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Quantifying Cognitive Decrements Caused by Cranial Radiotherapy
Published on: October 18, 2011
[Radiological clinical profile of multiple cranial neuropathy and recurrence risk factors]
Alejandra Martínez-Vázquez1, Ricardo Jorge García-Bermúdez2, Julián Alberto Hernández-Domínguez1
1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Servicio de Neurología. Ciudad de México, México.
Background:
Multiple cranial neuropathies (MCN) are the dysfunction of 2 or more cranial nerves, simultaneously or sequentially. The most common causes are tumors, followed by vascular and traumatic causes, central nervous system infections and Guillain-Barré syndrome and its variants.
Objective:
To identify the radiological clinical profile of MCN in patients of a tertiary-care hospital.
Material And Methods:
Observational, cross-sectional, retrospective and analytical study in patients of 18 years of age or older, with a diagnosis of MCN. It was used descriptive statistics, and normality curves were determined. To establish differences, it was used chi-squared or Student's t test with the statistical package SPSS, version 29.
Results:
46 patients with a mean age 49 years (± 16) were studied. 29 (63%) were male. Findings in the magnetic resonance of the skull were normal in 34%; the reinforcement of the cavernous sinus in 26%. Non-infectious inflammatory was the most frequent etiology (43%). 83% of the inflammatory etiology presented improvement at discharge while those of non-inflammatory etiology were discharged without improvement (odds ratio [OR] 8, p 0.001). 87% had pain in their clinical picture unlike subjects with non-inflammatory etiology (OR 4, p < 0.01). 73% of the population with inflammatory etiology presented recurrence, and none of the subjects with a non- inflammatory cause (OR 0.5, p 0.022).
Conclusions:
The most common presentation of MCN in our study was cavernous sinus syndrome or sphenoidal cleft, with a non-acute course. The possibility of documenting an inflammatory etiology impacts the risk of recurrence and improvement upon hospital discharge.
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