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2008, Número 3

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Rev Hosp Jua Mex 2008; 75 (3)


Vasoespasmo cerebral posterior a hemorragia subaracnoidea aneurismática: Métodos diagnósticos y escalas de valoración

Reyes SG, Mendizábal GR, Acosta GR, Ayala AA, Soto BJC, Pérez CJC, Delgado HC, Hernández ML

Idioma: Español
Referencias bibliográficas: 64
Paginas: 206-212
Archivo PDF: 199.50 Kb.


RESUMEN

El vasoespasmo cerebral como complicación de hemorragia subaracnoidea (HSA), fue descrita hace más de 50 años por Ecker y Riemenschnaider. La incidencia mundial de hemorragia es subaracnoidea de 6 a 10.5 por cada 100,000 habitantes al año. El vasoespasmo es causado por la presencia de sangre en el espacio subaracnoideo. El déficit neurológico causado por vasoespasmo, rara vez aparece dentro de los tres primeros días después de la HSA, siendo más frecuente entre los días 6 8. Los aneurismas pueden romperse en cualquier momento e incluso durante el sueño, 85% de los aneurismas rotos suele romperse hacia el espacio subaracnoideo y 15% hacia el parénquima cerebral, ventrículos y espacio subdural. El pico de resangrado es mayor en las primeras 24 48 horas. La utilidad del Doppler transcraneal tiene valor pronóstico en el vasoespasmo cerebral. La angiografía cerebral sigue siendo el estándar de oro en diagnóstico de vasoespasmo. El uso de calcio antagonistas se sigue usando para prevención de vasoespasmo cerebral.


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