Boris Zurita Cueva - Academia.edu (original) (raw)

Papers by Boris Zurita Cueva

Revista colombiana de psiquiatría/Revista colombiana de psiquiatria, May 1, 2024

Neurotarget, Nov 1, 2009

Ten patients with advanced Parkinson's disease underwent radiofrecuency subthalamotomy at the cau... more Ten patients with advanced Parkinson's disease underwent radiofrecuency subthalamotomy at the caudal zona incerta and pre-rubral field of Forel, just bellow the thalamic ventral intermediate nucleus (Vim). Motor function was assessed by applying the UPDRS III, Hoehn & Yarhr, Schwab & England scales, preoperatively in "ON" state and 6 and 12 months postoperatively. Following surgery tremor score improved by 80%. There were no complications. The procedure is safe and effective for treatment patients with advanced Parkinson's disease.

Neurotarget, May 1, 2011

Se describe un método rápido y fácil para encontrar el núcleo subtálamico mediante las imágenes e... more Se describe un método rápido y fácil para encontrar el núcleo subtálamico mediante las imágenes estereotáxicas de la tomografía computarizada (TC). Consiste en la identificación visual del núcleo subtalámico en el corte axial a 4 milímetros por debajo de la línea intercomisural CA-CP (CA, comisura anterior; CP, comisura posterior) al reconocer varias estructuras anatómicas típicas del corte, con la ayuda del atlas de Talairach. A este nivel, el extremo posterior del tercer ventrículo está situado a 2-3 mm por detrás del punto medio intercomisural; a 12 mm por fuera de este punto se sitúa la división somatomotora del núcleo subtalámico, en la mayoría de los casos.

Neurotarget, Nov 1, 2017

RESUMEN Se describe el caso de un paciente con hemiparkinson con predominio de temblor. El pacien... more RESUMEN Se describe el caso de un paciente con hemiparkinson con predominio de temblor. El paciente fue sometido a tratamiento con radiofrecuencia estereotáxica a nivel de zona incerta caudal (ZI), con resultado regular; en la misma intervención, se decidió realizar una lesión adicional en el globo pálido interno, cediendo totalmente el temblor. Se describe la técnica quirúrgica utilizada y se discute el papel del globo pálido interno (Gpi) en el temblor parkinsoniano.

Interdisciplinary Neurosurgery, Feb 29, 2024

We described a safe surgical corridor to dorsal medulla cavernous malformation. No deficits appea... more We described a safe surgical corridor to dorsal medulla cavernous malformation. No deficits appeared in the postoperative period.

Research Square (Research Square), Nov 6, 2023

Some patients with autism and severe intellectual disability may experience uncontrolled aggressi... more Some patients with autism and severe intellectual disability may experience uncontrolled aggression, causing serious injury or harm to others, and the therapeutic ineffectiveness of traditional pharmacological and behavioral treatment may aggravate symptoms. Deep brain stimulation (DBS) has been tested in patients with little evidence in children and adolescents. Therefore, we analyzed the e cacy and safety of DBS in refractory aggression in pediatric subjects with autism (ASD) and severe intelligence de cit (ID). Methods: A meta-analytic review of Web of Science (WOS) and Scopus articles, following Prisma criteria. A total of 555 articles were identi ed, but after applying the inclusion criteria, only 18 were analyzed. The review of the registries and the extraction of information was performed by 2 independent groups, to reduce the evaluator's bias. For the description of the results, pediatric patients with ASD or ID present in each registry, with an application of specialized scales (Overt aggression scale, OAS, and THE modi ed version of the OAS, MOAS) pre and post-DBS, with a clinical follow-up of at least 12 months, were considered valid. Clinical improvement was calculated using tests of aggressiveness. In each registry with available data and then pooling the means of all patients in the OAS and MOAS, the effect size of DBS (overall and per study) was estimated. Finally, the adapted NOS scale was applied to rate the studies' quality and level of bias. Results: In the studies analyzed, 65/100 were pediatric patients, with a mean age of 16.8 years. Most of the studies were conducted in South America and Europe. In all teams, aggressive behavior was intractable, but only 9 groups (53/65) applied specialized scales to measure aggressiveness, and of these, only 51 subjects had a follow-up of at least 12 months. Thus, in 48/51 a clinical improvement of patients was estimated (94.2%), with a considerable overall effect size (OAS: d=4.32; MOAS: d=1.46). However, adverse effects and complications were found in 13/65 subjects undergoing DBS. The brain target with the most evidence and the fewest side effects was the posteromedial hypothalamic nuclei (pHypN). Finally, applying the adapted NOS scale, quality, and bias, only 9 studies show the best indicators. Conclusion: An optimal level of e cacy was found in only half of the publications. This is mainly due to design errors and irrelevant information in the reports. We believe that DBS in intractable aggressiveness in children and adolescents with ASD and severe ID can be safe and effective if working groups apply rigorous criteria for patient selection, interdisciplinary assessments, objective scales for aggressiveness, and known surgical targets.

