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Colegio de Medicina Interna de México.

2008, Número 5

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Med Int Mex 2008; 24 (5)


Embolia paradójica en el sistema nervioso central, comunicación de un caso y revisión bibliográfica

Carrillo ER, Sánchez GJR

Idioma: Español
Referencias bibliográficas: 24
Paginas: 361-365
Archivo PDF: 253.70 Kb.


RESUMEN

Una causa frecuente de embolia paradójica en el sistema nervioso central es la persistencia del agujero oval permeable, casi siempre unilateral. Se comunica el caso de un hombre de 64 años de edad que ingresó a la unidad de terapia intensiva por deterioro rostrocaudal secundario a infartos temporoparietales bilaterales. El ecocardiograma reveló agujero oval permeable de 4 a 5 mm y aneurisma del tabique interauricular, por lo que se consideró embolia paradójica debida a los eventos isquémicos bilaterales. La embolia paradójica asociada con foramen oval permeable es causa importante de eventos cerebrovasculares, por lo general unilaterales y de repetición. Los eventos bilaterales, como en el paciente de este estudio, son poco frecuentes y suelen tener mal pronóstico. Se requiere de sospecha clínica importante y del diagnóstico diferencial adecuado para establecer su diagnóstico, tratar oportunamente el defecto del tabique interauricular y evitar los eventos isquémicos repetidos.


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