Preventing Alzheimer’s disease has ceased to be a theoretical aspiration and has become a scientific, clinical, and social obligation. For decades, Alzheimer’s has been viewed with a mixture of resignation and fatalism, as if its onset were an inexorable part of aging. However, this narrative is no longer compatible with current knowledge. Today we know that a significant proportion of the risk of cognitive decline and dementia is linked to modifiable factors, and that intervening on these factors can delay or prevent a significant number of cases. This reality takes on even greater urgency when we consider that the number of people with dementia worldwide could rise from 57.4 million in 2019 to more than 150 million in 2050.
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Interfase Neurona-material: Del Implante Rígido a la Bioelectrónica Blanda. Neuron-material Interface: From Rigid Implants to Soft Bioelectronics
Spinal cord injury continues to represent one of the greatest therapeutic challenges in neurology, not only due to the complexity of the initial damage but also because of persistent limitations in long-term functional recovery. Despite advances in rehabilitation, electrical stimulation, and pharmacological strategies, clinical outcomes remain modest. In this context, it is becoming increasingly clear that one of the main bottlenecks lies not solely in neuronal regeneration itself, but rather in the interface between neural tissue and the materials used for its repair or stimulation.
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Buddleja globosa (Matico) Como Fuente Potencial de Compuestos Fenólicos de Interés Neuroprotector en la Enfermedad de Alzheimer. Buddleja globosa (Matico) as a Potential Source of Phenolic Compounds of Neuroprotective Interest in Alzheimer’s Disease
The insightful review by Bonilla-Santos et al. highlights that neuroinflammation alterations in Alzheimer’s disease (AD) constitute a priority therapeutic target, especially in the early stages of mild cognitive impairment, when biological and behavioral markers precede anatomical damage. In this context, identifying plant-derived compounds with anti-inflammatory and antioxidant activity, capable of modulating relevant cell signaling pathways, is pertinent for future pharmacological development. This letter aims to emphasize the potential of Buddleja globosa (Matico) as a source of phenolic compounds of neuroprotective interest in AD.
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Tensiones Entre las Funciones Ejecutivas y su Correlación con el Enfoque de Género en las Infancias. Tensions Between Executive Functions and Gender Perspectives in Childhood
Regarding the article “Executive functions and gender: systematic review,” published in this journal in 2024 (volume 3), it is reinforced that both working memory and cognitive flexibility are central processes for self-regulation and social adaptation. According to the authors, “Executive functions constitute mechanisms of intermodal and intertemporal integration that allow cognitions and emotions to be projected from the past into the future in order to find the best solution to novel and complex situations.” This process, then, allows children to integrate past experiences with new situations. In this context, and from a gender perspective, we can consider the value of play, since it is through play that gender begins to be constructed socially. However, human groups tend to confuse biological sex and gender, which could generate interpretive tension in the correlations linked to executive functions.
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Caracterización Clínica de la Migraña Crónica Refractaria Tratada con Toxina Botulínica A en Panamá. Clinical Characterization of Refractory Chronic Migraine Treated With Botulinum Toxin A in Panama
Introduction: Chronic migraine limits the quality of life of patients. This condition requires rescue and prophylactic treatment. Many patients do not respond to first-line prophylactic treatment. Since 2015, botulinum toxin A has been used in Panama for patients who do not respond to first-line prophylactic therapy.
Objective: Determine the impact of Botulinum Toxin A as a prophylactic therapy in patients with chronic migraine in Panama.
Methodology: A retrospective, descriptive study. Sample was equal to universe: 29 participants in the PREEMPT 1 protocol. Data collection was based on reviewing medical records. The study evaluated demographic and clinical characteristics, including MIDAS and HIT-6 scales scores.
Results: Participants had an average age of 43 years; all were female. A total of 55.1% experienced 25 to 30 days of acute migraine crises per month. Therapy shows a crisis reduction of 89.66% and 93.10% at 3 and 6 months, respectively. No adverse effects were reported.
Conclusions: Panamanian patients with a diagnosis of chronic migraine resistant to first-line prophylactic therapy have responded positively to treatment with botulinum toxin A, with a significant improvement in their quality of life.