Some patients with autism and severe intellectual disability may experience uncontrolled aggressi... more Some patients with autism and severe intellectual disability may experience uncontrolled aggression, causing serious injury or harm to others, and the therapeutic ineffectiveness of traditional pharmacological and behavioral treatment may aggravate symptoms. Deep brain stimulation (DBS) has been tested in patients with little evidence in children and adolescents. Therefore, we analyzed the e cacy and safety of DBS in refractory aggression in pediatric subjects with autism (ASD) and severe intelligence de cit (ID). Methods: A meta-analytic review of Web of Science (WOS) and Scopus articles, following Prisma criteria. A total of 555 articles were identi ed, but after applying the inclusion criteria, only 18 were analyzed. The review of the registries and the extraction of information was performed by 2 independent groups, to reduce the evaluator's bias. For the description of the results, pediatric patients with ASD or ID present in each registry, with an application of specialized scales (Overt aggression scale, OAS, and THE modi ed version of the OAS, MOAS) pre and post-DBS, with a clinical follow-up of at least 12 months, were considered valid. Clinical improvement was calculated using tests of aggressiveness. In each registry with available data and then pooling the means of all patients in the OAS and MOAS, the effect size of DBS (overall and per study) was estimated. Finally, the adapted NOS scale was applied to rate the studies' quality and level of bias. Results: In the studies analyzed, 65/100 were pediatric patients, with a mean age of 16.8 years. Most of the studies were conducted in South America and Europe. In all teams, aggressive behavior was intractable, but only 9 groups (53/65) applied specialized scales to measure aggressiveness, and of these, only 51 subjects had a follow-up of at least 12 months. Thus, in 48/51 a clinical improvement of patients was estimated (94.2%), with a considerable overall effect size (OAS: d=4.32; MOAS: d=1.46). However, adverse effects and complications were found in 13/65 subjects undergoing DBS. The brain target with the most evidence and the fewest side effects was the posteromedial hypothalamic nuclei (pHypN). Finally, applying the adapted NOS scale, quality, and bias, only 9 studies show the best indicators. Conclusion: An optimal level of e cacy was found in only half of the publications. This is mainly due to design errors and irrelevant information in the reports. We believe that DBS in intractable aggressiveness in children and adolescents with ASD and severe ID can be safe and effective if working groups apply rigorous criteria for patient selection, interdisciplinary assessments, objective scales for aggressiveness, and known surgical targets.

