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Orduna Martínez J, López Pisón J, Curto Simón B, García-Iñiguez JP, Samper Villagrasa P, Lafuente Hidalgo M. Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature. Neurocirugia (Astur : Engl Ed) 2022; 33:157-164. [PMID: 35725217 DOI: 10.1016/j.neucie.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/14/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVE Arachnoid cysts (ACs) are relatively frequent lesions related to different neurological symptoms, being mostly incidentally diagnosed. This study aims to clarify whether AC surgery in epileptic patients is useful in their treatment. MATERIAL AND METHODS The patients registered in the database of the Neuropediatrics Section from May 1990 to August 2019 are analyzed retrospectively. Patients in whom the diagnosis of ACs and epilepsy coincide are studied. The location, size and number of ACs, neurological development, age at diagnosis, follow-up time, the performance of surgery on the cyst, evolution, anatomical relationship between brain electrical activity and location of AC, and type of epilepsy are analyzed. RESULTS After analyzing the database, we found 1881 patients diagnosed with epilepsy, of which 25 had at least one intracranial AC. In 9 of the patients, cerebral or genetic pathologies were the cause of epilepsy. Of the other 16, only 2 patients showed that the type of epilepsy and the epileptogenic focus coincided with the location of the AC; one of them was surgically treated without success, and the other one remained asymptomatic without receiving medical or surgical treatment. CONCLUSIONS Although it is necessary to design a prospective study to establish causality, the results of our research and the available literature suggest that there is no causal relationship between the presence of ACs and epilepsy. The study and treatment of these patients should be carried out in a multidisciplinary epilepsy surgery unit, without initially assuming that the AC is the cause of epilepsy.
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Affiliation(s)
| | - Javier López Pisón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
| | - Beatriz Curto Simón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
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Martínez JO, Pisón JL, Simón BC, García-Iñiguez JP, Villagrasa PS, Hidalgo ML. Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature. Neurocirugia (Astur) 2021; 33:S1130-1473(21)00033-6. [PMID: 33875379 DOI: 10.1016/j.neucir.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/28/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVE Arachnoid cysts (ACs) are relatively frequent lesions related to different neurological symptoms, being mostly incidentally diagnosed. This study aims to clarify whether AC surgery in epileptic patients is useful in their treatment. MATERIAL AND METHODS The patients registered in the database of the Neuropediatrics Section from May 1990 to August 2019 are analyzed retrospectively. Patients in whom the diagnosis of ACs and epilepsy coincide are studied. The location, size and number of ACs, neurological development, age at diagnosis, follow-up time, the performance of surgery on the cyst, evolution, anatomical relationship between brain electrical activity and location of AC, and type of epilepsy are analyzed. RESULTS After analyzing the database, we found 1881 patients diagnosed with epilepsy, of which 25 had at least one intracranial AC. In 9 of the patients, cerebral or genetic pathologies were the cause of epilepsy. Of the other 16, only 2 patients showed that the type of epilepsy and the epileptogenic focus coincided with the location of the AC; one of them was surgically treated without success, and the other one remained asymptomatic without receiving medical or surgical treatment. CONCLUSIONS Although it is necessary to design a prospective study to establish causality, the results of our research and the available literature suggest that there is no causal relationship between the presence of ACs and epilepsy. The study and treatment of these patients should be carried out in a multidisciplinary epilepsy surgery unit, without initially assuming that the AC is the cause of epilepsy.
