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Publications (9)2.89 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Ophthalmic artery aneurysms are infrequent lesions and they have very specific particularities. to present the anatomoclinical and surgical characteristic of our patients with ophthalmic aneurysms and to analyze our surgical results. 604 patients with intracranial aneurysms were operated on between January 1982 and December 2004. There were 50 patients with ophthalmic artery aneurysms. Average age was 52 years, 80% were women, 60% harbored multiple aneurysms and 20% were giant lesions. 12% had bilateral ophthalmic aneurysms. 20% of ophthalmic aneurysms were incidental. 50% had ophthalmological manifestations; however, this presentation occurred in 100% of the patients with large and giant aneurysms. Initially, 12% of ophthalmologic disorders were missed. We utilized unilateral or bilateral pterional approach associated to others in multiple aneurysms. We performed retrograde decompression- suction technique modified for large and giant aneurysms. RESULTS. Thirty patients (60%) obtained a complete recovery, fourteen patients (28%) an incomplete recovery and two were seriously disabled. There were not patients in vegetative state. There were four deaths (8%). 50% of postoperatory deficits disappeared and 64% of ophthalmologic disorders improved three months later. Microsurgical method allowed to treat unique, multiple, bilateral, large and giant ophthalmic aneurysms with good recovery of neurological and visual deficits.
    Neurocirugia (Asturias, Spain) 09/2006; 17(4):303-16. · 0.34 Impact Factor
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    ABSTRACT: Introducción. Los aneurismas de la arteria oftálmica son lesiones poco frecuentes y con particularidades específicas. Objetivo. Presentar las características anatomoclínicas, quirúrgicas y los resultados del tratamiento microquirúrgico de nuestros pacientes con aneurismas de esta región. Pacientes y métodos. 604 pacientes con aneurismas intracraneales fueron llevados al quirófano entre enero de 1982 y diciembre del 2004. Hubo 50 pacientes con aneurismas de la región de la arteria oftálmica. El promedio de edad fue de 52 años, el 80% fueron mujeres, el 60% presentaban aneurismas múltiples y un 20% gigantes. El 12% poseían lesiones aneurismáticas bilaterales. El 20% de los aneurismas fueron incidentales. El 50% tenían manifestaciones oftalmológicas y la frecuencia se elevó al 100% en los aneurismas grandes y gigantes. El 16 % de los trastornos visuales fueron ignorados o confundidos inicialmente. En aneurismas múltiples empleamos la ruta pterional uni o bilateral asociada a otros abordajes. En los aneurismas oftálmicos grandes o gigantes utilizamos la técnica de descompresión-succión retrógrada modificada. Resultados. Treinta pacientes (60%) obtuvieron una recuperación completa, catorce pacientes (28%) una recuperación incompleta y dos incapacidad grave. No hubo pacientes en estado vegetativo. Hubo cuatro fallecidos (8%). El 50% de los déficit postoperatorios desaparecieron y el 64% de los trastornos visuales mejoraron a los tres meses. Conclusión. El método microquirúrgico permitió tratar aneurismas de la región de la arteria oftálmica únicos, múltiples, bilaterales, grandes y gigantes con buena recuperación de los déficit neurológicos y de los trastornos visuales.
    Neurocirugia (Asturias, Spain) 01/2006; · 0.34 Impact Factor
  • S D Vega-Basulto, S Silva-Adán, G Mosquera-Betancourt
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    ABSTRACT: Distal anterior cerebral artery is the portion of the anterior cerebral artery located distal to the anterior communicating artery. Aneurysms of that territory represent 0.35 - 4.5% of all intracranial aneurysms. 524 patients with intracranial aneurysms were operated on between January 1981 and April 2002. We treated 20 patients with distal anterior cerebral artery aneurysms. They were classified as infracallosa, located at the genu of the corpus callosum and supracallosal. Specialized anesthetic methods, Sugita head holder, and microsurgical techniques were utilized. Approaches were modified regarding aneurysm localization and multiplicity. Patients were evaluated six months after surgery. Glasgow Outcome Scale was applied. Thirteen patients (65%) were between 31 and 45 years of age. All were operated on at Grade I or II of the World Federation Neurological Surgeon Scale. There were multiple aneurysms in 35% of the cases. All of the aneurysms were 11 mm long or less in diameter. The segment of the distal anterior cerebral artery next to the genu of the corpus callosum was the most commonly involved (65%). 16 (80%) patients made a complete postoperative recovery of. There were not deaths. Distal anterior, cerebral artery aneurysms were not frequent and they needed special management. Their high tendency to multiplicity and early bleeding were two main characteristics. As they are midline located, they permit to perform small size craniotomy. Cerebral retractors were avoided to reduce postoperative morbidity.
    Neurocirugia (Asturias, Spain) 10/2003; 14(4):302-8. · 0.34 Impact Factor
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    ABSTRACT: Elderly patients are a growing population group in developing countries because of optimal health care. 13% of Cuba population is older than sixty years and it is expected to grow to 20% in 2005. Subarachnoid hemorrhage secondary to ruptured aneurysms in geriatric patients carries a high mortality but a few patients are selected for surgical treatment. Manuel Ascunce Domenech Hospital attended 1112 patients older than 60 years between January 1994 and December 2001. Of these there were 96 patients with symptomatic intracranial aneurysms and we selected 30 for surgical treatment. They were all in clinical grades I and II of the WFNS scale. They had good health to face surgery and familiar consent. The size and location of the aneurysms were not considered among the exclusion criteria. Aneurysms were mainly localized at posterior communicating and middle cerebral arteries. There were two deaths, one due to a medical cause an the other to the surgical procedure. 74% of the patients obtained satisfactory outcome six month after the operation. The clue is to not consider age as a negative point for surgery. Surgical procedures can be performed in patients with good clinical grade (WFNS). New technical advances, stroke units, accurately selected patients and minimal invasive surgical methods will help to obtain good results.