Revista Ecuatoriana De Neurologia, 2004

Resumen: El abordaje subfrontal ha sido considerado durante años, mucho más traumático que el pte... more Resumen: El abordaje subfrontal ha sido considerado durante años, mucho más traumático que el pterional. Nosotros describimos brevemente algunos detalles técnicos, ventajas y desventajas del abordaje. Concluimos que el abordaje subfrontal con técnica tipo " keyhole " es tan efectivo como el pterional si está correctamente indicado. Abstract: Subfrontal keyhole approach has been considered more traumatic to the brain than the traditional pterional approach. We describe some technical tips and make recommendations to choose this approach to some specific target areas. We conclude that the subfrontal keyhole is as minimally invasive as the pterional approach if it is performed in the correct settings. Se han descrito múltiples abordajes quirúrgicos para la fosa anterior y media; la característica común de estos abordajes es la exposición relativamente grande del cerebro y retracción cerebral que a la larga nos traerá un aumento de la morbilidad postoperatoria, no relacionada a la lesión en sí misma. Existen abordajes que comparten el concepto de lo que se llama cirugía mínimamente invasiva, es decir, el abordaje lo mas pequeño posible con resultados posquirúrgicos óptimos. Desde el año 1974, en que Yasargil describió el abordaje pterional, la vía subfrontal para región selar y paraselar fue quedando poco a poco en el abandono. Los defensores de la vía pterional, preconizaban que esta brinda una menor distancia (20mm) de la superficie craneal hasta las estructuras de la base craneal, como son el nervio óptico, carótida supraclinoidea, etc. La distancia por vía subfrontal es de (55mm) aproximadamente. De este modo, se concluía que se produciría menos trauma quirúrgico por retracción cerebral por vía pterional (Seeger) (25, 32, 35, 36). Actualmente, con el advenimiento de la endoscopía y la vuelta a la popularidad de los abordajes " key –hole " por parte de Perneczky y su grupo, se pone a evaluación al cirujano entre las dos técnicas. El propósito de esta comunicación es dar a conocer las ventajas y desventajas de cada abordaje, procurar dar las indicaciones del abordaje subfrontal y sus limitaciones, para por último, concluir si realmente es invasivo o no.

Revista Ecuatoriana De Neurologia, 2001

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología

Revista Ecuatoriana De Neurologia, 2002

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología

Los autores realizan un analisis del manejo microquirurgico de los aneurismas intracraneales oper... more Los autores realizan un analisis del manejo microquirurgico de los aneurismas intracraneales operados en los ultimos catorce anos, correlacionando esta experiencia con el advenimiento de la cirugia endovascular. Se realiza una breve revision de la literatura actual. Los autores recomiendan que estas lesiones debieran ser manejadas, lo mas pronto posible, con clipaje microquirurgico o endovascularmente. Los mejores resultados en el clipaje se dan en pacientes jovenes con buen nivel neurologico, sin deficits secundarios a isquemia hemisferica, en aneurismas de menos de 10 mm, de circulacion anterior, saculares, sin evidencia de vasoespasmo radiologico (angiografia cerebral, doppler transcraneal). El tratamiento endovascular estaria recomendado en pacientes con mal nivel neurologico, mal estado general, en aneurismas de la circulacion posterior y como tratamiento complementario al clipaje definitivo, sobre todo en aneurismas grandes y complejos

Revista Ecuatoriana De Neurologia, 2000

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología Esta página está hospedada en www.medicosecuador.com Desea más información? Búsquela en medicosecuador.com

Revista Colombiana de Psiquiatría

Introducción: La pandemia del coronavirus continúa afectando a la salud mental del personal sanit... more Introducción: La pandemia del coronavirus continúa afectando a la salud mental del personal sanitario en Latinoamérica (LA).

Interdisciplinary Neurosurgery: Advanced Techniques, 2023

We described a safe surgical corridor to dorsal medulla cavernous malformations . No deficits ap... more We described a safe surgical corridor to dorsal medulla cavernous malformations . No deficits appeared in the postoperative period.

Revista Ecuatoriana De Neurologia, 2006

Neurocirugía, 1993

Resumen Los meningiomas del cuarto ventriculo son raros. Se describe un meningioma meningotelial ... more Resumen Los meningiomas del cuarto ventriculo son raros. Se describe un meningioma meningotelial en esta localizacion. Se discuten algunos detalles de la tecnica quirurgica y se revisa la literatura.