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Affiliation(s)
| | - Javier López Pisón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
| | - Beatriz Curto Simón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
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Clavero Adell M, Ayerza Casas A, Jiménez Montañés L, Palanca Arias D, López Ramón M, Alcalá Nalvaiz JT, Samper Villagrasa P. Evolution of strain and strain rate values throughout gestation in healthy fetuses. Int J Cardiovasc Imaging 2019; 36:59-66. [PMID: 31664680 DOI: 10.1007/s10554-019-01695-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/03/2019] [Indexed: 12/14/2022]
Abstract
Myocardial deformation by speckle tracking echocardiography is a novel method for evaluating cardiac function. To test the hypothesis that right ventricular and left ventricular function have age-specific patterns of development, we tracked the evolution of ventricular strain mechanics by speckle tracking echocardiography in the fetus. We conducted a retrospective cross sectional echocardiography study in 154 healthy fetuses, and characterized cardiac function by measuring right and left ventricles global longitudinal strain and strain rate. Comparison of the data of both ventricles according to gestational age was carried out. The magnitudes of right and left ventricle global longitudinal strain show wide range values and decreased throughout gestation. Strain values are higher in left ventricle compared to the right one throughout pregnancy. Strain rate values were similar over gestation in each ventricle, but the magnitudes declined overtime in the right and left ventricle. The maturational patterns of left and right strain are gestational specific. With accepted physiological maturation patterns in healthy subjects, these myocardial deformation parameters can provide a valid basis that allows comparison between health and disease.
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Affiliation(s)
- Marcos Clavero Adell
- Miguel Servet University Hospital, Paseo Isabel La Católica, 1-3, 50009, Zaragoza, Spain.
| | | | | | | | - Marta López Ramón
- Pediatric Cardiology Unit, Miguel Servet University Hospital, Zaragoza, Spain
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Corella Aznar EG, Ayerza Casas A, Carboné Bañeres A, Calvo Escribano MÁC, Labarta Aizpún JI, Samper Villagrasa P. Quality of life and chronic health conditions in childhood acute leukaemia survivors. Med Clin (Barc) 2018; 152:167-173. [PMID: 30017209 DOI: 10.1016/j.medcli.2018.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Survival of childhood acute lymphoblastic leukaemia involves an increasing risk of long-term morbidities. Due to the impact of cancer treatment and comorbidities, AL survivors may experience a decrease in their health-related quality of life. OBJECTIVE We aimed to describe the long-term comorbidities, related quality of life and their development predictors in these survivors. METHODS cross-sectional study of 54 survivors aged ≥18 and who have a survival rate of more than 10 years. Quality of life was assessed by personal interview using SF-36 questionnaire. RESULTS 53.7% of AL survivors developed more than one comorbidity (24.7% hypothyroidism; 20.3% obesity; 14.8% metabolic syndrome; 18.5% subclinical cardiac dysfunction); 20.3% of them were severe. 73.3% of high-risk leukaemias and 66.6% of patients treated with radiotherapy or stem cells transplantation reported long-term comorbidity, P<.05. Global quality of live score was: 86.3 (14) (classified as very good). Patients with high-risk acute leukaemia (83.2 vs. 89.5), severe long-term comorbidities (80.4 vs. 89.7) and females (81.8 vs. 89.9), reported worse quality of life, P<.05. Physical summary score was worse in: obese (80 vs. 92) and hypothyroid (84.9 vs. 92.4) and radiotherapy-treated survivors (82.3 vs. 87.5); mental summary was worse in survivors with hypogonadism (68.2 vs. 86.3) and trasplanted patients (77.2 vs. 83.1), P<.05. CONCLUSIONS Acute leukaemia survivors reported an increase prevalence of chronic comorbidities, related to cancer-treatment. Despite a decrease in scores for certain physical or mental items, global quality of life was very good in all acute leukaemia survivors, even better than compared with the general population.
