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1.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 68(1): 44-49, Jan. 2022. tab
Article Dans Anglais | LILACS | ID: biblio-1360708

Résumé

SUMMARY OBJECTIVE: The aim of this study was to investigate the correlation between the Trial of Org 10172 in acute stroke treatment classification and the National Institutes of Health Stroke Scale score of acute cerebral infarction as well as acute cerebral infarction's risk factors. METHODS: The clinical data of 3,996 patients with acute cerebral infarction hospitalized in Hebei Renqiu Kangjixintu Hospital from January 2014 to November 2018 were analyzed retrospectively. According to Trial of Org 10172 in acute stroke treatment, they were divided into five groups: arteriosclerosis, cardio cerebral embolism, arterial occlusion, other causes, and unknown causes. Through questionnaire design, routine physical examination, and physical and chemical analysis of fasting venous blood samples, the risk factors were evaluated, and the correlation between Trial of Org 10172 in acute stroke treatment classification and National Institutes of Health Stroke Scale classification was analyzed using multivariate logistic regression. In addition, the relationship between National Institutes of Health Stroke Scale score and risk factors in different groups was compared, and the correlation between Trial of Org 10172 in acute stroke treatment classification and National Institutes of Health Stroke Scale score was analyzed. RESULTS: Multivariate logistic regression analysis showed that diabetes, atrial fibrillation or stroke history, age, and education level were related to Trial of Org 10172 in acute stroke treatment classification. In the National Institutes of Health Stroke Scale comparison, the scores of the cardio cerebral embolism group were significantly higher than those of the other four groups, and patients with diabetes, atrial fibrillation, or stroke history had a high share, especially atrial fibrillation (33.06%). CONCLUSIONS: The nerve function defect is more serious after acute cerebral infarction with cardiogenic cerebral embolism, indicating a poor prognosis.


Sujets)
Humains , Accident vasculaire cérébral/étiologie , États-Unis , Infarctus cérébral/complications , Infarctus cérébral/diagnostic , Chondroïtines sulfate , Études rétrospectives , Facteurs de risque , Chondroïtine sulfate B , Héparitine sulfate , National Institutes of Health (USA)
2.
Article Dans Français | AIM | ID: biblio-1271850

Résumé

La mortalité à 3 mois des infarctus cérébraux demeure encore élevée en Afrique Sub Saharienne. L'objectif de notre étude était d'évaluer la mortalité intra hospitalière, à un mois et à 3 mois des patients hospitalisés pour infarctus cérébral au Burkina Faso. Il s'agissait d'une étude de cohorte prospective de patients consécutivement hospitalisés pour infarctus cérébral, de mars 2015 à février 2016, puis suivis en consultation externe durant au moins 3 mois après l'AVC au Centre Hospitalier Universitaire de Tingandogo, à Ouagadougou, au Burkina Faso. Les caractéristiques sociodémographiques, cliniques et paracliniques des patients à l'admission, les complications et la mortalité cumulée respectivement à la sortie d'hospitalisation, à un mois et à 3 mois, ont été analysées. En tout, 151 patients ont été enregistrés, avec une prédominance masculine (59,6 %) et une moyenne d'âge de 63,4 ans. Lors de l'admission, le National Institute of Health Stroke Score (NIHSS) moyen était de 14. L'oedème cérébral (39,7 %) et l'effet de masse (35,1 %) était les complications neuroradiologiques précoces les plus fréquentes. La durée moyenne d'hospitalisation était de 13,4 jours. Les taux de mortalité, intra hospitalière, à un mois et 3 mois étaient respectivement de 17,9 %, 19 % et 25,9 %. La mortalité des infarctus cérébraux reste élevée en Afrique Sub Saharienne. L'utilisation de la fibrinolyse, la mise en place des unités neurovasculaires et un accès des patients à la rééducation fonctionnelle, contribueront à l'amélioration de la survie des patients après infarctus cérébraux


Sujets)
Afrique subsaharienne , Burkina , Infarctus cérébral/complications , Infarctus cérébral/diagnostic , Infarctus cérébral/épidémiologie , Infarctus cérébral/mortalité , Patients hospitalisés
3.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 28(3): 267-275, jul.-ago. 2018. tab
Article Dans Anglais, Portugais | LILACS | ID: biblio-916465

