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Article ; Online: Catastrophising in spinal surgery and the impact of radiology reports.

Delgado-López, Pedro David / Fernández Carballal, Carlos / Paredes, Igor / Roldan Delgado, Héctor / Suárez Fernández, David / Vázquez Míguez, Alfonso

Neurocirugia (English Edition)

2023 Volume 34, Issue 5, Page(s) 217–220

MeSH term(s)	Humans ; Catastrophization ; Radiology
Language	English
Publishing date	2023-07-27
Publishing country	Spain
Document type	Editorial
ISSN	2529-8496
ISSN (online)	2529-8496
DOI	10.1016/j.neucie.2023.07.005
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Article ; Online: Late recurrence of medulloblastoma after 17 years of complete remission.

Vargas López, Antonio Jose / Sola Vendrell, Emma / Fernández Carballal, Carlos

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2019 Volume 64, Page(s) 33–35

Abstract: Background: To describe an exceptional case of late recurrence of medulloblastoma after 17 years of complete remission.: Case description: A 42-year-old male consulted in ER for 10-day occipital headache. He had a previous history of cerebellar ... ...

Abstract	Background: To describe an exceptional case of late recurrence of medulloblastoma after 17 years of complete remission. Case description: A 42-year-old male consulted in ER for 10-day occipital headache. He had a previous history of cerebellar medulloblastoma 17 years ago treated with gross total resection, chemotherapy and radiotherapy. During his yearly follow-up he had maintained complete remission. MRi showed a cerebellar mass suggestive of medulloblastoma recurrence vs radio-induced tumor. Craniotomy and complete resection of the tumor was performed. The anatomopathological analysis confirmed the recurrence of medulloblastoma. The patient received high dose of adjuvant chemotherapy and he maintains complete remission after 18 months. Conclusion: Recurrence of medulloblastoma may occur despite more than 15 years of complete remission. Because of this fact it is mandatory to continue the follow-up of these patients. Aggressive management of recurrence is recommended in absence of disease dissemination.
MeSH term(s)	Adult ; Cerebellar Neoplasms/pathology ; Cerebellar Neoplasms/therapy ; Chemoradiotherapy, Adjuvant/methods ; Chemotherapy, Adjuvant/methods ; Combined Modality Therapy/methods ; Humans ; Male ; Medulloblastoma/pathology ; Medulloblastoma/therapy ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Remission Induction
Language	English
Publishing date	2019-03-21
Publishing country	Scotland
Document type	Case Reports ; Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2019.03.028
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Article: Incidencia y factores de riesgo de reingreso hospitalario a los 30 días en pacientes neuroquirúrgicos.

Vargas López, Antonio José / Fernández Carballal, Carlos

Neurocirugia (Asturias, Spain)

2016 Volume 28, Issue 1, Page(s) 22–27

Abstract: Aim: The 30-day readmission rate has become an important indicator of health care quality. This study focuses on the incidence of 30-day readmission in neurosurgical patients and related risk factors.: Material and methods: A retrospective review was ...

Title translation	Incidence and risk factors of 30-day readmission in neurosurgical patients.
Abstract	Aim: The 30-day readmission rate has become an important indicator of health care quality. This study focuses on the incidence of 30-day readmission in neurosurgical patients and related risk factors. Material and methods: A retrospective review was performed on patients treated in a neurosurgery department between 1 January 2012 and the 31 December 2013. Patients requiring readmission within 30 days of discharge and the readmission diagnosis were identified, and the factors related to their readmission were analysed. Results: A total of 1,854 interventions were carried out on 1,739 patients during the aforementioned (study) period. Of the remaining patients, 174 (10.2%) required readmission within 30 days of discharge. The main causes of readmission were problems related to the surgical wound (21.2% of all readmissions), followed by respiratory processes (18.8%). A total of 73.9% of readmissions occurred in patients who had undergone cranial surgery. Multiple comorbidities estimated by Charlson comorbidity index and length of hospital stay were identified as factors related to a higher readmission rate. Conclusions: The 30-day readmission rate observed in our series was 10.2%. Multiple comorbidity expressed by the Charlson comorbidity index and length of hospital stay were related to readmission.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Comorbidity ; Diagnosis-Related Groups ; Female ; Hospital Mortality ; Hospitals, General/statistics & numerical data ; Hospitals, University/statistics & numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects ; Patient Discharge/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Respiration Disorders/epidemiology ; Retrospective Studies ; Risk Factors ; Spain/epidemiology ; Surgical Wound Infection/epidemiology ; Young Adult
Language	Spanish
Publishing date	2016-09-15
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2151282-6
ISSN	1130-1473
ISSN	1130-1473
DOI	10.1016/j.neucir.2016.06.003
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Article ; Online: Spinal epidural abscess caused by Streptococcus agalactiae in an immunocompetent patient.