Neurocirugía, 1992

ABSTRACT

Revista colombiana de psiquiatría/Revista colombiana de psiquiatria, May 1, 2024

Neurotarget, Nov 1, 2009

Ten patients with advanced Parkinson's disease underwent radiofrecuency subthalamotomy at the cau... more Ten patients with advanced Parkinson's disease underwent radiofrecuency subthalamotomy at the caudal zona incerta and pre-rubral field of Forel, just bellow the thalamic ventral intermediate nucleus (Vim). Motor function was assessed by applying the UPDRS III, Hoehn & Yarhr, Schwab & England scales, preoperatively in "ON" state and 6 and 12 months postoperatively. Following surgery tremor score improved by 80%. There were no complications. The procedure is safe and effective for treatment patients with advanced Parkinson's disease.

Neurotarget, May 1, 2011

Se describe un método rápido y fácil para encontrar el núcleo subtálamico mediante las imágenes e... more Se describe un método rápido y fácil para encontrar el núcleo subtálamico mediante las imágenes estereotáxicas de la tomografía computarizada (TC). Consiste en la identificación visual del núcleo subtalámico en el corte axial a 4 milímetros por debajo de la línea intercomisural CA-CP (CA, comisura anterior; CP, comisura posterior) al reconocer varias estructuras anatómicas típicas del corte, con la ayuda del atlas de Talairach. A este nivel, el extremo posterior del tercer ventrículo está situado a 2-3 mm por detrás del punto medio intercomisural; a 12 mm por fuera de este punto se sitúa la división somatomotora del núcleo subtalámico, en la mayoría de los casos.

Neurotarget, Nov 1, 2017

RESUMEN Se describe el caso de un paciente con hemiparkinson con predominio de temblor. El pacien... more RESUMEN Se describe el caso de un paciente con hemiparkinson con predominio de temblor. El paciente fue sometido a tratamiento con radiofrecuencia estereotáxica a nivel de zona incerta caudal (ZI), con resultado regular; en la misma intervención, se decidió realizar una lesión adicional en el globo pálido interno, cediendo totalmente el temblor. Se describe la técnica quirúrgica utilizada y se discute el papel del globo pálido interno (Gpi) en el temblor parkinsoniano.

Interdisciplinary Neurosurgery, Feb 29, 2024

We described a safe surgical corridor to dorsal medulla cavernous malformation. No deficits appea... more We described a safe surgical corridor to dorsal medulla cavernous malformation. No deficits appeared in the postoperative period.

Research Square (Research Square), Nov 6, 2023

Some patients with autism and severe intellectual disability may experience uncontrolled aggressi... more Some patients with autism and severe intellectual disability may experience uncontrolled aggression, causing serious injury or harm to others, and the therapeutic ineffectiveness of traditional pharmacological and behavioral treatment may aggravate symptoms. Deep brain stimulation (DBS) has been tested in patients with little evidence in children and adolescents. Therefore, we analyzed the e cacy and safety of DBS in refractory aggression in pediatric subjects with autism (ASD) and severe intelligence de cit (ID). Methods: A meta-analytic review of Web of Science (WOS) and Scopus articles, following Prisma criteria. A total of 555 articles were identi ed, but after applying the inclusion criteria, only 18 were analyzed. The review of the registries and the extraction of information was performed by 2 independent groups, to reduce the evaluator's bias. For the description of the results, pediatric patients with ASD or ID present in each registry, with an application of specialized scales (Overt aggression scale, OAS, and THE modi ed version of the OAS, MOAS) pre and post-DBS, with a clinical follow-up of at least 12 months, were considered valid. Clinical improvement was calculated using tests of aggressiveness. In each registry with available data and then pooling the means of all patients in the OAS and MOAS, the effect size of DBS (overall and per study) was estimated. Finally, the adapted NOS scale was applied to rate the studies' quality and level of bias. Results: In the studies analyzed, 65/100 were pediatric patients, with a mean age of 16.8 years. Most of the studies were conducted in South America and Europe. In all teams, aggressive behavior was intractable, but only 9 groups (53/65) applied specialized scales to measure aggressiveness, and of these, only 51 subjects had a follow-up of at least 12 months. Thus, in 48/51 a clinical improvement of patients was estimated (94.2%), with a considerable overall effect size (OAS: d=4.32; MOAS: d=1.46). However, adverse effects and complications were found in 13/65 subjects undergoing DBS. The brain target with the most evidence and the fewest side effects was the posteromedial hypothalamic nuclei (pHypN). Finally, applying the adapted NOS scale, quality, and bias, only 9 studies show the best indicators. Conclusion: An optimal level of e cacy was found in only half of the publications. This is mainly due to design errors and irrelevant information in the reports. We believe that DBS in intractable aggressiveness in children and adolescents with ASD and severe ID can be safe and effective if working groups apply rigorous criteria for patient selection, interdisciplinary assessments, objective scales for aggressiveness, and known surgical targets.

