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Biomedical subjects

G Mosquera-Betancourt

Publications and source records attributed to G Mosquera-Betancourt.

8 recordsLinked to original sources
PubMed2006

[Ophthalmic artery aneurysms].

INTRODUCTION: Ophthalmic artery aneurysms are infrequent lesions and they have very specific particularities. OBJECTIVE: to present the anatomoclinical and surgical characteristic of our patients with ophthalmic aneurysms and to analyze our surgical results. PATIENT AND METHODS: 604 patients with intracranial aneurysms were operated on between January 1982 and December 2004. There were 50 patients with ophthalmic artery aneurysms. Average age was 52 years, 80% were women, 60% harbored multiple aneurysms and 20% were giant lesions. 12% had bilateral ophthalmic aneurysms. 20% of ophthalmic aneurysms were incidental. 50% had ophthalmological manifestations; however, this presentation occurred in 100% of the patients with large and giant aneurysms. Initially, 12% of ophthalmologic disorders were missed. We utilized unilateral or bilateral pterional approach associated to others in multiple aneurysms. We performed retrograde decompression- suction technique modified for large and giant aneurysms. RESULTS. Thirty patients (60%) obtained a complete recovery, fourteen patients (28%) an incomplete recovery and two were seriously disabled. There were not patients in vegetative state. There were four deaths (8%). 50% of postoperatory deficits disappeared and 64% of ophthalmologic disorders improved three months later. CONCLUSION: Microsurgical method allowed to treat unique, multiple, bilateral, large and giant ophthalmic aneurysms with good recovery of neurological and visual deficits.

Cerebral Angiography↗
PubMed2003

[Distal anterior cerebral artery aneurysms surgery].

INTRODUCTION: Distal anterior cerebral artery is the portion of the anterior cerebral artery located distal to the anterior communicating artery. Aneurysms of that territory represent 0.35 - 4.5% of all intracranial aneurysms. MATERIAL AND METHODS: 524 patients with intracranial aneurysms were operated on between January 1981 and April 2002. We treated 20 patients with distal anterior cerebral artery aneurysms. They were classified as infracallosa, located at the genu of the corpus callosum and supracallosal. Specialized anesthetic methods, Sugita head holder, and microsurgical techniques were utilized. Approaches were modified regarding aneurysm localization and multiplicity. Patients were evaluated six months after surgery. Glasgow Outcome Scale was applied. RESULTS: Thirteen patients (65%) were between 31 and 45 years of age. All were operated on at Grade I or II of the World Federation Neurological Surgeon Scale. There were multiple aneurysms in 35% of the cases. All of the aneurysms were 11 mm long or less in diameter. The segment of the distal anterior cerebral artery next to the genu of the corpus callosum was the most commonly involved (65%). 16 (80%) patients made a complete postoperative recovery of. There were not deaths. CONCLUSION: Distal anterior, cerebral artery aneurysms were not frequent and they needed special management. Their high tendency to multiplicity and early bleeding were two main characteristics. As they are midline located, they permit to perform small size craniotomy. Cerebral retractors were avoided to reduce postoperative morbidity.

Adolescent↗
PubMed2002

[Aneurysms surgery in the patients aged seventy to eighty years].

Elderly patients are a growing population group in developing countries because of optimal health care. 13% of Cuba population is older than sixty years and it is expected to grow to 20% in 2005. Subarachnoid hemorrhage secondary to ruptured aneurysms in geriatric patients carries a high mortality but a few patients are selected for surgical treatment. Manuel Ascunce Domenech Hospital attended 1112 patients older than 60 years between January 1994 and December 2001. Of these there were 96 patients with symptomatic intracranial aneurysms and we selected 30 for surgical treatment. They were all in clinical grades I and II of the WFNS scale. They had good health to face surgery and familiar consent. The size and location of the aneurysms were not considered among the exclusion criteria. Aneurysms were mainly localized at posterior communicating and middle cerebral arteries. There were two deaths, one due to a medical cause an the other to the surgical procedure. 74% of the patients obtained satisfactory outcome six month after the operation. The clue is to not consider age as a negative point for surgery. Surgical procedures can be performed in patients with good clinical grade (WFNS). New technical advances, stroke units, accurately selected patients and minimal invasive surgical methods will help to obtain good results.

Age Factors↗
PubMed2002

[Ogilvie's syndrome. A report of 3 cases].