Vales Montero, Marta / Mateo Sierra, Olga / Romero Martínez, Julia / Fortea Gil, Fernando / Fernández Carballal, Carlos / Cuello, Juan Pablo

Medicina clinica

2019 Volume 153, Issue 7, Page(s) 290–292

Abstract: Background: Streptococcus agalactiae is an uncommon microorganism that causes spinal epidural abscess (SEA) and usually affects individuals with a predisposing condition or potential source of infection.: Case description: We present the case of an ... ...

Title translation	Absceso epidural espinal por Streptococcus agalactiae en un paciente inmunocompetente.
Abstract	Background: Streptococcus agalactiae is an uncommon microorganism that causes spinal epidural abscess (SEA) and usually affects individuals with a predisposing condition or potential source of infection. Case description: We present the case of an immunocompetent 53-year-old patient with an unremarkable past medical history who developed progressive low extremity weakness, bowel and bladder dysfunction and genital sensory impairment. A neurological exam on admission revealed flaccid proximal paraparesis, T10 sensory level, atonic anal sphincter and normal myotatic reflexes. Urgent neuroimaging showed a large thoracic epidural spinal abscess. Laminectomy and abscess drainage were immediately performed and systemic antibiotic treatment was initiated. Abscess cultures revealed Streptococcus agalactiae. After an exhaustive workup no predisposing factors or local or systemic source for the infection were found. Conclusions: We report a singular case of spinal epidural abscess caused by Streptococcus agalactiae in a healthy patient with no predisposing factors. This case also highlights the importance of an early diagnosis and treatment to obtain a better neurological outcome.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Combined Modality Therapy/methods ; Emergencies ; Epidural Abscess/diagnostic imaging ; Epidural Abscess/microbiology ; Epidural Abscess/therapy ; Humans ; Immunocompetence ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Streptococcal Infections/diagnostic imaging ; Streptococcal Infections/microbiology ; Streptococcal Infections/therapy ; Streptococcus agalactiae/isolation & purification
Chemical Substances	Anti-Bacterial Agents
Language	Spanish
Publishing date	2019-09-03
Publishing country	Spain
Document type	Case Reports ; Journal Article
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2019.06.003
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Article ; Online: DREZotomy in the treatment of deafferentation pain: review of results and analysis of predictive factors for success.

Montalvo Afonso, Antonio / Ruiz Juretschke, Fernando / González Rodrigálvarez, Rosario / Mateo Sierra, Olga / Iza Vallejo, Begoña / García Leal, Roberto / Valera Melé, Marc / Casitas Hernando, Vicente / Hernández Poveda, Jose Manuel / Fernández Carballal, Carlos

Neurocirugia (English Edition)

2020 Volume 32, Issue 1, Page(s) 1–9

Abstract: Background and objectives: The treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. ...