Some patients with autism and severe intellectual disability may experience uncontrolled aggressi... more Some patients with autism and severe intellectual disability may experience uncontrolled aggression, causing serious injury or harm to others, and the therapeutic ineffectiveness of traditional pharmacological and behavioral treatment may aggravate symptoms. Deep brain stimulation (DBS) has been tested in patients with little evidence in children and adolescents. Therefore, we analyzed the e cacy and safety of DBS in refractory aggression in pediatric subjects with autism (ASD) and severe intelligence de cit (ID). Methods: A meta-analytic review of Web of Science (WOS) and Scopus articles, following Prisma criteria. A total of 555 articles were identi ed, but after applying the inclusion criteria, only 18 were analyzed. The review of the registries and the extraction of information was performed by 2 independent groups, to reduce the evaluator's bias. For the description of the results, pediatric patients with ASD or ID present in each registry, with an application of specialized scales (Overt aggression scale, OAS, and THE modi ed version of the OAS, MOAS) pre and post-DBS, with a clinical follow-up of at least 12 months, were considered valid. Clinical improvement was calculated using tests of aggressiveness. In each registry with available data and then pooling the means of all patients in the OAS and MOAS, the effect size of DBS (overall and per study) was estimated. Finally, the adapted NOS scale was applied to rate the studies' quality and level of bias. Results: In the studies analyzed, 65/100 were pediatric patients, with a mean age of 16.8 years. Most of the studies were conducted in South America and Europe. In all teams, aggressive behavior was intractable, but only 9 groups (53/65) applied specialized scales to measure aggressiveness, and of these, only 51 subjects had a follow-up of at least 12 months. Thus, in 48/51 a clinical improvement of patients was estimated (94.2%), with a considerable overall effect size (OAS: d=4.32; MOAS: d=1.46). However, adverse effects and complications were found in 13/65 subjects undergoing DBS. The brain target with the most evidence and the fewest side effects was the posteromedial hypothalamic nuclei (pHypN). Finally, applying the adapted NOS scale, quality, and bias, only 9 studies show the best indicators. Conclusion: An optimal level of e cacy was found in only half of the publications. This is mainly due to design errors and irrelevant information in the reports. We believe that DBS in intractable aggressiveness in children and adolescents with ASD and severe ID can be safe and effective if working groups apply rigorous criteria for patient selection, interdisciplinary assessments, objective scales for aggressiveness, and known surgical targets.

