OBJECTIVE: To identify indicators of outcome following surgery for cerebral aneurysms at Hospital Guillermo Almenara from January 01, 1983 to October 31, 1996. MATERIAL AND METHODS: In a consecutive series of 369 patients who underwent surgery for aneurysms, factors that could affect the outcome, such as age, Hunt and Hess grades, aneurysm location, presence of multiple aneurysms or arterio-venous malformations, and postoperative complications were assessed. RESULTS: 57,7% of patients were female. Mean age was 46,6 ± 14,57 years. 37% of patients were preoperatively classified in Hunt and Hess neurological Grade II, and 34% in Grade III. Single aneurysms were the most frequent (85%). As regards aneurysmal location, intracavernous aneurysms was the most frequent (28,67%). Patient condition at discharge was well in 42,5% of cases and very well in 32,5%. The higher the Hunt and Hess grade, ...

Here we introduce the case of a five-year-old girl, who felt down on a corn plant stake, resulting in head injury with prick-cutting injury, leaving some cane fragments along the stretch both retro-ocular and intracerebral. Both remision and recovery ad integrum thanks to surgical management, were obtained. The clinical case and evolution are discussed here.

OBJECTIVE: Experimental models (EM) design to acquire brain neuroendoscopy (BNE) skill to be applied on patients. MATERIAL AND METHODS: Study performed in three phases. For the first two -design and training- we used bovine and human coipses randomly assigned to groups A and B according to physiological sodium chloride solution (SCS) volume needed to produce satisfactory hydrocephalus to perform BNE. During phase three, BNE was performed in 5 patients with brain pathology confirmed by CAT or NMR. RESULTS: SCS volume needed for satisfactory BNE in the bovine EM was usually 70 mL (p< 0,01). In human EM, artifitial hydrocephalus was obtained with 150 mL of SCS (p< 0,0 l). BNE was used as a diagnostic and therapeutic tool. Post BNE complications consisted in hallucinations, fever and memory impairment, that responded well to symptomatic therapy. CONCLUSIONS: EMs designed for this study...

Se presentan y discuten aquí los pasos dados y los resultados obtenidos entre febrero de 1997 y julio de 1998 para la utilización de la neuroendoscopía cerebral como técnica diagnóstica y terapéutica de múltiples enfermedades neuroquirúrgicas, en especial en aquellas localizadas en el Sistema Ventricular Cerebral. Se exponen las tres fases del estudio diseño y entrenamiento de un modelo en cadáveres de vacunos; diseño y entrenamiento de un modelo en cadáveres humanos; y finalmente su aplicación en cinco pacientes con procesos neuroquirúrgicos seleccionados. Este es el primer reporte sobre uso de neuroendoscopía en Perú y se demuestran los beneficios de esta técnica en enfermedades del sistema nervioso central prevalentes en nuestro medio, de tipo tumoral, parasitarias, infecciosas o en general de aquellas susceptibles de manejo neuroendoscópico.

Se estudiaron 28 pacientes portadores de lesiones neurovasculares complejas, tales como fístulas arteriovenosas, malformaciones arteriovenosas, aneurismas gigantes y tumores hipervasculares, los cuales fueron tratados mediante técnicas endovasculares. Se evaluaron los hallazgos clínico radiológicos, así como la estrategia, materiales embólicos, resultados y complicaciones de la embolización, demostrándose la factibilidad de: 1. Acceder por vía endovascular mediante microcatéteres al interior de lesiones neurovasculares complejas. 2. Realizar una evaluación angiográfica superselectiva de las mismas. 3. Colocar por vía endovascular y en el seno de estas lesiones, agentes terapéuticos trombogénicos con resultados curativos, coadyuvantes a la cirugía o paliativos con un mínimo de morbilidad.