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The Effectiveness of Immersive Virtual Reality for Spatial Learning Tasks in Two Diverse Age Groups. Efectividad de la Realidad Virtual Inmersiva Para Tareas de Aprendizaje Espacial en Dos Grupos Diversos de Edad
Spatial learning is a critical function for our effective functioning in the world. Despite the importance of this function, its study has been limited to unrealistic contexts, hindering a deep understanding of its underlying mechanisms. Today’s technological advancements allow us to study this phenomenon in environments close to natural ones, with the potential to perform physiological measurements that help us understand its mechanisms in humans. In this work, we aimed to evaluate the box room task implemented in an Immersive Virtual Reality System (IVRS) for studying spatial learning in humans. The sample consisted of healthy children and older adults, without neurological or psychiatric alterations. All participants successfully completed the task without any problems associated with the use of IVRS. Although in different ways, both children and older adults showed improvements in the three established performance measures used to assess their performance over the course of the rounds: time, travel distance, and number of errors. Our results support the effectiveness of the box room task implemented in an IVRS for studying spatial learning and navigation in humans. The flexibility of the task positions it as a valuable tool for investigating spatial cognition in a variety of populations with diverse characteristics.
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Bases Neurofisiológicas y Neuropsicológicas Implicadas en las Conductas Delictivas: Una Revisión Sistemática. Neurophysiological and Neuropsychological Bases Implicated in Delinquent Behaviors: A Systematic Review
Neurophysiological and neuropsychological structures are factors that may be involved in the commission of criminal behavior, however, their evaluation in the forensic expert field is far from being considered as evidence or support in court cases in our context. The objective of this research was to identify the neurophysiological and neuropsychological bases involved in criminal behaviors through a quantitative systematic review. For this purpose, previous research housed in Scopus and Pubmed was taken into account. For this reason, a total of 15 articles were identified and analyzed through the application of inclusion and exclusion criteria. The results suggest that most of the neurophysiological structures involved in crimes come from areas linked to the frontal lobe and the limbic system or nearby. Likewise, it was identified that offenders present neuropsychological deficiencies related to decision-making, self-regulation, emotional recognition, aggressiveness, anticipation, planning, among others. In conclusion, it was possible to identify that those evaluated do indeed present neurophysiological and neuropsychological anomalies; however, the commission of criminal behaviors also depends on other biological and social factors. Finally, the systematic review opens the gap to the importance of including forensic neuropsychological evaluation for the clarification of crimes, thus generating one more piece of evidence in judicial processes.
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Refractory Infantile Spasm Syndrome Treatment: A Systematic Review. Tratamiento del Síndrome de Espasmos Infantiles Refractario: Una Revisión Sistemática
Introduction: Infantile spasm syndrome is an epileptic and neurodevelopmental encephalopathy whose first-line treatment includes vigabatrin and hormonal therapy. However, there are refractory cases.
Objective: To compare the efficacy of the available treatments for refractory infantile spasm syndrome (RISS).
Methods: We searched PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL Clinical Trials, International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov until March 2024 for randomized controlled trials (RCTs) comparing the efficacy of two of the following three treatment alternatives: antiepileptics, ketogenic diet and surgery. The primary outcome was electroclinical response. The GRADE methodology was used to appraise the certainty of the evidence. We generated a Summary of Findings table using the GRADEpro software.
Results: We did not find enough RCTs to do a meta-analysis. Only one trial was close to fulfill our inclusion criteria. This study involved 318 patients with RISS receiving antiepileptic drugs and compared the modified Atkins diet (MAD) versus normal diet. However, we found a high risk of bias.
Conclusion: High-quality RCTs comparing treatment modalities for patients with RISS are urgent due to the devastating nature of this condition.