Revista Ecuatoriana De Neurologia, 2004

Resumen: El abordaje subfrontal ha sido considerado durante años, mucho más traumático que el pte... more Resumen: El abordaje subfrontal ha sido considerado durante años, mucho más traumático que el pterional. Nosotros describimos brevemente algunos detalles técnicos, ventajas y desventajas del abordaje. Concluimos que el abordaje subfrontal con técnica tipo " keyhole " es tan efectivo como el pterional si está correctamente indicado. Abstract: Subfrontal keyhole approach has been considered more traumatic to the brain than the traditional pterional approach. We describe some technical tips and make recommendations to choose this approach to some specific target areas. We conclude that the subfrontal keyhole is as minimally invasive as the pterional approach if it is performed in the correct settings. Se han descrito múltiples abordajes quirúrgicos para la fosa anterior y media; la característica común de estos abordajes es la exposición relativamente grande del cerebro y retracción cerebral que a la larga nos traerá un aumento de la morbilidad postoperatoria, no relacionada a la lesión en sí misma. Existen abordajes que comparten el concepto de lo que se llama cirugía mínimamente invasiva, es decir, el abordaje lo mas pequeño posible con resultados posquirúrgicos óptimos. Desde el año 1974, en que Yasargil describió el abordaje pterional, la vía subfrontal para región selar y paraselar fue quedando poco a poco en el abandono. Los defensores de la vía pterional, preconizaban que esta brinda una menor distancia (20mm) de la superficie craneal hasta las estructuras de la base craneal, como son el nervio óptico, carótida supraclinoidea, etc. La distancia por vía subfrontal es de (55mm) aproximadamente. De este modo, se concluía que se produciría menos trauma quirúrgico por retracción cerebral por vía pterional (Seeger) (25, 32, 35, 36). Actualmente, con el advenimiento de la endoscopía y la vuelta a la popularidad de los abordajes " key –hole " por parte de Perneczky y su grupo, se pone a evaluación al cirujano entre las dos técnicas. El propósito de esta comunicación es dar a conocer las ventajas y desventajas de cada abordaje, procurar dar las indicaciones del abordaje subfrontal y sus limitaciones, para por último, concluir si realmente es invasivo o no.

Revista Ecuatoriana De Neurologia, 2001

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología

Revista Ecuatoriana De Neurologia, 2002

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología

Los autores realizan un analisis del manejo microquirurgico de los aneurismas intracraneales oper... more Los autores realizan un analisis del manejo microquirurgico de los aneurismas intracraneales operados en los ultimos catorce anos, correlacionando esta experiencia con el advenimiento de la cirugia endovascular. Se realiza una breve revision de la literatura actual. Los autores recomiendan que estas lesiones debieran ser manejadas, lo mas pronto posible, con clipaje microquirurgico o endovascularmente. Los mejores resultados en el clipaje se dan en pacientes jovenes con buen nivel neurologico, sin deficits secundarios a isquemia hemisferica, en aneurismas de menos de 10 mm, de circulacion anterior, saculares, sin evidencia de vasoespasmo radiologico (angiografia cerebral, doppler transcraneal). El tratamiento endovascular estaria recomendado en pacientes con mal nivel neurologico, mal estado general, en aneurismas de la circulacion posterior y como tratamiento complementario al clipaje definitivo, sobre todo en aneurismas grandes y complejos

Revista Ecuatoriana De Neurologia, 2000

Página principal Presentación Equipo directivo y comité científico Información para los autores I... more Página principal Presentación Equipo directivo y comité científico Información para los autores INDICE Revistas Anteriores Envio de artículos Enlaces a revistas médicas Congreso virtual de neurología Esta página está hospedada en www.medicosecuador.com Desea más información? Búsquela en medicosecuador.com

Revista Colombiana de Psiquiatría

Introducción: La pandemia del coronavirus continúa afectando a la salud mental del personal sanit... more Introducción: La pandemia del coronavirus continúa afectando a la salud mental del personal sanitario en Latinoamérica (LA).

Interdisciplinary Neurosurgery: Advanced Techniques, 2023

We described a safe surgical corridor to dorsal medulla cavernous malformations . No deficits ap... more We described a safe surgical corridor to dorsal medulla cavernous malformations . No deficits appeared in the postoperative period.

Revista Ecuatoriana De Neurologia, 2006

Neurocirugía, 1993

Resumen Los meningiomas del cuarto ventriculo son raros. Se describe un meningioma meningotelial ... more Resumen Los meningiomas del cuarto ventriculo son raros. Se describe un meningioma meningotelial en esta localizacion. Se discuten algunos detalles de la tecnica quirurgica y se revisa la literatura.

Neurocirugía, 1992

ABSTRACT