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Trombosis venosa cerebral después de cirugía cerebral
Ana João Nunes1, Marta Carvalho2
1University of Porto, Faculty of Medicine, Porto, Portugal.
Clinical neurology and neurosurgery
|February 19, 2026
Resumen
La trombosis venosa cerebral (TVC) después de cirugía cerebral es rara pero cada vez más reconocida. El manejo requiere decisiones individualizadas debido a la evidencia limitada, lo que enfatiza la necesidad de una mayor investigación.
Área de la Ciencia:
- Neurología
- Neurocirugía
- Medicina Vascular
Sus antecedentes:
- La trombosis venosa cerebral (TVC) es una complicación rara después de la cirugía cerebral.
- El aumento del reconocimiento está relacionado con la frecuente obtención de imágenes posoperatorias.
- Existe controversia sobre el tratamiento antitrombótico agudo.
Objetivo del estudio:
- Revisar la literatura sobre TVC en pacientes poscirugía cerebral.
- Enfocarse en las estrategias de manejo diagnóstico y terapéutico.
- Analizar la evidencia actual e identificar lagunas de investigación.
Principales métodos:
- Revisión narrativa de la literatura publicada.
- Búsqueda en PubMed de artículos (2014-2025).
- Inclusión de 32 estudios después de la selección.
Principales resultados:
- La TVC a menudo es asintomática y se detecta en imágenes de rutina.
- Los síntomas incluyen hipertensión intracraneal, convulsiones y recuperación tardía.
- El diagnóstico utiliza venografía por TC/RM; se indica el cribado de trombofilia.
- La anticoagulación parenteral es de primera línea; se prefiere la heparina no fraccionada inicialmente.
- Terapia endovascular para casos de alto riesgo/refractarios.
- Medidas preventivas: minimizar la lesión sinusal, asegurar la hidratación.
- Se considera la anticoagulación profiláctica posoperatoria según el riesgo.
- El pronóstico es generalmente favorable, pero la evidencia es limitada.
Conclusiones:
- La TVC poscirugía cerebral es rara y requiere un manejo específico para cada caso.
- La evidencia limitada exige la extrapolación de poblaciones generales.
- La investigación específica es crucial para mejorar los resultados y la guía del tratamiento.
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