ABSTRACT
Los aneurismas de la arteria carótida extracraneal son raros y representan una minoría de la cirugía carotídea en la mayoría de las unidades vasculares. Se presenta un caso clínico de un aneurisma sacular de la arteria carótida interna en un paciente joven, sin causa aparente. La mayoría de estos aneurismas son asintomáticos, aunque, en este paciente debutó como ictus por embolización distal. El manejo consistió en un abordaje quirúrgico abierto a las 4 semanas tras el episodio inicial. En la intervención se extirpó el aneurisma con sutura termino-terminal de la arteria carótida interna
Aneurysms of the extracranial carotid artery are rare and represent a minority of the carotid surgery in most vascular units. A clinical case of a saccular aneurism of the internal carotid artery, in a young patient without apparent cause, is showcased. They are often asymptomatic, but they also may show (as it was in this patient) stroke from distal embolisation as a debut. The management consisted in an open surgical approach (by meaning, aneurysm excision with termino-terminal suture of the internal carotid artery, without shunt), 4 weeks after the initial episode
Subject(s)
Humans , Male , Middle Aged , Carotid Artery Diseases/diagnostic imaging , Carotid Artery, Internal/diagnostic imaging , Carotid Artery Diseases/surgery , Carotid Artery, Internal/surgery , Computed Tomography Angiography/methodsABSTRACT
Ocular ischemia syndrome is caused by ocular chronic hypoperfusion due to stenosis or occlusion of the ipsilateral common or internal carotid artery. We present the case of a 58-year-old male with recurrent unilateral amaurosis fugax, ophthalmological examination compatible with chronic ocular ischemia, and severe stenosis of ipsilateral internal carotid artery. After angioplasty and stenting of the carotid stenosis, the findings resolved.
El síndrome de isquemia ocular es causado por la hipoperfusión ocular crónica debido a estenosis u oclusión de arteria carótida común o interna ipsilateral. Presentamos el caso de un varón de 58 años con episodios de amaurosis fugax unilateral, exploración oftalmológica compatible con isquemia ocular crónica y estenosis severa de arteria carótida interna ipsilateral. Tras la angioplastia y stent de la zona de estenosis carotídea, los hallazgos resolvieron.
Subject(s)
Carotid Stenosis/complications , Eye/blood supply , Ischemia/etiology , Eye/diagnostic imaging , Humans , Ischemia/diagnostic imaging , Male , Middle Aged , SyndromeABSTRACT
BACKGROUND: Revascularization with carotid stent (CAS) is considered the therapeutic alternative to endarterectomy (CEA). However, its role compared to CEA remains questioned, mainly due of the heterogeneity of long-term results. The objective of this study was to report the efficacy and durability of CAS in terms of stroke prevention in a "real world experience". METHOD: This was a single-center retrospective analysis of 344 patients treated with CAS between January 2001 and December 2015.The primary outcome of the trial was stroke, myocardial infarction, or death during a periprocedural period or any stroke event over a 15-year follow-up. The secondary aim was to identify risk factors for 30-day complications, long-term neurological complications, and intra-stent restenosis. RESULTS: The primary composite end point (any stroke, myocardial infarction, or death during the periprocedural period) was 2.3%. The use of an EPD was protective against major complications.Long-term follow-up was achieved in 294 patients (85,5%) with a median of 50 months (range 0-155 months). Fifty-six (16,3%) died within this period, most commonly of nonvascular causes (4 patients had stroke-related deaths). During the follow-up period, 8 strokes and 3 TIAs were diagnosed (3.2%).ISR determined by sequential ultrasound was assessed in 4.4% of the patients and remained asymptomatic in all but 2 patients (0.6%). All patients with restenosis underwent revascularization with balloon angioplasty. CONCLUSION: The long-term follow-up results of our study validate CAS as a safe and durable procedure with which to prevent ipsilateral stroke, with an acceptable rate of restenosis, recurrence and mortality.
