Tenoch Herrada - Academia.edu (original) (raw)

Papers by Tenoch Herrada

World Neurosurgery

Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: P... more Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: Pituitary Tumor Surgery: A Review of 3004 Patients WORLD NEUROSURGERY xx [x]: xxx, MONTH 2012.

World Neurosurgery, 2014

raniopharyngiomas are one of the most challenging parasellar tumors; Friedrich Albert Von Zenker ... more raniopharyngiomas are one of the most challenging parasellar tumors; Friedrich Albert Von Zenker first C described craniopharyngioma in 1857. Histologically, craniopharyngiomas are benign lesions with local invasion of the sellar region with two histological subtypes: 1) adamantinomatous, most commonly found during childhood; and 2) papillary, mostly found in the adult population (15). In this issue of WORLD NEUROSURGERY, Wang et al. present a series of 16 patients with infradiaphragmatic craniopharyngiomas, seen during a period of 5 years, with clinical findings, treatment, and results that are sequentially described and reviewed.

World Neurosurgery, 2013

The nasolacrimal duct resides in the wall of the medial nasal cavity and influences minimal acces... more The nasolacrimal duct resides in the wall of the medial nasal cavity and influences minimal access endoscopic transmaxillary approaches to the lateral skull base. We describe an algorithm for surgical approach selection on the basis of the relationship of the target lesion to a line drawn from the anterior nasal SEptum through the Nasolacrimal Duct to the lesion (i.e., SEND line). We use the SEND line to estimate the lateral extent in the endonasal middle meatal transmaxillary approach, where the surgeon has good surgical freedom without the use of angled instruments and endoscopes. Lesions with an epicenter lateral to the SEND line were addressed through a sublabial anterior antrostomy transmaxillary corridor. Tumors with a more medially located epicenter, such as those involving the lateral sphenoid sinus and pterygoid plates, were addressed through the endonasal middle meatal corridor. Extensive tumors involving both domains were addressed through a combination approach. We describe three instructive cases in which the approach selection was determined in part by preoperative assessment of the location of the tumor relative to the SEND line. The endoscopic sublabial transmaxillary and endoscopic endonasal middle meatal transmaxillary approaches are complementary corridors to the anterior skull base that can be used independently or in combination. The location of the target lesion relative to the SEND line as determined on preoperative imaging can serve as a guide for surgical decision making.

World Neurosurgery, 2013

To report the efficacy, safety, and outcomes through time of the biggest series to our knowledge ... more To report the efficacy, safety, and outcomes through time of the biggest series to our knowledge of pituitary surgery using transcranial, transsphenoidal, and endoscopic techniques. An observational, retrospective, and descriptive review was performed of 3004 patients surgically treated by the senior author from 1973 to June 2011 in Mexico City. A sublabial approach was used in 3000 patients, and a transnasal approach was used in the remaining 4 patients. Tumors were classified according to size as microadenomas or macroadenomas. During the time period of this study, 3004 patients were surgically treated; there were 510 prolactinomas, 822 growth hormone adenomas, 62 adrenocorticotropic hormone-producing adenomas, 8 tumors that produced Nelson syndrome, and 1562 adenomas that were not biologically active. The cure rate of prolactinoma was 82% for microadenomas and 9% for macroadenomas. Gender distribution showed a male predominance of 57.1%. Cure rate for growth hormone adenomas was 87%. Adrenocorticotropic hormone adenomas showed no cure rate; surgery simply aided pharmacologic control. Global mortality rate was 1.6%. The main complications were cerebrospinal fluid fistula, diabetes insipidus, and meningitis. The sum of this 38-year experience of managing pituitary pathology and its surgical treatment shows the importance of working together with other specialists such as endocrinologists, ophthalmologists, and radiologists. The correct treatment approach for each case must be individually selected. Transsphenoidal surgery is an effective and safe treatment for most patients with pituitary adenoma and could be considered the first-choice therapy in all cases except for prolactinomas that respond to pharmacologic therapy (dopamine agonist).

Neurological Research, 2005

We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wastin... more We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems. To rule out other causes of hyponatremia (SIADH, secondary adrenal dysfunction and thyroid dysfunction) a correct diagnosis is very important, as proper treatment of CSWS with fluid and salt replacement will decrease mortality and morbidity. In conclusion, CSWS should be suspected in any polytrauma patient with minor head trauma and hyponatremia.

