Distensibilidad arterial: un parámetro más para valorar el riesgo cardiovascular / No disponible

La distensibilidad arterial (DA) es la capacidad que tienen los vasos sanguíneos para distenderse y contraerse apropiadamente en respuesta a los cambios de volumen y de presión. Existen dos tipos: 1. Distensibilidad capacitiva (C1): refleja las arterias grandes. 2. Distensibilidad oscilatoria oreflexiva (C2): refleja las arterias más pequeñas y arteriolas localizadas periféricamente. A la hora de estudiarla y comprender lo que está sucediendo es importante conocer los aspectos que rodean a la hemodinámica arterial. Su importancia clínica radica en que es un marcador de alteraciones cardiovasculares, siendo su parámetro más relevante la “velocidad de la onda del pulso”, la cual se propaga a una velocidadde 8-10 m/seg, de manera que la onda llega a las arteriasmás alejadas del corazón antes de que haya terminado elperíodo de evacuación ventricular. El aparato SphygmocorPx-Vx nos proporciona los datos más importantes a la horade valorar la DA, merced a un sistema que deriva la forma de la onda de presión arterial calibrada en la aorta ascendente de un registro transcutáneo de la forma de onda de presión arterial radial por tonometría plana

Arterial distensibility (AD) is the ability of the blood vessels to distend and contract appropriately in response to volume and pressure changes. There are two types: 1. Capacitive distensibility (C1): it reflects the large arteries. 2. Oscillating or reflective distensibility (C2): it reflects the smaller arteries and arterioles located peripherally. When studying and understanding what is happening, it is importantto know the aspects surrounding the arterial hemodynamics. It is clinically important because it is a marker of cardiovascular alterations, its parameter being more relevant to “pulse wave rate”. This propagates at a speed of 8-10 m/s, so that the wave reaches the arteries farthest away from theheart before it has completed the ventricular evaluation period. The Sphygmocor Px-Vx apparatus provides us the most important data when evaluating the AD, thanks to a system that derives the calibrated arterial pressure wave form in the ascending aorta of a transcutaneous registry having the form of radial arterial pressure wave by flat tonometry

Adicción alcohólica de origen tumoral: meningioma frontal / Tumor originated alcohol addiction: frontal meningioma

Se presenta un caso clínico de meningioma frontal que comenzó con una adicción al alcohol de carácter progresivo. La enferma, mujer de 53 años sin antecedentes personales de interés, no tenía hábitos tóxicos conocidos, ni llevaba ningún tratamiento, había comenzando tres meses antes de su diagnóstico a ingerir cantidades crecientes de etanol que le producían ocasionalmente estados de embriaguez. Cuatro meses después, a raíz de una somnolencia diurna y una crisis de ausencia que duró cinco minutos, consultó por todo lo sucedido. La exploración clínica por aparatos fue normal. La analítica puso de manifiesto un aumento de las transaminasas, con discreta anemia de tipo megaloblástico. La tomografía axial computarizada (TAC) y la resonancia magnética nuclear (RMN) cerebral pusieron de manifiesto una masa en el lóbulo frontal, compatible con meningioma, que se trató con radiocirugía fotónica de forma satisfactoria

A clinical case of frontal meningioma is presented. It began with progressive alcohol addiction. The patient, a 53-year-old woman with no personal background of interest, had no known toxic habits and was not receiving any treatment. Three months after her diagnosis, she began to take increasing amounts of alcohol that occasionally led to states of drunkenness. Four months after, due to daytime drowsiness and absence episode that lasted five minutes, she consulted about this situation. The clinical examination with apparatuses was normal. Laboratory analysis showed increase of transaminases with mild megaloblastic anemia. The brain computed tomography (CT) and magnetic nuclear resonance (MRI) showed a mass in the frontal lobe consistent with meningioma that was treated with photon radiosurgery satisfactorily

[Spinal cord ischemia as a consequence of dissection of an abdominal aortic aneurysm]. / Isquemia medular como consecuencia de un aneurisma de aorta abdominal.

INTRODUCTION: Ischemic spinal cord infarct is the most frequent vascular lesion, but although aortic aneurysms are a possible cause, it is unusual for such cases to be seen. Clinical case. We present a case of spinal ischemia as the first sign of the dissection of an aneurysm of the abdominal aorta. A 58 year old man was seen in the hospital Emergency Department complaining of lumbar pain and the sudden onset of paraplegia of the legs, associated with pain in the middle of his back but with no history of previous trauma or effort. The only relevant personal history was of smoking. Whilst he was in the Neurology Department, the anomaly was diagnosed after dorsal, and lumbar gadolinium magnetic resonance (MR), when a zone of ischaemia at T9-T10 was seen and, as a casual observation, an image compatible with an aneurysm of the abdominal aorta. The relationship between the dissection of the aorta and the neurological complications may be explained by a clear understanding of the vascular supply to the spinal cord. In this case, both the clinical findings and the MR were clearly indicative of an anterior spinal artery syndrome. CONCLUSIONS: In spite of its rarity, aortic aneurysm should be included in the differential diagnosis of a clinical picture of ischemic myelopathy, especially when there is lumbar and/or abdominal pain before the appearance of neurological symptoms. Spinal MR is important for this diagnosis.