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Ataques isquémicos transitorios lacunares: ¿un concepto clínicamente útil?

G J Hankey¹, C P Warlow

¹Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.

Lancet (London, England)

|February 9, 1991

Resumen

Los ataques isquémicos transitorios (AIT) muestran heterogeneidad. Los IAT corticales están relacionados con la enfermedad de la arteria carótida, mientras que los IAT lacunares sugieren problemas de vasos pequeños, lo que afecta el diagnóstico y el tratamiento.

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Área de la Ciencia:

Neurología Neurología.
Neurología Vascular Neurología Vascular
Enfermedad Cerebrovascular Enfermedad Cerebrovascular

Sus antecedentes:

Los accidentes cerebrovasculares isquémicos lacunares y corticales son entidades clínicas distintas.
Los ataques isquémicos transitorios (AIT) también pueden exhibir heterogeneidad.

Objetivo del estudio:

Investigar la potencial heterogeneidad de las AIT.
Para diferenciar entre TIAs corticales y lacunares basados en la patología subyacente.

Principales métodos:

Estudio prospectivo de 130 pacientes con AIT.
La angiografía carotídea se realizó en 71 pacientes.
Correlación del tipo de AIT con la estenosis de la arteria carótida interna.

Principales resultados:

Estenosis ipsilateral significativa de la arteria carótida interna (>50%) se encontró en el 67% de los pacientes con AIT cortical.
Solo el 6% de los pacientes con AIT lacunar tenían estenosis significativa (p < 0,0001).
AIT corticales asociados con enfermedad extracraneal de los vasos grandes; AIT lacunares con enfermedad intracraneal de los vasos pequeños.

Conclusiones:

Los AIT corticales están vinculados a la enfermedad ateromatosa de la arteria carótida extracraneal.
Los AIT lacunales pueden indicar una enfermedad de los vasos pequeños intracraneales.
Distinguir los tipos de AIT es crucial para una investigación y gestión adecuadas.