Title translation	Drezotomía en el tratamiento del dolor por desaferentización: revisión de resultados y análisis de factores predictores de éxito.
Abstract	Background and objectives: The treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. The objectives of this study are to demonstrate that DREZotomy continues to be an effective and safe treatment and to analyse predictive factors for success. Patients and methods: A retrospective study was conducted of all patients treated in our department with spinal DREZotomy from 1998 to 2018. Bulbar DREZotomy procedures were excluded. A visual analogue scale (VAS) and the reduction of routine medication were used as outcome variables. Demographic, clinical and operative variables were analysed as predictive factors for success. Results: A total of 27 patients (51.9% female) with a mean age of 53.7 years underwent DREZotomy. The main cause of pain was brachial plexus injury (BPI) (55.6%) followed by neoplasms (18.5%). The mean time of pain evolution was 8.4 years with a mean intensity of 8.7 according to the VAS, even though 63% of the patients had previously received neurostimulation therapy. Favourable outcome (≥50% pain reduction in the VAS) was observed in 77.8% of patients during the postoperative period and remained in 59.3% of patients after 22 months average follow-up (mean reduction of 4.9 points). This allowed for a reduction in routine analgesic treatment in 70.4% of them. DREZotomy in BPI-related pain presented a significantly higher success rate (93%) than the other pathologies (41.7%) (p=.001). No association was observed between outcome and age, gender, DREZ technique, duration of pain or previous neurostimulation therapies. There were six neurological complications, four post-operative transient neurological deficits and two permanent deficits. Conclusion: Dorsal root entry zone surgery is effective and safe for treating patients with deafferentation pain, especially after brachial plexus injury. It can be considered an alternative treatment after failed neurostimulation techniques for pain control. However, its indication should be considered as the first therapeutic option after medical therapy failure due to its good long-term results.
MeSH term(s)	Brachial Plexus ; Brachial Plexus Neuropathies ; Causalgia/etiology ; Causalgia/therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Nerve Roots/surgery
Language	Spanish
Publishing date	2020-05-04
Document type	Journal Article ; Review
ISSN	2529-8496
ISSN (online)	2529-8496
DOI	10.1016/j.neucir.2020.02.007
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Article ; Online: Normal tissue content impact on the GBM molecular classification.

Madurga, Rodrigo / García-Romero, Noemí / Jiménez, Beatriz / Collazo, Ana / Pérez-Rodríguez, Francisco / Hernández-Laín, Aurelio / Fernández-Carballal, Carlos / Prat-Acín, Ricardo / Zanin, Massimiliano / Menasalvas, Ernestina / Ayuso-Sacido, Ángel

Briefings in bioinformatics

2020 Volume 22, Issue 3

Abstract: Molecular classification of glioblastoma has enabled a deeper understanding of the disease. The four-subtype model (including Proneural, Classical, Mesenchymal and Neural) has been replaced by a model that discards the Neural subtype, found to be ... ...

Abstract	Molecular classification of glioblastoma has enabled a deeper understanding of the disease. The four-subtype model (including Proneural, Classical, Mesenchymal and Neural) has been replaced by a model that discards the Neural subtype, found to be associated with samples with a high content of normal tissue. These samples can be misclassified preventing biological and clinical insights into the different tumor subtypes from coming to light. In this work, we present a model that tackles both the molecular classification of samples and discrimination of those with a high content of normal cells. We performed a transcriptomic in silico analysis on glioblastoma (GBM) samples (n = 810) and tested different criteria to optimize the number of genes needed for molecular classification. We used gene expression of normal brain samples (n = 555) to design an additional gene signature to detect samples with a high normal tissue content. Microdissection samples of different structures within GBM (n = 122) have been used to validate the final model. Finally, the model was tested in a cohort of 43 patients and confirmed by histology. Based on the expression of 20 genes, our model is able to discriminate samples with a high content of normal tissue and to classify the remaining ones. We have shown that taking into consideration normal cells can prevent errors in the classification and the subsequent misinterpretation of the results. Moreover, considering only samples with a low content of normal cells, we found an association between the complexity of the samples and survival for the three molecular subtypes.
MeSH term(s)	Biomarkers, Tumor/biosynthesis ; Biomarkers, Tumor/genetics ; Brain/metabolism ; Brain/pathology ; Brain Neoplasms/classification ; Brain Neoplasms/genetics ; Brain Neoplasms/metabolism ; Brain Neoplasms/pathology ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Glioblastoma/classification ; Glioblastoma/genetics ; Glioblastoma/metabolism ; Glioblastoma/pathology ; Humans ; Male ; Microdissection
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2020-07-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Study
ZDB-ID	2068142-2
ISSN	1477-4054 ; 1467-5463
ISSN (online)	1477-4054
ISSN	1467-5463
DOI	10.1093/bib/bbaa129
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Article: Hypoglossal nerve paresis secondary to anterior approach of upper cervical spine followed by spontaneous recovery.

