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Preste atención a la advertencia: un informe de caso sobre el síndrome de advertencia cápsula.

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El síndrome de advertencia cápsula, una rara causa de accidente cerebrovascular, puede presentarse con síntomas fluctuantes. El reconocimiento inmediato y el seguimiento cercano son vitales, incluso si los síntomas iniciales se resuelven, debido al alto riesgo de accidente cerebrovascular dentro de las 48 horas.

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Área de la Ciencia:

  • Neurología Neurología.
  • Medicina de emergencia Medicina de emergencia.
  • Radiología Radiología.

Sus antecedentes:

  • Los déficits neurológicos agudos son comunes en el departamento de emergencias (ED).
  • Algunas presentaciones requieren una mayor preocupación, ya que la resolución de los síntomas no excluye una patología grave.
  • Este caso subraya la importancia de las evaluaciones repetidas para los déficits neurológicos agudos.

Objetivo del estudio:

  • Para resaltar la rara condición del síndrome de advertencia capsular.
  • Para enfatizar la importancia de reconocer los síntomas fluctuantes en el accidente cerebrovascular agudo.
  • Discutir las implicaciones del manejo del síndrome de advertencia capsular en la DE.

Principales métodos:

  • Un hombre de 59 años con enfermedad arterial coronaria y VIH presentó caída facial del lado izquierdo y hemiparesia.
  • La angiografía por TC y la perfusión inicial no mostraron hemorragia ni oclusión de vasos grandes.
  • La resonancia magnética reveló un infarto isquémico agudo en los ganglios basales y la ínsula derecha, consistente con el síndrome de advertencia capsular.

Principales resultados:

  • El paciente experimentó una resolución recurrente de los síntomas y una recurrencia después de la administración de alteplasa.
  • La resonancia magnética confirmó un infarto isquémico agudo en los ganglios basales derechos y la región insular.
  • La presentación clínica y las imágenes fueron consistentes con el síndrome de advertencia capsular.

Conclusiones:

  • El síndrome de advertencia cápsula ocurre en el 1,5-5% de los pacientes con accidente cerebrovascular y requiere un reconocimiento inmediato.
  • La resolución de los síntomas no descarta una patología grave; el alto riesgo de accidente cerebrovascular persiste dentro de las 48 horas.
  • Los síntomas recurrentes después de la trombólisis justifican un manejo agudo y una estrecha vigilancia del síndrome de advertencia capsular.