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Palabras clave: Epilepsia,
Espasmos Infantiles,
Revisión Sistemática,
Síndromes Epilépticos,
Sistema nervioso central,
Síndrome de Guillain-Barré y su Variante Faringo Cervicobraquial: Presentación Inusual y Desafíos Clínicos. Guillain-Barré Syndrome and its Pharyngocervicobrachial Variant: Unusual Presentation and Clinical Challenges
Guillain-Barré syndrome (GBS) encompasses a variety of clinical manifestations, including the rare and easily underdiagnosed pharyngeal-cervical-brachial variant (PCB). Here, we present the case of a 57-year-old woman with no significant medical history who lives in an area endemic for vector-borne diseases. She presented to the emergency department with four days of cervicobrachial weakness and acute dysphagia. Although imaging was normal, lumbar puncture revealed albuminocytologic dissociation and neurophysiological tests demonstrated acute demyelinating polyradiculopathy, confirming the diagnosis of the CPB variant. First described in 1986, this variant has been reported following arbovirus infections, such as dengue and chikungunya. This case highlights the importance of considering this atypical form of GBS and suggests the need for future research on its possible association with vector -borne infection.
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Nuevas Posibles Mutaciones para Aceruloplasminemia. New Possible Mutations for Aceruloplasminemia
Aceruloplasminemia is an ultrarare ad late-onset entity within the group of neurodegeneration with brain iron accumulation (NBIA) diseases. There are new mutations to describe, such as the one in this clinical case.
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Presentación Atípica de la Enfermedad de Creutzfeldt-Jakob. Reporte de Caso en la Patagonia Chilena. Atypical Presentation of Creutzfeldt-Jakob Disease. A Case Report in Chilean Patagonia
Introduction: Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disease. Symptoms include rapidly progressive dementia, myoclonus and motor impairment. In Chile, there is a remarkably high incidence, which together with the lethality of it highlights the importance of early diagnosis.
Case report: A 64-year-old woman presented with vertigo, gait instability, dysarthria and diplopia. Physical examination revealed ataxia, dysmetria and dysdiadochokinesia. Magnetic resonance imaging and electroencephalogram were ordered, with findings suggestive of CJD. Patient’s condition deteriorated rapidly, developing dementia after 3 months and dying in the fourth month.
Discussion and conclusion: CJD variants may present without alteration of cognitive functions and nonspecific prodromes. Diagnosis requires a high index of suspicion, taking as essential tests the nuclear magnetic resonance and the measurement of 14-3-3 protein in cerebrospinal fluid. The increased incidence in Chile may be due to mutations and environmental factors, suggesting the need to thoroughly in vestigate the causes and develop appropriate treatments.
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Palabras clave: demencia,
Enfermedades por prión,
Síndrome de Creutzfeldt-Jako b,
Trastornos Neurocognitivos,
Encefalitis de Hashimoto. Hashimoto´s Encephalitis
Introduction: Hashimoto’s encephalitis (HD) is a clinical entity characterized by neurological alterations associated with the presence of positive antithyroid antibodies. This encephalopathy responds well to management with corticosteroids.
Objective: The objective of the manuscript is to present the case of a patient with Hashimoto’s encephalitis.
Clinical case: This is an 18-year-old woman with no significant history, who was admitted for a 5-day history that began with photopsias, recurrent generalized tonic-clonic seizure episodes, with recovery of consciousness between seizures. On admission she was tachycardic, disoriented, unresponsive during questioning, symmetrical pupils, with presence of vertical nystagmus, preferential gaze to the right, clonic facial and left upper limb movements. Paraclinical and imaging studies on admission were normal. On the third day of admission, the patient presented status epilepticus with ventilatory failure, so she decided to manage a barbiturate coma. Lumbar puncture showed hyperproteinorrachia as the only finding; extension studies ruled out autoimmune encephalitis; however, she had subclinical hypothyroidism with positive antiperoxidase antibodies (Anti-TPO). Given this, it was suspected that she had Hashimoto’s encephalitis, so treatment with corticosteroids (prednisolone 50 mg every day) was given, resulting in an adequate clinical evolution of the patient.
Conclusions: This is a low prevalence disease, with varied neurological and psychiatric symptoms, where one of the most important criteria for this pathological entity is the presence of positive antithyroid antibodies with a good response to management with corticosteroids.
