Accidente Cerebrovascular: una revisión del alcance
DOI:
https://doi.org/10.33448/rsd-v10i13.19904Palabras clave:
Accidente Cerebrovascular Isquémico; Accidente Cerebrovascular Hemorrágico; Infarto cerebral.Resumen
El ictus es una enfermedad con una elevada carga de morbilidad y mortalidad a nivel nacional y mundial. En Estados Unidos, es la quinta causa de muerte, con una prevalencia global del 2,6% en el periodo comprendido entre 2009 y 2012. En Brasil, se estima que hay 2.231.000 personas con ictus y 568.000 con discapacidades graves. Este artículo pretende describir las características de este agravio para ayudar a los profesionales de la salud a encontrar información importante relacionada con esta patología. Factores de riesgo como la hipertensión arterial sistémica (HSA), la diabetes, la dislipidemia, la fibrilación auricular y la estenosis carotídea se asociaron a un mayor riesgo de desarrollar un ictus, siendo la HSA el más importante. Aunque los signos y síntomas clínicos son importantes, la neuroimagen es fundamental para diferenciar el ictus isquémico del hemorrágico y orientar el tratamiento más adecuado. Algunos de los diagnósticos diferenciales del ictus son el accidente isquémico transitorio (AIT), las convulsiones, la cefalea, la hipoglucemia, los tumores, el vértigo y la alteración del estado mental. Algunas complicaciones médicas tras los AVC son la disfagia, la incontinencia urinaria, la embolia pulmonar, la trombosis venosa profunda (TVP), la neumonía, la depresión y las úlceras por presión. El diagnóstico correcto y precoz del ictus es sumamente importante para evitar las secuelas de este evento agudo y el tratamiento adecuado de la hipertensión, la diabetes mellitus y la dislipidemia son de gran importancia para reducir la alta prevalencia del ictus.
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Abbott, A. L. (2009). Medical (Nonsurgical) Intervention Alone Is Now Best for Prevention of Stroke Associated With Asymptomatic Severe Carotid Stenosis. Stroke, 40(10). https://doi.org/10.1161/STROKEAHA.109.556068
Andrews, C. M., Jauch, E. C., Hemphill, J. C., Smith, W. S., & Weingart, S. D. (2012). Emergency Neurological Life Support: Intracerebral Hemorrhage. Neurocritical Care, 17(S1), 37–46. https://doi.org/10.1007/s12028-012-9757-2
Barer, D. H. (1989). The natural history and functional consequences of dysphagia after hemispheric stroke. Journal of Neurology, Neurosurgery & Psychiatry, 52(2), 236–241. https://doi.org/10.1136/jnnp.52.2.236
Barthels, D., & Das, H. (2020). Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866(4), 165260. https://doi.org/10.1016/j.bbadis.2018.09.012
Beckett, N. S., Peters, R., Fletcher, A. E., Staessen, J. A., Liu, L., Dumitrascu, D., Stoyanovsky, V., Antikainen, R. L., Nikitin, Y., Anderson, C., Belhani, A., Forette, F., Rajkumar, C., Thijs, L., Banya, W., & Bulpitt, C. J. (2008). Treatment of Hypertension in Patients 80 Years of Age or Older. New England Journal of Medicine, 358(18), 1887–1898. https://doi.org/10.1056/NEJMoa0801369
Bensenor, I. M., Goulart, A. C., Szwarcwald, C. L., Vieira, M. L. F. P., Malta, D. C., & Lotufo, P. A. (2015). Prevalence of stroke and associated disability in Brazil: National Health Survey - 2013. Arquivos de Neuro-Psiquiatria, 73(9), 746–750. https://doi.org/10.1590/0004-282X20150115
Brandstater, M. E., Roth, E. J., & Siebens, H. C. (1992). Venous thromboembolism in stroke: literature review and implications for clinical practice. Archives of Physical Medicine and Rehabilitation, 73(5-S), S379-91. http://www.ncbi.nlm.nih.gov/pubmed/1301012
Brocklehurst, J. C., Andrews, K., Richards, B., & Laycock, P. J. (1985). Incidence and Correlates of Incontinence in Stroke Patients. Journal of the American Geriatrics Society, 33(8), 540–542. https://doi.org/10.1111/j.1532-5415.1985.tb04618.x
Broderick, J., Connolly, S., Feldmann, E., Hanley, D., Kase, C., Krieger, D., Mayberg, M., Morgenstern, L., Ogilvy, C. S., Vespa, P., & Zuccarello, M. (2007). Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Out. Circulation, 116(16). https://doi.org/10.1161/CIRCULATIONAHA.107.183689
Camm, A. J., Kirchhof, P., Lip, G. Y. H., Schotten, U., Savelieva, I., Ernst, S., Van Gelder, I. C., Al-Attar, N., Hindricks, G., Prendergast, B., Heidbuchel, H., Alfieri, O., Angelini, A., Atar, D., Colonna, P., De Caterina, R., De Sutter, J., Goette, A., Gorenek, B., & Zupan, I. (2010). Guidelines for the management of atrial fibrillation. EP Europace, 12(10), 1360–1420. https://doi.org/10.1093/europace/euq350
Caplan, L. R. (2020). Etiology, classification, and epidemiology of stroke.