Résumé

O acidente vascular cerebral (AVC) é a maior causa de incapacidade em todo mundo, e atualmente é também considerado como a segunda maior causa de morte no Brasil. O AVC isquêmico é o subtipo mais comum e pode ser subdividido etiologicamente em car-dioembólico, aterosclerótico de grandes ou pequenas artérias (lacunas), criptogênico ou de outras etiologias. Dependendo da etiologia encontrada, a profilaxia secundária de novos eventos deve ser feita através de medicações antitrombóticas específicas. Portanto, investigar adequadamente a etiologia do evento vascular isquêmico é fundamental para a instituição da profilaxia secundária apropriada. A terapia antitrombótica pós-AVC isquêmico evoluiu consideravelmente na última década. Especificamente para pacientes com AVC e fibrilação atrial, a incorporação de anticoagulantes de ação direta à prática clínica representa um grande avanço, já que tais medicações são mais eficazes e seguras para o tratamento de pacientes de alto risco. No presente artigo, discutiremos o uso de antitrombóticos em pacientes com AVC em diferentes momentos pós-icto vascular e nas distintas etiologias possíveis


Stroke is the leading cause of disability worldwide, and is currently also considered the second leading cause of death in Brazil. Ischemic stroke is the most common subtype and can be subdivided etiologically into cardioembolic, atherosclerotic (large artery atherosclero-sis or small vessel disease-lacunae), cryptogenic or strokes of other etiologies. Depending on the etiology, secondary prophylaxis of new events should be undertaken with specific antithrombotic medications. Therefore, a thorough investigation of ischemic vascular event etiology is essential for the introduction of appropriate secondary prophylaxis. Antithrombotic therapy after ischemic stroke has evolved considerably in the last decade. The incorporation of direct-acting anticoagulants into clinical practice represents a major advance, particularly for stroke and atrial fibrillation patients, since such medications are safer and more effective for the treatment of high-risk patients. In this article, we will discuss the use of antithrombo-tics in stroke patients at different post-stroke stages and in the distinct possible etiologies


Sujets)
Humains , Mâle , Femelle , Traitement thrombolytique/méthodes , Accident vasculaire cérébral/étiologie , Accident vasculaire cérébral/physiopathologie , Prévention des Maladies , Antiagrégants plaquettaires/usage thérapeutique , Infarctus cérébral/diagnostic , Acide acétylsalicylique/usage thérapeutique , Facteurs de risque , Diabète , Prévention secondaire/méthodes , Mode de vie sédentaire , Rivaroxaban/usage thérapeutique , Hypertension artérielle , Anticoagulants/usage thérapeutique
4.
Rev. neuro-psiquiatr. (Impr.) ; 79(1): 16-22, ene.-mar. 2016. tab, graf
Article Dans Espagnol | LILACS, LIPECS | ID: lil-786593

Résumé

Objetivos: Precisar la etiología del infarto cerebral en adultos jóvenes hospitalizados en el Departamento de Enfermedades Neurovasculares del Instituto Nacional de Ciencias Neurológicas (INCN) durante el periodo 2010 al 2013. Material y métodos: Estudio descriptivo, retrospectivo, de corte transversal; en paciente jóvenes con diagnóstico de infarto cerebral, hospitalizados en el INCN, en el periodo de estudio que tuvieron tomografía y/o imagen de resonancia magnética cerebral. Resultados: Un total de 43 pacientes cumplieron los criterios de inclusión. El 55,8% fueron mujeres. La media de edad fue 37,6+/-6,4 años. El 69,8% provenían de Lima. El 44,2% de los casos fueron de etiología indeterminada, 23,3% cardioembólica. La media de edad para la etiología atero-trombótica fue de 41,8 años, y para la etiología indeterminada de 34,7 años. El territorio vascular mayormente comprometido fue el de la circulación anterior con 65,1%.Conclusiones: Se describen las características clínicas, sociodemográficas y la etiología del infarto cerebral en adultos jóvenes. Los más frecuentes fueron: indeterminada y cardioembólica. Las enfermedades metabólicas y el uso de anticonceptivos orales fueron los factores asociados más frecuentes. No hubo mortalidad. El territorio vascular cerebral mayormente comprometido fue la circulación anterior.


