Browsing by Author "Valenzuela Mangini, Raúl Francisco"

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    Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico. Experiencia de un centro universitario
    (2008) Mellado T., Patricio; Peredo Orellana, Pilar Andrea; Valenzuela Mangini, Raúl Francisco; Arrese Jiménez, Marco; Pérez Ayuso, Rosa María; Domínguez, Pilar; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge
    Background: Orthotopic liver transplantation (OLT) is the treatment of choice for multiple acute and chronic end-stage liver diseases as well as for selected cases of liver malignancy and liver-site metabolic disorders. Neurological impairment is a major source of morbidity and mortality following OLT. Aim: To describe the incidence and the type of neurological complications occurring in the post-operative period of OLT in patients transplanted in our hospital. Material and methods: Between March 1994 and August 2007, 76 adult patients underwent OLT. Data on incidence, time of onset, and outcome of central nervous system (CNS) complications have been obtained from our program data base and patient charts. Results: Twenty three patients (30.3%) had CNS complications following OLT. The leading complications were immunosuppressive drug-related neurological impairment in nine patients (39.1%), peripheral nerve damage in five patients (21.7%), central pontine myelinolysis in four patients (17.4%), cerebrovascular disease in three (13%) and CNS infection in three (13%). Most CNS events (90%) occurred in the first 2 weeks after OLT. Five patients with neurological complications died (22%). Conclusions: CNS complications occurred in almost one fifth of the population studied, and they had a poor outcome, as previously reported
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    Diabetic complete external ophthalmoplegia
    (1990) Luco Franzoy, Cristian; Valenzuela Mangini, Raúl Francisco
    A 69-year-old diabetic patient taking oral hypoglycemic drugs and with no systemic complications presented a right peripheral facial palsy, and 2 months later a complete right external ophthalmoplegia with sparing of the pupillary function. Clinical, radiologic, and other laboratory investigation ruled out compressive, infectious, and inflammatory etiology. Four months later, after achieving good metabolic control, there was almost complete recovery of the ophthalmoplegia without signs of aberrant regeneration of the third nerve. Diabetes is proposed as the etiology of this case. A possible anatomic substrate is presented to explain the findings. © 1990 Raven Press, ltd., New York.
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    Gliomas de bajo grado: viejas controversias, nuevas evidencias
    (2005) Valenzuela Mangini, Raúl Francisco
    Many aspects of the management of low-grade gliomas have been controversial. Warren Mason reviews the new evidence addressing some of them in the article "Advances in the management of low-grade gliomas, published in Can J. Neurol. Sci. 2005". This information should be specially useful for tailoring therapies to each particular situation. The presence of an oligodendroglial component and 1p and 19q deletions confers a better prognosis and better response rates to chemotherapy and radiotherapy. Delaying interventions in stable, asymptomatic patients does not seem to affect overall survival. More extensive resections are associated to longer and better quality survival. Early radiotherapy prolongs time to progression, but not overall survival as compared to delayed radiotherapy. The optimal dose is in the range between 45Gy and less than 59.4 Gy. Chemotherapy produces responses in most of these patients.
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    Pseudotumor cerebri como una manifestación excepcional de la enfermedad de Behçet: Caso clínico
    (2010) Durán Santa Cruz, Josefina Gracia; Jurado Orellana, Marisol Andrea; Jacobelli, Sergio; Eymin Lago, Gonzalo; Castiglione, Enzo; Valenzuela Mangini, Raúl Francisco; Gutiérrez Torres, Miguel Alejandro
    The classical manifestations of Behçet disease are mouth and genital ulcers, cutaneous lesions and ocular involvement. The central nervous system is affected in 5 to 59% of the cases, usually in the form of meningoencephalitis or sinus venous thrombosis. We report a 17-year-old female presenting with a two weeks history of progressive headache, nausea and blurred vision. An initial magnetic resonance was normal. Fifteen days later she was admitted to the hospital due to progression of visual impairment. She gave a history of oral ulcers and arthralgias. A new magnetic resonance was normal. A lumbar puncture showed a cerebrospinal fluid with a protein concentration of 14 mg/dl, a glucose concentration of 64 mg/dl, 20 fresh red blood cells and a pressure of 26 cm H2 O. The diagnosis of a pseudotumor cerebri, secondary to Behçet disease was raised and the patient was treated with colchicine and acetazolamide. The evolution was torpid and an anterior uveitis was also found. After discharge, she continued with oral and genital ulcers and was treated with infliximab. Despite treatment, headache persists