Solving problems at the cath lab.

We describe a case of aortic rupture following transcatheter aortic valve implantation that was managed percutaneously.

Complex Left Atrial Appendage Occlusion Using the Novel Amplatzer Steerable Delivery Sheath.

Left atrial appendage (LAA) occlusion has emerged as an al- ternative to oral anticoagulation in non-valvular atrial fibril- lation. The success rate is high, but we are still facing some challenging LAA anatomies that may increase the risk of sub- optimal results. These images show that the Amplatzer steer- able sheath is useful for LAA occlusion, especially in cases with challenging anatomies.

Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure.

Aims: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared.

Methods: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013.

Clinical and economic analysis of hospital acquired infections in patients diagnosed with brain tumor in a tertiary hospital.

Objectives: To analyze the relationship between hospital acquired infections and clinical outcomes, duration of stay, and cost per infectious episode in patients diagnosed with brain tumors in our service.

Materials And Methods: We conducted a retrospective study on patients diagnosed with brain tumors and admitted to the department of neurosurgery in the Cruces Hospital of the University of the Basque Country between January 1st, 2007 and December 31st, 2007. We collected demographics, responsible pathogens, infection location, length of hospitalization, and costs of various medical and surgical procedures performed.

[Adult spontaneous cerebrospinal fluid otorrhea. Report of two cases and review of the literature].

Introduction: Spontaneous cerebrospinal fluid otorrhea is a relatively rare entity and can be easily missed in adults. Every adult older than 50 years with a negative history of otologic disease who has recurrent serous otitis media should be evaluated for this pathology. Meningitis is the most serious complication, so there is no doubt that the condition needs immediate attention and correction.

Surgical results and complications in a series of 71 consecutive cervical spondylotic corpectomies.

Background: Cervical corpectomy is a common procedure in spondylosis. It is normally a well-tolerated surgery and clinical improvement is widely described. However, it is associated with potential risky complications (subsidence, clinical deterioration, vertebral artery injury.

Opposite changes in cannabinoid CB1 and CB2 receptor expression in human gliomas.

Gliomas are the most important group of malignant primary brain tumors and one of the most aggressive forms of cancer. During the last years, several studies have demonstrated that cannabinoids induce apoptosis of glioma cells and inhibit angiogenesis of gliomas in vivo. As the effects of cannabinoids rely on CB(1) and CB(2) receptors activation, the aim of the present study was to investigate both receptors protein expression in cellular membrane homogenates of human glial tumors using specific antibodies raised against these proteins.

DNA copy number variation and gene expression analyses reveal the implication of specific oncogenes and genes in GBM.

To understand the pathogenesis of glioblastoma multiforme (GBM) we used high-resolution comparative genomic hybridization arrays and gene expression microarrays to identify DNA copy number alterations and gene expression changes in comparable sets of GBM samples. Gains were detected at chromosomes 1, 2, 7, 9, 12, 19, and 20 and losses at 6, 9, and 10. Gene expression analyses identified specific genes overexpressed in GBM mapping at amplified chromosomal regions.

Outcome of bilateral deep brain subthalamic stimulation in patients carrying the R1441G mutation in the LRRK2 dardarin gene.

Objective: Deep brain subthalamic stimulation provides symptomatic relief to patients with Parkinson's disease. The present study analyzes the postoperative outcome of deep brain subthalamic stimulation in patients carrying the R1441G mutation in the leucine-rich repeat kinase-2 (LRRK2) (dardarin) gene.

Methods: Five of the 48 patients treated in our unit carried a mutation in the LRRK2 (dardarin) gene.

[Neuronal tumors: gangliocytoma].

Introduction: Gangliocytomas are neuronal tumors of the central nervous system. They tend to appear in children and young adults. These tumors usually appear in the supratentorial compartment in the temporal lobe.

Monoamine oxidase B activity is increased in human gliomas.

Glial tumours are the most common type of brain neoplasm in humans. Tumour classification and grading represent key factors for patient management. However, current grading schemes are still limited by subjective histological criteria.

[Imidazoline I(2) receptors as a possible marker for malignancy in human glial cell tumours].

Aim: To present the experimental data that support the hypothesis that the imidazoline I(2) receptors may be assessed as a biological marker to establish diagnosis and grade of human gliomas.

Development: Gliomas constitute the most important group of brain neoplasm in humans. In these tumours accurate histopathologic diagnosis is a first crucial prerequisite for patient treatment.

Electrophysiological characterization of substantia nigra dopaminergic neurons in partially lesioned rats: effects of subthalamotomy and levodopa treatment.

Progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta is the main histopathological characteristic of Parkinson's disease. We studied the electrophysiological characteristics of the spontaneous activity of substantia nigra pars compacta dopaminergic neurons in rats with a partial, unilateral, 6-hydroxydopamine lesion of the nigrostriatal pathway. In addition, the effects of subthalamotomy and prolonged levodopa treatment on the activity of dopaminergic neurons were investigated.

A prospective study of a series of 356 patients with supratentorial spontaneous intracerebral haematomas treated in a Neurosurgical Department.

