Publications by authors named "Miguel Angel Arraez-Sanchez"

Introduction: Shunt overdrainage is one of the long-term complications associated with ventriculoperitoneal shunts. Treatment of refractory cases may require further upgrading of both the valve opening pressure and antisiphon device. The aim of this paper is to describe the results of this combination in a selected group of patients.

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Background: The objective of this study was to assess long-term outcome in patients with spontaneous intracerebral hemorrhage admitted to the intensive care unit.

Methods: Mortality and Glasgow Outcome Scale, Barthel Index, and 5-level EQ-5D version (EQ-5D-5L) scores were analyzed in a multicenter cohort study of three Spanish hospitals (336 patients). Mortality was also analyzed in the Medical Information Mart for Intensive Care III (MIMIC-III) database.

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The endoscopic transventricular transchoroidal approach facilitates entry into the posterior part of the third ventricle, allowing a visualization field from the foramen of Monro to the pineal region through this anatomical corridor. Combined surgery to treat the target lesion and possible endoscopic third ventriculostomy (ETV) can be performed through a single burr hole. A detailed description of this surgical technique is given, and a series of cases from our center is presented.

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Article Synopsis
  • Idiopathic intracranial hypertension (IIH) is a rare condition in children that causes increased intracranial pressure with no clear cause, and its connection to venous sinus stenosis (VSS) has led to specific treatment options.
  • In a case study, a 6-year-old girl with severe IIH symptoms was successfully treated using transverse sinus stenting and a lumboperitoneal shunt.
  • The findings suggest that VSS stenting can be effective for acute IIH cases, but additional surgical interventions may sometimes be required.
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Objetives: Indication for endoscopic third ventriculostomy (ETV) in the treatment for noncommunicating hydrocephalus is widely accepted. There is controversy regarding the indication of a second procedure (re-ETV) when the first has failed. The objective of this work is to revise ETV failures in a series in which re-ETV was performed and to describe the factors related to its prognosis.

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Although intraventricular neuroendoscopy is considered a minimally invasive technique with good results, there is nevertheless a risk of developing certain complications. As no agreement apparently exists concerning the classification of these complications, we aim to propose a form of classification based on the results of our series, comparing them with recent publications. We undertook a retrospective study of 170 children who underwent intraventricular neuroendoscopy between 2003 and September 2020 at our center.

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  • The study aimed to evaluate the effectiveness of endoscopic third ventriculostomy (ETV) for treating pediatric chronic communicating congenital hydrocephalus (CCCH).
  • A retrospective analysis included 11 children, tracking their symptoms, surgery details, and follow-up results, focusing on clinical and radiological improvements post-surgery.
  • Results indicated that ETV was generally successful, with most patients showing significant improvement and only three requiring additional shunt placement over an average follow-up of nearly 36 months.
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Objetives: Indication for endoscopic third ventriculostomy (ETV) in the treatment for noncommunicating hydrocephalus is widely accepted. There is controversy regarding the indication of a second procedure (re-ETV) when the first has failed. The objective of this work is to revise ETV failures in a series in which re-ETV was performed and to describe the factors related to its prognosis.

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Article Synopsis
  • The study aimed to evaluate the quality of life of pediatric patients with hydrocephalus after being treated with endoscopic third ventriculostomy (ETV) and identify clinical and radiological factors influencing their outcomes.
  • The research involved 40 patients aged 5 to 18 years and used the Hydrocephalus Outcome Questionnaire-Spanish version (HOQ-Sv) to collect data on their quality of life post-treatment.
  • Results indicated a mean age of 7 years at ETV and revealed that previous epileptic seizures, prior shunt placements, and the type of hydrocephalus negatively impacted the patients' functional outcomes across various quality of life domains.
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Background: The prognosis for patients with glioblastoma depends particularly on the degree of tumor resection. Patients with tumor remnants in postsurgical magnetic resonance imaging (<72 hours) may benefit from early reoperation. We present our results concerning the impact on overall survival (OS) and progression-free survival (PFS) of reoperation in patients who have already undergone surgery for glioblastoma.

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Introduction: Neuroendoscopy has become an effective and safe treatment for arachnoid cysts in the paediatric population. We review the paediatric patients with arachnoid cysts treated by neuroendoscopy in our hospital and analyse the results.

Material And Methods: A retrospective analysis of 20 patients operated on from 2005 to 2018.

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Introduction: Dysembryoplastic neuroepithelial tumours (DNET) are a type of benign glioneuronal neoplasia of typically temporal location that produce drug-resistant epileptic seizures in children and young adults.

Objective: This work aims to assess the usefulness of functional magnetic resonance imaging (fMRI) in the preoperative study in four patients with DNET. A Philips Intera 3.

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Background/objectives: Peripheral nerve tumours (PNT) are rare lesions that are generally categorised as soft tissue tumours, so they are usually managed by a range of surgical disciplines such as plastic, orthopaedic and trauma surgery, dermatology, general surgery and neurosurgery. Appropriate knowledge of the therapeutic indication and surgical management are essential in order to avoid neurological deficit.

