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

Targol Tarahomi¹, Sean Serio^1,2, Alexander John Scumpia¹

¹HCA Florida Aventura Hospital, Department of Emergency Medicine, Aventura, Florida.

Clinical practice and cases in emergency medicine

|February 10, 2026

Resumen

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.

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.

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