Isquemia cerebral transitoria y riesgo de infarto cerebral isquémico

Autores/as

  • Luis Guillermo Rosales Bravo Caja Costarricense del Seguro Social, Hospital México

DOI:

https://doi.org/10.51481/amc.v48i1.214

Palabras clave:

Isquemia cerebral transitoria, emergencia neurológica, infarto cerebralisquémico

Resumen

La enfermedad vascular cerebral es la principal causa de hospitalización neurológica en el mundo. Costa Rica no es la excepción; en nuestros hospitales cada día es más frecuente el número de pacientes que ingresan con infartos cerebrales isquémicos. Esta común enfermedad obedece a la prevalencia de enfermedades crónicas como la hipertensión arterial, diabetes mellitus, dislipidemias, tabaquismo y la alta expectativa de vida de los costarricenses, todos considera dos factores de riesgo. Aproximadamente un 80% de los infartos cerebrales son isquémicos secundarios a la oclusión arterial aguda de un territorio vascular específico; el restante 20% corresponde a la variante hemorrágica. Las secuelas neurológicas secundarias a esta entidad son la principal causa de discapacidad crónica en los pacientes y conllevan una alta morbilidad y mortalidad.

Aunque muchos sufren el infarto cerebral isquémico en forma aguda, otro grupo de pacientes experimenta uno o varios episodios previos de isquemia cerebral transitoria, lo cual los pone en riesgo de sufrir un infarto cerebral isquémico durante un periodo corto, es decir, son pacientes vulnerables. Esta revisión pretende actualizar los conocimientos médicos, especialmente para aquellos que trabajan en la atención primaria y en los servicios de urgencias hospitalarias, que reconozcan a este grupo de pacientes y les brinden la atención médica necesaria para de prevenir un infarto cerebral isquémico. La isquemia cerebral transitoria debe ser considerada como una emergencia neurológica.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Claiborne S.Transient Ischemic Attack. N Engl J Med 2002;21:1687-1692.

Johnson RT, Griftin JW and Mcarthur JC. Current therapy inNeurologic disease. Sixth edition. USA: Mosby, 2002.

The National Institute of Neurological Disorder and Stroke rt-PAStroke Study Group. Tissue plasminogen activator for acute ischemicstroke. N Engl J Med 1995;333:1581-1587.

Bricker ME, MD. Cardioembolic Stroke. Am J Med 1996;100:465-474.

Hankey G, Slattery J, Warlow C. Transient ischaemic attacks: whichpatients are at high (and low) risk of serious vascular events? JNeurol Neurosurg Psychiatry 1992;55:640-652.

Wolf P, Abbot R, Kannel W. Atrial fibrillation as an independent riskfactor for stroke: the Framingham Study. Stroke 1991;22:983-988.

Wolf P, Mitchell J, Baker C, Kannel W, D`Angostino R. Impact ofatrial fibrillation on mortality, stroke, and medical costs. Arch InternMed 1998;158:229-234.

Norris J. Risk of cerebral infarction, myocardial infarction and vas-cular death in patients with asymptomatic carotid disease, transientischemic attack and stroke. Cerebrovasc Dis 1992;2(suppl):2-5.

Adams HP. Treating ischemic stroke as an emergency. ArchNeurol.1998;55:457-461.

Barinagarrementería F, Cantú C. Enfermedad Vascular Cerebral.México: McGraw- Hill Interamericana, 1999.

Lee J, Zipfel G, Choi D. The changing landscape of ischaemic braininjury mechanism. Nature 1999;399:Suppl:A7-A14.

Brott T, Bogousslovsky J. Treatment of acute ischemic stroke. N EngJ Med 2000;343:710-722.

Kristian T, Siesjo B. Calcium in ischemic cell death. Stroke1998;29:705-718.

Guidelines for the management of transient ischemic attacks. Fromthe Ad Hoc Committee on Guidelines of the Management ofTransient Ischemic Attacks of the Stroke Council of the AmericanHeart Association. Stroke 1994;25:1320-1335.

