Neurocirugia
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Historical Article
[History of the Spanish Neurosurgery Society (SENEC, formerly SLEN].
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The procedure of surgical treatment of lumbar disc herniation belongs to the group of clinical practice procedures that have a great repercussion on health care systems. The high prevalence of this disease, the management variability and the possibility of improvement, explain the great interest in the evaluation of the quality of both treatment procedure and outcomes. ⋯ This method established a significant correlation between STQ and clinical and presurgical variables, as well as between STQ and pain and activity after surgery.
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Clinical or critical pathways are a useful tool in the continuous quality improvement. They develop the main characteristics of the quality programs: implementation of the evidence based medicine, increase staff and patient satisfaction and adequacy in hospital costs. This is the application of evidence-based medicine to a process management and it promotes integration of clinical guides, protocols and algorithms. ⋯ Critical pathways are still under development and changing continuously. Nevertheless their impact on improving patient care and satisfaction, and resource consumption is already evident, and it constitutes a major aim to work in its complete development.
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Case Reports
[Preoperative embolization in meningioma of the ponto-cerebellar angle. Indications and advantages].
Preoperative embolization of meningiomas has been performed in order to reduce surgical hemorrhage during the removal of these vascularized tumors. In this paper we emphasize the fact that occlusion of the tumoral vessels by artificial emboli produces an ischemic necrosis that greatly helps tumor exeresis. ⋯ In our case, a giant ponto-cerebellar meningioma was dried up totally and then removed with relative ease through a conventional suboccipítal lateral craniectomy. The technique, indications and control of preoperative embolization are reviewed.
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Review Multicenter Study
[Minor head injury management in Spain: a multicenter national survey].
Despite of the high incidence of minor head injury, there is still controversy and disparity of criteria regarding its management. The lack of consensual protocols and clinical guidelines can lead to deficiencies in the attention to these patients and to inadequate use of resources. The objective of this study has been to describe the present situation of the management of this entity in the neurosurgical departments of the Spanish public hospitals, and to compare it with other European countries. ⋯ This study shows the inter-hospital variability of minor head injury management in Spain. Clinical guidelines are considered as positive and necessary. Although the Spanish situation is similar to that in other European countries, following the tendency toward a broader cranial CT utilisation, would improve diagnosis profitability and economical efficiency. The results of this study may contribute to the creation of consensual protocols and clinical guidelines in our country that help in daily practice decision-making optimising assistance quality.