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Enfermedad de Lafora: Primer Caso Clínico Diagnosticado en Ecuador Mediante Prueba Genética. Lafora Disease: First Genetically Confirmed Case in Ecuador
Lafora disease is an autosomal recessive progressive myoclonic epilepsy characterized by refractory generalized tonic-clonic seizures, persistent myoclonus, severe and progressive cognitive decline, and a fatal course. We present the first genetically confirmed case in Ecuador. A 17-year-old male developed generalized tonic-clonic seizures at age 13, refractory to combined pharmacological treatment. He exhibited severe and progressive cognitive decline, significant neuropsychological regression, and an IQ of 32. The electroencephalogram (EEG) showed generalized epileptiform activity compatible with progressive myoclonic epilepsy. Genetic testing confirmed a mutation in the NHLRC1 gene. A ketogenic diet was initiated as a complementary therapeutic approach. This case highlights the importance of early genetic diagnosis and a comprehensive multidisciplinary management strategy.
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Palabras clave: diagnós tico genético,
dieta cetogénica,
Enfermedad de Lafora,
epilepsia mioclónica progresiva,
Calcificaciones en Ganglios Basales Compatibles con Síndrome de Fahr en un Contexto Autoinmune. Basal Ganglia Calcifications Consistent with Fahr Syndrome in an Autoimmune Context
A 53-year-old woman with a long history of rheumatoid arthritis, treated with methotrexate and adalimumab, underwent a computed tomography scan of the head during the evaluation of persistent headache. The study revealed dense calcifications in the basal ganglia, predominantly on the left, associated with mild cortical atrophy, without other relevant intracranial abnormalities.
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Criptococosis con Vasculitis del Sistema Nervioso Central Mediada Inmunológicamente: Un Reto Diagnóstico. Cryptococcosis with Immune-Mediated Central Nervous System Vasculitis: A Diagnostic Challenge
We report the case of a 63-year-old man who initially presented with hearing loss and optic neuritis. He subsequently developed vertigo, and multiple multitopographic cerebral infarctions were documented, with negative vascular risk factor evaluation. Panangiography revealed findings suggestive of central nervous system vasculitis, and the initial lumbar puncture showed no evidence of infection; therefore, an immune-mediated vasculitis was considered. Following further neurological deterioration, central nervous system infection due to Cryptococcus neoformans was confirmed. This case highlights the diagnostic challenge and the limitations of initial microbiological testing in central nervous system cryptococcosis.
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Palabras clave: Criptococosis,
efecto prozona,
Síndrome de Cogan,
Vasculitis del sistema nervioso central,
Inteligencia Artificial en Neurología: Una Aliada Para Ser Utilizada como Herramienta en Nuestra Práctica Diaria. Artificial Intelligence in Neurology: An Ally to Be Used as a Tool in Our Daily Practice
Neurology has always been a complex discipline in which every consultation, every complementary study, and each patient challenges us to interpret the signs and symptoms of the physical examination, arrive at a diagnosis, and ultimately determine the appropriate treatment. In recent years, artificial intelligence (AI) has been added, and its presence continues to grow in our field, already becoming part of our daily practice. When used properly, these tools help neurologists shorten the time required to search for differential diagnoses while maintaining clinical depth.
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La Simulación Como Metodología de Aprendizaje Fundamental para la Enseñanza de la Neurología. Simulation as a Fundamental Learning Methodology for the Teaching of Neurology
Reading the article by Castellanos-Ruiz et al. on the application of virtual reality for the treatment of hemiplegia invites reflection on the relevance of simulation in healthcare. Accordingly, the aim of this letter is to highlight the importance of simulation in neurology training.
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Prevalence of Dehydration at Acute Ischemic Stroke Onset and the Impact of Dehydration Subtypes on Severity: A Prospective Observational Study. Prevalencia de la Deshidratación al Inicio del Ictus Isquémico Agudo y el Impacto de los Subtipos de Deshidratación en la Gravedad: Un Estudio Observacional Prospectivo
Background: Dehydration has been suggested to influence stroke severity and recovery through mechanisms like increased blood viscosity and thromboembolism risk. This study aims to estimate the prevalence of dehydration at acute ischemic stroke (AIS) onset and assess the impact of different dehydration subtypes on stroke severity.
Methods: This prospective observational study was conducted at a tertiary care center over a period of one year. Dehydration was assessed using specific biomarkers to check for intracellular dehydration (Group A using urine osmolarity, plasma osmolarity, urine/plasma osmolarity ratio >1.5) and mixed dehydration (Group B using BUN/creatinine ratio >0.20 ) parameters. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS).
