ABSTRACT
Mujer de 28 años, ASA I, que presentó en la gestación a término clínica neurológica deficitaria consistente en desviación de la comisura bucal, disfagia, disartria y debilidad de hemicuerpo izquierdo. Fue diagnosticada de trombosis de un segmento de la arteria cerebral media derecha que condicionaba un área de infarto establecido en el lóbulo frontal derecho. Se decidió la finalización de la gestación y el tratamiento conservador con buena resolución del cuadro clínico (AU)
A 28 year old woman, ASA I, who, in the final stages of her pregnancypresented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms(AU)
Subject(s)
Adult , Female , Humans , Pregnancy , Intracranial Thrombosis/complications , Intracranial Thrombosis , Frontal Lobe , Frontal Lobe/surgery , Frontal Lobe , Stroke/complications , Stroke/surgery , Stroke , Deglutition Disorders/complications , Deglutition Disorders/drug therapy , Dysarthria/drug therapy , Thrombosis/drug therapy , Thrombosis/surgery , Pregnancy Complications/drug therapy , Facial Paralysis/complications , Facial Paralysis , Neuroimaging/methodsABSTRACT
A 28 year old woman, ASA I, who, in the final stages of her pregnancy presented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms.
Subject(s)
Infarction, Middle Cerebral Artery/diagnosis , Pregnancy Complications, Cardiovascular/diagnosis , Adult , Anticoagulants/therapeutic use , Brain Ischemia/diagnostic imaging , Brain Ischemia/drug therapy , Brain Ischemia/etiology , Carotid Artery Thrombosis/diagnosis , Carotid Artery Thrombosis/diagnostic imaging , Cesarean Section , Computed Tomography Angiography , Conservative Treatment , Female , Frontal Lobe/blood supply , Frontal Lobe/diagnostic imaging , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Imaging, Three-Dimensional , Infarction, Middle Cerebral Artery/diagnostic imaging , Infarction, Middle Cerebral Artery/drug therapy , Magnetic Resonance Angiography , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Pregnancy , Thrombophilia/geneticsABSTRACT
Objetivo: Evaluar la incidencia de cefalea postpunción dural en pacientes sometidos a cirugía mayor ambulatoria bajo anestesia espinal intradural. Material y métodos: Estudio retrospectivo y descriptivo de9.992 pacientes intervenidos en un periodo de 9 años. Se cuantifican la relación de CPPD-tipo de aguja empleada, así como el consumo de agujas espinales por año de estudio. Se valoró por las consultas e ingresos al Servicio de Urgencias de los casos de CPPD según criterios de Jones. El método estadístico empleado fue la t de Student para las variables cuantitativas y la (..) (AU)
Objective: To evaluate the ratio of headaches after dural puncture (PDPH) in patients undergoing intradural spinal anaesthesia for ambulatory surgery. Material and methods: We undertook a retrospective and descriptive study of 9,992 patients over a period of 9 years. The relationship between PDPH and the type of needle used, as well as the consumption of spinal needles per year of study, were quantified. We evaluated the number of cases of PDPH through the consultations and admissions to the Emergency Service according to the Jones criteria. The statistical methods used were: Students t test for the quantitative variables and chi-squared test of frequencies for the qualitative variables. Results: The incidence of PDPH was 0.60%. The average age of PDPH appearance was 43.12 ± 15.62 years, with a predominance of the feminine sex (63,3%). The incidence of PDPH when using a 22-G Quincke type needle was superior, with statistically significant differences, with respect to the rest of needles. The PDPH was severe in 58% of the cases. The evolution of the migraine in most of the cases (91%) was benign with medical treatment. Conclusions: The progressive reduction in the number of days of hospitalization, accentuated, in the last years, with the new organizational models for surgical assistance has lead to the appearance, in primary medicine, of clinical problems usually found only in hospitalized patients. The PDPH is characterized bya front occipital headache that gets worse when in the upright position in surgical patients undergoing spinal anaesthesia, and is benign and self-limited when treated with conventional medication (AU)