Vargas López, Antonio José / González Quarante, Laín Hermes / Gil de Sagredo Del Corral, Oscar Lucas / Montalvo Afonso, Antonio / Fernández Carballal, Carlos

Journal of spine surgery (Hong Kong)

2017 Volume 3, Issue 3, Page(s) 481–483

Abstract: We describe an exceptional complication of cervical spine surgery in a 63-year-old male. He suffered the impact of a beam to the top of his head. During evaluation in the emergency room he reported intense neck pain with no other neurological symptoms or ...

Abstract	We describe an exceptional complication of cervical spine surgery in a 63-year-old male. He suffered the impact of a beam to the top of his head. During evaluation in the emergency room he reported intense neck pain with no other neurological symptoms or findings on physical examination. Spine computed tomography (CT) showed C3 vertebral body fracture that required surgical stabilization. A right side anterior approach to upper cervical spine with C3 corpectomy and placement of iliac bone autograft was performed. After surgery the patient presented dysphagia, dysarthria and limitation tongue mobility to the right side. These findings were consistent with hypoglossal neuropraxia probably related to soft tissue traction generated by the upper part of the self-retaining retractor. After discharge the patient experienced spontaneous improvement of hypoglossal paresis.
Language	English
Publishing date	2017-10-06
Publishing country	China
Document type	Case Reports
ZDB-ID	2874556-5
ISSN	2414-4630 ; 2414-469X
ISSN (online)	2414-4630
ISSN	2414-469X
DOI	10.21037/jss.2017.06.19
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Article ; Online: Long-term Thalamic Deep Brain Stimulation for Essential Tremor: Clinical Outcome and Stimulation Parameters.

Rodríguez Cruz, Pedro M / Vargas, Antonio / Fernández-Carballal, Carlos / Garbizu, Jose / De La Casa-Fages, Beatriz / Grandas, Francisco

Movement disorders clinical practice

2016 Volume 3, Issue 6, Page(s) 567–572

Abstract: Background: The reasons underlying the loss of efficacy of deep brain stimulation (DBS) of the thalamic nucleus ventralis intermedius (VIM-DBS) over time in patients with essential tremor are not well understood.: Methods: Long-term clinical outcome ... ...

Abstract	Background: The reasons underlying the loss of efficacy of deep brain stimulation (DBS) of the thalamic nucleus ventralis intermedius (VIM-DBS) over time in patients with essential tremor are not well understood. Methods: Long-term clinical outcome and stimulation parameters were evaluated in 14 patients with essential tremor who underwent VIM-DBS. The mean ± standard deviation postoperative follow-up was 7.7 ± 3.8 years. At each visit (every 3-6 months), tremor was assessed using the Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) and stimulation parameters were recorded (contacts, voltage, frequency, pulse width, and total electrical energy delivered by the internal generator [TEED Results: The mean reduction in FTM-TRS score was 73.4% at 6 months after VIM-DBS surgery ( Conclusions: The current findings suggest that the waning effect of VIM-DBS over time in patients with essential tremor may be the consequence of a combination of factors. Superimposed on the progression of the disease, tolerance can occur during the early years of stimulation.
Language	English
Publishing date	2016-03-01
Publishing country	United States
Document type	Journal Article
ISSN	2330-1619
ISSN (online)	2330-1619
DOI	10.1002/mdc3.12337
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Article: Abordaje anterior y anterolateral en el tratamiento de la compresión medular metastásica a nivel torácico y lumbar.

Vargas López, Antonio José / Fernández Carballal, Carlos / Panadero Useros, Teresa / Aracil González, Cristina / Garbizu Vidorreta, José Manuel / González Rodrigálvarez, Rosario

Neurocirugia (Asturias, Spain)

2015 Volume 26, Issue 3, Page(s) 126–136

Abstract: Objectives: To analyse the results of the anterior and anterolateral approaches in the treatment of thoracic and lumbar spine metastasis.: Materials and methods: Patients who underwent surgery between 2003 and 2012 in our institution using an ... ...