Materials And Methods: This is a retrospective study of 66 tumour lesions in 64 patients, acquired from the joint experience of 2surgical teams specialised in peripheral nerve surgery.

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Background: Suprasellar epidermoid cysts (SECs) constitute a large portion of so-called pearly tumors. Despite their insidious development and infiltration into vital neurovascular structures, they have a friable consistency, which particularly facilitates their resection; the only alternative to surgery is wait-and-see policy. We present a case of SEC in a patient with bitemporal hemianopia and no other significant symptoms and results of analysis of data on surgical treatment of 71 similar cases reported in the last 4 decades.

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Objective: The aims of our study were to evaluate tumour response in a series of patients with vestibular schwannoma (VS) treated with linear accelerator stereotactic radiosurgery (LINAC-RS), to describe the complications and to analyze the variables associated with the response to treatment.

Material And Methods: This retrospective descriptive study included 64 patients treated from 2010 to 2016 with a minimum follow-up of one year, excluding patients with neurofibromatosis. Clinical-radiological parameters were evaluated.

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Background: Atypical meningioma is a heterogeneous group of tumors with an unpredictable behavior. Our objectives were to study patients with atypical meningioma, monitor their follow-up, identify the histologic characteristics, and analyze factors associated with severe outcomes.

Methods: This retrospective study involved 28 patients with atypical meningioma from 1994 to 2014.

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Neuroendoscopy enables diagnostic biopsy of intraventricular and/or paraventricular tumors and the simultaneous treatment of associated hydrocephalus in selected cases. The objective of this paper was to analyze the effectiveness and safety of this procedure. This retrospective study included 80 patients between 2 months and 78 years old diagnosed with intraventricular and/or paraventricular expansive lesion who underwent neuroendoscopic biopsy from 2004 to 2016.

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Objective: Validation of the intracerebral haemorrhage (ICH) score in patients with a diagnosis of spontaneous ICH admitted to the intensive care unit (ICU).

Methods: A multicentre cohort study was conducted in all consecutive patients with ICH admitted to the ICUs of three hospitals with a neurosurgery department between 2009 and 2012 in Andalusia, Spain. Data collected included ICH, Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores.

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The diagnostic criteria and management of this condition continue to be a topic of debate in the literature. The term definitive symptomatic LOVA (longstanding overt ventriculomegaly in adults) is applied to patients that fulfil a series of diagnostic criteria,which are reviewed in our paper. The main subject of our study is to propose a rearrangement of the criteria for the diagnosis of this entity and adjusted treatment strategies.

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Article Synopsis
  • The study aimed to evaluate surgical treatment outcomes and survival rates in patients with supratentorial spontaneous intracerebral hemorrhage (ICH) admitted to Spanish hospitals between 2009 and 2012.
  • Data collected included patient age, Glasgow Coma Score, intracerebral hemorrhage score, treatment type, and survival rates, revealing a significant difference in mortality between surgical and conservative treatment, especially in those with intraventricular hemorrhage (IVH).
  • Results indicated that patients who underwent surgery had lower hospital mortality rates compared to those who received conservative treatment, particularly among patients with IVH, suggesting surgical intervention may improve survival outcomes in this group.
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Background: Rhinoliquorrhoea suggests a communication between the subarachnoid space and the sinonasal tract. Clinical presentation includes clear nasal discharge, headache, pneumocephalus, meningitis or brain abscess. Cerebrospinal fluid (CSF) leaks are mostly of traumatic origin (skull base fractures), iatrogenic (secondary to endoscopic endonasal surgery) or associated with tumour aetiology.

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Introduction: The role of robotic surgery is well established in various specialties such as urology and general surgery, but not in others such as neurosurgery and otolaryngology. In the case of surgery of the skull base, it has just emerged from an experimental phase.

Objective: To investigate possible applications of the da Vinci surgical robot in transoral skull base surgery, comparing it with the authors' experience using conventional endoscopic transnasal surgery in the same region.

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  • Atypical teratoid rhabdoid tumors (AT/RT) are aggressive central nervous system tumors mostly affecting young patients, with low survival rates, highlighting the need for comprehensive treatment protocols.
  • Three cases treated between 2009 and 2014 utilized multimodal therapy with favorable outcomes for two patients, showing no disease progression, unlike most documented cases.
  • Factors influencing a better prognosis include younger patient age, the tumor's location (supratentorial), and a reduction in complications from adjuvant treatments, supporting multidisciplinary approaches combining surgery, radiotherapy, and chemotherapy.
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Bone xanthoma is an extremely rare and benign tumor in terms of its nature and growth over time. We describe the first case coexisting with ventriculomegaly secondary to aqueduct stenosis (non-tumoral hydrocephalus), the second xanthoma of the clivus described to date. The patient was a 51-year-old woman with headaches and absence seizures.

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  • A 44-year-old male, with no previous health issues, underwent surgery for a mass found in the supraclavicular area after experiencing progressive weakness in his left arm for a month.
  • The mass was diagnosed as encapsulated fat necrosis, characterized by cystic formation and inflammation.
  • This case is notable as it is the first recorded instance of fat necrosis causing compression of the brachial plexus in the supraclavicular region, which is quite rare.
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