagnostico histopatológico fue de un cavernoma. El angioma cavernoso constituye cerca del 15% de todas las malformaciones vasculares del sistema nervioso central, y los del aparato visual son infrecuentes. Se debe sospechar cuando el paciente presenta apoplejía quiasmática u óptica. Su exéresis es útil para evitar empeoramiento o un nuevo déficit visual

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

Demencias potencialmente reversibles no quirúrgicas / Non-surgical potentially reversible dementias

Objetivo. Revisamos las demencias que presentan un potencial de reversibilidad. El presente artículo resume las demencias de manejo básicamente médico, mientras que en una segunda entrega destacaremos las de índole quirúrgica. Estos artículos pretenden evitar los diagnósticos y etiquetas erróneas en pacientes que tienen un alto potencial de mejoría de su trastorno cognitivo y orientar hacia un manejo más adecuado. Desarrollo. La demencia es un problema de salud pública, principalmente en los países con expectativa de vida amplia. Su incidencia es de 3-11% en pacientes mayores de 65 años, y de 20-50% en mayores de 85 años. La mayoría (50-70%) presentan demencia de tipo Alzheimer, seguida del tipo vascular (20%), y quedan en menor porcentaje las denominadas demencias subcorticales y las secundarias a patologías médicas y/o quirúrgicas, potencialmente reversibles. Estas últimas no son fáciles de reconocer, y su incidencia en distintas series va del 0 al 37%. Una vez diagnosticadas, es todavía difícil poder asegurar si serán en realidad reversibles; por tanto, debemos detectar precozmente sus causas más comunes, como las carenciales, metabólicas, asociadas a enfermedades crónicas, tóxicas, etc., para lo que nos valdremos de la observación clínica y del laboratorio. Conclusiones. Aunque todavía se encuentra en disputa el potencial de mejoría de los pacientes con un diagnóstico de demencia reversible, esta revisión sucinta nos orienta a la búsqueda intencionada de sus causas y su manejo, ya que es altamente probable que su detección y manejo tardíos sean la causa de una pobre evolución

Aims. In this study, we review dementias that are potentially reversible. The paper summarises the causes that essentially require management by medical means, while causes of a surgical nature will be dealt with in a second article. These papers attempt to avoid mistaken diagnoses and labels in patients with a high potential to improve their cognitive disorder and to guide us towards a more suitable management. Development. Dementia is a public health problem, mainly in countries with long life expectancy. It has an incidence of 3-11% in patients over the age of 65, and 20-50% in those over 85 years old. Most of them (50-70%) have Alzheimer-type dementia, followed by the vascular type (20%); there is a smaller percentage of cases of the so-called subcortical dementias and also those secondary to medical and/or surgical conditions that suggest potential reversibility. These latter cases are not easy to recognise and their incidence, depending on the series, ranges from 0 to 37%. Once they have been diagnosed, it is still difficult to state whether they will in fact turn out to be reversible. Their most common causes, such as deficiencies, metabolic disorders, chronic diseases, toxins, and so on, must be detected as early as possible, which can be done by means of clinical observation and use of the laboratory. Conclusions. Although the potential to improve in patients with a diagnosis of reversible dementia is still subject to discussion, this brief review guides us in the search for their causes and their management, since late detection and management are very likely to be the cause of a poor progression

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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