INTRODUCTION: Lumbar spine surgery represents a common procedure in Neurosurgery. Ogilvie's Syndrome is an infrequent complication of lumbar disc surgery, characterized by acute paralytic ileum as a result of acute colonic dilatation without mechanical obstruction. CLINICAL CASES: We present the clinical data, surgical findings and evolution of three patients operated on for large lumbar disc herniation. They presented with unilateral lumbociatic pain related with physical effort and monoradicular deficit. Diagnosis was established by CT scan and all patients were operated on through a standard laminectomy. Abdominal pain, distention and lack of bowels sounds began on the second postoperatory day. This complication was avoided by conservative treatment and parenteral administration of neostigmine. Ogilvie's Syndrome appeared in 3 cases out of more than 1000 patients undergoing lumbar disc surgery and is characterized by acute colonic dilatation including cecal distention. Other lumbar disc surgery complications such as gastrointestinal perforation, urethral injury or intra-abdominal vessels damage were excluded. Conservative treatment including parenteral neostigmine was always sucessful.

Adult↗
PubMedDate not supplied

[Subthalamic nucleus targeting and spatial variability].

AIM: The effectiveness of anatomic localization of the subthalamic nucleus (EAL) was assessed and the mapping method is described here. The symmetry of contralateral nuclei (SCN) was analyzed on 11 parkinsonian patients submitted to bilateral subthalamotomy with ablative lesioning. PATIENTS AND METHODS: To assess EAL the percentage so much of first trajectory (p1) as the total of trajectories (pt) that hit the target and the rest of subthalamic nucleus average distance (d) was calculated. The anatomic localization error (epsilon) is determined as a difference between first trajectory coordinates with those of medial determined nucleus point, through electrophysiological data as to the statistical significance of this error. SCN is analyzed by contrasting equality hypothesis at the nucleus maximum height alongside a trajectory, average electrophysiological position center and spatial distribution of all intranuclear recordings found in each hemisphere in all patients. RESULTS: The pi, pt and d obtained values were 86.36%, 86.13% and 1.41 +/- 1.01 mm respectively. The epsilon value was greater in anteroposterior direction of 1.11 +/- 0.83 mm without statistical significance. The average number of recorded trajectories for the first procedure was 6.45 and 6 for the second. The asymmetry of contralateral nucleus was not significant. CONCLUSIONS: An indirect method with CT brain images and a new electrophysiological mapping method with a multiunitary recording for first and second nucleus is safe enough and it yields a high effectiveness in anatomofunctional nucleus localization. The nucleus of a same patient are symmetrical. There is little space variability among patient non related to the differences in the intercommissural distance.

Aged↗
PubMedDate not supplied

[The diagnosis of arteriovenous malformations of the brain].

INTRODUCTION: Arteriovenous malformations (AVM) of the brain are, at present, entities that are difficult to diagnose owing to the variations in their clinical presentation and the different localisations in the central nervous system. Their most frequent clinical forms are haemorrhage, which is typically located in the intraparenchymatous region, seizures and, less frequently, vascular headache and progressive neurological deficit. DEVELOPMENT AND CONCLUSIONS: Several imaging studies with different resolutions must be performed for a final and conclusive diagnosis of an AVM, and brain angiography remains the first choice procedure, both in diagnosis and in planning management. The more recent use of functional studies has enabled us to better evaluate the haemodynamic characters of AVM and the repercussion on the surrounding brain tissue. The use of transoperative angiography, as a complement in resective surgery, allows us to determine the level of resection before closing the skull and, thus, to correct technical defects. It therefore diminishes the post operative complications derived from remnants of the lesion.

Cerebral Angiography↗
PubMedDate not supplied

[Modes of treatment for arteriovenous malformations of the brain].

INTRODUCTION AND DEVELOPMENT: Over the years new kinds of therapy have been incorporated into the treatment of arteriovenous malformations (AVM). Current treatment of AVM of the brain employs three well established options: radiosurgery, endovascular therapy (embolisation) and microsurgical resection. Radiosurgery is the simplest and least invasive, but 2 3 years are required to achieve total obliteration, and throughout this time there is the risk of bleeding; its use is limited to small AVM. Embolisation today plays a fundamental role more as an adjunct than when it is associated, although the other modes improve their cure interval by 25%. Microsurgery has the advantage of being the only mode of therapy that offers a degree of immediate angiographic obliteration of almost 100% and is still the most widely employed, despite its morbidity rate also being the highest. We establish an AVM management algorithm, in which, according to the size and localisation, we suggest that these therapeutic options should be used alone or in combination. CONCLUSIONS: The management of these lesions requires a combined effort of all the factors that can be of any help in the solution, and these modes are more complementary than competitive in situations in which they are all valid therapeutic options.

Algorithms↗