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Affiliation(s)
| | | | - Ana Carboné Bañeres
- Oncohematología Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, España
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Aurensanz Clemente E, Ayerza Casas A, Samper Villagrasa P, Ruiz Frontera P, Bueno Lozano G. Evaluación de la función cardiaca en un grupo de niños pequeños para la edad gestacional en edad escolar en tratamiento con hormona de crecimiento. Med Clin (Barc) 2017; 148:101-106. [DOI: 10.1016/j.medcli.2016.09.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 12/30/2022]
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Aurensanz Clemente E, Samper Villagrasa P, Ayerza Casas A, Ruiz Frontera P, Bueno Lozano O, Moreno Aznar LA, Bueno Lozano G. [Effects of growth hormone treatment on anthropometrics, metabolic risk, and body composition variables in small for gestational age patients]. An Pediatr (Barc) 2016; 86:240-248. [PMID: 27267657 DOI: 10.1016/j.anpedi.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/25/2016] [Accepted: 05/03/2016] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Small for gestational age (SGA) children without catch-up growth can benefit from treatment with growth hormone (rhGH). However, they should be monitored very closely because they are at increased risk of metabolic syndrome. MATERIAL AND METHOD A group of 28 SGA children with a mean age of 8.79 years and undergoing treatment with rhGH were selected for evaluation. Over the course of 4 years, an annual evaluation was performed on the anthropometric variables (weight, height, body mass index [BMI], growth rate, blood pressure and waist perimeter), metabolic risk variables (glycaemia, glycosylated haemoglobin, cholesterol ratio, insulinaemia, insulin-like growth factor 1[IGF1], IGF binding protein-3 [IGFBP-3], IGF1/IGFBP3 ratio, and HOMA index), and body composition variables. RESULTS Treatment with rhGH was associated with a significant increase in height (-2.76±.11 SD to -1.53±.17 SD, P=.000), weight (-1.50±.09 SD to -1.21±.13 SD; P=.016), and growth rate (-1.43±.35 SD to .41±.41 SD; P=.009), without a corresponding change in the BMI. Insulinaemia (9.33±1.93mU/ml to 16.55±1.72mU/ml; P=.044) and the HOMA index (3.63±.76 to 6.43±.67; P=.042) increased, approaching insulin resistance levels. No changes were observed in the lipid profile. Body composition changes were observed, with a significant increase in lean mass (73.19±1.26 to 78.74±1.31; P=.037), and a reduction of fat mass (26.81±1.26 to 21.26±1.31; P=.021). CONCLUSION Treatment with rhGH is effective for improving anthropometric variables in SGA patients who have not experienced a catch-up growth. It also produces changes in body composition, which may lead to a reduction in risk of metabolic syndrome. However, some insulin resistance was observed. It is important to follow up this patient group in order to find out whether these changes persist into adulthood.
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Affiliation(s)
| | | | - Ariadna Ayerza Casas
- Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España; Departamento de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Pablo Ruiz Frontera
- Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Olga Bueno Lozano
- Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España
| | - Luis Alberto Moreno Aznar
- Growth Exercise Nutrition and Development (GENUD) Research Group, España; Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Gloria Bueno Lozano
- Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España
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Ochoa Gómez L, López Pisón J, Fernando Martínez R, Fuertes Rodrigo C, Samper Villagrasa P, Monge Galindo L, Peña Segura JL, García Jiménez MC. Pronóstico de las epilepsias sintomáticas según la edad de inicio, controladas durante tres años en una unidad de neuropediatría de referencia regional. Rev Neurol 2016. [DOI: 10.33588/rn.6206.2015455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ochoa Gómez L, López Pisón J, Fernando Martínez R, Fuertes Rodrigo C, Samper Villagrasa P, Monge Galindo L, Peña Segura JL. Estudio descriptivo de las epilepsias no sintomáticas según la edad de inicio en una unidad de neuropediatría de referencia regional. Rev Neurol 2016. [DOI: 10.33588/rn.6310.2016111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ochoa Gómez L, López Pisón J, Fuertes Rodrigo C, Fernando Martínez R, Samper Villagrasa P, Monge Galindo L, Peña Segura JL. Pronóstico de las epilepsias no sintomáticas según la edad de inicio, controladas durante tres años en una unidad de neuropediatría de referencia regional. Rev Neurol 2016. [DOI: 10.33588/rn.6204.2015463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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