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Humanos , Feminino , Ginkgo biloba/efeitos adversos , Hemorragia Cerebral/induzido quimicamente , Fatores de RiscoRESUMO
Introducción. La secuencia T2* eco de gradiente en resonanciamagnética cerebral (RM-T2*) permite detectar microsangrados(MS) producidos de modo silente y cuyo significadoclínico es en gran medida desconocido.Objetivo. Establecer la frecuencia de MS en una muestrade pacientes consecutivos con enfermedad cerebrovascularsintomática (ECS), analizando su asociación con distintosfactores de riesgo vascular y su posible significación clínica.Método. Examinamos mediante RM-T2* a 198 pacientesconsecutivos ingresados por ECS. Se analiza la asociación entre lapresencia y número de MS con distintos factores de riesgo vascular(FRV), subtipo de ictus y toma de medicación antitrombótica.Resultados. El 52,5% de nuestros pacientes presentaronMS. La mayor frecuencia (72,2%) se encontró en pacientes conhemorragia intracraneal (HIC), siendo el accidente isquémicotransitorio el subtipo con la menor proporción (42,9 %). Enanálisis bivariante los factores asociados con la presencia deMS fueron edad avanzada (72,4±10,5 frente a 67,7±12,7 años;p 0,004), hipertensión arterial (HTA) (65,4 frente a 51,1%;p 0,041), diabetes (35,6 frente a 22,3%; p 0,041) y el tratamientoantitrombótico (45,2 frente a 28,7%; p 0,017). En análisismultivariante fueron predictores de la presencia de MS la edadavanzada (p 0,019; OR: 1,03 [1,01-1,06]), HTA (p 0,031; OR: 1,97[1,06-3,65]), tratamiento antitrombótico previo (p 0,038;OR: 1,95 [1,04-3,65]) y haber sufrido un ictus hemorrágico(p 0,028; OR: 3,63 [1,15-11,46]).Conclusiones. La presencia de MS es frecuente entrepacientes con ECS, siendo especialmente elevada entre pacientescon ictus hemorrágico. Se asocian a FRV clásicamenteasociados con enfermedad de pequeño vaso y a la tomade tratamiento antitrombótico previo (AU)
Introduction. T2*-weighted gradient echo MRI sequences(T2*-MRI) have made it possible to detect cerebralmicrohemorrhages (MH) that have been consideredas subclinical but whose clinical significance is largelyunknown.Objective. To establish the frequency of MH in asample of consecutive symptomatic cerebrovascular disease(SCD) patients, analyzing its associations with differentvascular risk factors (VRF) and its clinical significance.Methods. A total of 198 patients with SCD were consecutivelyexamined using T2*-MRI. Preferential locationof MH and associations between MH presence and MHnumber with VRF, previous antithrombotic treatment andSCD subtypes were analyzed.Results. A total of 52.5% of our patients had MH.The highest frequency of MH was found in hemorrhagicstrokes (72.2%), Transitoy ischemic attack (TIA) (42.9%)being the group with the lowest frequency. According tothe bivariate analysis, the factors associated with the presenceof MH were elderly age (72.4±10.5 vs 67.7±12.7;p 0.004), hypertension (65.4 vs 51.1%; p 0.041), diabetes(35.6 vs 22.3 %; p 0.041) and being under antithrombotictreatment (45.2 vs 28.7 %; p 0.017). According to the multivariateanalysis, elderly age (p 0.019; OR: 1.03 [1.01-1.06]), hypertension (p 0.032; OR: 1.97 [1.06-3.65]), use ofantithrombotic treatment (p 0.038; OR: 1.95 [1.04-3.65])and having a hemorrhagic stroke (p 0.028; OR: 3.63 [1.15-11.46]) were predictors of MH presence.Conclusions. The presence of MH is frequent amongpatients with SCD, this being especially elevated in patientswith hemorrhagic stroke. Cerebral MHs are classically associatedwith VRF classically related with small vessel diseaseand previously taking antithrombotic treatment(AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ataque Isquêmico Transitório/complicações , Hemorragia Cerebral/diagnóstico , Estudos Prospectivos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Espectroscopia de Ressonância Magnética , Hemorragia Cerebral/etiologiaRESUMO
INTRODUCTION: T2*-weighted gradient echo MRI sequences (T2*-MRI) have made it possible to detect cerebral microhemorrhages (MH) that have been considered as subclinical but whose clinical significance is largely unknown. OBJECTIVE: To establish the frequency of MH in a sample of consecutive symptomatic cerebrovascular disease (SCD) patients, analyzing its associations with different vascular risk factors (VRF) and its clinical significance. METHODS: A total of 198 patients with SCD were consecutively examined using T2*-MRI. Preferential location of MH and associations between MH presence and MH number with VRF, previous antithrombotic treatment and SCD subtypes were analyzed. RESULTS: A total of 52.5% of our patients had MH. The highest frequency of MH was found in hemorrhagic strokes (72.2%), Transitory ischemic attack (TIA) (42.9%) being the group with the lowest frequency. According to the bivariate analysis, the factors associated with the presence of MH were elderly age (72.4+/-10.5 vs 67.7+/-12.7; p 0.004), hypertension (65.4 vs 51.1%; p 0.041), diabetes (35.6 vs 22.3 %; p 0.041) and being under antithrombotic treatment (45.2 vs 28.7 %; p 0.017). According to the multivariate analysis, elderly age (p 0.019; OR: 1.03 [1.01- 1.06]), hypertension (p 0.032; OR: 1.97 [1.06-3.65]), use of antithrombotic treatment (p 0.038; OR: 1.95 [1.04-3.65]) and having a hemorrhagic stroke (p 0.028; OR: 3.63 [1.15- 11.46]) were predictors of MH presence. CONCLUSIONS: The presence of MH is frequent among patients with SCD, this being especially elevated in patients with hemorrhagic stroke. Cerebral MHs are classically associated with VRF classically related with small vessel disease and previously taking antithrombotic treatment.
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Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/patologia , Transtornos Cerebrovasculares/patologia , Idoso , Idoso de 80 Anos ou mais , Hemorragia Cerebral/fisiopatologia , Transtornos Cerebrovasculares/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de RiscoRESUMO
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Humanos , Masculino , Pessoa de Meia-Idade , Mucocele/diagnóstico , Crânio , Mucocele/cirurgia , Espectroscopia de Ressonância Magnética , EndoscopiaRESUMO
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Feminino , Adulto , Humanos , Anticonvulsivantes/efeitos adversos , Glaucoma/induzido quimicamente , Doença AgudaRESUMO
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Adolescente , Masculino , Feminino , Humanos , Conhecimentos, Atitudes e Prática em Saúde , Hemorragias Intracranianas , Atitude Frente a Saúde , Transtornos Cerebrovasculares , Seio Cavernoso , Diagnóstico Diferencial , Imageamento por Ressonância MagnéticaAssuntos
Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico , Transtornos da Consciência/etiologia , Trombose Intracraniana/complicações , Trombose Intracraniana/diagnóstico , Encéfalo/diagnóstico por imagem , Isquemia Encefálica/etiologia , Transtornos da Consciência/diagnóstico , Diagnóstico Diferencial , Fator V/metabolismo , Feminino , Humanos , Trombose Intracraniana/etiologia , Pessoa de Meia-Idade , Proteína C/metabolismo , Tomografia Computadorizada por Raios XRESUMO
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