Reporte de caso clínico: Disección de arteria vertebral

Tonchy Daniel Marinkovic Alvarez; Vannia Carolina  Jimenez Ruiz

doi:10.58296/rm.v28i1.73

Autores/as

Tonchy Daniel Marinkovic Alvarez Hospital Obrero No.2 -CNS
Vannia Carolina Jimenez Ruiz Hospital Obrero No.2 -CNS

DOI:

https://doi.org/10.58296/rm.v28i1.73

Palabras clave:

Disección, arteria vertebral , isquemia

Resumen

La disección arterial cervico-cerebral es una causa frecuente de infarto cerebral, en especial en sujetos menores de 45 años, es una de las causas principales de infarto cerebral en jóvenes; se asocia a enfermedades del tejido conectivo, dependiendo de factores geneticos, de riesgo cardiovascular y factores externos como traumatismos

Las manifestaciones clinicas de la patologia se basan en sintomatologia local,que inicia por cefalea,sintomas isquemicos,dependiendo de su anatomia y sintomas hemorragicos con afeccion intracraneal o de la subadventicia.

Metodos de diagnostico precoz no invasivos como ser la angiografia cerebral,la Resonancia Magnetica y Doppler cerebral

El tratamiento se basa en el uso de antitrombóticos y anticoagulantes aunque su eficacia no se ha determinado en ensayos clínicos controlados .

Los eventos isquémicos recurrentes se dan normalmente, dentro de las primeras 2 semanas después del diagnóstico, por lo cual el paciente debe continuar en controles y en uso de anticoagulacion y/o antiagregacion plaquetaria.

Métricas

Cargando métricas ...

Biografía del autor/a

Vannia Carolina Jimenez Ruiz, Hospital Obrero No.2 -CNS

Médico Internista

Citas

-. Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 2001. DOI: https://doi.org/10.1056/NEJM200103223441206

-.Arauz A, Hoyos L, Espinoza C, Cantú C, Barinagarrementeria F, Román G. Dissection of cervical arteries: Long-term follow-up study of 130 consecutive cases. Cerebrovasc Dis 2006. DOI: https://doi.org/10.1159/000093244

-.Vadim Beletsky, Zurab Nadareishvili, John Lynch, Ashfaq Shuaib, Andrew Woolfenden, John W. Norris cervical arterial dissection: time for a therapeutic trial?. Stroke 2003. DOI: https://doi.org/10.1161/01.STR.0000098649.39767.BC

-. Lee Vivien, Robert D, Brown Jr, Jayawant N Mandrekar, Bahram Mokri. Incidence and outcome of cervical artery dissection. A population-based study. Neurology 2006 Schievink WI, Mokri B, Piepgras DG, Kuiper JD. Recurrent DOI: https://doi.org/10.1212/01.wnl.0000244486.30455.71

-.Spontaneous arterial dissections: risk in familial versus non familial disease. Stroke 1996

-. McColgan P, Sharma P. The genetics of carotid dissection: meta-analysis of a MTHFR/C677T common molecular variant.Cerebrovascular Diseases 2008. DOI: https://doi.org/10.1159/000132202

-.Grond-Ginsbach C,Wigger F, Morcher M, Von Pein F, Grau A, Hausser I, Brandt T. Sequence analysis of the COL5A2 gene in patients with spontaneous cervical artery dissections. Neurology 2002 DOI: https://doi.org/10.1212/WNL.58.7.1103

-.Brandt T, Hausser I, Orberk E. Ultrastructural connective tissue abnormalities in patients with spontaneous cervicocerebral artery dissections. Ann Neurol 1998. DOI: https://doi.org/10.1002/ana.410440224

-.Pepin M, Schwarze U, Superti-furga A, Byers PH. Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular.