Objectives: Clarify the etiology of cerebral infarction in young adults hospitalized in the Department of Neurovascular Diseases at the National Institute of Neurological Sciences (INCN), during the period 2010 to 2013. Material and Methods: Descriptive, retrospective, cross-sectional study in a sample of young patients diagnosed with cerebral infarction, hospitalized during the study period and who underwent tomography and / or magnetic resonance imaging brain tests. Results: A total of 43 patients, 55.8 % of them female, met the inclusion criteria. The mean age was 37.6 +/- 6.4 years, 69.8% came from Lima, and 44.2% of the cases were of undetermined etiology and 23.3%, cardioembolic. The average age for artery occlusive disease was 41.8 years, and for undetermined etiology, 34.7 years. The vascular territory mostly compromised was that of the anterior circulation with 65.1%. Conclusions: Sociodemographic, clinical characteristics, and etiological factors of cerebral infarction in young adults were described. The most frequent etiologieswerecardioembolic and undeterminated. Metabolic diseases and the use of oral contraceptives were the most frequently associated factors. The cerebral vascular territory mostlyaffected was that of the anterior circulation. No deaths occurred.


Sujets)
Humains , Mâle , Femelle , Jeune adulte , Infarctus cérébral/diagnostic , Infarctus cérébral/étiologie , Épidémiologie Descriptive , Études rétrospectives , Études transversales
5.
Rev. méd. Chile ; 143(8): 1081-1084, ago. 2015. ilus
Article Dans Anglais | LILACS | ID: lil-762675

Résumé

We report a 61 years old male presenting with a right cerebral infarction, along with a type I persistent left proatlantal artery (PA), which is a form of primitive carotid-basilar anastomosis. The patient had an absence of the ipsilateral vertebral artery (VA) and hypoplasia of the contralateral VA, while the basilar artery was supplied by the PA. Other vascular anomalies present were a fusiform aneurysm of the right subclavian artery, and an A1 segment aplasia of the hypoplastic anterior right cerebral artery, which originated from the anterior communicating artery. To our knowledge these anomalies were not described previously.


Sujets)
Humains , Mâle , Adulte d'âge moyen , Anévrysme intracrânien/diagnostic , Artère subclavière/malformations , Artère vertébrale/malformations , Encéphalopathie ischémique/complications , Infarctus cérébral/diagnostic , Endartériectomie carotidienne , Issue fatale , Accident vasculaire cérébral/complications
6.
Rev. méd. Chile ; 143(4): 520-524, abr. 2015. ilus
Article Dans Espagnol | LILACS | ID: lil-747557

Résumé

Intracranial sinus venous thrombosis (ICSVT) is a rare complication of ulcerative colitis that affects from 1.7 to 7.5% of patients. We report a 22 year-old male with ulcerative colitis in treatment with mesalazine and prednisone presenting with headache and speech disturbances. A magnetic resonance imaging of the brain showed a left temporal hemorrhagic infarct with thrombosis of the ispilateral superficial vein and sigmoid venous sinus. No cause of thrombophilia was detected. Anticoagulation with heparin was started which was changed to oral anticoagulation with warfarin. The patient was discharged ten days after admission.


Sujets)
Humains , Mâle , Jeune adulte , Rectocolite hémorragique/complications , Thromboses des sinus intracrâniens/étiologie , Anti-inflammatoires/usage thérapeutique , Anticoagulants/usage thérapeutique , Infarctus cérébral/diagnostic , Rectocolite hémorragique/traitement médicamenteux , Énoxaparine/usage thérapeutique , Céphalée/traitement médicamenteux , Céphalée/étiologie , Mésalazine/usage thérapeutique , Prednisone/usage thérapeutique , Thromboses des sinus intracrâniens/diagnostic , Thromboses des sinus intracrâniens/traitement médicamenteux , Troubles de la parole/traitement médicamenteux , Troubles de la parole/étiologie
8.
Korean Journal of Radiology ; : 858-861, 2014.
Article Dans Anglais | WPRIM | ID: wpr-228618

Résumé

We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.


