Enfermedades cerebrovasculares. Hemorragia cerebral
| Autor: | P. Irimia Sieira, Eduardo Martínez-Vila, I. Esparragosa, R. Valentí |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Gynecology
Vascular wall medicine.medical_specialty medicine.diagnostic_test business.industry Computed tomography General Medicine medicine.disease 03 medical and health sciences 0302 clinical medicine Vascular rupture 030220 oncology & carcinogenesis medicine 030212 general & internal medicine business Surgical treatment Stroke Amyloid angiopathy |
| Zdroj: | Medicine - Programa de Formación Médica Continuada Acreditado. 12:4075-4084 |
| ISSN: | 0304-5412 |
| DOI: | 10.1016/j.med.2019.01.001 |
| Popis: | espanolResumen La hemorragia intracerebral (HIC) representa un 20% de todos los ictus, y se produce por la extravasacion de sangre dentro del parenquima encefalico, producida por la ruptura de un vaso sanguineo. Las causas mas frecuentes son las denominadas primarias, en las que la pared de los vasos se debilita por la hipertension art erial cronica o por causas degenerativas como la angiopatia amiloide. Las causas secundarias incluyen las malformaciones vasculares, tumores o hemorragias inducidas por farmacos y drogas de abuso. Los factores de riesgo mas relevantes para padecer una HIC son hipertension arterial, tabaquismo y consumo excesivo de alcohol y drogas. Las manifestaciones clinicas de la HIC estan en funcion de la localizacion del sangrado y del volumen del hematoma. El diagnostico requiere la realizacion de una TC o RM cerebral para distinguir la HIC de una lesion isquemica u otras lesiones estructurales. La localizacion del sangrado y la presencia de microhemorragias (solo visibles en RM) permiten establecer la causa mas probable del sangrado. Estos pacientes deben ser atendidos en un hospital con unidad de ictus y su tratamiento es medico, limitandose la cirugia a un reducido y seleccionado numero de casos. EnglishIntracerebral hemorrhage (ICH) accounts for 20% of all strokes; caused by the collection of blood within the cerebral parenchyma as the result of vascular rupture. Taking into account its etiology, primary hemorrhages are the most common and are caused by the vascular wall weakness as a result of chronic arterial hypertension or due to degenerative processes as amyloid angiopathy. Secondary causes include arteriovenous malformations, tumors, hemorrhages induced by drugs and substance abuse. The most important risk factors for developing ICH are arterial hypertension, smoking, substance abuse (alcohol and drugs). Hemorrhage location and bleeding volume determine clinical manifestations. In order to distinguish between ICH and other ischemic or structural lesions, both computed tomography (CT) and magnetic resonance imaging (MRI) may be used for the diagnosis. To determine the most likely bleed cause, bleed location and microbleed detection (only detected by MRI) are necessary. Treatment for patients with ICH is fundamentally medical, and they must be cared for in a hospital with stroke unit. Surgical treatment is only recommended for a reduced number of carefully selected cases. |
| Databáze: | OpenAIRE |
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