Cirugía y Cirujanos, 2015

Cirugía y Cirujanos, 2015

Cranieovertebral junction lesions in the paediatric population are associated with a low survival... more Cranieovertebral junction lesions in the paediatric population are associated with a low survival rate, which has declined in recent years. Neurological disability is a major concern due to the high economical cost it represents. Paediatric patients are more susceptible to this lesion because of hyperextension capacity, flat articulation, and increased ligamentous laxity. Survival after these kinds of injuries has been more often reported in adults, but are limited in the paediatric population. A case is reported of an 8-year-old male with occipitocervical and atlantoaxial dislocation associated with clivus fracture, brain oedema, and post-traumatic subarachnoid haemorrhage (SAH). A halo vest system was placed with no traction. One month after the trauma the patient was surgically treated with C1 and C2 trans-articular screws, occipitocervical fixation with plate and screws, and C1- C2 fixation with tricortical bone graft and wires without complication. He has now returned to school and is self-sufficient. With better pre-hospital medical care and with improved surgical techniques the mortality rate has declined in this kind of lesion.

World Neurosurgery

Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: P... more Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: Pituitary Tumor Surgery: A Review of 3004 Patients WORLD NEUROSURGERY xx [x]: xxx, MONTH 2012.

Neurological Research, 2005

Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral... more Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral salt wasting syndrome (CSWS) must be considered when hyponatremia is associated with a decrease in circulating volume. We performed this study to determine the clinical characteristics and management paradigm of patients with serum sodium concentration abnormalities and aneurysmatic subarachnoid hemorrhage. We analyzed retrospectively clinical and laboratory data from eight patients with subarachnoid hemorrhage due to rupture of an intracranial saccular aneurysm and cerebral salt wasting syndrome. Their course, as well as their clinical findings and treatment, are described. In eight patients, hyponatremia that lasted for more than 24 hours was detected (serum sodium under 135 mEq/l). The sodium disturbance occurred between day 3 and day 10 in all cases, in six of them in day 7 or day 8. The specific treatment for CSWS was to increase volume delivery according to the characteristics of the patient. Except for one case, none of the remaining patients required more than 72 hours of treatment to correct hyponatremia. No treatment-related complications were found Cerebral salt wasting syndrome, occurring in some patients with subarachnoid hemorrhage, is more commonly related to certain specific anatomic locations of the ruptured aneurysm, responds to sodium replacement therapy and fluids and can be diagnosed and treated based on the clinical, hydroelectrolytic and hemodynamic course of the patient. Further studies are needed to define the underlying mechanism of this condition.

World Neurosurgery

Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: P... more Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: Pituitary Tumor Surgery: A Review of 3004 Patients WORLD NEUROSURGERY xx [x]: xxx, MONTH 2012.

World Neurosurgery, 2014

raniopharyngiomas are one of the most challenging parasellar tumors; Friedrich Albert Von Zenker ... more raniopharyngiomas are one of the most challenging parasellar tumors; Friedrich Albert Von Zenker first C described craniopharyngioma in 1857. Histologically, craniopharyngiomas are benign lesions with local invasion of the sellar region with two histological subtypes: 1) adamantinomatous, most commonly found during childhood; and 2) papillary, mostly found in the adult population (15). In this issue of WORLD NEUROSURGERY, Wang et al. present a series of 16 patients with infradiaphragmatic craniopharyngiomas, seen during a period of 5 years, with clinical findings, treatment, and results that are sequentially described and reviewed.

World Neurosurgery, 2013

The nasolacrimal duct resides in the wall of the medial nasal cavity and influences minimal acces... more The nasolacrimal duct resides in the wall of the medial nasal cavity and influences minimal access endoscopic transmaxillary approaches to the lateral skull base. We describe an algorithm for surgical approach selection on the basis of the relationship of the target lesion to a line drawn from the anterior nasal SEptum through the Nasolacrimal Duct to the lesion (i.e., SEND line). We use the SEND line to estimate the lateral extent in the endonasal middle meatal transmaxillary approach, where the surgeon has good surgical freedom without the use of angled instruments and endoscopes. Lesions with an epicenter lateral to the SEND line were addressed through a sublabial anterior antrostomy transmaxillary corridor. Tumors with a more medially located epicenter, such as those involving the lateral sphenoid sinus and pterygoid plates, were addressed through the endonasal middle meatal corridor. Extensive tumors involving both domains were addressed through a combination approach. We describe three instructive cases in which the approach selection was determined in part by preoperative assessment of the location of the tumor relative to the SEND line. The endoscopic sublabial transmaxillary and endoscopic endonasal middle meatal transmaxillary approaches are complementary corridors to the anterior skull base that can be used independently or in combination. The location of the target lesion relative to the SEND line as determined on preoperative imaging can serve as a guide for surgical decision making.