Results: Out of 177 AIS admissions, 71 patients met the inclusion criteria (49 males, 22 females; average age: 61.1 years for males, 62.8 years for females). Dehydration was present in 65% of patients at stroke onset. Among dehydrated patients, 33.3% had abnormal Group A parameters, 30% had abnormal Group B parameters, and 36% had abnormalities in both groups. A significant correlation was found between the presence of multiple dehydration markers and increased stroke severity (p < 0.005).
Discussion: The high prevalence of dehydration in AIS patients at onset suggests it may be a potential trigger for stroke and exacerbates stroke severity. Dehydration subtypes, categorized into intracellular, mixed, and extracellular dehydration, have distinct physiological implications requiring specific management strategies. Further research into standardized protocols and innovative biomarkers for dehydration assessment is recommended to enhance patient outcomes.
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Análisis de Redes de Adherencia al tratamiento farmacológico, Calidad de vida y síntomas no Motores en pacientes con Parkinson de Azogues, Biblián y Déleg. Network analysis of adherence to pharmacological treatment, quality of life and nonmotor symptoms in Parkinson’s patients from Azogues, Biblián and Déleg
This study aims to analyze medication adherence, quality of life, and non-motor symptoms in Parkinson’s disease patients in Azogues, Biblián, and Déleg. A descriptive and correlational approach was used, collecting data on various variables such as Age, Age at Diagnosis, Mobility, Daily Activity, Emotional Well-Being, Stigma, Social Support, Cognitive Status, Communication, Physical Discomfort, Medication Adherence, and Non-Motor Symptoms. The normality of variable distributions was assessed, and Pearson correlations were applied to examine their relationships. The results showed significant correlations between Age and other variables, such as Mobility, Daily Activity, and Emotional Well-Being. The relationship between Mobility and Daily Activity was extremely strong, and non-motor symptoms notably impacted quality of life, particularly Cognitive Status and Communication. The Gaussian graphical model revealed direct interactions between the variables. In conclusion, the research highlights how mobility, emotional well-being, and social support influence the quality of life of Parkinson’s patients, while non-motor symptoms negatively affect their overall well-being, suggesting key areas for intervention and improvement in the treatment of these patients.
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Palabras clave: adherencia a la medicación,
calidad de vida,
enfermedad de Parkinson,
síntomas no motores,
IMPACT Score as a Predictor of Mortality in Patients with Severe Traumatic Brain Injury in The Intensive Care Unit. Puntaje IMPACT como Predictor de Mortalidad en Pacientes con Traumatismo Craneoencefálico Severo en la Unidad de Cuidados Intensivos
Objective: To assess whether the IMPACT score predicts mortality in patients with traumatic brain injury (TBI).
Design: Cohort study.
Setting: A total of 260 patients with moderate and severe TBI were enrolled from the Intensive Care Unit (ICU) of Hospital Regional Docente de Trujillo, a trauma referral hospital in northern Peru. The data collection period spanned from 2018 to 2023.
Patients: Patients with moderate and severe TBI admitted to the ICU.
Interventions: Patients with TBI in whom the predictive performance of the IMP ACT score for mortality was assessed.
Main Outcome Measure: In-hospital mortality.
Results: A total of 260 patients with moderate and severe TBI were included. When evaluating the IMPACT score and its models (core, extended, and laboratory), we found adequate predictive values expressed by their respective ROC AUCs (0.74, 0.83, and 0.84). Additionally, upon constructing a predictive model utilizing the IMPACT score laboratory model, an increased risk of mortality was observed (adjusted RR 1.21; 95% CI 1.12–1.31). Furthermore, the variables: mechanism of TBI (adjusted RR 5.6; 95% CI 3.03–10.85), Glasgow Coma Scale (GCS) (adjusted RR 1.35; 95% CI 1.15–1.58), and use of vasopressors (adjusted RR 2.2; 95% CI 1.14–4.42) behaved as independent predictors of in-hospital mortality.
