Material y método. Se trataron tres pacientes, todos con s(nlomas de hipertensión endocrunearia secundaria a hidrocefalia y diognóstico definitivo de neurocisticercosis. Caso I: presentó dos quistes en cisternas int erpeduncular y prepontina_ Caso 2: presentó dos quistes en ventrículo lateral. Caso 3: quiste en la cisterna interpeduracularTodos recibieron tratamiento médico (albendazol + dexametasona por 1 mes) y quirúrgico, realizando resección parcial (Coso 3) o total (Casos 1 y 2) de los quistes por vía endoscópica transventricular y derivaciones internas (tercerventriculostornia o septopelucidostomia) en dos pacientes (Casos 1 y 3).
Rematados. Dos casos requirieron derivación valuular a posteriori por hidrocefalia comunicante. Todos evolucionaron fovarablemente, sin ventriculitis ni disfunción miar:dar en el seguimiento.
Conclusiones. El tratamiento mínimamente invasiva endosoopioo para la neurocisticercosis intraventricular y de cisternas basales ofrece una alternativa terapéutica simple y de baja morbilidad a esta grave y compleja patología. Permite remover los quistes, en casos seleccionados, evitando la degeneración quistica, y realizar derivaciones internas reduciendo la necesidad de derivación valuular, y así sus complicaciones.]]>

Cuetter AC, Andrews RJ. Intraventricular neurscysticercsele: 18 con secutive patientes and review of the Litereture. Nearca-un Poma 2002;12(6): Anide 5.

Del Brut to OH. Neurocisticercosis: actualización en diagnóstico y tratamiento. Neurología, 2995; 20(8): 412-5,

Gsvindappa SS, Narayanan JP, Kriahnamoorthy VM, Shisnkar Shastry Chf Balasubramaniarn A, Kriahno SS. Improved Detection of Introventricular Cysticercal Cyats with the Uee ofThree-dlmensional Constructive interferente in Steady State MR Sequences. AJNR Ala J Neuroradial 2000; 21: 679-84,

Sinha 5, S harma BS. N eurocys tícerrosie: A review ofcurrent status and manogement. J akaical Nouroachusca 2009; 16: 867-76.

Sotels J, Dei Bruna OH. Revicw of neurscysticercosie. Nearoattrg Focas 2002; 12(6): Article 1.

Ramirez-CeballasJA, Marqu.lx-Castillo PM. Tratamiento encloscópico de la neurocisticercosis intraventricular. Ray Ne aroalrugLa 1X, 2007; 4: 107-113.

Tarree-Corzo J, Rodriguez-Della Vecchia R, Castilla., Bruna synd reme cau 'sed by intraventricular neurscysticercosie treatad uaing flexible endoscopy. Jltsurttaurg 2006; 104: 746-8.

Husain M, Jho DK, Raetogi M, Husain N, Gupta RK, Neuro-endoscopic management of intraventricutar neurocysticercoele INCC).

Proarto JV, Torres-Corzo J, Rodriguez-Della Veceida R, GuizarSahavn G, Rangel-Caetilla L. Intraventricular and subarachnoid basa] cisterna neurocysticeressis: a comparative atudy between tre.dítisnal treatment versus neuroendsecspic surgery. Childs Nerv Syst 2009; 25: 1467-75.

Bergsneider M, Hslly LT, Hang Lee J, King WA, Frazee JG, Endoscopic management sf cyaticercal cyste within the lateral and third ventriclee. Nal:remar' Poca, 1999; 614): Artic.le 7.

HajekJ, Keyetone J. Intraventricular Neu rocystieercoei e Managed with Albenda.zole and Dexamethasone. Casa J %crol Ilart 2009; 36: 102-4,

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Citow JS, Johnson JP, MCbride DQ, AL:mirad M. Imagina feo tures and surgery-related outcomes in intraventricular neurocyaticercosis. Focas 2002; 12(6): Anide 6.

]]> Resultados. Se incluyeron 31 cirugías realizadas en 30 pacientes, 9 con diagnóstico de OW (8 mujeres) con un promedio de edad fue de 24,3 años, y 21 con OTD (18 mujeres) de 37,4 años en promedio. Un 90% de todos los casos de outlet presentaron alteraciones neurofisiológicas preoperatorias, y los estudios imagenológicos fueron anormales en 66,6%. Una vez realizada la exploración, el 100% de los OTV presentó una alteración anatómica claramente relacionada con la sintomatología, hecho observado sólo en el 36,7% de los OTD operados. El 87,5% de los OW mejoraron sus síntomas sensítivos luego de la cirugía, mientras que 77,7% mejoraron desde el punto de vista motor. Por el contrario, 45.4% de los OTD mejoraron permanentemente, 36,3% no tuvieron cambios, 13,6% mejoraron transitoriamente y 4,5% (un caso) empeoró. Las complicaciones postoperatorías fueron más frecuentes aunque transitorias en el grupo de OTV (3 casos sobre 9 operados, 33.3%) que en los OTD (3 casos sobre 22, un 13,6%).
Conclusión. El OTV es una patología infrecuente cuyo tratamiento quirúrgico suele evolucionar favorablemente. En cambio, el OTD constituye un diagnóstico de exclusion y su tratamiento quirúrgico da un resultado bueno aunque inferior al del OTV. Un análisis reciente de la literatura indica que no existe evidencia estadísticamente concluyente sobre los criterios diagnósticos y terapéuticos de los pacientes que sufren estos síndromes.]]>

