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Accidente cerebrovascular isquémico recurrente temprano en pacientes con accidente cerebrovascular sometidos a
Dimitrios Georgiadis1, Stefan Engelter, Barbara Tettenborn
1Department of Neurology, University of Zürich, Frauenklinikstrasse 26, 8091 Zürich, Switzerland. Dimitrios.Georgiadis@usz.ch
Circulation
|July 13, 2006
Resumen
El accidente cerebrovascular isquémico recurrente temprano es raro en pacientes que reciben trombolisis intravenosa, y ocurre en menos del 1% de los casos. La hemorragia intracraneal sintomática es más común, con un tiempo diferente después del tratamiento.
Área de la Ciencia:
- Neurología Neurología.
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Medicina de emergencia Medicina de emergencia.
Sus antecedentes:
- Evaluación de la incidencia de accidente cerebrovascular isquémico recurrente temprano en pacientes tratados con activador de plasminógeno de tipo tisular intravenoso (tPA).
- Comparando el patrón temporal del accidente cerebrovascular isquémico recurrente con la hemorragia intracraneal sintomática (HIC).
Objetivo del estudio:
- Para determinar la frecuencia del accidente cerebrovascular isquémico recurrente temprano después del tratamiento con tPA.
- Para comparar el tiempo de recurrente accidente cerebrovascular isquémico versus ICH sintomático en pacientes con accidente cerebrovascular agudo.
Principales métodos:
- Análisis retrospectivo de datos prospectivamente recopilados basados en la población de 341 pacientes con accidente cerebrovascular agudo tratados con tPA.
- Resultado primario: deterioro neurológico (≥4 puntos en la Escala de Accidentes Cerebrovasculares de los NIH) dentro de las 24 horas, atribuido a un accidente cerebrovascular isquémico recurrente o ICH sintomático.
- Datos recogidos de 8 centros médicos suizos entre enero de 2001 y noviembre de 2004.
Principales resultados:
- El accidente cerebrovascular isquémico recurrente temprano ocurrió en el 0,59% de los pacientes (2/341).
- La ICH sintomática ocurrió en el 4,40% de los pacientes (15/341).
- Los accidentes cerebrovasculares isquémicos recurrentes ocurrieron durante la trombólisis; ICHs sintomáticos ocurrieron 2-22 horas después de la infusión.
Conclusiones:
- El ictus isquémico recurrente es una causa poco común de deterioro neurológico temprano en pacientes con ictus agudo que reciben trombolisis intravenosa.
- La ocurrencia temporal del ictus isquémico recurrente difiere significativamente de la del ictus isquémico sintomático.
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