Compresiones neurovasculares de la fosa craneal posterior en la neuralgia del trigémino. Estudio anatomoclínico

La neuralgia del trigémino (NT) es un síndrome doloroso facial caracterizado por un dolor neuropático paroxístico irradiado al territorio sensitivo del nervio trigémino. A lo largo de las últimas décadas la creciente evidencia experimental y clínica ha contribuido a establecer la teoría de una compresión neurovascular (CNV) del nervio trigémino como causa fundamental de este trastorno. Esta teoría apoya el tratamiento quirúrgico de la NT mediante una descompresión microvascular (DMV). Actualmente la DMV es aceptada como la primera opción de tratamiento quirúrgico de la NT refractaria a tratamiento médico. Pese a la cantidad de trabajos que analizan la utilidad de la RM preoperatoria con secuencias de alta resolución volumétricas potenciadas en T2 (RM 3DT2), no hay unanimidad respecto a la precisión de estas secuencias de RM para el diagnóstico y la caracterización de una posible CNV en pacientes con NT refractaria candidatos a tratamiento mediante DMV...

Unusual striped dolphin mass mortality episode related to cetacean morbillivirus in the Spanish Mediterranean sea

BACKGROUND In the last 20 years, Cetacean Morbillivirus (CeMV) has been responsible for many die-offs in marine mammals worldwide, as clearly exemplified by the two dolphin morbillivirus (DMV) epizootics of 1990-1992 and 2006-2008, which affected Mediterranean striped dolphins (Stenella coeruleoalba). Between March and April 2011, the number of strandings on the Valencian Community coast (E Spain) increased. CASE PRESENTATION Necropsy and sample collection were performed in all stranded animals, with good state of conservation. Subsequently, histopathology, immunohistochemistry, conventional reverse transcription polymerase chain reaction (RT-PCR) and Universal Probe Library (UPL) RT-PCR assays were performed to identify Morbillivirus. Gross and microscopic findings compatible with CeMV were found in the majority of analyzed animals. Immunopositivity in the brain and UPL RT-PCR positivity in seven of the nine analyzed animals in at least two tissues confirmed CeMV systemic infection. Phylogenetic analysis, based on sequencing part of the phosphoprotein gene, showed that this isolate is a closely related dolphin morbillivirus (DMV) to that responsible for the 2006-2008 epizootics. CONCLUSION The combination of gross and histopathologic findings compatible with DMV with immunopositivity and molecular detection of DMV suggests that this DMV strain could cause this die-off event.