Background: Spontaneous supratentorial intracerebral haemorrhages (SSIH) carry high morbidity and mortality rates. At present, the proper role of surgery is not clear and data from the International STICH trial have not clarified this challenging question. On the other hand, few prospective studies have measured long term survival regardless of the treatment and clinical condition of the patient.

Parkinson's disease-like presentation of multiple system atrophy with poor response to STN stimulation: a clinicopathological case report.

We report on a clinicopathological case of multiple system atrophy with good response to levodopa and subsequent development of motor complications. Because the subject complied with all the inclusion criteria (Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease), bilateral subthalamic nucleus deep brain stimulation electrodes were implanted.

Improvement in quality of life in patients with advanced Parkinson's disease following bilateral deep-brain stimulation in subthalamic nucleus.

In this article we investigate the changes observed in the scales that quantify the quality of life (PDQ-39) in patients that have already completed 1 and 2 years of bilateral subthalamic stimulation (DBS-STN). Fourteen patients were evaluated 1 year after DBS-STN; the evaluation was repeated on 11 of them, 2 years after surgery. All of them suffered from Parkinson's disease with a 14.

[Intraabdominal complications in the lumbar disc surgery].

Introduction: : Removal of a lumbar disc herniation is, at present, the most frequent surgical procedure, related to the spine in Neurosurgical Departments. It carries a very low rates of complications and a short postoperative hospital stay. However, in spite of their rarity, serious adverse intraoperative complications may occur, so we must be aware of its existence in order to make an early diagnosis and treatment to prevent a fatal outcome.

[Tentorial meningiomas. Report of our series].

Purpose: The main objectives of this report are to describe the clinical and radiological features, surgical management, complications, and final outcome of patients with a tentorial meningioma.

Methods: This is a retrospective study of 25 patients operated on for tentorial meningiomas at our department since december 1975 to may 2002. All the patients, except the first, were diagnosed by computed tomography; in 13 of them a magnetic resonance imaging was performed too; in 14 patients, diagnosis was completed with cerebral arteriography.

Imidazoline I(2) receptor density increases with the malignancy of human gliomas.

Background: Current glioma grading schemes are limited by subjective histological criteria. Imidazoline I(2) receptors are principally expressed on glial cells.

Objective: To investigate the feasibility of using the measurement of imidazoline I(2) receptor expression to differentiate glial tumours from other types of brain tumours and for grading the different gliomas.

[Bilateral subthalamic nucleus deep-brain stimulation (STN-DBS) in Parkinson's disease: initial experience in Cruces Hospital].

Introduction: Clinical outcomes of Parkinson's disease patients treated for 12 months with STN-DBS were analyzed. PATIENTS ADN METHODS: Twelve patients were selected using the CAPSIT protocol criteria and placement of electrodes in the appropriate target was performed according to results of fusion image techniques and intraoperative microrecording.

Results: A reduction in motor UPDRS (44 %) and activities of daily living (58 %) scores during <> phases were observed.

[Neuropsychological changes and bilateral subthalamic deep brain stimulation in Parkinson's disease].

Introduction: To investigate neuropsychiatric changes in Parkinson's disease (PD) patients after 12 months of bilateral subthalamic deep brain stimulation (DBS-STN).

Subjects: Nine out of 23 patients with PD subjected to DBS-STN were included. The mean follow-up of this cohort was 12 months, mean disease duration 14.

Prognostic factors in a series of 185 consecutive spontaneous supratentorial intracerebral haematomas.

We report a retrospective observational study of 185 cases with spontaneous supratentorial intracerebral haemorrhage, in which, by univariate and multivariate analysis, the main clinical and CT findings influencing patient outcome were studied. Forty (22%) patients died and 77 (41%) remained in a very disabled state. Using logistic regression analysis we found that the volume of the haematoma, its deep location, surgical treatment and the preictal status in relation to activities of daily living (ADL) were independent factors for patient outcome measured with the Modified Rankin Scale.

Giant pituitary adenomas: clinical characteristics and surgical results.

Although most pituitary neoplasms are benign, some grow rapidly, spreading to extrasellar tissues. Definition of these 'giant' pituitary adenomas (PAs) is not clear. In order to clarify this question, we studied all pituitary macroadenomas operated in our hospital during the last 20 years, differentiating those with diameter > or = 3 cm (n = 43) and attempting to identify their typical features and prognosis.

[Prophylactic antiepileptic treatment of cerebral aggressions].

Objective: On the occasion of the First Congress of the Spanish Anti Epilepsy League we had reviewed the use of antiepileptic drugs for preventing postoperative and posttraumatic seizures.

Development: Two specific causes of epilepsy are particularly relevant to neurosurgical practice; postoperative and posttraumatic epilepsy. After reviewing the seizures arising after craniotomy for supratentorial conditions such as vascular malformations (aneurysms and arteriovenous malformations), cerebral tumours and supratentorial abscesses and empyemas, we discuss the different types of posttraumatic epilepsy and the risk factors.

[Lumbar root compression secondary to juxtafacet cysts: review of 10 cases].

Object: We report a series of 10 patients with 11 juxtafacet cysts of the lumbar spine treated in our center from 1994 to 2000.

Methods: The clinical histories, radiographic images, surgical protocols and pathological records of the 10 patients diagnosed of lumbar juxtafacet cyst have been analyzed.

Results: Six patients were women and four were men.