Carota, A., Berney, A., Aybek, S., Iaria, G., Staub, F., Ghika-Schmid, F., Annable, L., Guex, P., & Bogousslavsky, J. (2005). A prospective study of predictors of poststroke depression. Neurology, 64(3), 428–433. https://doi.org/10.1212/01.WNL.0000150935.05940.2D
Clissold, B., Phan, T. G., Ly, J., Singhal, S., Srikanth, V., & Ma, H. (2020). Current aspects of TIA management. Journal of Clinical Neuroscience, 72, 20–25. https://doi.org/10.1016/j.jocn.2019.12.032
Cordonnier, C., Girot, M., Dorp, E., Rimetz, P., Bouillaguet, S., Hénon, H., Lucas, C., Godefroy, O., & Leys, D. (2000). Stroke Units from Scientific Evidence to Practice: The Experience of the Lille Stroke Unit. Cerebrovascular Diseases, 10(4), 17–20. https://doi.org/10.1159/000047587
Cordonnier, C., Oppenheim, C., Lamy, C., Meder, J.-F., & Mas, J.-L. (2005). Serial diffusion and perfusion-weighted MR in transient hypoglycemia. Neurology, 65(1), 175–175. https://doi.org/10.1212/01.wnl.0000167128.14769.7b
Cucchiara, B., & Kasner, S. E. (2011). Transient Ischemic Attack. Annals of Internal Medicine, 154(1), ITC1. https://doi.org/10.7326/0003-4819-154-1-201101040-01001
Endres, M. (2005). Statins and Stroke. Journal of Cerebral Blood Flow & Metabolism, 25(9), 1093–1110. https://doi.org/10.1038/sj.jcbfm.9600116
Falavigna, A., Teles, A. R., Vedana, V. M., Kleber, F. D., Mosena, G., Velho, M. C., Mazzocchin, T., Silva, R. C. da, Lucena, L. F., Santin, J. T., & Roth, F. (2009). Awareness of stroke risk factors and warning signs in southern Brazil. Arquivos de Neuro-Psiquiatria, 67(4), 1076–1081. https://doi.org/10.1590/S0004-282X2009000600022
Fernandes, P. M., Whiteley, W. N., Hart, S. R., & Al-Shahi Salman, R. (2013). Strokes: mimics and chameleons. Practical Neurology, 13(1), 21–28. https://doi.org/10.1136/practneurol-2012-000465
Giles, M. F., Albers, G. W., Amarenco, P., Arsava, M. M., Asimos, A., Ay, H., Calvet, D., Coutts, S., Cucchiara, B. L., Demchuk, A. M., Johnston, S. C., Kelly, P. J., Kim, A. S., Labreuche, J., Lavallee, P. C., Mas, J.-L., Merwick, A., Olivot, J. M., Purroy, F., & Rothwell, P. M. (2010). Addition of brain infarction to the ABCD2 Score (ABCD2I): a collaborative analysis of unpublished data on 4574 patients. Stroke, 41(9), 1907–1913. https://doi.org/10.1161/STROKEAHA.110.578971
Gordon, C., Hewer, R. L., & Wade, D. T. (1987). Dysphagia in acute stroke. BMJ, 295(6595), 411–414. https://doi.org/10.1136/bmj.295.6595.411
Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Dávalos, A., Guidetti, D., Larrue, V., Lees, K. R., Medeghri, Z., Machnig, T., Schneider, D., von Kummer, R., Wahlgren, N., & Toni, D. (2008). Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. New England Journal of Medicine, 359(13), 1317–1329. https://doi.org/10.1056/NEJMoa0804656
Hackett, M. L., Yapa, C., Parag, V., & Anderson, C. S. (2005). Frequency of depression after stroke: a systematic review of observational studies. Stroke, 36(6), 1330–1340. https://doi.org/10.1161/01.STR.0000165928.19135.35
Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. The Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16146-1
Helbok, R., Kurtz, P., Schmidt, J. M., Stuart, R. M., Fernandez, L., Malhotra, R., Presciutti, M., Ostapkovich, N. D., Connolly, E. S., Lee, K., Badjatia, N., Mayer, S. A., & Claassen, J. (2011). Effect of mannitol on brain metabolism and tissue oxygenation in severe haemorrhagic stroke. Journal of Neurology, Neurosurgery & Psychiatry, 82(4), 378–383. https://doi.org/10.1136/jnnp.2009.198754