-.Brandt T, Morcher M, Hausser I. Association of Cervical Artery Dissection with connective tissue abnormalities in skin and arteries. Frontiers in Neurology and Neuroscience 2005 DOI: https://doi.org/10.1159/000088131

-.Guillon B, Tzourio C, Biousse V, Adrai V, Bousser MG, Touboul PJ. Arterial wall properties in carotid artery dissection: an ultrasound study. Neurology 2000 DOI: https://doi.org/10.1212/WNL.55.5.663

PA, Bogousslavsky J. Uncommon ultrasound findings in traumatic extracranial vertebral artery dissection. Eur J Ultrasound 2001;12:227-31. DOI: https://doi.org/10.1016/S0929-8266(00)00114-2

-. Campos CR, Calderaro M, Scaff M, Conforto AB. Primary headaches and painful spontaneous cervical artery dissection. J Headache Pain 2007. DOI: https://doi.org/10.1007/s10194-007-0387-6

-. Nishino A, Suzuki I, Utsunomiya A, Suzuki S, Uenohara H, Sakurai Y. Clinical manifestation and treatment strategy for non hemorrhagic cerebral arterial dissection. Acta Neurochir Suppl 2008

-. . Gobin-Metteil MP, Oppenheim C, Domigo V, Trystram D, BramiZylberberg F, Naggara O, Meder JF. Cervical arteries dissection:diagnostic color Doppler US criteria at the acute phase. J Radiol 200.

-. Bartels E. Dissection of the extracranial vertebral artery: clinical findings and early noninvasive diagnosis in 24 patients. J Neuroimaging 2006. DOI: https://doi.org/10.1177/1051228405280646

-. Bachmann R, Nassenstein I, Kooijman H, Dittrich R, Stehling C,Kugel H, Niederstadt T, et al. High-resolution magnetic resonance imaging (MRI) at 3.0 Tesla in the short-term followup of patients with proven cervical artery dissection. Invest Radiol 2007 DOI: https://doi.org/10.1097/01.rli.0000262758.98098.d6

-. Charbonneau F, Gauvrit JY, Touze E, Moulin T, Bracard S, Leclerc X, Mas JL, Meder JF. Diagnosis and follow-up of cervical arterial dissections. Results of the SFNV-SFNR study. J Neuroradiol 2005

-. Leys D, Debette S. Long-term outcome in patients with cervicalartery dissections: There is still a lot to know. Cerebrovasc Dis 2006 Baumgartner, Benign long-term outcome of conservatively treated cervical aneurysms due to carotid dissection. Neurology 2007. DOI: https://doi.org/10.1159/000093958

- Caso V, Maurizio Paciaroni, Francesco Corea, Mohammed Hamam, Paolo Mili. Recanalization of cervical artery dissection:influencing factors and role in neurological outcome.Cerebrovascular Diseases 2004. DOI: https://doi.org/10.1159/000075775

-.Geordiadis D, Caso V, Baumgartner RW. Acute therapy and prevention of stroke in spontaneous carotid dissection. Clinical and Experimental Hypertension 2006. DOI: https://doi.org/10.1080/10641960600549652

-.. Benninger DH, Georgiadis D, Kremer C. Mechanism of ischemic infarct in spontaneous carotid dissection. Stroke 2004 DOI: https://doi.org/10.1016/j.jvs.2004.03.011

-.Lucas C, Moulin T, Deplanque D. Stroke patterns of internal carotid artery dissection in 40 patients. Stroke 1998 DOI: https://doi.org/10.1161/01.STR.29.12.2646

-.Stepper F, Remonda L, Bassetti C, Mattle H. Thrombolysis in patients with acute stroke caused by cervical artery dissection analysis of 9 patients and review of the literature. Arch Neurol 2002.

- Jens P. Dreier; Frank Lürtzing; Melanie Kappmeier; Georg Bohner; Randolf Klin. Delayed Occlusion after Internal Carotid Artery Dissection under Heparin. Cerebrovascular Diseases 2004. DOI: https://doi.org/10.1159/000080355

-. Engelter S, Brandt T, debette S, Caso V et Al: Antiplatelets versus Anticoagulation in cervical artery Dissection. Stroke. 2007. DOI: https://doi.org/10.1161/STROKEAHA.107.489666