Aneurisma Gigante en arteria comunicante anterior: Reporte de Caso

Aneurisma Gigante en arteria comunicante anterior: Reporte de Caso

Journal

  • Journal title: Revista Cadena de Cerebros
  • ISSN: 2448-8178 (online)
  • Publisher: Independent
  • Country of publisher: mexico
  • Platform/Host/Aggregator: Web
  • Date added to EuroPub: 2020/Aug/04

Subject and more

  • LCC Subject Category: Health science, Social Sciences, Biological Sciences, Education, Medicine, Psychology
  • Publisher's keywords: Aneurisma gigante; aneurisma sacular; hemorragia subaracnoidea aneurismática; arteria comunicante anterior; clipaje; Giant aneurysm; saccular aneurysm; aneurysmal subarachnoid hemorrhage; anterior communicating artery; clipping
  • Language of fulltext: spanish, catalan, english
  • Full-text formats available: PDF
  • Time From Submission to Publication: 6

AUTHORS

    Israel Hernández-Peralta, Regina Cartagena Torres, Francisco Javier Cid Hernández, Nallely Martínez Gerónimo, Ricardo Portillo Bonilla

FULL TEXT

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ABSTRACT

Los aneurismas son lesiones adquiridas relacionadas con estrés hemodinámico de las paredes de los vasos sanguíneas, comúnmente originados en las bifurcaciones arteriales. Presentan una incidencia entre el 0.4% y el 6% en la población general, sin embargo, un gran número de estos casos suelen pasar desapercibidos. El riesgo de ruptura de los aneurismas depende de su localización, tamaño, forma e historia previa de HSA. La mayoría de los aneurismas intracraneales son asintomáticos a menos que presenten una ruptura, por lo que generalmente se encuentran en forma incidental. La aparición de signos y síntomas es de instauración súbita; en un individuo que por lo general no presentaba alteraciones neurológicas previas. El inicio de los síntomas frecuentemente está precedido por una actividad física intensa. Paciente femenino de 48 años de edad residente de Tulancingo Hidalgo con diagnóstico principal de Hemorragia subaracnoidea Fisher III, Hunt y Hess II, WFNS II, formación de aneurisma gigante en arteria comunicante anterior; confirmado por TAC y angio TAC; tratamiento definitivo: craneotomía pterional izquierda más colocación de clipaje en aneurisma hipofisiario gigante; cuyo desenlace final es el deceso 7 días posteriores al acto quirúrgico. La craneotomía y el clipaje directo de un aneurisma intracraneal sin ruptura ha probado ser altamente efectivo para la obliteración, sin embargo, la morbimortalidad postquirúrgica en pacientes con múltiples factores de riesgo es elevada y se relaciona con un mal pronóstico. --- Intracranial aneurysms are acquired lesions related to shear stress of blood vessels walls, that often arise from the artery junctions. This entity presents an incidence between 0.4% and 6% in the general population, nevertheless a large portion of these cases may go undetected. The risk of aneurysm rupture depends on its location, size, shape and prior history of SAH. Most intracranial aneurysms are asymptomatic unless they rupture, so they are found incidentally. The onset of signs and symptoms is sudden and quite vivid in an individual whose previous neurological state was normal, and frequently preceded by intense physical activity. A 48-year-old female patient from Tulancingo Hidalgo with a primary diagnosis of subarachnoid hemorrhage Fisher III, Hunt and Hess II, WFNS II, giant aneurysm formation in the anterior communicating artery; confirmed by CT and angio CT; definitive treatment: left pterional craniotomy plus giant pituitary aneurysm clipping; whose outcome is death 7 days after surgery. Craniotomy and direct clipping of an unruptured intracranial aneurysm has proved to be a highly efficient treatment for obliteration of the lesion, however, postsurgical morbimortality in patients with multiple risk factors is very high and often associated with a bad prognosis.

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