World Neurosurgery, 2013

To report the efficacy, safety, and outcomes through time of the biggest series to our knowledge ... more To report the efficacy, safety, and outcomes through time of the biggest series to our knowledge of pituitary surgery using transcranial, transsphenoidal, and endoscopic techniques. An observational, retrospective, and descriptive review was performed of 3004 patients surgically treated by the senior author from 1973 to June 2011 in Mexico City. A sublabial approach was used in 3000 patients, and a transnasal approach was used in the remaining 4 patients. Tumors were classified according to size as microadenomas or macroadenomas. During the time period of this study, 3004 patients were surgically treated; there were 510 prolactinomas, 822 growth hormone adenomas, 62 adrenocorticotropic hormone-producing adenomas, 8 tumors that produced Nelson syndrome, and 1562 adenomas that were not biologically active. The cure rate of prolactinoma was 82% for microadenomas and 9% for macroadenomas. Gender distribution showed a male predominance of 57.1%. Cure rate for growth hormone adenomas was 87%. Adrenocorticotropic hormone adenomas showed no cure rate; surgery simply aided pharmacologic control. Global mortality rate was 1.6%. The main complications were cerebrospinal fluid fistula, diabetes insipidus, and meningitis. The sum of this 38-year experience of managing pituitary pathology and its surgical treatment shows the importance of working together with other specialists such as endocrinologists, ophthalmologists, and radiologists. The correct treatment approach for each case must be individually selected. Transsphenoidal surgery is an effective and safe treatment for most patients with pituitary adenoma and could be considered the first-choice therapy in all cases except for prolactinomas that respond to pharmacologic therapy (dopamine agonist).

Neurological Research, 2005

We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wastin... more We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems. To rule out other causes of hyponatremia (SIADH, secondary adrenal dysfunction and thyroid dysfunction) a correct diagnosis is very important, as proper treatment of CSWS with fluid and salt replacement will decrease mortality and morbidity. In conclusion, CSWS should be suspected in any polytrauma patient with minor head trauma and hyponatremia.

Cirugía y Cirujanos, 2015

Cirugía y Cirujanos, 2015

Cranieovertebral junction lesions in the paediatric population are associated with a low survival... more Cranieovertebral junction lesions in the paediatric population are associated with a low survival rate, which has declined in recent years. Neurological disability is a major concern due to the high economical cost it represents. Paediatric patients are more susceptible to this lesion because of hyperextension capacity, flat articulation, and increased ligamentous laxity. Survival after these kinds of injuries has been more often reported in adults, but are limited in the paediatric population. A case is reported of an 8-year-old male with occipitocervical and atlantoaxial dislocation associated with clivus fracture, brain oedema, and post-traumatic subarachnoid haemorrhage (SAH). A halo vest system was placed with no traction. One month after the trauma the patient was surgically treated with C1 and C2 trans-articular screws, occipitocervical fixation with plate and screws, and C1- C2 fixation with tricortical bone graft and wires without complication. He has now returned to school and is self-sufficient. With better pre-hospital medical care and with improved surgical techniques the mortality rate has declined in this kind of lesion.

World Neurosurgery

Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: P... more Loyo-Varela, Mauro, Tenoch Herrada-Pineda, Francisco Revilla-Pacheco, Salvador Manrique-Guzman: Pituitary Tumor Surgery: A Review of 3004 Patients WORLD NEUROSURGERY xx [x]: xxx, MONTH 2012.

Neurological Research, 2005

Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral... more Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral salt wasting syndrome (CSWS) must be considered when hyponatremia is associated with a decrease in circulating volume. We performed this study to determine the clinical characteristics and management paradigm of patients with serum sodium concentration abnormalities and aneurysmatic subarachnoid hemorrhage. We analyzed retrospectively clinical and laboratory data from eight patients with subarachnoid hemorrhage due to rupture of an intracranial saccular aneurysm and cerebral salt wasting syndrome. Their course, as well as their clinical findings and treatment, are described. In eight patients, hyponatremia that lasted for more than 24 hours was detected (serum sodium under 135 mEq/l). The sodium disturbance occurred between day 3 and day 10 in all cases, in six of them in day 7 or day 8. The specific treatment for CSWS was to increase volume delivery according to the characteristics of the patient. Except for one case, none of the remaining patients required more than 72 hours of treatment to correct hyponatremia. No treatment-related complications were found Cerebral salt wasting syndrome, occurring in some patients with subarachnoid hemorrhage, is more commonly related to certain specific anatomic locations of the ruptured aneurysm, responds to sodium replacement therapy and fluids and can be diagnosed and treated based on the clinical, hydroelectrolytic and hemodynamic course of the patient. Further studies are needed to define the underlying mechanism of this condition.