Sujets)
Sujet âgé , Humains , Mâle , Anticoagulants/usage thérapeutique , Artères carotides/imagerie diagnostique , Infarctus cérébral/diagnostic , Antiagrégants plaquettaires/usage thérapeutique , Endoprothèses/effets indésirables , Thrombose/traitement médicamenteux , Ticlopidine/analogues et dérivés , Tomodensitométrie
9.
Korean Journal of Ophthalmology ; : 314-322, 2014.
Article Dans Anglais | WPRIM | ID: wpr-156978

Résumé

PURPOSE: To evaluate patterns of macular retinal ganglion cell (RGC) loss measured by spectral domain optical coherence tomography in patients with neurologic lesions mimicking glaucoma. METHODS: We evaluated four patients with neurological lesions who showed characteristic patterns of RGC loss, as determined by ganglion cell thickness (GCT) mapping. RESULTS: Case 1 was a 30-year-old man who had been treated with glaucoma medication. A left homonymous vertical pattern of RGC loss was observed in his GCT map and a past brain magnetic resonance imaging (MRI) revealed a hemorrhagic lesion around the right optic radiation. Case 2 was a 72-year-old man with a pituitary adenoma who had a binasal vertical pattern of RGC loss that corresponded with bitemporal hemianopsia. Case 3 was a 77-year-old man treated for suspected glaucoma. His GCT map showed a right inferior quadratic pattern of loss, indicating a right superior homonymous quadranopsia in his visual field (VF). His brain MRI revealed a left posterior cerebral artery territory infarct. Case 4 was a 38-year-old woman with an unreliable VF who was referred for suspected glaucoma. Her GCT map revealed a left homonymous vertical pattern of RGC loss, which may have been related to a previous head trauma. CONCLUSIONS: Evaluation of the patterns of macular RGC loss may be helpful in the differential diagnosis of RGC-related diseases, including glaucoma and neurologic lesions. When a patient's VF is unavailable, this method may be an effective tool for diagnosing and monitoring transneuronal retrograde degeneration-related structural changes.


Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Lésions encéphaliques/diagnostic , Infarctus cérébral/diagnostic , Diagnostic différentiel , Glaucome/diagnostic , Hémianopsie/diagnostic , Imagerie par résonance magnétique , Neurofibres/anatomopathologie , Maladies du système nerveux/diagnostic , Tumeurs de l'hypophyse/diagnostic , Cellules ganglionnaires rétiniennes/anatomopathologie , Études rétrospectives , Tomographie par cohérence optique , Tonométrie oculaire , Acuité visuelle , Tests du champ visuel , Champs visuels
10.
The Korean Journal of Gastroenterology ; : 120-124, 2014.
Article Dans Anglais | WPRIM | ID: wpr-62193

Résumé

We presented two interesting cases of gastrocolocutaneous fistula that occurred after percutaneous endoscopic gastrostomy (PEG) tube placement, and its management. This fistula is a rare complication that occurs after PEG insertion, which is an epithelial connection between mucosa of the stomach, colon, and skin. The management of the fistula is controversial, ranging from conservative to surgical intervention. Endoscopists should be aware of the possibility of gastrocolocutaneous fistula after PEG insertion, and should evaluate the risk factors that may contribute to the development of gastrocolocutaneous fistula before the procedure. We reviewed complications of gastrostomy tube insertion, symptoms of gastrocolocutaneous fistula, and its risk factors.


Sujets)
Sujet âgé , Humains , Mâle , Adulte d'âge moyen , Infarctus cérébral/diagnostic , Fistule digestive/étiologie , Endoscopie gastrointestinale , Nutrition entérale/effets indésirables , Gastrostomie , Maladies du système nerveux/diagnostic , Facteurs de risque , Tomodensitométrie
11.
Arq. bras. neurocir ; 32(4)dez. 2013. ilus
Article Dans Portugais | LILACS | ID: lil-721641

Résumé

Entende-se por infarto maligno aquele que acomete mais da metade do território da artéria cerebral média, atingindo níveis de mortalidade de até 80%. A craniotomia descompressiva tem se mostrado como técnica operatória capaz de reduzir significativamente essas taxas. No entanto, persistem na literatura muitas dúvidas quanto à indicação do procedimento relacionadas a idade, hemisfério cerebral acometido, time cirúrgico e status neurológico pré-operatório. Analisamos 10 pacientes vítimas de acidente vascular cerebral (AVC) isquêmicos extensos, tratados no hospital SEMPER-BH, levando-se esses fatores em consideração. Concluímos que a idade e o quadro neurológico prévio ao momento cirúrgico são os dois fatores mais importantes no prognóstico do paciente submetido à craniotomia descompressiva.


It is understood that malignant infarction affects more than half of the middle cerebral artery territory and reaches mortality rates up to 80%. A decompressive craniotomy has been recommended as the surgical technique that can significantly reduce these rates. However, many questions persist in the literature as the indication of the procedure related to age, hemisphere affected, surgical time and preoperative neurological status. We analyzed 10 patients who suffered extensive ischemic stroke treated in hospital SEMPER-BH taking these factors into consideration. We conclude that age and neurological status prior to the surgical time are the two most important factors in the prognosis of patients undergoing decompressive craniotomy.


