Objective:To investigate Gamma Knife and LINAC radiosurgery technologies regarding technical aspects and clinical results.
Patients and methods: A comparison was made with respect to stereotactic frame, mechanical accuracy, dosimetry, radiobiology, treatment planning and clinical results regarding both systems.
Results: The different stereotactic frames available in the market are not different in terms of proper fixation as well as for geometric localization reference. Similar excellent clinical results are obtained for small lesions with photon beams of the gamma knife and the linac. Similar beam dose distributions with sharp fall-off for small spherical shaped targets are obtained for both devices. The superior mechanical precision for the gamma knife as compared with the linac is of limited clinical relevance because inaccuracy of cranial target localization based on contemporary available radiological imaging is greater than the typical linac imprecision (of around 1mm). Treatment planning systems for the linac are not standardized but are based on well-known algorithms. The linac has no field size limitations, achieving more homogeneous dose distributions compared with that obtained with the gamma unit.
Conclusion: Linac based radiosurgery is a practical treatment method with equivalent physical, radiobiological and clinical results compared to the gamma knife technology although its routine methodology requires multidisciplinary effort
 

Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma (NHL) which affects brain, spinal cord, leptomeninges and eyes. Its clinical course and radiological features are different in inmunocompetent patients comparated with inmunocomprised patients, especially in patients with acquired inmunodeficiency syndrome (AIDS). The diagnosis should be followed for a detailed evaluation, including a carefully physical examination, ophthalmologic evaluation, a chest/abdomen/pelvis computed tomography (CT) scan, cerebrospinal fluid (CSF) analysis, human immuno deficiency virus (HIV) testing and a contrast enhanced brain magnetic resonance image (MRI). MRI usually shows one or more enhanced paraventricular lesions, deep in the white matter, spanning the corpus callosum. Stereotactic brain biopsy sampling is the gold standard for the diagnosis. The use of Metotrexate in high doses followed by radiotherapy has demonstrated the best results in the treatment of PCNSL. A 44 years old woman, with apparently spontaneous remission of multiple brain lesions demonstrated in MRI plus initial negative biopsy sampling for PCNSL, showed tumoral enlarging after a follow up of 2 years.
 

The care of neurosurgical patients in intensive care units has proven to be beneficial not only for patients but also for hospital institutions. However, the benefits of the care that these units provide to the neurocritical patient depend on multiple factors intrinsic to the patient, which should be studied in order to make better use of resources in the care of them. The present descriptive work shows an analysis of the characteristics of the patients admitted by the specialty of Neurosurgery to the Intensive Care Unit of the Ricardo Palma Clinic during 2007, and a total of 115 patients were studied.
The most common pathologies were: ischemic stroke (37%), intracerebral hemorrhage (17%), and brain tumor (13%). %). The mean length of stay in the ICU was 4.7 days +/- SD 6.6, ranging from 4.3 days for stroke to 11.0 days for a polytrauma patient. The overall mortality found for the neurosurgical patient was 13 per 100, being higher in patients with intracranial hemorrhage (25 per 100). The readmissions and complications of these patients were minimal.

Infectious diseases and infestations are due to the local aggression of the central nervous system and its envelopes, by microbial or parasitic agents, capable of causing damage to our health, causing local and general symptoms.
CRANE AND BRAIN PATHOLOGY GROUPS:
Abscess or epidural empyema
Subdural empyema or abscess
Abscess or intracerebral empyema
Ventriculitis
GROUPS OF COLUMN AND MEDULA PATHOLOGY SPINAL AND SPINAL CORD
Abscess or epidural empemema
Subdural empyema or abscess
Abscess or intramedullary start
NERVOUS SYSTEM CYSTICERCOSIS
Cysticercosis Racemosa
Cysticercosis Cystic
Obstructive Hydrocephalus

Endonasal endoscopic surgery is a team surgery according to Snyderman et al., which requires learning of non-familiar surgical anatomy, use of new technologies and the development of new surgical skills. The major concerns during surgery are the identification of the internal carotid artery, optic nerves and preservation of small cerebral vessels. The potential for a disaster is great if the surgeon is unfamiliar with the anatomy, there is a lack of adequate equipment and clumsiness to maintain adequate visibility with the endoscope. Many publications speak on the subject, both on transsphenoidal endoscopic anatomy, and on anatomy with the approach by extending its limits.

Cysticercosis is the most common parasitic infection affecting the central nervous system and typically involves the cerebral parenchyma, the subarachnoid space, or the ventricular system. Spinal cysticercosis is rare (0.7-3.2%) even in endemic regions and may require more aggressive management due to the natural confines of the spinal canal. The condition of the lesion, its size, and the inflammatory response generated by cyst degeneration are important factors for the management of spinal CC. We report two cases of spinal cysticercosis in which patients underwent surgical treatment.

With the advances in the medicine, we have a high average of life and at the present time leave increment of patient with spine pain for pathological fractures taken place by osteoporosis or in other conditions such as: Spinal metastases, multiple myeloma lesions, and hemangiomas. It is necessary the vertebral stabilization in these patients to improve the pain and at the moment with technical Percutaneous Spinal Vertebroplasty can be reinforced and to give bigger consistency or hardness to the fractured spine.The technique consists to guide placement of the needle and the plastic bone cement that is injected into the vertebrae to stabilize them using Poly methyl methacrylate (PMMA), which is radiopaque due to sterile barium powder, is injected into the bone in the vertebral fractured body, through a stem.Sometimes at level of the spinal compression fractures, we can to introduce and inflates a small balloon into the vertebra to expand its height before injecting the PMMA. This technique is known as Kyphoplasty or Vertebroplasty mediating balloon. The indications of the Vertebroplasty and Kyphoplasty at the moment are the reinforcement of vertebral fractures for spinal metastases too.
In this paper we review the technical basis of the vertebroplasty, according to our experience in this treatment and we present our experience with a small number of cases which had a good outcome for the majority of them.