Infante-Valenzuela A, Góngora-Rivera F, Villarreal-Velázquez HJ

Idioma: Español
Referencias bibliográficas: 20
Paginas: 22-29
Archivo PDF: 218.86 Kb.

RESUMEN

Introducción: La isquemia cerebral transitoria (ICT) es un síndrome caracterizado por déficit neurológico focal de causa vascular y clínicamente autolimitado en ‹ 24 h. Identificar su etiología y establecer el tratamiento de prevención secundaria en forma oportuna disminuye el riesgo de recurrencia y de infarto cerebral definitivo. Objetivo: Describir la experiencia en el diagnóstico, terapéutica y pronóstico de los síndromes cerebrovasculares agudos en un sistema de atención inmediata, el programa SOS-AIT-HU. Material y métodos: En el primer año de operaciones se incluyeron 83 adultos con sospecha de ICT, referidos por los departamentos de Urgencias o Consulta Externa. Se clasificó la etiología según los sistemas TOAST y A-S-C-O, y estratificados por ABCD² y ABCD³+i. Se dio seguimiento a 30 y 90 días. Resultados: Se identificaron 49 (59%) casos que no correspondieropn genuinamente a ICT, principalmente de causas metabólicas y convulsivas. Se confirmaron 34 (41%) casos con ICT, con etiología según TOAST como sigue: siete (20%) aterotrombosis, cinco (14%) cardioembólicos, 15 (44%) de pequeños vasos, cuatro (12%) con otras causas determinadas y tres (9%) indeterminados. El tiempo promedio de hospitalización fue de 2.5 días y en 90% de los pacientes se definió la etiología en menos de tres días. Once sujetos (35%) tuvieron lesión en DWI-RM (infarto menor con recuperación espontánea ad integrum). La recurrencia fue de 5% a los 30 días y 14% a los 90 días. Conclusiones: El programa SOS-AIT-HU ha logrado aumentar la captación de pacientes con ICT y ha definido mejor los casos con etiologías que lo mimetizan. Se ha logrado un pronóstico similar al reportado en la literatura internacional. Hasta donde sabemos, el programa SOS-AIT-HU es el primero en su tipo en México.

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