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La Autorregulación en el Espectro Autista: Una Visión Sobre su Influencia en la Intervención del Proceso Enseñanza-Aprendizaje. Self-Regulation in the Autism Spectrum: A View of its Influence on the Intervention of the Teaching-Learning Process
The aim of this study is to describe the emotional and behavioral management capacity of autistic people under various conditions or scenarios and its influence on the teaching-learning process. The methodology, according to the source, is cross-sectional documentary, where scientific articles were explored in Google Scholar. Among the most important conclusions, it can be mentioned that emotional management is a vital factor for the development of skills and abilities, learning and memorization are enhanced when the autistic person focuses on aspects of his or her interest, and self-regulating his or her emotions and behaviors allows for a balanced environmental interaction whether or not he or she has comorbidities.
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Prevalencia de Depresión y Ansiedad en Adultos Ecuatorianos: Una Revisión Sistemática Narrativa. Prevalence of Depression and Anxiety in Ecuadorian Adults: A Narrative Systematic Review
The present narrative systematic review aims to estimate the prevalence of depression and anxiety in the Ecuadorian adult population, a field little explored despite the growing global burden of these mental disorders. The importance of this review lies in the need to synthesize scattered evidence on the prevalence of these disorders in Ecuador, where there is no previous systematic review. The methods included an exhaustive search in five electronic databases and complementary sources, selecting 33 observational studies. The results reveal wide variability in prevalence rates, influenced by methodological heterogeneity and the characteristics of the studied populations. Depression figures reported in the included studies ranged from 5.6% to 86.81%, while the prevalence of anxiety showed an even more extreme range, from 0.02% to 77.1%. Consistently higher prevalences are observed in vulnerable groups such as health professionals, hospitalized patients, and university students, which underscores the urgency of standardizing research methodologies and strengthening mental health policies in Ecuador, focusing on early detection and psychosocial interventions.
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Intervention methods for working memory: A systematic review. Métodos de intervención para la memoria de trabajo: Una revisión sistemática
Working memory refers to storing and manipulating information to achieve a specific goal or completing a task at a high cognitive level. This component is part of the executive functions and is essential for daily life. A quantitative systematic review aims to identify the intervention methods currently developed to rehabilitate and improve working memory. The articles were obtained from SCOPUS, ScienceDirect, PubMed, and Scielo databases. Initially, 550 articles were found, and after applying the inclusion and exclusion criteria, 65 articles were selected and included in the data extraction process and used for the descriptive statistical analysis. The main results found that computerized treatments prevailed in 41 studies, transcranial electrical stimulation in 16, and sport and cognitive stimulation in two, respectively. These findings will be analyzed to develop new proposals that can contribute to clinical practice and offer mental health professionals a selection of intervention methods helpful in carrying out intervention plans aimed at working memory deficits.
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Reto Diagnóstico en Enfermedad del Espectro de Neuromielitis Óptica Asociado a Bandas Oligoclonales Tipo 2 Positivas: Reporte de Caso. Diagnostic Challenge in Neuromyelitis Optica Spectrum Disease Associated with Type 2 Positive Oligoclonal Bands: Case Report
Neuromyelitis Optica spectrum disorder, formerly known as Devic’s disease, is characterized by an autoimmune-mediated pathology of the central nervous system. This pathology generates an inflammatory process directed against the channels of the protein Aquaporin 4, located mainly in the membrane of astrocytes. Aquaporin-4 is a protein related to water transport, which plays a crucial role in brain inflammation through mechanisms that involve the release of cytokines and astrocytic inflammation. These pathological changes cause demyelination and secondary axonal damage, with diverse clinical manifestations in the brain, spinal cord, and optic nerve sheaths. The detection of antibodies against the protein Aquaporin 4, the analysis of oligoclonal bands in the cerebrospinal fluid, and radiological findings by magnetic resonance imaging of the brain and spinal cord must be carefully evaluated to reach an accurate diagnosis in challenging clinical cases. This report reviews the differential etiologies of this disease and the challenge of comprehensive analysis of the corresponding diagnostic tests.
