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2009, Número 2

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Med Sur 2009; 16 (2)


Actualidades en terapia intensiva neurológica.Tercera parte.Craniectomía descompresiva

Carrillo ER, Leal GP, Morones O

Idioma: Español
Referencias bibliográficas: 34
Paginas: 55-62
Archivo PDF: 123.06 Kb.


RESUMEN

Antecedentes: La craniectomía descompresiva es una maniobra terapéutica que permite la expansión cerebral en aquellos casos donde el edema cerebral es el determinante principal de la hipertensión intracraneal. Objetivo: Revisar la evidencia científica actual del impacto de la craniectomía descompresiva en aquellos enfermos con hipertensión intracraneal secundaria a traumatismo craneoencefálico y enfermedades vasculares cerebrales hemorrágicas o isquémicas. Discusión: La craniectomía descompresiva disminuye la presión intracraneal de manera significativa tanto en enfermos con traumatismo craneoencefálico como en enfermos con patología cerebrovascular aguda. El impacto de la maniobra en la evolución neurológica en los enfermos con traumatismo craneoencefálico a largo plazo no es concluyente hasta este momento. En los enfermos con patología cerebrovascular aguda tiene un impacto favorable en la evolución de estos enfermos. Conclusión: Es necesario el desarrollo y resultados de estudios aleatorizados, multicéntricos para evaluar la efectividad de la maniobra terapéutica en los enfermos con traumatismo craneoencefálico. El grado de evidencia en los enfermos con enfermedad cerebrovascular aguda es lo suficientemente fuerte como para recomendarse en casos de hipertensión intracraneal.


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