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Colloid cyst are benign intracranial lesions located in the III ventricle in the region of the foramen of Monro. The majority present in the third and fourth decades of life and are rare under the age of ten. We report a case of an incidentally colloid cyst presented in a 2.5 -years-old girl who was managed conservatively; follow-up with MRI showed a progressive reduction in size. We review the four similar case previously reported.

Research in marine Spanish waters are focused on several actions to achieve an effectively management on protected areas, with the active participation of the stakeholders and research as basic tools for decision-making. Among these actions, there is one about the knowledge and control on NIS. One of its objectives is the creation of NIS factsheets, which are going to be added to the National Marine Biodiversity Geographical System (GIS) providing complementary information about taxonomic classification, common names, taxonomic synonyms, species illustrations, identification morphological characters, habitat in the native and introduced regions, biological and ecological traits, GenBank DNA sequences, world distribution, first record and evolution in the introduced areas, likely pathways of introduction, effects in the habitats and interaction with native species, and potential management measures to apply. The database will also provide data for (1) the European online platforms, (2) the environmental assessment for the Descriptor 2 (D2-NIS) of the EU Marine Strategy Framework Directive (MSFD), as well as (3) supporting decisions made by stakeholders. It is the result of extensive collaboration among scientist, manager’s and citizen science in the Spanish North-Atlantic, South-Atlantic, Gibraltar Strait-Alboran, Levantine-Balearic and Canary Islands marine divisions, providing an updated overview of the spatial distribution of relevant extended and invasive NIS of recent and established NIS introduced by maritime transport and aquaculture pathways, as well as on cryptogenic or native species in expansion due to the climatic water warming trend.

Background and aims: Wastewater-based epidemiology is an additional indicator of drug use that is gaining reliability to complement the current established panel of indicators. The aims of this study were to: (i) assess spatial and temporal trends of population-normalized mass loads of benzoylecgonine, amphetamine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) in raw wastewater over 7 years (2011–17); (ii) address overall drug use by estimating the average number of combined doses consumed per day in each city; and (iii) compare these with existing prevalence and seizure data. Design: Analysis of daily raw wastewater composite samples collected over 1 week per year from 2011 to 2017. Setting and Participants: Catchment areas of 143 wastewater treatment plants in 120 cities in 37 countries. Measurements: Parent substances (amphetamine, methamphetamine and MDMA) and the metabolites of cocaine (benzoylecgonine) and of Δ9-tetrahydrocannabinol (11-nor-9-carboxy-Δ9-tetrahydrocannabinol) were measured in wastewater using liquid chromatography–tandem mass spectrometry. Daily mass loads (mg/day) were normalized to catchment population (mg/1000 people/day) and converted to the number of combined doses consumed per day. Spatial differences were assessed world-wide, and temporal trends were discerned at European level by comparing 2011–13 drug loads versus 2014–17 loads. Findings: Benzoylecgonine was the stimulant metabolite detected at higher loads in southern and western Europe, and amphetamine, MDMA and methamphetamine in East and North–Central Europe. In other continents, methamphetamine showed the highest levels in the United States and Australia and benzoylecgonine in South America. During the reporting period, benzoylecgonine loads increased in general across Europe, amphetamine and methamphetamine levels fluctuated and MDMA underwent an intermittent upsurge. Conclusions: The analysis of wastewater to quantify drug loads provides near real-time drug use estimates that globally correspond to prevalence and seizure data. © 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction

Solitary fibrous tumours/haemangiopericytomas (SFT/HPC) are fibroblastic mesenchymal neoplasms that harbour a genetic fusion of NAB2/STAT6. There are few reported cases in the central nervous system (CNS), of which spinal tumours are minority. We present a case of a 63-year-old woman with progressive paraparesis and a sensory level of T6. On the MRI we detected an intradural extramedullary lesion on T9-T10. We performed a laminectomy with an intraoperative ultrasound study in which we observed a heterogeneous lesion with an infiltrating pattern affecting the medulla at several points, and resection of the lesion. Immunohistological findings revealed positivity for vimentin, CD34 and STAT6; Ki-67 was 2%. A final diagnosis of SFT/HPC with SFT phenotype was made. SFT/HPC of the CNS is a rare neoplasm that should be taken into account in the differential diagnosis of these kinds of lesions, as clinical and MRI findings often lead to errors in diagnostic approach. The support of intraoperative ultrasound can assist in surgical decision-making.

