Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

traumatismo craneoencefálico

 

Correlación entre variables clínicas sugestivas de hipertensión intracraneal y alteraciones en la neuroimagen en trauma craneoencefálico. Correlation between clinical variables suggestive of intracranial hypertension and alterations in neuroimaging in traumatic brain injury

Methods: Retrospective observational cohort study where patients admitted for TBI to the ICU area of the HLV were included. 

Results: We included a total of 297 subjects. The most common neuroimaging lesion was multiple lesions (35.4%). We found that there is a significant correlation between the presence of lesion in neuroimaging and the presence of fixed pupils at admission (p = <0.001), score ≤ 8 on the Glasgow scale (p = <0.001) and need for orotracheal intubation (p = <0.001). Similarly, the same 3 variables were significant when related to the score ≥ III on the Marshall scale. In the logistic regression model, pupil fixation was the only one that was shown to increase the risk of a score ≥ III on the Marshall scale (OR: 3.50, 95% CI 1.53-7.99). 

Conclusion: The clinical variables: pupil fixation, need for endotracheal intubation and Glasgow ≤ 8 are related to the development and severity of lesion on neuroimaging in patients with TBI.

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Palabras clave: escala de Marshall, hipertensión intracraneal, injuria cerebral aguda, injuria cerebral traumática, neuroimagen, tomografía, traumatismo craneoencefálico,

Keywords: acute brain injury, Cranioencephalic traumatism, Intracranial hypertension, Marshall scale, neuroimaging, tomography, traumatic brain injury,

Etiología del Daño Cerebral: Un Aporte Neuropsicológico en su Construcción Teórica (Primera Parte). Etiology Of Brain Damage: A Neuropsychological Contribution In Its Theoretical Construction (First Part)

The brain is the organ responsible for all the brilliant activities that human beings perform, such as thinking, acting, speaking, solving problems, making decisions, regulating emotions and other fascinating mental abilities. Any of these brain functions can be damaged at the least expected moment, generating cognitive and behavioral problems in the patient who suffers from acquired brain damage. This article proposes a theoretical review of various etiological factors of brain damage: (a) the most frequent of them, traumatic brain injury (TBI), a condition that causes a range of cognitive and behavioral deficiencies, in addition to being the main cause of prolonged dysfunction in industrialized countries; (b) brain tumors are also an important etiological factor, since any area of ​​the Central Nervous System (CNS) can be affected and the effects are very varied according to the location of the tumor, its level of severity, its nature and whether or not surgery was performed; (c) thirdly, epilepsy is presented as a neurological disease present in 50 million people around the world and whose consequences on the CNS are related to seizures and anti-seizure drugs; finally, (d) the neurobiology of child abuse is exposed, which can generate alterations in the brain configuration of a minor. In each of these factors, its definition, classification, associated risk factors and, finally, what is its effect on the brain and the nature of the damage will be presented.

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Palabras clave: Daño cerebral adquirido, Epilepsia, maltrato infantil, traumatismo craneoencefálico, tumores cerebrales,

Keywords: Acquired brain damage, brain tumors, child abuse, Epilepsy, head trauma,

Análisis neurofutbolístico de Loris Karius: de la gloria al infierno. Loris Karius neurofutbolistic analysis: from glory to hell.

In the soccer context there have been huge errors that have cost the teams dearly. Sometimes they occur due to nerves or deconcentration, however, according to our clinical eye, sometimes the brain plays a trick and its malfunction, the product of traumatic brain injury that occurred in the same game, is what determines the score of an encounter. This is what happened to the Liverpool goalkeeper in the final of the 2018 Champions League, who, from our neuro-soccer reflection, had errors that cost him the match, due to an affectation of the cerebral magnocellular pathway that allows processing spatial visual perceptual information. In the featured article, we reflect on his brain state before and after the trauma suffered and highlight that a footballer who is awake and expressing that he can continue, is not necessarily an individual with his brain preserved, since it may be only a part of his brain mass speaking, but, as seen in Karius, however, other silencers may have been altered. We close the work by highlighting the need to incorporate neuropsychological knowledge to understand the effect of trauma on the playfield, since this work confirms that humans do not play soccer with their legs or hands, they do so with your brain.

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Palabras clave: estado de conciencia, fútbol, neuropsicología, traumatismo craneoencefálico,

Keywords: neuropsychology, soccer, state of consciousness, traumatic brain injury,

Futbolistas Talentosos, el Gran Secreto Está en el Cerebro: La Gran Tragedia del Marshal y la Suerte de los Magos con un Sistema Nervioso Indemne. Talented Soccer Players, The Big Secret Is In The Brain: The Great Tragedy Of The Star Player And The Fate Of Magicians With A Preserved Nervous Systems.

In previous work, we have presented case studies from fascinating films for the eye of the neuropsychologist;1,2,3 continuing with this line of research, we describe here for your consideration a critical analysis of the role of brain functions in one of the most fascinating sports, soccer. In this analysis, we will look more closely at the brain damage suffered by the great footballer Salvador Cabañas and the role of the highly complex brain functions that allow the magical players to stand out in this sport. In the next pages, we present the case of Salvador Cabañas, both before and after his cerebral accident, and later we analyze the cerebral functions that are activated in brilliant players like Messi or Ronaldinho. We conclude this article by reflecting on the role of the brain in our normal human activities, and how catastrophic it becomes on a daily basis when our brain tissue is damaged so that as a result of this condition we can lose everything.

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Palabras clave: Daño cerebral adquirido, funcionamiento cerebral en deportistas, Funciones Ejecutivas, lóbulo frontal, rehabilitación neuropsicológica, traumatismo craneoencefálico,

Keywords: Brain damage, cerebral functioning in athletes, Executive functions, frontal lobe, neuropsychological rehabilitation, traumatic brain injury,

Resolución clínica de un hematoma subdural crónico en un niño con quiste aracnoideo conocido.

Chronic subdural haematoma is a well-known and relatively frequent entity in the elderly. It is originated by a slight trauma which provokes subdural veins to rupture after suffering stretching due to cortical atrophy.
We report the case of a 11 year old patient with a previous known arachnoid cyst who was diagnosed as chronic subdural haematoma without association to cranial trauma and with slight neurological impairment. He responded successfully to pharmacological therapy. The following clinical case permits review pathophysiology of chronic subdural haematoma and considers subarachnoid cyst as a risk factor.

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Palabras clave: Hematoma subdural crónico, quiste aracnoideo, traumatismo craneoencefálico,

Keywords: arachnoid cyst, chronic subdural haematoma, Head injury,
 
 
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