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Insonation of the Posterior Cerebral Artery Via the Transforaminal Window: An Unusual but Feasible Observation. Insonación de la Arteria Cerebral Posterior a Través de la Ventana Transforaminal: Una Observación Inusual pero Factible
Transcranial Doppler (TCD) ultrasonography typically visualizes the posterior cerebral arteries (PCAs) through the transtemporal window, while the basilar and vertebral arteries are assessed via the suboccipital approach. This report describes an unusual technical finding: visualization of PCA flow through the suboccipital window. During routine TCD in a patient with excellent acoustic access, two vascular structures arising from the distal basilar artery were identified at a depth of 92 mm, with flow characteristics consistent with PCAs. Favorable bone transmission and vascular alignment likely enabled this alternative insonation route. This observation suggests that, in exceptional anatomical conditions, suboccipital PCA assessment is feasible and may expand posterior circulation evaluation.
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Bilateral Globus Pallidus T1 Hyperintensity in Hepatic Cirrhosis. Hiperintensidades de Globos Pálidos en Cirrosis Hepática
Bilateral symmetric T1 hyperintensities in the globus pallidus on MRI are a hallmark of manganese deposition secondary to hepatic dysfunction, reflecting portosystemic shunting and subclinical hepatic encephalopathy. A 60-year-old man with history of diabetes mellitus type 2, and chronic liver disease, presented with troubling gait. The rest of the neurological examination was unremarkable.
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Palabras clave: cirrosis hepática,
Hiperintensidades de Globos Pálidos,
Keywords: Bilateral Globus Pallidus,
Hepatic Cirrhosis,
Técnica de Doble Stent Retriever para Trombectomía Mecánica en Ictus: Primera Experiencia en Ecuador. Double Stent Retriever Technique for Mechanical Thrombectomy in Acute Ischemic Stroke: First Experience in Ecuador
Endovascular treatment of acute ischemic stroke has become established as an effective and safe technique for reperfusion in selected cases. Although early studies did not demonstrate superiority over intravenous thrombolysis, the development of advanced devices, such as aspiration catheters and stent retrievers (SR), made it possible to show significantly improved outcomes.
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La Sociedad Médica Ecuatoriana de Neurología (SEN) a la Comunidad Médica
Times have always been difficult for the SEN, from the initial efforts to constitute it involving all the neurologists of that era, to the present day. I can imagine the tremendous and arduous task faced by the neurologists of that time, as it was first necessary to dissolve the former SENNCA (Ecuadorian Society of Neurology, Neurosurgery, and Related Sciences). This event took place on October 28, 1981, within the context of the VII Latin American Congress of Neurosurgery and the XIII Latin American Congress of Electroencephalography and Neurophysiology. I can envision the intense level of that dialectic and the maieutics applied to give birth to our society in March 1983.
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Disfagia Orofaríngea y Ataque Cerebrovascular: Implicaciones de un nuevo Síndrome Geriátrico
Dear Editor:
Oropharyngeal dysphagia (OD) is a condition that increases in frequency with aging. It is multifactorial, resulting from the accumulation of deficits across various systems, and is associated with adverse health outcomes in older adults (OA). Consequently, it has been recognized over the last decade as an emerging geriatric syndrome.
Prominent among its causes is ischemic stroke, which caused approximately 14,000 deaths and 246,400 disability-adjusted life years among older adults in Colombia during 2021, ranking as the leading cause of disability. This burden is largely explained by swallowing disorders, which appear to be highly prevalent among older adults in Colombia; this was evidenced by a study in Medellín in which 3 out of 4 participants with stroke presented with OD, with age being identified as one of the specific factors that increased the likelihood of developing it.
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Palabras clave: Ataque Cerebrovascular,
Disfagia Orofaríngea,
Keywords: Oropharyngeal Dysphagia,
stroke,
Restaurando la Homeostasis Metálica en Alzheimer: Avances y Desafíos en la Terapia de Quelación
To the Editor:
Alzheimer’s disease (AD) continues to challenge conventional therapeutic approaches, necessitating alternative strategies based on its pathophysiology. Among these, metal chelation therapy emerges as a promising option that directly addresses the metal dyshomeostasis implicated in AD, offering disease-modifying effects beyond symptomatic relief. Copper, iron, and zinc actively participate in the progression of AD, promoting amyloid-β oligomerization, oxidative stress, and tau hyperphosphorylation. Post-mortem studies have identified elevated concentrations of these metals in the brains of AD patients, particularly copper in amyloid plaques, which reaches levels three times higher than normal.
