Neuralgia del trigémino

La neuralgia del trigémino es una patología que puede llegar a ser altamente incapacitante. En la actualidad, cuando la terapia médica falla, su manejo se divide entre las técnicas que destruyen la porción sensitiva del nervio, denominadas ablativos, y la descompresión microvascular. Mediante la revisión de la literatura observamos que ambas tendencias han tenido resultados satisfactorios; sin embargo, la descompresión microvascular parece ofrecer un mejor y duradero alivio del dolor, además de la conservación de la fisiología del 5to. nervio craneal

Surgical Management of Familial Trigeminal Neuralgia With Different Inheritance Patterns: A Case Report

IntroductionTrigeminal neuralgia is a disorder characterized by unilateral electric shock-like pain, distributed in one or more trigeminal nerve branches and triggered by usually innocuous stimuli. Among the few case reports and literature reviews on familial trigeminal neuralgia (FTN), the results of several suggest the involvement of genes associated with biochemical alterations or atherosclerotic vascular malformations.BackgroundWe present four cases of FTN within two families (family A: two brothers; family B: two sisters). All patients were submitted to surgical treatment by the same surgeon.DiscussionCases 1 and 2 (family A) exhibited FTN with an uncommon autosomal recessive pattern and clinical features consistent with previous literature reviews and case reports. However, in cases 3 and 4 (family B), we found FTN with a dominant autosomal pattern and an unusual physiopathology characterized by arachnoid adhesions.ConclusionWe conclude, in this case report, that there are several inheritance patterns as well as physiopathology that may be involved in FTN, and that both patterns described in our reported cases were successfully managed with surgery

Suprameatal extension of retrosigmoid approach for microvascular decompression of trigeminal nerve: Case report

Introduction: Trigeminal neuralgia is produced in a significant number of cases by vascular compression at the level of cisternal segment of the nerve at the entry of the pons. It is common to find superior cerebellar artery (SCA) responsible for this compression. The retrosigmoid approach (RA), with asterional craniectomy, clearly exposes the cisternal portion of the trigeminal nerve (TN). Presentation of case: We describe in this case report how vessels at the trigeminal pore level known as “Meckel’s segment” can compress the TN. This situation is unusual. One of the reasons why the compression of this Meckel’s segment level could be overlooked is a suprameatal tubercle (ST) prominence that would prevent trigeminal pore visualization through retrosigmoid approach. Discussion: The suprameatal extension of this approach has been described for other purposes, especially in tumors invading Meckel’s cave resection. We could not find publications for the use of the resection of the suprameatal tubercle in the retrosigmoid approach for microvascular decompression of the trigeminal neuralgia. Conclusion: Microvascular decompression of the TN is an effective treatment for trigeminal neuralgia, however in some cases, in which vascular compression is not evident when exploring the cerebellopontine angle, it is important to note that association of a prominent ST can hide a vascular compression of the nerve in this region

Efecto de la craneoplastía realizada de manera temprana en pacientes adultos craniectomizados con déficit neurológico residual

La craneotomía descompresiva por muchos años ha sido la única alternativa terapéutica de la neurocirugía se continua empleando como un efectivo método de controlar la hipertensión intracraneal. Sin embargo, puede causar molestias debido a los efectos de la presión arterial en el cerebro por lo que recomendamos la craneoplastía temprana. Se presentan 13 pacientes operados y sus resultado

Microsurgical anatomy of the cranial nerve-centric triangles of the posterior cranial base: cadaveric and radiological anatomical study

Tumors in the posterior fossa can be situated either dorsal and lateral, ventral and medial, or occupying both regions in relation to the cranial nerves, with the latter position being especially challenging. In an effort to organize neurovascular complexes contained within, anatomically based triangles have been proposed to serve as guiding landmarks for locating critical neurovascular structures. The objectives of this study were to: (1) provide a review of historical anatomically based vascular-centric triangles of the posterior fossa based on respective neurovascular complexes; (2) introduce a more organized alternative system of triangles with the conceptualization of a projection system from superficial to deep; and (3) propose and describe two new triangles of the posterior fossa: Petrous-Acousticofacial and Acousticofacial-Trigeminal. Five cadavers were studied. Neurovascular complexes were described with the use of anatomically guided cranial nerve-centric triangles, each of which was formed by cranial nerves, petrous bone, brainstem, tentorium, and superior petrosal vein. All triangles were measured and anatomical boundaries confirmed by neuronavigation. Two circumferential frameworks were created to correlate superficial and deep anatomy: (1) Outer circumference and (2) Inner circumference. Posterior fossa was divided into the following: (1) Superior complex-corresponds to the sub-asterional region, which was projected to the trigeminal nerve; (2) Middle complex-corresponds to the mastoid emissary vein foramen, which was projected to the facial and vestibulocochlear nerves; and (3) Inferior complex-corresponds to the posterior condylar canal, which projects to the lower cranial nerves. Neuronavigation confirmed these landmarks. Two new triangles were proposed: (1) The Petrous-Acousticofacial triangle, and (2) The Acousticofacial-Trigeminal triangle. Triangles provide a useful anatomical guide to the posterior fossa. We have introduced an organized schema, as well as proposed two new triangles, with the intent to minimize manipulation of neurovascular structures

Fomento de redes formales e informales para la intervención social

Realizado en la Escuela Universitaria de Trabajo Social, por 7 profesores del centro para la asignatura de Trabajo Social y Servicios Sociales III de la Diplomatura en Trabajo Social. Los objetivos fueron: 1. Favorecer el aprendizaje práctico de los alumnos; 2. Lograr la adquisición y asimilación de conocimientos relativos a los recursos formales e informales existentes en la ciudad de León; 3. Creación de una herramienta de trabajo para la práctica de la docencia que ayude en las asignaturas troncales de Trabajo Social a estructurar los contenidos del programa. Para ello, se elaboró una guía didáctica sobre el fomento de redes formales e informales para la intervención social: marco teórico, fichas de recursos y legislación. Su utilización en la intervención didáctica y profesional será el modo de validación para ver si ese instrumento es útil.Junta de Castilla y León. Consejería de Educación y CulturaCastilla y LeónJunta de Castilla y León. Consejería de Educación y Cultura; Monasterio de Nuestra Señora de Prado. Autovía Puente Colgante, s. n.; 47071 Valladolid; Tel. +34983411881; Fax +34983411939; [email protected]