    Neurocirugia (Asturias, Spain) 11/2002; 13(5):371-7. · 0.34 Impact Factor
  • S D Vega-Basulto, G Mosquera-Betancourt, A Varela Hernández
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    ABSTRACT: INTRODUCTION: Lumbar spine surgery represents a common procedure in Neurosurgery. Ogilvie's Syndrome is an infrequent complication of lumbar disc surgery, characterized by acute paralytic ileum as a result of acute colonic dilatation without mechanical obstruction. CLINICAL CASES: We present the clinical data, surgical findings and evolution of three patients operated on for large lumbar disc herniation. They presented with unilateral lumbociatic pain related with physical effort and monoradicular deficit. Diagnosis was established by CT scan and all patients were operated on through a standard laminectomy. Abdominal pain, distention and lack of bowels sounds began on the second postoperatory day. This complication was avoided by conservative treatment and parenteral administration of neostigmine. Ogilvie's Syndrome appeared in 3 cases out of more than 1000 patients undergoing lumbar disc surgery and is characterized by acute colonic dilatation including cecal distention. Other lumbar disc surgery complications such as gastrointestinal perforation, urethral injury or intra-abdominal vessels damage were excluded. Conservative treatment including parenteral neostigmine was always sucessful.
    Neurocirugia (Asturias, Spain) 07/2002; 13(3):229-32. · 0.34 Impact Factor
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    Sergio Diego Vega Basulto, S Silva-Adán, G Mosquera-Betancourt
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    ABSTRACT: Introduction Distal anterior cerebral artery is the portion of the anterior cerebral artery located distal to the anterior communicating artery. Aneurysms of that territory represent 0.35–4.5% of all intracranial aneurysms. Material and Methods 524 patients with intracranial aneurysms were operated on between January 1981 and April 2002. We treated 20 patients with distal anterior cerebral artery aneurysms. They were classified as infracallosa, located at the genu of the corpus callosum and supracallosal. Specialized anesthetic methods, Sugita head holder, and microsurgical techniques were utilized. Approaches were modified regarding aneurysm localization and multiplicity. Patients were evaluated six months after surgery. Glasgow Outcome Scale was applied. Results Thirteen patients (65%) were between 31 and 45 years of age. All were operated on at Grade I or II of the World Federation Neurological Surgeon Scale. There were múltiple aneurysms in 35% of the cases. All of the aneurysms were 11 mm long or less in diameter. The segment of the distal anterior cerebral artery next to the genu of the corpus callosum was the most commonly involved (65%). 16 (80%) patients made a complete postoperative recovery of. There were not deaths. Conclusion Distal anterior, cerebral artery aneurysms were not frequent and they needed special management. Their high tendency to multiplicity and early bleeding were two main characteristics. As they are midline located, they permit to perform small size craniotomy. Cerebral retractors were avoided to reduce postoperative morbidity.
    Neurocirugía: Organo oficial de la Sociedad Española de Neurocirugía, ISSN 1130-1473, Vol. 14, Nº. 4, 2003, pags. 302-308.
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    ABSTRACT: Elderly patients are a growing population group in developing countries because of optimal health care. 13% of Cuba population is older than sixty years and it is expected to grow to 20% in 2005. Subarachnoid hemorrhage secundary to ruptured aneurysms in geria-tric patients carries a high mortality but a few patients are selected for surgical treatment. Manuel Ascunce Domenech Hospital attended 1112 patients older than 60 years between January 1994 and December 2001. Of these there were 96 patients with symptomatic intracranial aneurysms and we selected 30 for surgical treat ment. They were all in clinical grades I and II of the WFNS scale. They had good health to face surgery and familiar consent. The size and location of the aneu rysms were not considered among the exclusion criteria. Aneurysms were mainly localized at posterior communicating and middle cerebral arteries. There were two deaths, one due to a medical cause an the other to the surgical procedure. 74% of the patients obtained satisfactory outcome six month after the operation. The clue is to not considere age as a negative point for sur gery. Surgical procedures can be performed in patients with good clinical grade (WFNS). New technical advan-ces, stroke units, accurately selected patients and mini-mal invasive surgical methods will help to obtain good results.
    Neurocirugía. 13(5):371–377.
  • S.D. Vega-Basulto, G. Mosquera-Betancourt, A. Varela Hernández
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Lumbar spine surgery represents a common procedure in Neurosurgery. Ogilvie's Syndrome is an infrequent complication of lumbar disc surgery, characterized by acute paralytic ileum as a result of acute colonic dilatation without mechanical obstruction. Clinical cases We present the clinical data, surgical findings and evolution of three patients operated on for large lumbar disc herniation. They presented with unilateral lumbociatic pain related with physical effort and monoradicular deficit. Diagnosis was established by CT sean and all patients were operated on through a standard laminectomy. Abdominal pain, distention and lack of bowels sounds began on the second postoperatory day. This complication was avoided by conservative treatment and parenteral administration of neostigmine. Ogilvie's Syndrome appeared in 3 cases out of more than 1000 patients undergoing lumbar disc surgery and is characterized by acute colonic dilatation including cecal distention. Other lumbar disc surgery complications such as gastrointestinal perforation, uretral injury or intrabdominal vessels damage were excluded. Conservative treatment including parenteral neostigmine was always sucessfull.
    Neurocirugía. 13(3):229–232.
  • S Vega-Basulto, G Mosquera-Betancourt
    Revista de neurologia 32(10):1000. · 1.18 Impact Factor