Hemphill, J. C., Greenberg, S. M., Anderson, C. S., Becker, K., Bendok, B. R., Cushman, M., Fung, G. L., Goldstein, J. N., Macdonald, R. L., Mitchell, P. H., Scott, P. A., Selim, M. H., & Woo, D. (2015). Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke, 46(7), 2032–2060. https://doi.org/10.1161/STR.0000000000000069
Howard, V. J., McCLure, L. A., Meschia, J. F., Pulley, L., Orr, S. C., & Friday, G. H. (2006). High Prevalence of Stroke Symptoms Among Persons Without a Diagnosis of Stroke or Transient Ischemic Attack in a General Population. Archives of Internal Medicine, 166(18), 1952. https://doi.org/10.1001/archinte.166.18.1952
Jahan, R., Saver, J. L., Schwamm, L. H., Fonarow, G. C., Liang, L., Matsouaka, R. A., Xian, Y., Holmes, D. N., Peterson, E. D., Yavagal, D., & Smith, E. E. (2019). Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA, 322(3), 252. https://doi.org/10.1001/jama.2019.8286
Johnston, K. C., Li, J. Y., Lyden, P. D., Hanson, S. K., Feasby, T. E., Adams, R. J., Faught, R. E., & Haley, E. C. (1998). Medical and Neurological Complications of Ischemic Stroke. Stroke, 29(2), 447–453. https://doi.org/10.1161/01.STR.29.2.447
Kamalian, S., & Lev, M. H. (2019). Stroke Imaging. Radiologic Clinics of North America, 57(4), 717–732. https://doi.org/10.1016/j.rcl.2019.02.001
Kamphuisen, P. W., Agnelli, G., & Sebastianelli, M. (2005). Prevention of venous thromboembolism after acute ischemic stroke. Journal of Thrombosis and Haemostasis, 3(6), 1187–1194. https://doi.org/10.1111/j.1538-7836.2005.01443.x
Kamphuisen, P. W., & Agnelli, G. (2007). What is the optimal pharmacological prophylaxis for the prevention of deep-vein thrombosis and pulmonary embolism in patients with acute ischemic stroke? Thrombosis Research, 119(3), 265–274. https://doi.org/10.1016/j.thromres.2006.03.010
Kelly, J., Hunt, B. J., Lewis, R. R., Swaminathan, R., Moody, A., Seed, P. T., & Rudd, A. (2004). Dehydration and venous thromboembolism after acute stroke. QJM : Monthly Journal of the Association of Physicians, 97(5), 293–296. https://doi.org/10.1093/qjmed/hch050
Kelly, J., Rudd, A., Lewis, R., & Hunt, B. J. (2001). Venous thromboembolism after acute stroke. Stroke, 32(1), 262–267. https://doi.org/10.1161/01.str.32.1.262
Kerber, K. A., Brown, D. L., Lisabeth, L. D., Smith, M. A., & Morgenstern, L. B. (2006). Stroke Among Patients With Dizziness, Vertigo, and Imbalance in the Emergency Department. Stroke, 37(10), 2484–2487. https://doi.org/10.1161/01.STR.0000240329.48263.0d
Krishnamurthi, R. V, Feigin, V. L., Forouzanfar, M. H., Mensah, G. A., Connor, M., Bennett, D. A., Moran, A. E., Sacco, R. L., Anderson, L. M., Truelsen, T., O’Donnell, M., Venketasubramanian, N., Barker-Collo, S., Lawes, C. M. M., Wang, W., Shinohara, Y., Witt, E., Ezzati, M., Naghavi, M., & Murray, C. (2013). Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet Global Health, 1(5), e259–e281. https://doi.org/10.1016/S2214-109X(13)70089-5
Kumar, S., Selim, M. H., & Caplan, L. R. (2010). Medical complications after stroke. The Lancet Neurology, 9(1), 105–118. https://doi.org/10.1016/S1474-4422(09)70266-2
Kvistad, C. E., Novotny, V., Næss, H., Hagberg, G., Ihle-Hansen, H., Waje-Andreassen, U., Thomassen, L., & Logallo, N. (2019). Safety and predictors of stroke mimics in The Norwegian Tenecteplase Stroke Trial (NOR-TEST). International Journal of Stroke, 14(5), 508–516. https://doi.org/10.1177/1747493018790015
Landi, G., D’Angelo, A., Boccardi, E., Candelise, L., Mannucci, P. M., Morabito, A., & Orazio, E. N. (1992). Venous thromboembolism in acute stroke. Prognostic importance of hypercoagulability. Archives of Neurology, 49(3), 279–283. https://doi.org/10.1001/archneur.1992.00530270093024