Sujets)
Humains , Adulte , Adulte d'âge moyen , Sujet âgé de 80 ans ou plus , Craniectomie décompressive , Infarctus cérébral/chirurgie , Infarctus cérébral/diagnostic
12.
Bahrain Medical Bulletin. 2013; 35 (4): 215-217
Dans Anglais | IMEMR | ID: emr-143111

Résumé

We present a case of cerebral venous thrombosis and cerebral infarction associated with diabetic ketoacidosis. The patient presented with vomiting, headache, lethargy and altered sensorium. CT venography provided the final diagnosis; therefore, anticoagulant was used, which resulted in the improvement of neurological outcome. Neurological deterioration during an episode of diabetic ketoacidosis is usually assumed to be caused by cerebral edema. Neuroimaging should always be performed in suspected cerebral edema associated with diabetic ketoacidosis in order to exclude other pathologies.


Sujets)
Humains , Femelle , Acidocétose diabétique/complications , Thromboses des sinus intracrâniens/diagnostic , Thromboses des sinus intracrâniens/étiologie , Thrombose intracrânienne/complications , Infarctus cérébral/diagnostic , Spectroscopie par résonance magnétique , Conscience immédiate , Angiographie cérébrale , Neuroimagerie , Veines de l'encéphale/imagerie diagnostique , Maladies rares
13.
Arq. neuropsiquiatr ; 70(12): 942-944, Dec. 2012. ilus
Article Dans Anglais | LILACS | ID: lil-660318

Résumé

The authors highlights the importance of the vestibulo-ocular reflex examination through the head impulse test as a diagnostic method for vestibular dysfunction as well as, and primarily, a bedside semiotic resource capable of differentiating between acute peripheral vestibulopathy and a cerebellar or brainstem infarction in emergency rooms.


Os autores ressaltam a importância do exame do reflexo vestíbulo-ocular por meio do teste do impulso da cabeça como método diagnóstico de hipofunção vestibular. Este método é também - e principalmente - um instrumento semiótico de beira do leito capaz de auxiliar no diagnóstico diferencial entre a vestibulopatia periférica aguda e o infarto cerebelar ou do tronco cerebral na sala de emergência.


Sujets)
Humains , Maladies du cervelet/diagnostic , Infarctus cérébral/diagnostic , Réflexe vestibulo-oculaire/physiologie , Maladies vestibulaires/diagnostic , Épreuves vestibulaires/méthodes , Urgences
14.
Rev. cuba. obstet. ginecol ; 38(2): 269-275, abr.-jun. 2012.
Article Dans Espagnol | LILACS | ID: lil-642069

Résumé

La enfermedad cerebrovascular durante la gestación es rara. El presente trabajo tiene como objetivo describir las características clínicas de una paciente con embolismos de la arteria humeral derecha y tallo encefálico en el periodo expulsivo de un parto eutócico sin foco embolígeno causante de dicho accidente cerebrovascular. Se presenta el caso de una parturienta de 29 años con 40,2 semanas de edad gestacional que durante el periodo expulsivo de un parto eutócico comenzó a presentar dolor intenso en el miembro superior derecho con cambios de coloración y temperatura e impotencia funcional, imposibilidad para la apertura palpebral bilateral, vómitos sin náuseas, disartria y dificultad en los movimientos oculares...


The cerebrovascular disease during pregnancy is uncommon. The objective of present paper is to describe the clinical features of a patient with embolisms of the right humeral artery and of the brainstem at expulsion period of a spontaneous labor without emboligen focus causing this cerebrovascular accident...


Sujets)
Humains , Femelle , Grossesse , Adulte , Embolie et thrombose intracrâniennes/chirurgie , Embolie et thrombose intracrâniennes/traitement médicamenteux , Infarctus cérébral/diagnostic , Troubles du postpartum/physiopathologie , Présentations de cas
15.
Indian J Pediatr ; 2010 Mar; 77(3): 316-317
Article Dans Anglais | IMSEAR | ID: sea-142529

Résumé

A 10-yr-old HbE/Beta thalassemia child who developed subacute to chronic occipitotemporal hemorrhagic infarct with smaller chronic infarct with gliotic changes in the left frontal periventricular white matter. Genetic tests showed that patient was positive for HbE and IVS1-5 mutation and was negative for thrombogenic mutations. Hemorrhagic infarct was confirmed by magnetic resonance imaging study. Antigenic levels of Protein C and Protein S were low. Based on these outcomes, it was concluded that Protein C and Protein S deficiency were the causative factor for developing hemorrhagic infarct in the HbE/ Beta thalassemia patient.


