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M Gelabert

Publications and source records attributed to M Gelabert.

27 records · Page 2Linked to original sources
PubMed1988

Brain cysticercosis treated with praziquantel. Report of six cases.

Cysticercosis is the most common parasitosis affecting the central nervous system and it is endemic in many countries. Although cysticercosis is nowadays a rare disease in Spain, three of such cases have been treated with Praziquantel at the Hospital "Princesa Sofía" of León and another three at the Hospital General de Galicia of Santiago, and the six of them are reported together. The six patients presented at CT scans cysts located at different levels in the brain parenchyma, subarachnoid space and ventricular system. Praziquantel was administrated at daily dosage of 50 mg per kilogram of body weight, by oral route, distributed in three doses during 15 days. Moderate hepatotoxic effect were detected in two cases. No significant neurological disfunction was observed in any case during the treatment. The therapeutic effect on the brain cysts was evaluated in the CT scans obtained after treatment. In four cases a positive effect on the cysts was observed, but no apparent effect was noticed in the other two.

Adult↗
PubMedDate not supplied

[Cervical epidural abscess as a cause of tetraparesis].

INTRODUCTION: An epidural spinal abscess is a rare clinical condition which may cause rapid, irreversible neurological deterioration. Usually, the patient presents with back pain in the affected spinal segment, but the condition is rarely considered in the differential diagnosis. CLINICAL CASE: A 57 year old man with no significant clinical history initially consulted complaining of cervicalgia. Some days later, this had worsened and he also had odinophagia, fever and general malaise. A diagnosis of retropharyngeal abscess was made. He was admitted to the Ear, Nose and Throat Department (ENT) and antibiotic treatment started with ceftazidime, vancomycin and clindamycin. Eight hours after admission he complained of paresthesia and subsequently of flaccid tetraparesia. CT and MR showed the presence of a paravertebral mass which extended to the epidural space between the fourth and seventh cervical vertebrae. On suspicion of a retropharyngeal abscess complicated by an epidural spinal abscess we proceeded to emergency operation and drained the prevertebral and epidural pus. On microbiological culture St. aureus was grown. The patient regained the mobility of his limbs. On discharge from hospital he still had paresia of the right leg, although this did not impede walking. CONCLUSIONS: It should not be forgotten that, although rare, one of the causes of spinal compression and neurological deterioration (particularly in a febrile patient) is an epidural spinal abscess. Prompt diagnosis and satisfactory surgical decompression are essential to avoid irreversible neurological sequelae.

Central Nervous System Bacterial Infections↗
PubMedDate not supplied

[Intracranial collections of pus. A review of 100 cases].

INTRODUCTION: In recent decades, important scientific advances have been made, leading to modification of the diagnosis and the treatment of intracranial collections of pus (ICP). OBJECTIVES: To analyze the changes in various clinicopathological aspects of ICP during the twenty years studied. PATIENTS AND METHODS: We present a retrospective analysis of 100 cases of ICP diagnosed between 1979 and 1998 in the Hospital General de Galicia. We divided the patients into two groups: A (1979-1988) and B (1989-1998), and analyzed the similarities and differences between them. RESULTS: In these two decades, there was a predominance of men over women (4/1) ENT infections (30/100) and surgical-trauma (25/100) were the commonest causes. The diagnosis was established during the week the symptoms started in 40% of group A and 58.1% of group B. The most frequent site for abscesses was in the frontal lobes (28.5%) and temporal lobes (26.1%) and was closely related to the origin of the infection. Culture was positive in 45% of group A and in 60.3% of group B. The commonest micro-organisms found were Streptococcus (38%) and Staphylococcus (26%). More anaerobes were observed in the second decade. The most usual surgical treatment was excision (86%). Mortality was 33.3% in the first decade and 5.4% in the second. CONCLUSION: Technological improvements permit earlier, more reliable radiological and micro-biological diagnosis as well as lower morbi-mortality figures for ICP.

Adolescent↗
PubMedDate not supplied

[Cystic hemangioblastoma of the spinal bulb].

INTRODUCTION: Hemangioblastomas are histologically benign tumors that comprise 8%-12% of all posterior fossa lesions in the adult. Brain stem hemangioblastomas may be solid or cystic tumors, and surgical removal of these tumors is usually possible and is the optimal treatment. We describe a case of hemangioblastoma in the medulla oblongata diagnosed with MRI. Using microsurgery technic a total excision of this intramedullary tumor was performed. CLINICAL CASE: A 37-year-old woman with a 3-months history of progressive dysphagia and occipital headache. Neurological examination at the time of admission revealed bilateral horizontal nystagmus, paresis of cranial nerves IX, X and XII, motor weakness of the four extremities. A MRI revealed a cystic intramedullary tumor. Using a suboccipital craniectomy the tumor was totally removed. CONCLUSIONS: Cystic hemangioblastomas of the medulla oblongata represent a small segment in the spectrum of brain stem tumors. Surgical removal of these tumors can be accomplished successfully with a low risk of neurological injury.

Adult↗