Primary and secondary non-traumatic intra-cerebral haemorrhage: MRI findings.

Intracranial haemorrhage (ICH) accounts for 10-30% of strokes, being the form with the worst prognosis. The causes of cerebral haemorrhage can be both primary, mainly hypertensive and amyloid angiopathy, and secondary, such as tumours or vascular lesions. Identifying the aetiology of bleeding is essential since it determines the treatment to be performed and the patient's prognosis. The main objective of this review is to review the main magnetic resonance imaging (MRI) findings of the primary and secondary causes of ICH, focusing on those radiological signs that help guide bleeding due to primary angiopathy or secondary to an underlying lesion. The indications for MRI in the event of non-traumatic intracranial haemorrhage will also be reviewed.

Hemorragia cerebral primaria y secundaria no traumática: Hallazgos en RM / Primary and secondary non-traumatic intra-cerebral haemorrhage: MRI findings

La hemorragia intracraneal (HIC) supone un 10-30% de los ictus, siendo la forma de peor pronóstico. Las causas de hemorragia cerebral pueden ser primarias, fundamentalmente la angiopatía hipertensiva y amiloide, o secundarias, como tumores o lesiones vasculares. Identificar la etiología del sangrado es importante, ya que determina el tratamiento a realizar y el pronóstico del paciente. El objetivo principal de esta revisión es repasar los principales hallazgos por resonancia magnética (RM) de las causas de HIC primarias y secundarias, deteniéndonos en aquellos signos radiológicos que ayudan a orientar hacia un sangrado por una angiopatía primaria o bien secundario a una lesión subyacente. También se revisarán las indicaciones de RM ante una hemorragia intracraneal no traumática (AU)

Intracranial hemorrhage (ICH) accounts for 10-30% of strokes, being the form with the worst prognosis. The causes of cerebral hemorrhage can be both primary, mainly hypertensive and amyloid angiopathy, and secondary, such as tumors or vascular lesions. Identifying the etiology of bleeding is essential since it determines the treatment to be performed and the patient's prognosis. The main objective of this review is to review the main magnetic resonance imaging (MRI) findings of the primary and secondary causes of ICH, focusing on those radiological signs that help guide bleeding due to primary angiopathy or secondary to an underlying lesion. The indications for MRI in the event of non-traumatic intracranial hemorrhage will also be reviewed (AU)

Divertículo uretral con degeneración maligna: una complicación infrecuente en una dolencia frecuente / Malignant degeneration in a urethral diverticulum: an uncommon complication in a common condition

El divertículo uretral adquirido es una lesión relativamente frecuente en la mujer. Suelen ser asintomáticos pero pueden complicarse, siendo la infección y la formación de cálculos las complicaciones más frecuentes. La degeneración maligna con desarrollo de una tumoración maligna en el divertículo es una complicación rara que debe ser tenida en cuenta. Son pocos los casos descritos en la literatura de desarrollo de neoplasias malignas a partir de divertículos uretrales. Presentamos a continuación un caso de una mujer que fue diagnosticada de una tumoración maligna en un divertículo uretral. Revisamos los hallazgos de imagen de los divertículos uretrales y sus complicaciones (AU)

Acquired urethral diverticula are relatively common in women. They are usually asymptomatic but they can lead to complications; infection and stones are the most common complications. Malignant degeneration with the development of a malignant tumor in the diverticulum is a rare complication that must be taken into account. Few cases of malignant tumors in urethral diverticula have been reported. We present the case of a woman diagnosed with a malignant tumor in a urethral diverticulum. We review the imaging findings for urethral diverticula and the complications that can arise in this condition (AU)

[Malignant degeneration in a urethral diverticulum: an uncommon complication in a common condition]. / Divertículo uretral con degeneración maligna: una complicación infrecuente en una dolencia frecuente.

Acquired urethral diverticula are relatively common in women. They are usually asymptomatic but they can lead to complications; infection and stones are the most common complications. Malignant degeneration with the development of a malignant tumor in the diverticulum is a rare complication that must be taken into account. Few cases of malignant tumors in urethral diverticula have been reported. We present the case of a woman diagnosed with a malignant tumor in a urethral diverticulum. We review the imaging findings for urethral diverticula and the complications that can arise in this condition.

Herniación medular idiopática: una entidad poco frecuente / Idiopathic spinal cord herniation: a rare condition

La hernia medular idiopática es una entidad rara, causante de mielopatía progresiva. Es el resultado de una hernia de la médula espinal a través de un defecto de la duramadre, de etiología no conocida. La forma de presentación clínica más habitual es como un síndrome de Brown-Séquard. La importancia de un diagnóstico radiológico precoz radica en que es causa reversible de mielopatía, ya que el defecto dural es corregible quirúrgicamente con una alta tasa de recuperación funcional. La resonancia magnética es la técnica de imagen de elección para el diagnóstico. A continuación se presentan 2 casos de hernia medular idiopática donde se muestran los hallazgos radiológicos que nos permiten reconocer y diagnosticar esta entidad (AU)

Idiopathic spinal cord hernia, in which the reason that spinal cord protrudes through a defect in the dura mater is unknown, is a rare cause of progressive myelopathy. The most common clinical presentation is Brown-Séquard syndrome. Spinal cord herniation is a reversible cause of myelopathy: surgery to correct the defect in the dura mater has a high rate of functional recovery. Thus, early imaging detection is crucial. Magnetic resonance imaging is the technique of choice for the diagnosis. We present two cases of idiopathic spinal cord herniation and show the imaging findings that make it possible to recognize and diagnose this condition (AU)

[Idiopathic spinal cord herniation: a rare condition]. / Herniación medular idiopática: una entidad poco frecuente.

