Asociación entre enfermedad periodontal y demencia. Revisión de la bibliografía

Introduction

Periodontal disease and dementia are very prevalent, especially in elderly populations. Multiple studies have shown a link between these diseases; however, the conditions are highly heterogeneous and so is the diagnostic methodology, which may hinder interpretation and comparison of the results. The aim of this article is to provide a critical review of the literature linking these 2 processes.

Opciones de monitorización neurofisiológica en la resección de tumoraciones cerebrales. Documento de consenso entre el Grupo de Trabajo de Neurooncología de la Sociedad Española de Neurocirugía (SENEC) y la Sociedad Española de Neurofisiología Clínica (SENFC)

Brain tumours located in or in proximity to eloquent areas are a significant neurosurgical challenge. Performing this kind of surgery with neurophysiological monitoring to improve resections with reduced permanent focal neurological deficit has become widely accepted in the literature. However, how to conduct this monitoring, the exact definition of an eloquent area and whether to perform this surgery with the patient awake or asleep are still subject to rigorous scientific debate.Members of the Neuro-oncology Working Group (GTNO) of the Spanish Society of Neurosurgery (SENEC) and members of the Spanish Society of Clinical Neurophysiology (SENFC) have published a consensus statement to explain the different neurophysiological monitoring options currently available in awake and asleep patients to obtain better surgical resection without neurological deficits. An exhaustive review of the literature has also been conducted.     

Medidas de protección radiológica: implicaciones en el diseño de quirófanos de neurocirugía

Objective

To describe pros and cons of some radiation protection measures and the implications on the design of a neurosurgery operating room.

Importancia de la arteriografía cerebral y la monitorización neurofisiológica intraoperatoria en la endarterectomía carotídea

It is an increasingly common practice to indicate a carotid endarterectomy procedure based on the information provided by non-invasive tests like Duplex ultrasound, MR angiography or CT angiography, thereby obviating the performance of a conventional cerebral angiography. We present a case of symptomatic left carotid artery 80% stenosis in which cerebral angiography showed absence of the right A1 segment and bilateral anterior cerebral artery territories that filled only from a left injection. Just 90 seconds after carotid artery clamping at the neck, brain oximetry and somatosensory evoked potentials significantly dropped, that recovered after immediate clamp removal. Endarterectomy was dismissed and a carotid stent was successfully placed. This case highlights the importance of knowing the dynamics of cerebral blood circulation distal to the stenosis. If endarterectomy had been attempted, unawareness of the information provided by the cerebral angiography would have likely result in severe bi-hemispheric ischemia.     

Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología

Introduction

Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted.

Neuromodulación en cefaleas y neuralgias craneofaciales: Guía de la Sociedad Española de Neurología y de la Sociedad Española de Neurocirugía

IntroductionNumerous invasive and non-invasive neuromodulation devices have been developed and applied to patients with headache and neuralgia in recent years. However, no updated review addresses their safety and efficacy, and no healthcare institution has issued specific recommendations on their use for these 2 conditions.MethodsNeurologists from the Spanish Society of Neurology's (SEN) Headache Study Group and neurosurgeons specialising in functional neurosurgery, selected by the Spanish Society of Neurosurgery (SENEC), performed a comprehensive review of articles on the MEDLINE database addressing the use of the technique in patients with headache and neuralgia.ResultsWe present an updated review and establish the first set of consensus recommendations of the SEN and SENC on the use of neuromodulation to treat headache and neuralgia, analysing the current levels of evidence on its effectiveness for each specific condition.ConclusionsCurrent evidence supports the indication of neuromodulation techniques for patients with refractory headache and neuralgia (especially migraine, cluster headache, and trigeminal neuralgia) selected by neurologists and headache specialists, after pharmacological treatment options are exhausted. Furthermore, we recommend that invasive neuromodulation be debated by multidisciplinary committees, and that the procedure be performed by teams of neurosurgeons specialising in functional neurosurgery, with acceptable rates of morbidity and mortality.     

Recomendaciones para la coordinación de los servicios de Neurología y Neurorradiología en la atención a pacientes con esclerosis múltiple

IntroductionMagnetic resonance imaging (MRI) is widely used for the diagnosis and follow-up of patients with multiple sclerosis (MS). Coordination between Neurology and Neuroradiology departments is crucial for performing and interpreting radiological studies as efficiently and as accurately as possible. However, improvements can be made in the communication between these departments in many Spanish hospitals.MethodsA panel of 17 neurologists and neuroradiologists from 8 Spanish hospitals held in-person and online meetings to draft a series of good practice guidelines for the coordinated management of MS. The drafting process included 4 phases: 1) establishing the scope of the guidelines and the methodology of the study; 2) literature review on good practices or recommendations on the use of MRI in MS; 3) discussion and consensus between experts; and 4) validation of the contents.ResultsThe expert panel agreed a total of 9 recommendations for improving coordination between neurology and neuroradiology departments. The recommendations revolve around 4 main pillars: 1) standardising the process for requesting and scheduling MRI studies and reports; 2) designing common protocols for MRI studies; 3) establishing multidisciplinary committees and coordination meetings; and 4) creating formal communication channels between both departments.ConclusionsThese consensus recommendations are intended to optimise coordination between neurologists and neuroradiologists, with the ultimate goal of improving the diagnosis and follow-up of patients with MS.     

Anatomía microquirúrgica en 3 D del tracto corticoespinal y de la vía del lemnisco basada en microdisección de fibras y demostración a través de tractografía

Objective

To demonstrate tridimensionally the anatomy of the cortico-spinal tract and the medial lemniscus, based on fiber microdissection and diffusion tensor tractography (DTT).