2014, Número 2
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Rev Cubana Neurol Neurocir 2014; 4 (2)
Resangrado por ruptura aneurismática: epidemiología, factores asociados, fisiopatología y tratamiento
Rivero RD, Scherle MCE
Idioma: Español
Referencias bibliográficas: 49
Paginas: 184-191
Archivo PDF: 251.30 Kb.
RESUMEN
Objetivo: Revisar los aspectos actuales acerca de la epidemiología, los factores asociados, la fisiopatología y el tratamiento farmacológico del resangrado subaracnoideo por ruptura del aneurisma intracraneal.
Desarrollo: El resangrado subaracnoideo en el curso de la ruptura aneurismática es una complicación que constituye la principal causa de morbilidad y mortalidad de los pacientes con hemorragia subaranoidea. Se ha postulado el papel de factores asociados como la hipertensión sistólica (más de 160 mm Hg), el deterioro clínico al inicio de los síntomas, el hematoma intracerebral, el tamaño del aneurisma y la cefalea centinela. Los mecanismos fisiopatológicos supuestamente implicados abordan la presión transmural, la fibrinólisis y la coagulación. El tratamiento antifibrinolítico en los primeros tres días de la hemorragia ha demostrado ser eficaz en la disminución de esta complicación, así como el aislamiento aneurismático precoz.
Conclusiones: Se han identificado en los últimos años algunos factores asociados al resangrado por ruptura aneurismática, pero existen discrepancias en relación a su papel causal. El aseguramiento precoz del aneurisma y la terapia antifibrinolítica por cortos periodos de tiempo son las medidas terapéuticas que han demostrado eficacia en la prevención del resangrado por ruptura aneurismática.
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