ABSTRACT
Introducción. El ictus es una de las principales causas de invalidez y mortalidad en nuestra sociedad, con importantes repercusiones socioeconómicas y sanitarias. La asistencia precoz puede mejorar el pronóstico de los pacientes. Actualmente, existen tratamientos en fase aguda, que consiguen reperfundir el tejido isquémico en riesgo y revertir la sintomatología, pero son pocos los pacientes que se benefician, por el retraso en su atención, debido a la falta de reconocimiento de los síntomas y la escasa percepción de gravedad. Objetivo. Analizar el conocimiento de la población de nuestra área de salud sobre el ictus. Sujetos y métodos. La muestra analizada ha sido la población del sector III de la provincia de Zaragoza, con selección aleatoria. La herramienta utilizada ha sido una encuesta telefónica estructurada (total de 583). Resultados. Un 63,5% de los encuestados desconoce los síntomas del ictus, y un 48%, los factores de riesgo vascular. Sólo un 9% reconoce al menos dos síntomas y dos factores de riesgo. En cuanto a la actitud, un 56% actuaría correctamente frente a un 44% que no. El análisis multivariante mostró que los factores más relacionados con el conocimiento fueron el nivel cultural y la edad joven. Vivir en un pueblo y sexo femenino se relacionaron con la mejor actitud. Conclusiones. El conocimiento del ictus es escaso, con una baja percepción de urgencia. Los factores que implican un mejor conocimiento son la edad joven y el nivel cultural alto (AU)
Introduction. Acute cerebrovascular disease is a major cause of disability and mortality, with important socio-economic and health impacts. Early stroke care can reduce mortality and improve prognosis. Right now, we can apply treatments in the acute phase, with capacity to reverse the symptoms, but few patients who benefit not reach the hospital soon. One reason for this delay is the lack of recognition of symptoms and poor perception of gravity. Aim. To find out the knowledge of the public about the stroke. Subjects and methods. The sample analyzed was the population of Sector III of Zaragoza, with random selection. The tool used was a telephone survey structured. We analyzed 583 surveys. Results. 63.5% of respondents did not know any symptoms of stroke. 48% do not know any vascular risk factor. Only 9% recognized at least two symptoms and two risk factors. Regarding the attitude, 56% act properly against 44% who do not. Multivariate analysis showed that the factors more related to knowledge are the cultural level and young age. Living in town, and female, they are associated with the best attitude. Conclusions. Knowledge about stroke is poor, with a low sense of urgency. The factors most associated with the best knowledge are young age and cultural level (AU)
Subject(s)
Humans , Cerebrovascular Disorders , Stroke , Health Knowledge, Attitudes, Practice , Delayed Diagnosis/statistics & numerical data , Emergency Treatment , Health Care Surveys/statistics & numerical dataABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Ciprofloxacin/adverse effects , Myoclonus/chemically induced , Quinolones/adverse effects , Risk FactorsABSTRACT
BACKGROUND: This study assesses the lifetime and active prevalence of epilepsy in Spain in people older than 18 years. METHODS: EPIBERIA is a population-based epidemiological study of epilepsy prevalence using data from three representative Spanish regions (health districts in Zaragoza, Almería, and Seville) between 2012 and 2013. The study consisted of two phases: screening and confirmation. Participants completed a previously validated questionnaire (EPIBERIA questionnaire) over the telephone. RESULTS: A total of 1741 valid questionnaires were obtained, including 261 (14.99%) raising a suspicion of epilepsy. Of these suspected cases, 216 (82.75%) agreed to participate in phase 2. Of the phase 2 participants, 22 met the International League Against Epilepsy's diagnostic criteria for epilepsy. The estimated lifetime prevalence, adjusted by age and sex per 1,000 people, was 14.87 (95% CI: 9.8-21.9). Active prevalence was 5.79 (95% CI: 2.8-10.6). No significant age, sex, or regional differences in prevalence were detected. CONCLUSIONS: EPIBERIA provides the most accurate estimate of epilepsy prevalence in the Mediterranean region based on its original methodology and its adherence to ILAE recommendations. We highlight that the lifetime prevalence and inactive epilepsy prevalence figures observed here were compared to other epidemiological studies.
Subject(s)
Epilepsy/epidemiology , Adult , Age Factors , Female , Humans , Male , Middle Aged , Population Surveillance , Prevalence , Spain/epidemiology , Young AdultABSTRACT
No disponible
Subject(s)
Male , Female , Child , Adolescent , Humans , Carotid Arteries/anatomy & histology , Tunica Intima , Carotid Arteries , Reference ValuesABSTRACT
No disponible