Sujets)
Hémorragie cérébrale/diagnostic , Hémorragie cérébrale/étiologie , Infarctus cérébral/diagnostic , Infarctus cérébral/étiologie , Enfant , Humains , Imagerie par résonance magnétique , Mâle , Déficit en protéine C/complications , Déficit en protéine C/diagnostic , Déficit en protéine S/complications , Déficit en protéine S/diagnostic , bêta-Thalassémie/complications
18.
West Indian med. j ; 58(3): 261-264, June 2009. tab
Article Dans Anglais | LILACS | ID: lil-672481

Résumé

OBJECTIVE: To examine the pattern of stroke subtypes found on Computed Tomography (CT), Magnetic Resonance Imaging (MRI) at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. METHOD: A retrospective review was conducted for all patients diagnosed with stroke and who were subjected to CT or MRI evaluation at UHWI between January 2001 and December 2004. Data were collected for patient age and gender and type of stroke. RESULTS: Four hundred and thirty-three patients were identified and classified as having cerebral infarct, intra-parenchymal haemorrhage or subarachnoid haemorrhage. There were 414 patients who had CT scans and 19 had MRI scans. Within and across genders, over 80% suffered infarcts with no significant statistical difference between male and female patients. Subarachnoid haemorrhage was the least frequent subtype and occurred in younger patients. CONCLUSION: The pattern of stroke subtypes seen in this population was similar to that of Australian and European cohorts of patients but differed from that reported in Asians. Ischaemic infarct was the most frequent stroke subtype followed by intra- parenchymal haemorrhage and subarachnoid haemorrhage. There was no gender predilection for any specific type of stroke.


OBJETIVO: Examinar el patrón de los subtipos de accidente cerebrovascular encontrados en las imágenes de TAC y MRI en el Hospital Universitario de West Indies (HUWI), Kingston, Jamaica. MÉTODO: Se realizó un examen retrospectivo de todos los pacientes con diagnóstico de accidente cerebrovascular, sometidos a evaluación mediante TAC o MRI, entre enero 2001 y diciembre 2004. Los datos fueron recogidos teniendo en cuenta la edad y el género del paciente, así como el tipo de accidente. RESULTADOS: Cuatrocientos treinta y tres (433) pacientes fueron identificados y clasificados como pacientes con un infarto cerebral, hemorragia intraparenquimal o hemorragia subaracnoidea (HSA). Hubo 414 pacientes examinados con TAC y 19 con MRI. Dentro de ellos, ambos géneros incluidos, más del 80% sufrió infartos sin que hubiese diferencias estadísticas significativas entre hombres y mujeres. La hemorragia subaracnoidea fue el tipo menos frecuente, y se produjo en pacientes jóvenes. CONCLUSIÓN: El patrón de subtipos de accidente cerebrovascular en esta población fue similar al de cohortes de pacientes australianos y europeos, pero diferente al reportado para los asiáticos. El infarto isquémico fue el subtipo de accidente cerebrovascular más frecuente, seguido por la hemorragia intraparenquimal y la hemorragia subaracnoidea. No hubo preferencia de géneros en relación con ninguno de los tipos específicos de accidente cerebrovascular.


Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Hémorragie cérébrale/diagnostic , Infarctus cérébral/diagnostic , Accident vasculaire cérébral/classification , Hémorragie meningée/diagnostic , Répartition par âge , Hémorragie cérébrale/épidémiologie , Infarctus cérébral/épidémiologie , Intervalles de confiance , Jamaïque/épidémiologie , Modèles logistiques , Imagerie par résonance magnétique , Analyse multifactorielle , Odds ratio , Études rétrospectives , Répartition par sexe , Accident vasculaire cérébral/épidémiologie , Accident vasculaire cérébral/étiologie , Hémorragie meningée/épidémiologie , Tomodensitométrie
19.
Article Dans Anglais | IMSEAR | ID: sea-143517

