ABSTRACT
Resumen ANTECEDENTES: El síndrome de vasoconstricción cerebral reversible, o síndrome de Call-Fleming, es una alteración excepcional, de origen incierto, caracterizada por cefalea, déficit neurológico y vasoespasmo cerebral reversible. En cuanto a su mecanismo fisiopatológico, se señala la relación con vasoconstricción segmentaria reversible en diferentes áreas cerebrales. CASO CLÍNICO: Paciente de 34 años, sin antecedentes de importancia para el padecimiento actual, de 40 semanas de embarazo, que ingresó a la unidad médica por actividad uterina irregular, con cifras tensionales de 120-80 mmHg, pulso 80 por minuto, frecuencia respiratoria 20 por minuto y temperatura de 37 ºC; la frecuencia cardiaca fetal fue de 140 latidos por minuto. Al no existir progresión del trabajo de parto, se decidió su interrupción por vía abdominal y se obtuvo un recién nacido sano. Durante el puerperio inmediato, después de la administración de ergonovina, la paciente manifestó hipertensión arterial y cefalea súbita relacionada con déficit neurológico, por lo que requirió el ingreso a la unidad de cuidados intensivos hasta su estabilización. Se estableció el diagnóstico de cefalea tipo "trueno"; la tomografía computada no mostró alteraciones aparentes, el líquido cefalorraquídeo fue claro, con concentración leucocitaria de 10 mm3 y eritrocitaria de 6 mm3. CONCLUSIÓN: El síndrome de Call-Fleming es una alteración poco frecuente durante el embarazo y puerperio; por tanto, es importante conocer, identificar y establecer el diagnóstico diferencial de la enfermedad.
Abstract BACKGROUND: Reversible cerebral vasoconstriction syndrome, or Call-Fleming syndrome, is an exceptional disorder of uncertain origin, characterized by headache, neurological deficit and reversible cerebral vasospasm. Regarding its physiopathological mechanism, the relationship with reversible segmental vasoconstriction in different brain areas has been postulated. CLINICAL CASE: A 34-year-old patient, in the 40 weeks pregnant, admitted to the medical unit due to irregular uterine activity, with blood pressure figures of 120/80 mmHg, pulse 80/min, respiratory rate 20/min and temperature of 37 ° C; the fetal heart rate was 140 beats per minute. Due to the non-progression of labor, it was decided to interrupt it by abdominal route, from which a healthy newborn was obtained. During the immediate puerperium, after the administration of ergonovine, the patient manifested arterial hypertension and sudden headache related to neurological deficit, for which she required admission to the Intensive Care Unit until stabilization. The diagnosis of "thunder" type headache was established; the computed tomography showed no apparent alterations, the cerebrospinal fluid was clear, and leukocyte concentration of 10 mm3 and erythrocyte of 6 mm3. CONCLUSION: Call-Fleming syndrome is a rare condition during pregnancy and puerperium; therefore, it is important to know, identify and establish the differential diagnosis of the disease.
ABSTRACT
Couvelaire uterus is rare in modern obstetrics, a state of the hematic infiltration uterine myometrium due to the formation of a massive hematoma retroplacental that can not be sold to the vaginal cavity through the cervical route. In all cases described in the present there is a history of placental abruption during labor or trauma, and drugs that affect the collapse of the uterus-placental circulation
Subject(s)
Abruptio Placentae , Hematoma , Placenta Previa , Puerperal Disorders , Uterine Hemorrhage , Abruptio Placentae/diagnosis , Adult , Female , Hematoma/complications , Hematoma/diagnosis , Humans , Placenta Previa/diagnosis , Pregnancy , Puerperal Disorders/diagnosis , Uterine Hemorrhage/complications , Uterine Hemorrhage/diagnosisABSTRACT
The Systemic Inflammatory Response Syndrome is a rare entity during pregnancy. This paper describes the case of a 28 year old with a history of abdominal distension. She consulted due to abdominal pain in the right upper quadrant abdominal pain, gingival bleeding, epigastric pain, nausea and vomiting. Obstetrical ultrasound was performed reporting: pregnancy 22 weeks of gestation, with heart rate of 118 beats per minute. The patient was admitted requiring attention in intensive care units due to their development body hysterotomy was performed live only product obtained 430 g. The postpartum period has elapsed so torpid development of septic process, making more bilateral salpingo hysterectomy.