Idiopathic spinal cord hernia, in which the reason that spinal cord protrudes through a defect in the dura mater is unknown, is a rare cause of progressive myelopathy. The most common clinical presentation is Brown-Séquard syndrome. Spinal cord herniation is a reversible cause of myelopathy: surgery to correct the defect in the dura mater has a high rate of functional recovery. Thus, early imaging detection is crucial. Magnetic resonance imaging is the technique of choice for the diagnosis. We present two cases of idiopathic spinal cord herniation and show the imaging findings that make it possible to recognize and diagnose this condition.

[Use and abuse of intravenous catheters in conventional hospital wards]. / Uso y abuso de los catéteres intravenosos en las plantas de hospitalizacion convencional.

BACKGROUND: Information regarding the use intravenous catheters (IVC) in conventional hospital units and its consequence in terms of intravenous catéter-related bacteremia (ICRB) is scarce. OBJECTIVES: To evaluate the use of IVC in patients admitted in conventional wards of a general hospital and to measure IVCRB incidence in such patients. METHODS: We evaluated during one week IVC use in adult patients admitted in 12 de Octubre Hospital and we calculated la incidence density of ICRB. RESULTS: We evaluated the clinical charts of 731 patients (284 from medical wards and 447 from surgical wards), of which 338 (46.2%) had a peripheral VC inserted and 63 (8.6%) a central IVC. Central IVC had been inserted for a mean time 11.5 days globally (CI 95% 5.57-17.42), being 28.3 in medical wards and 8.32 days in surgical wards (p = 0.2). In 27.7 % of the patients with IVC intravenous antimicrobials was the only reason for the use of such catheters in spite of adequate oral tolerance in 30 % of the patients with central IVC an specific note explaining the reason for implanting such catheter was lacking in the clinical chart. IVCRB was detected in 12/401 patients (3%). The incidence density of IVCRB in central IVC was 8.28 per 1000 catheter-days. CONCLUSIONS: There are some aspects that could be clearly improved regarding the prevention of IVCRB, mostly in the indications, the excess of time those catheters are kept implanted and in the lost chances for catheter withdrawal when switch-therapy could be performed.

Uso y abuso de los catéteres intravenosos en las plantas de hospitalizacion convencional / Use and abuse of intravenous catheters in convetntional hospitals wards

Antecedentes: Existe escasa información acerca del uso de catéteres venosos (CVs) en unidades de hospitalización convencionales y la incidencia bacteriemia relacionada con catéteres venosos (BRCV) en dichas unidades. Objetivos: Evaluar el uso de catéteres venosos (CVs) en pacientes ingresados en plantas convencionales de un hospital general y las consecuencias en términos de BRCV. Métodos: Se evaluó durante una semana el uso de catéteres venosos y la densidad de incidencia de BRCV en pacientes adultos ingresados en los servicios de hospitalización del hospital 12 de Octubre de Madrid. Resultados: Se analizaron las historias clínicas de 731 pacientes (284 en servicios médicos y 447 en servicios quirúrgicos), de los cuales 338 (46,2%) eran portadores en ese momento de un CV periférico y 63 (8,6%) de un CV central. La media de días de colocación de un CV central fue globalmente de 11,5 (IC 95% 5,57-17,42), 28,3 en los servicios médicos días y 8,32 en los servicios quirúrgicos (p = 0,2). En el 27,7% de los pacientes con CVs la única indicación para el uso de un CV fue la administración intravenosa de antibióticos a pesar de que el paciente toleraba por vía oral y en un 30% de las ocasiones no había ninguna especificación en la historia que permitiera aclarar cuál era la indicación para la colocación del CV. Se detectó BRCV en 12/401 pacientes (3%). La densidad de incidencia de BRC en CV centrales fue de 8,28 por cada 1.000 días de catéter. Conclusiones: Existen claros aspectos que deben mejorarse en cuanto a la prevención de la BRC, fundamentalmente respecto al ajuste de las indicaciones, el tiempo que permanecen los catéteres centrales implantados y, sobre todo, en cuanto a las oportunidades perdidas de retirar el catéter secuenciando la medicación a vía oral

Background: Information regarding the use intravenous catheters (IVC) in conventional hospital units and its consequence in terms of intravenous catéter-related bacteremia (ICRB) is scarce. Objectives: To evaluate the use of IVC in patients admitted in conventional wards of a general hospital and to measure IVCRB incidence in such patients. Methods: We evaluated during one week IVC use in adult patients admitted in 12 de Octubre Hospital and we calculated la incidence densitity of ICRB. Results: We evaluated the clinical charts of 731 patients (284 from medical wards and 447 from surgical wards), of which 338 (46.2%) had a peripheral VC inserted and 63 (8.6%) a central IVC. Central IVC had been inserted for a mean time 11.5 days globally (CI 95% 5.57-17.42), being 28.3 in medical wards and 8.32 days in surgical wards (p=0.2). In 27.7 % of the patients with IVC intravenous antimicrobials was the only reason for the use of such catheters in spite of adequate oral tolerance in 30 % of the patients with central IVC an specific note explaining the reason for implanting such catheter was lacking in the clinical chart. IVCRB was detected in 12/401 patients (3%). The incidence density of IVCRB in central IVC was 8.28 per 1000 catheter-days. Conclusions: There are some aspects that could be clearly improved regarding the prevention of IVCRB, mostly in the indications, the excess of time those catheters are kept implanted and in the lost chances for catheter withdrawal when switch-therapy could be performed