Romero CI, Guzmán MAG, Islas RFG

Language: Spanish
References: 8
Page: 359-362
PDF size: 209.26 Kb.

ABSTRACT

The most important risk factor for presenting a cerebrovascular disease (CVA) is age. Stroke is also the most frequent cause of disability acquired in adulthood. According to the World Health Organization, it is estimated that by the year 2050, almost half of the population over 65 could suffer or have suffered a CVA. Due to the high incidence and negative impact of this disease, we present a clinical case of successful thrombolysis in a patient with ischemic stroke and hypertensive crisis in the emergency department. We emphasize the adequate evaluation with the different existing clinical, radiological and predictive scales (NIHSS, Dragon Score, ASPECT, HAT score), as well as the inclusion and exclusion criteria, which are indispensable to administer an intravenous reperfusion therapy. Conclusions: In Mexico, the cases reported with successful thrombolysis are only 5%. In this successful case, the proper performance in the emergency service impacted positively on the prognosis of the patient, since the timely diagnosis and administration of rTPA avoided important sequelae and provided a better quality of Life, which is decreased in up to 70% of patients suffering from a CVA (according to studies conducted in the USA).

REFERENCES

1. Stroke Association Guideline for Healthcare Professionals from the American Heart Association/American Guidelines for the Early Management of Patients with Acute Ischemic Stroke. 2013.

2. Rivera SC, Miranda LI, Pérez JE, Jesús J, Rivera BE, Torres LP. Guía de práctica clínica enfermedad vascular cerebral isquémica. Rev Med Inst Mex Seguro Soc. 2012; 50 (3): 335-346.

3. Arauz A, Ruiz A. Enfermedad vascular cerebral. Rev Fac Med UNAM. 2012; 55 (3): 11-21.

4. Guidelines for Adult Stroke Rehabilitation and Recovery. A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. 2016.

5. Werner MD, Markku MD, Erich PhD, Miroslav MD et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008; 359 (13): 1317-1329.

6. Sánchez JJ. El área de penumbra. Rev Neurol. 1999; 28: 810-816.

7. Chiquete E, Ruiz JL, Murillo LM, Arauz A, Villarreal J et al. Mortalidad por enfermedad vascular cerebral en México, 2000-2008: Una exhortación a la acción. Rev Mex Neuroci. 2011; 12 (5): 235-241.

8. Barinagarrementeria F. Trombólisis cerebral intravenosa en México. Una década perdida. Gac Med Mex. 2009; 145 (6): 539-540.