Peet RM, Henriksen JD, Anderson TP, Martin GM. Thoracic outlet syndrome: evaluation of a therapeutic exercise program. Proceedings of the Staff Meetings. Mayo Clinic 1956; 31(9): 281-7.

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]]> Material y método. La población de estudio estuvo dada por 52 pacientes con MAVs, en quienes utilizamos como métodos de análisis el examen neurológico, la TAC de cerebro, IRM y arteriografia cerebral de 4 vasos. La totalidad de los pacientes fueron tratados mediante cirugía convencional en nuestro Servicio durante el periodo comprendido entre los años 2000 al 2010.
Resultados. El promedio de edad fue 37,7 años. El porcentaje según sexo: varones: 61,53%; mujeres: 38,46%. Los síntomas y motivos de consulta más frecuentes fueron: cefalea 63,46%, eventos vasculares hemorrágicos 59,61%, convulsiones 26,92%. Localización de las MAVs: supratentoriales, 92,85%, infratentoriales: 7,15%.
Conclusión. Concordamos con la bibliografia consultada respecto a que el grupo poblacional más afectado está entre los 20 y los 40 años9. En relación a la distribución por sexo encontramos una prevalencia más elevada en el sexo masculino: 61,53% vs 38,46%. respectivamente. Respecto a la localización concordamos con los autores en la mayor prevalencia supratentorial. En cuanto a los síntomas de presentación y motivo de consulta coincidimos en que la cefalea, los eventos de sangrado y las crisis convulsivas fueron los más habituales1-4. Concordamos tambien en los diagnósticos de ingreso más frecuentes siendo el ACV hemorrágico, la cefalea, las crisis comiciales y el deficit neurológico los más comunes.]]>

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]]> Descripción. Paciente de sexo femenino, de 36 años, consultó por cefalea de Arnold de tres meses de evolución. No tenía antecedentes medicos de interés y el examen neurológico era normal. La radiografia en proyección trasoral mostraba un aplastamiento de la masa lateral derecha del atlas. TAC y RMI de columna cervical: lesión expansiva en arco anterior y masa lateral derecha del atlas.
Intervención. Se efectuó biopsia quirúrgica de la lesion mediante abordaje cervical anterior miniinvasivo y asistencia videoendoscópica, con buena evolución posoperatoria. Establecido el diagnóstico de plasmocitoma, se indicó radioterapia, con buena tolerancia. Seguidamente se efectuó una fijación occipitocervical por via posterior por dilocación atlantoaxoidea y no tuvo complicaciones. Al cabo de un año y medio se constataron lesiones liticas en cráneo, húmero, columna dorsal y pelvis. Se diagnosticó mieloma multiple y se efectuo autotrasplante de medula ósea, con evolución favorable. Actualmente, tras doce meses del trasplante, la paciente se encuentra asintomática y en excelente estado clínico.
Conclusión. El plasmocitoma solitario es una neoplasia de presentación excepcional a nivel del atlas. La cefalea de Arnold es una forma de presentatión clínica. La evolución a mieloma multiple amerita un seguimiento clínico estricto.]]>

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]]> Material y método. Este artículo es una revision no sistemática de las indicaciones, resultados, parámetros de programación y técnica quirúrgica de la ECP del Vim para el tratamiento del temblor.
Resultados. Aunque los resultados clínicos son similares usando la talamotomía o la ECP del Vim, la primera causa más efectos adversos que la última. Además, la ECP puede ser usada bilateralmente, mientras que la talamotomia tiene un alto riesgo de causar disartria cuando se realiza de ambos lados. La ECP del Vim logró una adecuada mejoria del temblor en varias series de pacientes con temblor causado por temblor esencial, enfermedad de Parkinson o esclerosis multiple. Además del Vim, hay otros blancos que están siendo usados por varios autores, tales como la zona incierta y las radiaciones prelemniscales.
Conclusion. La ECP del Vim es un tratamiento útil para el temblor incapacitante refractario al tratamiento medico. Es esencial realizar una precisa seleccion de pacientes, asi como utilizar una técnica quirúrgica correcta. Aún se desconoce el mejor blanco estereotáctico para el temblor, aunque el Vim es el más usado.]]>

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