Title translation	Anterior and anterolateral approach in the treatment of thoracic and lumbar vertebral metastasis causing spinal cord compression.
Abstract	Objectives: To analyse the results of the anterior and anterolateral approaches in the treatment of thoracic and lumbar spine metastasis. Materials and methods: Patients who underwent surgery between 2003 and 2012 in our institution using an anterior or an anterolateral approach for the treatment of thoracic or lumbar spine metastasis were retrospectively reviewed. Results: Twenty-two patients with median age of 49.5 years (26-73 years) and median follow-up of 9.5 months (0-96 months) were analysed. The most common primary malignancies were renal cell carcinomas and breast adenocarcinomas. Before the intervention, 12 (54.5%) patients were able to walk (Frankel D and E). Preoperative arteriography was performed in 14 (63.6%) patients, and 7 (31.8%) of them underwent tumour embolisation. Medical complications occurred in 5 (22.7%) patients during the immediate postoperative period, 2 (9.1%) of whom died. At the end of follow-up, 16 (72%) of the remaining 20 patients were able to walk (Frankel D and E). Ninety percent of the patients could reduce at least 50% of their analgesic drug requirements. During follow-up 16 patients died, with a median survival of 10 months (range 0-48 months). Conclusions: Resection of thoracolumbar vertebral metastases by an anterior/anterolateral approach, despite its considerable risk of morbidity and mortality, offers the possibility of significant improvement in the quality of life of the patient; and it does so not only by preserving or restoring their ability to walk but also by ameliorating pain. Preoperative angiography, considering the embolisation of the lesion, is an important tool.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Orthopedic Procedures/methods ; Retrospective Studies ; Spinal Cord Compression/etiology ; Spinal Cord Compression/surgery ; Spinal Neoplasms/complications ; Spinal Neoplasms/secondary ; Spinal Neoplasms/surgery ; Thoracic Vertebrae
Language	Spanish
Publishing date	2015-05
Publishing country	Spain
Document type	Clinical Study ; English Abstract ; Journal Article
ZDB-ID	2151282-6
ISSN	1130-1473
ISSN	1130-1473
DOI	10.1016/j.neucir.2014.11.003
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Article ; Online: Angiocentric Glioma in an Elderly Patient: Case Report and Review of the Literature.

Gonzalez-Quarante, Lain Hermes / Fernández Carballal, Carlos / Agarwal, Vijay / Vargas Lopez, Antonio J / Gil de Sagredo Del Corral, Oscar Lucas / Sola Vendrell, Emma

World neurosurgery

2017 Volume 97, Page(s) 755.e5–755.e10

Abstract: Background: Angiocentric glioma is a very uncommon low-grade tumor, predominantly occurring in pediatric patients, that was first described in 2005 and was codified 2 years later as a new central nervous system primary tumor. We herein report an ... ...

Abstract	Background: Angiocentric glioma is a very uncommon low-grade tumor, predominantly occurring in pediatric patients, that was first described in 2005 and was codified 2 years later as a new central nervous system primary tumor. We herein report an exceptionally rare case of an elderly patient with angiocentric glioma. Only one additional case of angiocentric glioma in a patient older than 65 years has been hitherto reported. Case description: An 83-year-old male patient presented at our institution complaining of a 1-month history of progressive weakness of his right hand and difficulty performing fine movements. Magnetic resonance imaging of the brain was performed, and fluid-attenuated inversion recovery and T2-hyperintense diffuse cortico-subcortical lesion were reported. A neuronavigation-guided frontal craniotomy was performed to expose the premotor cortex, motor cortex, Rolandic sulcus, and postcentral gyrus. Intraoperative mapping showed that the tumor was close to the shoulder area. Therefore, only partial resection was safely feasible. Pathology report described astrocytic neoplastic cells affecting mainly the cortex and piamater with the classic finding of subpial palisading, with no endothelial invasion or atypia. Neoplastic cells were positive for glial fibrillary acidic protein, epithelial membrane antigen, Wilms tumor protein-1, P16, and P53. Low proliferative activity was seen (Ki-67 < 2%). Abundant gliovascular structures were also reported. Conclusions: Considering the morphologic and immunohistochemical data, the final pathologic diagnosis was angiocentric glioma. Furthermore, a thorough review of the literature was performed with the purpose of updating and summarizing the main clinical, radiologic, and pathologic features of this rare tumor.
MeSH term(s)	Aged, 80 and over ; Brain Neoplasms/classification ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Diagnosis, Differential ; Evidence-Based Medicine ; Glioma/classification ; Glioma/pathology ; Glioma/surgery ; Humans ; Male ; Rare Diseases/pathology ; Rare Diseases/surgery ; Treatment Outcome
Language	English
Publishing date	2017-01
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2016.10.034
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