Resumen Introduccion el hematoma subdural cronico constituye el tipo mas frecuente de hemorragia intracraneal postraumatica. La mayoria, de los casos se desarrollan en pacientes de edad avanzada, presentando problemas especificos derivados de las patologias frecuentes en este grupo de edad. Pacientes y metodos realizamos un estudio retrospectivo sobre 90 pacientes mayores de 80 anos afectos de hematoma subdural cronico intervenidos en los ultimos 15 anos. Para la evaluacion clinica al ingreso y alta hospitalaria empleamos la escala especifica propuesta por Markwalder. La tecnica quirurgica empleada fue similar en todos los casos y consistente en la realizacion de un agujero de trepano e implantacion de un drenaje subdural cerrado. Resultados al ingreso, 73 pacientes (80%) se encontraban en buena situacion clinica (grados 0–2) y 17 (20%) en grados 3 o 4. Siete pacientes (7.7%) fallecieron durante el ingreso pero ninguno de ellos en relacion directa con la cirugia. Seis pacientes (6.6%) requirieron una segunda intervencion quirurgica por recidiva del hematoma. Al alta el 76.6% de los pacientes se encontraban en grados 0 o 1. Conclusiones en nuestra experiencia el hematoma subdural cronico en este grupo de edad debe ser tratado como primera opcion mediante una perforacion craneal y drenaje subdural. Dado los buenos resultados obtenidos la existencia de patologia sistemica asociada no debe considerarse como una contraindicacion para el tratamiento quirurgico.

Objectives: To study the clinical features and surgical results of patients with chronic subdural hematoma. Methods: A retrospective study of the records of 630 patients treated surgically for chronic subdural hematoma using a burr hole and closed drainage system was conducted. Results: Six hundred and thirty patients (438 males and 192 females) ranging from 12 to 100 years with a mean age of 66.7 years were identified. Upon admission, 242 (38%) patients were in satisfactory condition (grades 0–1), 262 (42%) patients were at grade 2 and 126 (20%) were at grades 3 or 4. In 5.3% of the patients, surgical intervention was required to remove a recurring hematoma. In 77% of the patients, the results achieved could be graded as good (grades 0–1), with mortality being 2.5%. The only factor affecting the outcome was the grade at admission (p < 0.05). Conclusion: A simple and routinely used burr hole procedure either under local or general anesthesia with a closed drainage system is a safe and effective procedure for the treatment of chronic subdural hematoma.

Interhemispheric subdural hematoma in adults is a rare complication of head injury with no more than 100 cases reported since 1940. The classical presentation of this disorder is a contralateral monoparesis of the leg or a hemiparesis more pronounced in the leg. We report three cases of interhemispheric subdural hematoma following closed head injuries and the review of the literature with an analysis and of the therapeutic possibilities. Conservative management under close supervision may be a proper attitude in those patients without alterations of consciousness. Surgical treatment is necessary in patients with progressive deterioration.

Spontaneous cerebellar hematomas make up nearly 10% of the intracranial intraparenchymatous hemorrhages. In recent years several algorithms have been published for the management of these patients.To study the type of treatment, conservative or operative, and the main prognostic factors.We present a retrospective analysis of 52 cases of spontaneous cerebellar hematomas diagnosed over the past 10 years in the Hospital General de Galicia. We studied the clinical and radiological factors with the greatest effect on prognosis and the approach to treatment.We found a male/female ration of 2/3. The age of 90.3% of our patients was over 60 years. Arterial hypertension had previously been diagnosed in 55.7% of the cases. The clinical picture was characterized by the profile of a stroke with headache (90.3%), vomiting (63.4%) and impaired consciousness (50%) being the commonest presenting symptoms. The most important factors in prognosis were the level of consciousness and the size of the hematoma. The prognosis was worse in cases with hydrocephalus, intraventricular hemorrhage or extension of the hematoma towards the midline. Neither age, sex nor the previous diagnosis of arterial hypertension were of importance in prognosis. Mortality was 25%.The spontaneous cerebellar hematomas typically affect patients over the age of 60 years and present with headache and vomiting of sudden onset. In our series the major prognostic factors were the size of the hematoma and level of consciousness, and treatment was given in accordance with this.

