Objetivos:Precisar la etiología del infarto cerebral en adultos jóvenes hospitalizados en el Departamento de Enfermedades Neurovasculares del Instituto Nacional de Ciencias Neurológicas (INCN) durante el periodo 2010 al 2013. Material y métodos:Estudio descriptivo, retrospectivo, de corte transversal; en paciente jóvenes con diagnóstico de infarto cerebral, hospitalizados en el INCN, en el periodo de estudio que tuvieron tomografía y/o imagen de resonancia magnética cerebral. Resultados: Un total de 43 pacientes cumplieron los criterios de inclusión. El 55,8% fueron mujeres. La media de edad fue 37,6±6,4 años. El 69,8% provenían de Lima. El 44,2% de los casos fueron de etiología indeterminada, 23,3% cardioembólica. La media de edad para la etiología atero-trombótica fue de 41,8 años, y para la etiología indeterminada de 34,7 años. El territorio vascular mayormente comprometido fue el de la circulación anterior con 65,1%.Conclusiones:Se describen las características clínicas, sociodemográficas y la etiología del infarto cerebral en adultos jóvenes. Los más frecuentes fueron: indeterminada y cardioembólica. Las enfermedades metabólicas y el uso de anticonceptivos orales fueron los factores asociados más frecuentes. No hubo mortalidad. El territorio vascular cerebral mayormente comprometido fue la circulación anterior.PALABRAS CLAVE: Adulto joven, etiología, infarto cerebral. SUMMARYObjectives:Clarify the etiology of cerebral infarction in young adults hospitalized in the Department of Neurovascular Diseases at the National Institute of Neurological Sciences (INCN), during the period 2010 to 2013.Material and Methods:Descriptive, retrospective, cross-sectional study in a sample of young patients diagnosed with cerebral infarction, hospitalized during the study period and who underwent tomography and / or magnetic resonance imaging brain tests.Results:A total of 43 patients, 55.8 % of them female, met the inclusion criteria. The mean age was 37.6 +/-6.4 years, 69.8% came from Lima, and 44.2% of the cases were of undetermined etiology and 23.3%, cardioembolic. The average age for artery occlusive disease was 41.8 years, and for undetermined etiology, 34.7 years. The vascular territory mostly compromised was that of the anterior circulation with 65.1%.Conclusions: Sociodemographic, clinical characteristics, and etiological factors of cerebral infarction in young adults were described. The most frequent etiologieswerecardioembolic and undeterminated. Metabolic diseases and the use of
Trabalho número 292, apresentação oral no XVII Congresso da Academia Brasileira de Neurocirurgia, Goiânia, 14 a 17 de junho de 2017. RESUMO Introdução:A distonia pode ser definida como um distúrbio neurológico com a presença de movimentos involuntários com contrações espasmódicas. A estimulação cerebral profunda (DBS) é considerada altamente efetiva em pacientes criteriosamente selecionados e avaliados. A maior efetividade da ECP é demonstrada principalmente nos casos de refratariedade do tratamento clínico e farmacológico na distonia cervical. Objetivo: realizar uma revisão de literatura comprando os resultados da Estimulação Cerebral Profunda no Globo Pálido Interno (GPi), analisando os resultados obtidos no tratamento da distonia focal e segmentar. Métodos: Foram pesquisados no banco de dados do MEDLINE artigos descrevendo DBS para distonia por meio de palavraschave. Resultados: Foram identificados 308 artigos que envolvem estudos no tratamento de distonia com DBS no GPi. Após aplicar os filtros na base de dados "MEDLINE", 48 artigos foram excluídos, restando 260 artigos elegíveis. Posteriormente, realizou-se uma revisão minuciosa dos artigos publicados na plataforma em questão. Conclusões: Aponta-se que pacientes com distonia primária são mais beneficiados pelo DBS quando eletrodos são inseridos na porção ventromedial do GPi com taxas de efeitos adversos aceitáveis. Um melhor prognóstico desses pacientes depende de um acompanhamento interdisciplinar individualizado no período pré e pós-operatório. ABSTRACT Introduction: Dystonia can be defined as a neurological disorder characterized by involuntary movements with spasmodic contractions. Deep brain stimulation (DBS) is considered highly effective in critically selected and evaluated patients. The greater effectiveness of DBS is demonstrated mainly in cases of clinical and pharmacological treatment of refractory cervical dystonia.Objective: This paper aims to review the literature comparing the results of the DBS at Globus Pallidus internus (GPi), analyzing the results obtained in the treatment of focal and segmental dystonia. Methods: We searched at MEDLINE database for articles describing DBS for dystonia using keywords. Results: We identified 308 articles involving studies in the treatment of dystonia with the GPi DBS. After applying filters in "MEDLINE" database, 48 articles were excluded, remaining 260 eligible articles. Subsequently, a thorough review of the articles published on this platform was carried out. Conclusions: it is pointed out that patients with primary dystonia are more benefited by DBS when electrodes are inserted in the ventromedial portion of the GPi with acceptable adverse effects rates. A better prognosis of these patients depends on an individualized interdisciplinary follow-up in the pre and postoperative period.
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