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Universitat Autònoma de Barcelona

1. Moncho Rodríguez, Dulce María. Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1.

Degree: Departament de Cirurgia, 2016, Universitat Autònoma de Barcelona

Chiari malformation type 1 (CM-1) is a congenital anomaly of the craniovertebral junction first described by Chiari as a displacement of cerebellar tonsils into the spinal canal. The classic neuroradiological diagnosis of this entity requires a tonsillar descent of more than 3-5 mm below the foramen magnum (FM). The most accepted etiopathogenic theory suggests that these patients have a pathological reduction in the volume of the posterior fossa (PF). The descent of the cerebellar tonsils hinders the passage of cerebrospinal fluid through the craniovertebral junction and may cause compression of the neural structures of the bulbo-medullary junction, consequently altering brainstem and upper spinal cord function. CM-1 patients may also present syringomyelia (30%-75%), hydrocephalus (40%), bone abnormalities of the craniovertebral junction (20%-60%), or scoliosis. In recent years, other variants have been added to the four types proposed by Chiari, including CM type 0 (CM-0) and CM type 1.5 (CM-1.5). Although no tonsillar ectopia is present, CM-0 is characterized by reduced PF, no cisterna magna, and, in most cases, associated syringomyelia. In CM-1.5 tonsillar ectopia, variable brainstem descent, and obex displacement below the FM, in the absence of spina bifida, are all present. The clinical symptoms of these patients can be highly variable and incidental diagnosis of cases is increasingly frequent, making the therapeutic strategy difficult to determine. Evoked potentials (EPs) provide objective information about the function of the brainstem and spinal cord, which can be useful in diagnosis and therapeutic decision-making in patients with these malformations. The main objectives of the present thesis were: 1) to describe the frequency of brainstem auditory EP (BAEP) and somatosensory EP (SEP) alterations in a homogeneous series of patients with classical CM-1, differentiating the findings according to the new classification (subtypes 0, 1, and 1.5); 2) to relate the different kinds of EP alteration with clinical and anatomical findings in CM-1 patients, differentiating subtypes 0, 1, and 1.5; and 3) to define subgroups of patients with different probabilities of presenting EP alterations based on morphometric craniospinal parameters. The control group with whom we compared patients was performed with a different EP device from that which was used in CM-1 patients. The validity of this information was confirmed by performing an analysis of variability between the two devices, which demonstrated that they can be used interchangeably. The results showed that 60% of patients with CM-1 present some alteration of the EPs at a central level. No significant differences in the EP findings of different subtypes of CM (0, 1, and 1.5) were found. Patients who are older, have a greater degree of tonsillar herniation, and present lower cranial nerve dysfunction are found to be more likely to have abnormal BAEPs. Patients with older age and a greater tonsillar herniation are shown to be more likely to have abnormal SEPs. In… Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Poca Pastor, Maria Antònia (director), Sahuquillo Barris, Juan (director), true (authorsendemail).

Subjects/Keywords: Malformació de Chiari tipus 1; Malformación de Chiari tipos 1; Chiari type 1 malformation; Potencials evocats; Potenciales evocados; Evoked potentials; Siringomièlia; Siringomielia; Syringomyelia; Ciències de la Salut; 617

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Moncho Rodríguez, D. M. (2016). Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1. (Thesis). Universitat Autònoma de Barcelona. Retrieved from http://hdl.handle.net/10803/399570

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Moncho Rodríguez, Dulce María. “Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1.” 2016. Thesis, Universitat Autònoma de Barcelona. Accessed September 23, 2019. http://hdl.handle.net/10803/399570.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Moncho Rodríguez, Dulce María. “Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1.” 2016. Web. 23 Sep 2019.

Vancouver:

Moncho Rodríguez DM. Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1. [Internet] [Thesis]. Universitat Autònoma de Barcelona; 2016. [cited 2019 Sep 23]. Available from: http://hdl.handle.net/10803/399570.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Moncho Rodríguez DM. Estudio neurofisiológico mediante potenciales evocados auditivos de tronco cerebral y somatosensoriales en pacientes con malformación de Chiari tipo 1. [Thesis]. Universitat Autònoma de Barcelona; 2016. Available from: http://hdl.handle.net/10803/399570

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. Vilalta i Vilalta, Aleix. Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal.

Degree: Departament de Cirurgia, 2010, Universitat de Lleida

Subjects/Keywords: bioètica del malalt; sofriment; espiritualitat; mort; cáncer; Psicologia bàsica; 1; 61; 617

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Vilalta i Vilalta, A. (2010). Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal. (Thesis). Universitat de Lleida. Retrieved from http://hdl.handle.net/10803/8072

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Vilalta i Vilalta, Aleix. “Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal.” 2010. Thesis, Universitat de Lleida. Accessed September 23, 2019. http://hdl.handle.net/10803/8072.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Vilalta i Vilalta, Aleix. “Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal.” 2010. Web. 23 Sep 2019.

Vancouver:

Vilalta i Vilalta A. Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal. [Internet] [Thesis]. Universitat de Lleida; 2010. [cited 2019 Sep 23]. Available from: http://hdl.handle.net/10803/8072.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Vilalta i Vilalta A. Evaluación de las necesidades espirituales de pacientes diagnosticados de cáncer avanzado y terminal. [Thesis]. Universitat de Lleida; 2010. Available from: http://hdl.handle.net/10803/8072

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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