Objetivo. Estudiar la relacion entre no comparecer a las consultas de neurologia y la demora existente, asi como con los factores demograficos que pueden influir en la no comparecencia. Pacientes y metodos. Se recogieron de forma prospectiva los datos de las consultas externas de neurologia de los meses de noviembre y diciembre de 2002. Se incluyeron los pacientes que se remitieron para la valoracion como primera visita programada. Resultados. El numero de pacientes fue de 1.035, con una edad media de 55,31 ± 19,84 (14-96). De estos, 605 fueron mujeres y 430 hombres, sin diferencias significativas en la edad de ambos grupos. Un 40% de los casos provenian del area rural. No se presentaron 237 (22,9%). Encontramos una relacion estadisticamente significativa entre la edad y no comparecer (t = 2,67; p = 0,008, t de Student). Tambien habia relacion entre no acudir a la consulta y la demora existente (t = ?5,84; p = 0,000, t de Student). Los pacientes remitidos desde Urgencias fallaron mas que los enviados por el medico de familia (P 2 = 2,4; p = 0,07, c 2). La fecha en la que recibieron la citacion se relaciono con la falta de comparecencia (t = ?2,55; p = 0,011, t de Student). Conclusiones. La falta de comparecencia se asocio sobre todo con la demora, con la juventud, el procedimiento de Urgencias y con el tiempo desde que se notifico la citacion.

Introduccion. Los quistes aracnoideos (QA) son estructuras patologicas de caracteristicas benignas tipicas de la infancia, donde representa aproximadamente el 1% de las lesiones intracraneales. Si se excluyen los casos de quistes secundarios de etiologia conocida, atribuibles a procesos inflamatorios o traumatismos craneoencefalicos, los quistes primarios son de etiologia desconocida; en los casos presentados hasta ahora, los quistes se presentaban desde el primer estudio de imagen practicado, por lo que se les atribuia un origen prenatal. Caso clinico. Nino al que a los 5 meses de edad se le descubre un voluminoso QA que no se presentaba en una ecografia transfontanelar realizada, por otras causas, a los 2 meses de edad. Conclusion. La importancia de este caso radica en la posibilidad de demostrar en imagenes seriadas la aparicion de un quiste despues del nacimiento, en una patologia a la que todas las teorias y pruebas atribuyen un origen congenito.

Introduction. The semantic verbal fluency (SVF) is usually evaluated with the task 'animals in 1 minute'. This is a test widely applied in the screening of cognitive impairment. In our best knowledge there are not other alternatives categories for this task validated in our environment (Spanish as mother tongue, Spain). Objective. To validate the category 'households items ' as an alternative parallel task to 'animals' in the assessment of SVF. Patients and methods. Prospective assessment of two categories (animals and household items) in two groups: normal controls and patients with Alzheimer's disease (AD). Results. Control group: n= 22 (13 M, 9 W); age: 73′5 years, education: 12′5 years; MMSE-MEC-35: 30′4; 'Animals': 15′4, Percentile distribution 10th: 11; 50th: 15; 90th: 20; 'household items': 17′4. Percentile distribution: 10th: 12; 50th: 17; 90th: 22. AD group: n = 24 (9 M, 15 W); age: 74′5 years; education: 11 ′5 years; MMSE-MEC-35: 17′8; 'Animals': 6′3. Percentile distribution: 10th: 2; 50th: 6; 90th: 9; 'household items': 6′4. Percentile distribution: 10th: 1; 50th: 6; 90th: 11. It is observed a positive correlation between the two categories (Spearman's Rho: 0.83, p< 0.0001). Conclusions. Both SVF categories had a similar distribution and a high correlation. This findings demonstrated the validity of the household items as an alternative and parallel form to animals in the assessment of SVF in patients with cognitive impairment or dementia.

INTRODUCTION Facio linguo masticatory paralysis resulting from bilateral lesion of the anterior opercular region, known today as Foix Chavany Marie syndrome, appears very frequently in adult patients as a consequence of generally ischemic vascular lesions, which directly affect the Rolandic opercula or the subcortical area surrounding them. However, forms that are secondary to infections, neoplasias and even unilateral lesions have been reported. CASE REPORT Female patient, aged 70, with unknown auricular fibrillation, which started suddenly with right faciobrachial paresis secondary to a left striated ischemic infarction. Approximately 24 hours after beginning intravenous heparinization, the patient presents anarthria, facial hypomimia without asymmetries, dysphagia above all for liquids and bilateral lingual paresis. Extraoccular movements, blinking and corneal reflex were normal. Understanding of spoken and written language was maintained and there were no apraxias or agnosias. Neurological exploration was compatible with an opercular syndrome (OS). Urgent brain CT revealed the existence of a right cortiico subcortical temporal haemorrhage, in addition to the prior contralateral ischemia. The association of both lesions, ischemic and haemorrhagic, mirrored, justified all the symptomatology. DISCUSSION Anterior OS is characterised by a bilateral voluntary central paresis of the muscles innervated by the 5th, 7th, 9th, 10th and 12th cranial pairs with preservation of emotional or automatic mobility. Underlying mechanisms are also discussed.