Liberman, A. L., & Prabhakaran, S. (2017). Stroke Chameleons and Stroke Mimics in the Emergency Department. Current Neurology and Neuroscience Reports, 17(2), 15. https://doi.org/10.1007/s11910-017-0727-0
Lodigiani, C., Iapichino, G., Carenzo, L., Cecconi, M., Ferrazzi, P., Sebastian, T., Kucher, N., Studt, J.-D., Sacco, C., Bertuzzi, A., Sandri, M. T., & Barco, S. (2020). Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis Research, 191, 9–14. https://doi.org/10.1016/j.thromres.2020.04.024
Lu, J., Kanji, S., Aggarwal, R., Das, M., Joseph, M., Wu, L.-C., Mao, H.-Q., Pompili, V. J., Hadjiconstantinou, M., & Das, H. (2013). Hematopoietic stem cells improve dopaminergic neuron in the MPTP-mice. Frontiers in Bioscience (Landmark Edition), 18, 970–981. https://doi.org/10.2741/4156
Merkler, A. E., Parikh, N. S., Mir, S., Gupta, A., Kamel, H., Lin, E., Lantos, J., Schenck, E. J., Goyal, P., Bruce, S. S., Kahan, J., Lansdale, K. N., LeMoss, N. M., Murthy, S. B., Stieg, P. E., Fink, M. E., Iadecola, C., Segal, A. Z., Cusick, M., … Navi, B. B. (2020). Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza. JAMA Neurology, 77(11), 1366. https://doi.org/10.1001/jamaneurol.2020.2730
Morgenstern, L. B., & Frankowski, R. F. (1999). Brain tumor masquerading as stroke. Journal of Neuro-Oncology, 44(1), 47–52. https://doi.org/10.1023/a:1006237421731
Morgenstern, L. B., Hemphill, J. C., Anderson, C., Becker, K., Broderick, J. P., Connolly, E. S., Greenberg, S. M., Huang, J. N., Macdonald, R. L., Messé, S. R., Mitchell, P. H., Selim, M., & Tamargo, R. J. (2010). Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Stroke, 41(9), 2108–2129. https://doi.org/10.1161/STR.0b013e3181ec611b
Morris, P. L., Shields, R. B., Hopwood, M. J., Robinson, R. G., & Raphael, B. (1994). Are there two depressive syndromes after stroke? The Journal of Nervous and Mental Disease, 182(4), 230–234. https://doi.org/10.1097/00005053-199404000-00007
Moulin, S., & Leys, D. (2019). Stroke mimics and chameleons. Current Opinion in Neurology, 32(1), 54–59. https://doi.org/10.1097/WCO.0000000000000620
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., de Ferranti, S., Després, J.-P., Fullerton, H. J., Howard, V. J., Huffman, M. D., Isasi, C. R., Jiménez, M. C., Judd, S. E., Kissela, B. M., Lichtman, J. H., Lisabeth, L. D., Liu, S., & Turner, M. B. (2016). Heart Disease and Stroke Statistics—2016 Update. Circulation, 133(4). https://doi.org/10.1161/CIR.0000000000000350
Mulley, G. P. (1982). Avoidable complications of stroke. Journal of the Royal College of Physicians of London, 16(2), 94–97. https://doi.org/7077569
Nakayama, H., Jørgensen, H. S., Pedersen, P. M., Raaschou, H. O., & Olsen, T. S. (1997). Prevalence and Risk Factors of Incontinence After Stroke. Stroke, 28(1), 58–62. https://doi.org/10.1161/01.STR.28.1.58
Ng, F. C., Coote, S., Frost, T., Bladin, C., & Choi, P. M. (2017). CT perfusion predicts tissue injury in TIA and minor stroke. Journal of Neurology, 264(4), 802–803. https://doi.org/10.1007/s00415-017-8423-1
Nor, A. M., Davis, J., Sen, B., Shipsey, D., Louw, S. J., Dyker, A. G., Davis, M., & Ford, G. A. (2005). The Recognition of Stroke in the Emergency Room (ROSIER) scale: development and validation of a stroke recognition instrument. The Lancet Neurology, 4(11), 727–734. https://doi.org/10.1016/S1474-4422(05)70201-5
Organização Mundial da Saúde. (2005). Enfoque passo a passo da OMS para a vigilância de acidentes vascular cerebrais.
