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2016, Número 2

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Rev Ciencias Médicas 2016; 20 (2)


Manejo quirúrgico de la hemorragia intraparenquimatosa primaria supratentorial

Pérez NFR, Rodríguez LM, Bermejo SJC, Hernández LO, Álvarez TN

Idioma: Español
Referencias bibliográficas: 41
Paginas: 259-270
Archivo PDF: 338.99 Kb.


RESUMEN

Introducción: La enfermedad cerebrovascular supone una de las primeras causas de mortalidad y discapacidad en el mundo. El objetivo a perseguir en el tratamiento quirúrgico es la máxima evacuación del hematoma minimizando el daño del tejido sano. En la actualidad no existe un criterio unánime para el manejo quirúrgico de la hemorragia intraparenquimatosa primaria lo que nos motivó a la realización de este trabajo con el.
Objetivo: de realizar una revisión bibliográfica actualizada en el tema, que logre exponer los diferentes criterios para el manejo quirúrgico y describir los mejores resultados.
Desarrollo: Las indicaciones actuales para la evacuación quirúrgica incluyen: deterioro neurológico progresivo, expansión importante del hematoma, presión intracraneal incontrolable o datos de herniación cerebral. Para realizar un adecuado tratamiento quirúrgico es imprescindible conocer su fisiopatología para poder lograr los objetivos quirúrgicos y mejorar la morbimortalidad. Aunque actualmente se mantiene en controversia el tiempo ideal para realizar la evacuación de la hemorragia cerebral estudios aleatorizados han determinado un rango de tiempo entre 4 a 96 horas desde el comienzo de los síntomas con buenos resultados. Estudios actuales han demostrado buenos resultados en el manejo en etapas tempranas y bajo apoyo endoscópico.
Conclusiones: El manejo quirúrgico de la hemorragia intracerebral primaria se mantiene controversial. La escala de la hemorragia intraparenquimatosa es confiable para determinar pronóstico de los pacientes. Nuevos estudios aleatorizados se deben desarrollar para determinar cuál será la terapéutica ideal con el fin de mejorar la calidad de vida una vez presentada la hemorragia.


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