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Úrculo-Bareño E, Poza-Aldea JJ, Larrea J, Armendariz M, Elua A, Samprón N, Undabeitia J. [Progressive Brown-Sequard syndrome secondary to idiopathic spinal cord herniation: clinico-radiological and surgical correlations]. Rev Neurol 2020; 71:26-30. [PMID: 32583412 DOI: 10.33588/rn.7101.2020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Idiopathic medullary herniation is an infrequent disease, which shows up in clinical form as a progressive mielopathy, most commonly known as the Brown-Sequard syndrome. Its anatomical base is a dural defect where a portion of anterior spinal cord gets progressively incarcerated. The MRI and myelo-CT scan show a bending of the spinal cord in the form of a «bell tent» towards the anterior dural sheath at the mid-dorsal portion mainly. CASE REPORT A 37 year old male, who was diagnosed of idiopathic medullary herniation and surgically treated by our own developed technique, reporting its neuroradiological, anatomo-surgical and clinical correlation. CONCLUSION Treatment should be individualized, as no standard surgical technique has been established up to the present.
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Affiliation(s)
| | | | - J Larrea
- Hospital Universitario Donostia, San Sebastián, España
| | - M Armendariz
- Hospital Universitario Donostia, San Sebastián, España
| | - A Elua
- Hospital Universitario Donostia, San Sebastián, España
| | - N Samprón
- Hospital Universitario Donostia, San Sebastián, España
| | - J Undabeitia
- Hospital Universitario Donostia, San Sebastián, España
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Undabeitia J, Torres-Bayona S, Samprón N, Arrázola M, Bollar A, Armendariz M, Torres P, Ruiz I, Caballero M, Egaña L, Querejeta A, Villanua J, Pardo E, Etxegoien I, Liceaga G, Urtasun M, Michan M, Emparanza J, Aldaz P, Matheu A, Úrculo E. Indirect costs associated with glioblastoma: Experience at one hospital. Neurología (English Edition) 2018. [DOI: 10.1016/j.nrleng.2016.05.009] [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: 10/18/2022] Open
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Undabeitia J, Torres-Bayona S, Samprón N, Arrázola M, Bollar A, Armendariz M, Torres P, Ruiz I, Caballero MC, Egaña L, Querejeta A, Villanua J, Pardo E, Etxegoien I, Liceaga G, Urtasun M, Michan M, Emparanza JI, Aldaz P, Matheu A, Úrculo E. Indirect costs associated with glioblastoma: Experience at one hospital. Neurologia 2016; 33:85-91. [PMID: 27449154 DOI: 10.1016/j.nrl.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 11/12/2015] [Revised: 04/27/2016] [Accepted: 05/04/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described. MATERIAL AND METHOD We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries. RESULTS We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015). DISCUSSION Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
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Affiliation(s)
- J Undabeitia
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España.
| | - S Torres-Bayona
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - N Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - M Arrázola
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España
| | - A Bollar
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - M Armendariz
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - P Torres
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España
| | - I Ruiz
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España
| | - M C Caballero
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Anatomía Patológica, Hospital Universitario Donostia, Donostia, España
| | - L Egaña
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Médica, Hospital Universitario Donostia, Donostia, España
| | - A Querejeta
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Oncología Radioterápica, Hospital Universitario Donostia, Donostia, España
| | - J Villanua
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurorradiología, Osatek, Hospital Universitario Donostia, Donostia, España
| | - E Pardo
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España
| | - I Etxegoien
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Radiología, Hospital Universitario Donostia, Donostia, España
| | - G Liceaga
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Farmacología, Hospital Universitario Donostia, Donostia, España
| | - M Urtasun
- Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Servicio de Neurología, Hospital Universitario Donostia, Donostia, España
| | - M Michan
- Servicio de Medicina Interna, Hospital Universitario Donostia, Donostia, España
| | - J I Emparanza
- Servicio de Epidemiología Clínica, Hospital Universitario Donostia, Donostia, España
| | - P Aldaz
- Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España
| | - A Matheu
- Grupo de Neuro-oncología, Instituto de Investigación Sanitaria Biodonostia, Donostia, España
| | - E Úrculo
- Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, España; Comité de Neurooncología, Hospital Universitario Donostia, Donostia, España; Departamento de Cirugía y Radiología y Medicina Física, Universidad del País Vasco, Donostia, España
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Undabeitia J, Castle M, Arrazola M, Pendleton C, Ruiz I, Úrculo E. [Multiple extraneural metastasis of glioblastoma multiforme]. An Sist Sanit Navar 2015; 38:157-61. [PMID: 25963474 DOI: 10.23938/assn.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Glioblastoma multiforme is the most frequent primary tumor in the brain. Despite improvements in its surgical, chemotherapy and radiotherapy treatment, prognosis remains poor. Extracranial metastases of glioblastoma are a rare complication in this disease. Its appearance has been described in lung, liver, bone or lymph nodes. CASE REPORT We describe the case of a 20 year-old patient who complained of a subacute-onset headache. In the MRI an enhancing right temporal lesion was detected suggesting a high grade glioma as first diagnosis. Surgery was performed, obtaining a gross total resection of the lesion. Our patient underwent adjuvant radiotherapy and chemotherapy treatment, according to our hospital's protocol. Five months after initial surgery our patient complained of chest pain and a hacking cough. A thoracic-abdominal-pelvic CT scan was obtained, which showed bilateral lung infiltrates with pleural effusion, a pancreatic nodule and several vertebral lytic lesions. The lung lesions were biopsied. The pathologic diagnosis was metastatic glioblastoma multiforme. The patient died eight months after initial diagnosis. CONCLUSION Extracranial metastases of glioblastoma remain a rare event although its incidence is increasing, probably due to the improvement in survival among these patients and better imaging techniques. The mechanisms for extracranial dissemination of glioblastoma are not entirely known, as several theories exist in this regard. Physicians must be aware of this complication and keep it in mind as a differential diagnosis to improve the quality of life of our patients.
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Affiliation(s)
- J Undabeitia
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, 20080, Spain.
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