HEMORRAGIA SUBARACNOIDEA TRAUMÁTICA: UNA REVISION NARRATIVA

Authors

  • Diana Marcela Sánchez Parra Instituto de Neurociencias, Grupo de investigación INUB-MEDITECH, Universidad del Bosque, Bogotá, Colombia.
  • Luis Ernesto Ricaurte Arcos Instituto de Neurociencias, Grupo de investigación INUB-MEDITECH, Universidad del Bosque, Bogotá, Colombia.
  • Carolina Martínez M.S XI semestre, Universidad el Bosque, Bogotá, Colombia
  • Ericka Ramírez M.D Residente de Neurocirugía primer año, Universidad el Bosque, Bogotá, Colombia.
  • Daniel Godoy Torres Intensivista Unidad De Cuidados Neurointensivos, Sanatorio Pasteur, San Fernando del Valle de Catamarca, Catamarca, Argentina
  • Andrés M Rubiano Neurocirujano, Jefe Servicio Neurocirugía, Clínica ValleSalud Cali, Colombia.

DOI:

https://doi.org/10.51437/nj.v27i2.203

Keywords:

Hemorragia subaracnoidea traumática, fisiopatología, tratamiento, complicaciones.

Abstract

Resumen

Introducción: La hemorragia subaracnoidea traumática (HSAt), es una afección poco estudiada y con fisiopatología no clara en su totalidad. En general se plantean cinco teorías que de manera individual o al integradas podrían aclarar las bases para la comprensión de esta entidad. El objetivo de esta revisión es realizar una actualización de la temática para el neurocirujano y los especialistas de cuidados intensivos que manejan integralmente este tipo de pacientes.

Metodología: Se realizó una búsqueda sistemática en PubMed y Google Académico con palabras claves como Hemorragia Subaracnoidea Postraumática (HSAt) en combinación con otros términos genéricos como: fisiopatología, tratamiento y complicaciones, priorizando artículos de los últimos 20 años.

Resultados: Se obtuvieron 40 artículos cuyo análisis arrojó las siguientes características de contenido: el diagnostico se basa en neuro-imágenes. La tomografía computada de cráneo simple es el estudio de mayor disponibilidad que permite un acercamiento inicial a una de las tres clasificaciones actualmente disponibles. Aunque la resonancia magnética no es de elección, las secuencias específicas como FLAIR, susceptibilidad magnética (SWi) y la inversión de gradiente eco (GRE), son útiles y sensibles para el diagnóstico. El manejo debe dirigirse a evitar lesiones secundarias, y desarrollo de complicaciones debido a su relación con pobre desenlace, especialmente en relación con complicaciones de tipo cardiovascular. A pesar de la prevalencia de la enfermedad, existe poca investigación en esta temática.

Conclusiones: La HSAt es una patología frecuente y juega un papel importante en el desenlace de los pacientes debido al riesgo de desarrollo de complicaciones cardio y cerebro-vasculares (vasoespasmo, arritmias, disfunción miocárdica). La literatura médica referente a la fisiopatología, diagnóstico y tratamiento, es escaza y en general se realizan aproximaciones terapéuticas basadas en estudios de pacientes con hemorragia subaracnoidea de origen nó traumático.

Palabras clave: Hemorragia subaracnoidea traumática, fisiopatología, tratamiento, complicaciones.

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Published

2021-04-28

How to Cite

Sánchez Parra, D. M., Ricaurte Arcos, L. E., Martínez, C., Ramírez, E., Godoy Torres, D., & Rubiano, A. M. (2021). HEMORRAGIA SUBARACNOIDEA TRAUMÁTICA: UNA REVISION NARRATIVA. Español, 27(2), 60–81. https://doi.org/10.51437/nj.v27i2.203

Issue

Section

Artículo de revisión