Adams H Jr, del Zoppo G, von Kummer R. Management of stroke: apractical guide for the prevention, evaluation and treatment of acutestroke. USA: Professional Communications NC, 2002.

Donders R, Kappelle L, Derksen R. Transient monocular blindnessand antiphospholipid antibodies in systemic lupus erythematosus.Neurology 1998;51:535-540.

Johnston S, Gress D, Browner W, Sidney S. Short-term prognosisalter emergency department diagnosis of TIA. JAMA2000;284:2901-2906.

Dennis M, Bamford J, Sandercock P, Warlow C. Prognosis of tran-sient ischemic attacks in the Oxfordshire Community Stroke Project.Stroke 1990;21:848-853.

Streifler J, Eliasziw M, Benavente O. The risk of stroke in patientswith first-ever retinal vs. hemispheric transient ischemic attacks andhigh-grade carotid stenosis: North American Symptomatic CarotidEndarterectomy Trial. Arch Neurol 1995;52:246-249.

O`Leary D, Polak J, Kronmal R. Carotid-artery intima and mediathickness as a risk factor for myocardial infarction and stroke in olderadults. Cardiovascular Health Study Collaborative Reserch Group. NEng J Med 1999;340:14-22.

Hart R, Palacio S, Pearce L. Atrial fibrillation, stroke and acuteantithrombotic therapy. Analysis of randomized clinical trials. Stroke2002;33:2722-2727.

Paciaroni M, Bogousslovsky J. Clopidogrel for cerebrovascular pre-vention. Cerebrovasc Dis 1999;9:253-260.

Adams H. Emergent use of anticoagulation for treatment of patientswith ischemic stroke. Stroke 2002;33:856-861.

Tanne D, Turgerman D, Adler Y. Management of acute ischemicstroke in the elderly. Drugs 2001;32:1074-1078.

Hachinski V, Graffagnino C, Beaudry M. Lipids and Stroke: a para-dox resolved. Arch Neurol 1996;53:303-308.

Plehn J, Davis B, Sacks F. Reduction of stroke incidence aftermyocardial infarction with pravastatina: the Cholesterol andRecurrent Events (CARE) Study. The care investigators. Circulation1999;99:216-223.

Blauw G, Lagaay A, Smelt A, Westendorp R. Stroke, statins, and cho-lesterol. A meta-analysis of randomized, placebo-controlled, double-blind trials with HMG-CoA reductasa inhibitors. Stroke1997;28:946-950.

Biller J, Feinberg W, Castaldo J. Guidelines for carotid endarterecto-my: a statement for healthcare professionals from a Special WritingGroup of the Stroke Council, American Heart Association.Circulation 1998;97:501-509.

Sacks D, Connors J. Carotid Stent Placement, Stroke Prevention, andTraining. Radiology 2004;234:49-52.

Connors J, Saks D, Furlan A, Selman W, Russell E, Stieg P et al.Training, Competency, and Credentialing Standards for DiagnosticCervicocerebral Angiography, Carotid Stenting, and CerebrovascularIntervention : A Joint Statement from the American Academy ofNeurology, American Association of Neurological Surgeons,American Society of Interventional and Therapeutic Radiology,American Society of Neuroradiology, Congress of NeurologicalSurgeons, AANS/CNS Cerebrovascular Section, and Society ofInterventional Radiology. Radiology 2005;234:26-34.

Yadav J, Wholey M, Kuntz R, Fayad P, Katzen B, Mishkel G et al.Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients. N Eng J Med 2004;351:1493-1501

Lin P, Bush R, Lubbe D, Cox M, Zhou W, McCoy S et al. Carotidartery stenting with routine cerebral protection in high-risk patients.Am J Surg 2004;188:644-652.

Solenski N. Transient ischemic attacks: Part II. Treatment. Am FamPhysician 2004;69:1681-1688.

Descargas

Publicado

2006-01-01

Cómo citar

Rosales Bravo, L. G. (2006). Isquemia cerebral transitoria y riesgo de infarto cerebral isquémico. Acta Médica Costarricense, 48(1), 5–11. https://doi.org/10.51481/amc.v48i1.214