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Hemorragia intracerebral espontánea que ocurre durante el sueño: características clínicas y factores de riesgo

Joji Inamasu¹, Sota Wakahara¹, Takeo Oshima²

¹Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.

Asian journal of neurosurgery

|August 25, 2025

Resumen

La hemorragia intracerebral (HIC) durante el sueño está relacionada con peores resultados, especialmente en pacientes con enfermedad renal crónica (ERC) o diabetes. El hecho de no despertar indica un mayor riesgo de mortalidad en estos casos de accidente cerebrovascular relacionados con el sueño.

Área de la Ciencia:

Neurología
Nefrología
Endocrinología

Sus antecedentes:

La hemorragia intracerebral espontánea (HIC) durante el sueño está poco estudiada en comparación con el accidente cerebrovascular isquémico.
Existen investigaciones limitadas sobre las características clínicas y los factores de riesgo de la ECI con inicio en el sueño.
Este estudio aborda la brecha de conocimiento sobre el ICH nocturno.

Objetivo del estudio:

Investigar las características clínicas y los factores de riesgo de la hemorragia intracerebral (HIC) que se produce durante el sueño.
Para comparar los resultados entre los pacientes que experimentan ICH durante el sueño frente a la vigilia.
Evaluar el valor pronóstico de las diferentes presentaciones clínicas en la ECI de inicio del sueño.

Principales métodos:

Análisis retrospectivo de 119 pacientes con ICH de inicio en el sueño y 401 con ICH de inicio en la vigilia (2012-2017).
Comparación de los datos demográficos y los resultados entre los grupos de sueño y de vigilia.
Regresión multivariada para identificar los factores de riesgo para el inicio del ICH en el sueño.
Clasificación de las presentaciones de ICH con inicio del sueño (déficits, dolor de cabeza, falta de despertar) para evaluar los resultados.

Principales resultados:

El grupo de sueño tuvo frecuencias más altas de enfermedad renal crónica (ERC) y diabetes mellitus.
La ERC fue identificada como un factor de riesgo significativo para la ECI durante el sueño.
La mortalidad hospitalaria fue significativamente mayor en el grupo del sueño.
La falta de despertar se asoció con una mayor tasa de mortalidad.

Conclusiones:

La ECI durante el sueño se asocia con peores resultados en los pacientes.
La hipertensión nocturna en pacientes con ERC y diabetes puede contribuir al aumento de la incidencia de ECI con inicio en el sueño.
La presentación clínica, específicamente la falta de despertar, puede servir como un indicador de pronóstico para el inicio del sueño ICH.

Palabras clave:

Enfermedad renal crónica la diabetes hemorragia intracerebral Factor de riesgo el sueño

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