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Academia Mexicana de Neurología, A.C.

2005, Número 6

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Rev Mex Neuroci 2005; 6 (6)


Vasoespasmo cerebral. Un reto para la medicina moderna

Varela HA, Vega BS, Herrera LO, De Zayas AE, Infante FJ

Idioma: Español
Referencias bibliográficas: 42
Paginas: 491-499
Archivo PDF: 67.04 Kb.


RESUMEN

Objetivo: Muchos aspectos relacionados con el vasoespasmo cerebral son aún enigmáticos y su manejo complejo. Se realiza una revisión de un grupo de artículos representativos de los principales avances realizados en este campo. Desarrollo: La literatura revisada muestra los avances logrados en la comprensión de las alteraciones a nivel molecular, sobre todo en el rol del óxido nítrico y las endotelinas. Siempre deben tenerse en cuenta los factores de riesgo de sufrir esta complicación frecuente en la hemorragia subaracnoidea y sus manifestaciones clínicas, para un diagnóstico oportuno mediante las tecnologías de punta como Doppler transcraneal y estudios directos del flujo sanguíneo cerebral. Aunque se ha avanzado en determinar la utilidad de cada técnica de tratamiento, se realza las investigaciones en otras modalidades terapéuticas como la angioplastia transluminar, donadores de óxido nítrico e inhibidores de las endotelinas. Conclusiones: Los vasos sanguíneos cerebrales cuentan con un balanceado sistema autocrino y paracrino, cuya alteración genera las manifestaciones fisiopatológicas y clínicas del vasoespasmo. La aplicación sistemática del Doppler transcraneal a los pacientes portadores de hemorragia subaracnoidea, y otros exámenes complementarios, permite una utilización más eficiente del arsenal terapéutico disponible. El desarrollo de nuevas modalidades de tratamiento basadas en las investigaciones básicas y en la evidencia clínica, permitirá mejorar el pronóstico de esta entidad.


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