Résumé

The viper is one of India’s most commonly encountered poisonous snakes and envenomation following viper bite usually leads to consumption coagulopathy. Clinical manifestations most frequently include external and internal bleeding. In the setting of viper envenomation, large-vessel thrombosis is a very rare occurrence. Also, bilateral anterior cerebral artery infarction, when unrelated to anatomical abnormalities, subarachnoid haemorrhage, surgery or trauma, itself is an exceedingly rare event. We report a case of a 24-year-old previously healthy man who presented with bilateral anterior cerebral artery infarction following a viper bite. We also present hypotheses that may explain this unusual occurrence. ©


Sujets)
Adulte , Amoxicilline/usage thérapeutique , Animaux , Antibactériens/usage thérapeutique , Sérums antivenimeux/usage thérapeutique , Artères cérébrales/anatomopathologie , Infarctus cérébral/induit chimiquement , Infarctus cérébral/diagnostic , Acide clavulanique/usage thérapeutique , Diurétiques osmotiques/usage thérapeutique , Facteur VIII , Fibrinogène , Humains , Mâle , Mannitol/usage thérapeutique , Phénytoïne/usage thérapeutique , Plasma sanguin , Morsures de serpent/complications , Venins de vipère/intoxication , Viperidae
20.
Rev. chil. med. intensiv ; 24(4): 209-214, 2009. ilus
Article Dans Espagnol | LILACS | ID: lil-669734

Résumé

El diagnóstico de infarto cerebeloso en su presentación inicial puede ser difícil, su reconocimiento tardío puede asociarse a graves complicaciones. Aunque sólo representa 2 por ciento a 3 por ciento de los infartos encefálicos, afecta a un importante número de pacientes, muchos de los cuales son jóvenes. De todos los infartos de cerebelo sólo 10 por ciento evolucionará en forma maligna, siendo denominado infarto pseudotumoral de cerebelo. Las causas más habituales son la embolia, la disección de la arteria vertebral y la aterotrombosis. La arteria cerebelosa póstero-inferior es la más frecuentemente comprometida, y en un tercio de los casos se encuentra una fuente cardioembólica. Su rasgo distintivo es el efecto de masa, el mismo que ocasiona compresión de troncoencéfalo e hidrocefalia aguda, generando un deterioro cuantitativo de conciencia. Las neuroimágenes, tomografía computada y resonancia magnética de encéfalo, son de vital importancia para establecer la presencia de un infarto cerebeloso e identificar potenciales complicaciones. Es importante recordar que la tomografía computada es menos sensible que la resonancia magnética para establecer el diagnóstico. El manejo especializado multidisciplinario y la implementación de las medidas de soporte generales y específicas pueden mejorar las posibilidades de sobrevida y recuperación funcional. Ante la presencia de un deterioro de conciencia, un abordaje quirúrgico agresivo pareciera ser la mejor opción de tratamiento.


The diagnosis of cerebellar infarction at initial presentation can be difficult, delayed recognition can be associated with serious complications. Although representing only 2 percent to 3 percent of brain infarcts, affects a significant number of patients, many of whom are young. Only 10 percent of cerebellar infarcts evolve into malignant form, being named pseudotumoral cerebellar infarction. Common causes include embolism, vertebral artery dissection and atherothrombosis. The postero-inferior cerebellar artery is the most frequently committed, and one third of cases there is a cardioemboIic sourse. Its distinguishing feature is the mass effect, causing brain stem compression and acute hydrocephalus, and generating a quantitative impairment of consciousness. The brain imaging, computed tomography and magnetic resonance imaging of brain, are of vital importance to establish the presence of a cerebellar infarct and identify potential complications. It is important to remember that computed tomography is less sensitive than magnetic resonance for diagnosis. The multidisciplinary specialized management and implementation of measures of general and specific support can improve the chances of survival and functional recovery. In the presence of impaired consciousness, an aggressive surgical approach appears to be the best treatment option.


Sujets)
Humains , Maladies du cervelet/diagnostic , Maladies du cervelet/thérapie , Infarctus cérébral/diagnostic , Infarctus cérébral/thérapie , Tumeurs du cervelet/diagnostic , Tumeurs du cervelet/thérapie , Maladies du cervelet/étiologie , Maladies du cervelet/physiopathologie , Infarctus cérébral/étiologie , Infarctus cérébral/physiopathologie , Tumeurs du cervelet/étiologie , Tumeurs du cervelet/physiopathologie , Pronostic
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