Patel, M., Coshall, C., Rudd, A. G., & Wolfe, C. D. A. (2001). Natural History and Effects on 2-Year Outcomes of Urinary Incontinence After Stroke. Stroke, 32(1), 122–127. https://doi.org/10.1161/01.STR.32.1.122
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.
Prabhakaran, S., Ruff, I., & Bernstein, R. A. (2015). Acute Stroke Intervention. JAMA, 313(14), 1451. https://doi.org/10.1001/jama.2015.3058
Redgrave, J. N. E., Coutts, S. B., Schulz, U. G., Briley, D., & Rothwell, P. M. (2007). Systematic review of associations between the presence of acute ischemic lesions on diffusion-weighted imaging and clinical predictors of early stroke risk after transient ischemic attack. Stroke, 38(5), 1482–1488. https://doi.org/10.1161/STROKEAHA.106.477380
Rordorf, G., & McDonald, C. (2021). Spontaneous intracerebral hemorrhage: Treatment and prognosis.
Sarikaya, H., Ferro, J., & Arnold, M. (2015). Stroke Prevention - Medical and Lifestyle Measures. European Neurology, 73(3–4), 150–157. https://doi.org/10.1159/000367652
Smithard, D. G., O’Neill, P. A., England, R. E., Park, C. L., Wyatt, R., Martin, D. F., & Morris, J. (1997). The Natural History of Dysphagia following a Stroke. Dysphagia, 12(4), 188–193. https://doi.org/10.1007/PL00009535
Trejo-Gabriel-Galán, J. M. (2020). Ictus como complicación y como factor pronóstico de COVID-19. Neurología, 35(5), 318–322. https://doi.org/10.1016/j.nrl.2020.04.015
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., & Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Trounson, A., & McDonald, C. (2015). Stem Cell Therapies in Clinical Trials: Progress and Challenges. Cell Stem Cell, 17(1), 11–22. https://doi.org/10.1016/j.stem.2015.06.007
Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., Charlson, F., Davis, A., Degenhardt, L., Dicker, D., Duan, L., Erskine, H., Feigin, V. L., Ferrari, A. J., Fitzmaurice, C., Fleming, T., Graetz, N., Guinovart, C., Haagsma, J., & Murray, C. J. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386(9995), 743–800. https://doi.org/10.1016/S0140-6736(15)60692-4
Wade, D. T., & Hewer, R. L. (1987). Functional abilities after stroke: measurement, natural history and prognosis. Journal of Neurology, Neurosurgery & Psychiatry, 50(2), 177–182. https://doi.org/10.1136/jnnp.50.2.177
Walker, M. D., Marler, J. R., Goldstein, M., Grayd, P. A., Toole, J. F., Baker, Wi. H., Castaldo, J. E., & Chambless, L. E. (1995). Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA, 273(18), 1421–1428. http://www.ncbi.nlm.nih.gov/pubmed/7723155
Whittaker, A., Anson, M., & Harky, A. (2020). Neurological Manifestations of COVID‐19: A systematic review and current update. Acta Neurologica Scandinavica, 142(1), 14–22. https://doi.org/10.1111/ane.13266
Wilson, P. W. F., Hoeg, J. M., D’Agostino, R. B., Silbershatz, H., Belanger, A. M., Poehlmann, H., O’Leary, D., & Wolf, P. A. (1997). Cumulative Effects of High Cholesterol Levels, High Blood Pressure, and Cigarette Smoking on Carotid Stenosis. New England Journal of Medicine, 337(8), 516–522. https://doi.org/10.1056/NEJM199708213370802
Zappella, N., Merceron, S., Nifle, C., Hilly-Ginoux, J., Bruneel, F., Troché, G., Cordoliani, Y.-S., Bedos, J.-P., Pico, F., & Legriel, S. (2014). Artery of Percheron Infarction as an Unusual Cause of Coma: Three Cases and Literature Review. Neurocritical Care, 20(3), 494–501. https://doi.org/10.1007/s12028-014-9962-2
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