| Revista: | Revista médica de Chile |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000449336 |
| ISSN: | 0034-9887 |
| Autores: | Castillo, José Luis1 Reyes, Pablo1 Gutiérrez, Rodrigo3 Matamala, José Manuel2 Segovia, Luis1 Menendez, Pedro1 Torres, Catalina1 Cid, Ricardo4 Bustamante, Gonzalo1 Feuerhake, Walter1 |
| Instituciones: | 1Clínica Santa María, Servicio de Neurología, Neurocirugía y Neurorradiología intervencional, Santiago de Chile. Chile 2Universidad de Chile, Facultad de Medicina, Santiago de Chile. Chile 3Universidad de Chile, Hospital Clínico, Santiago de Chile. Chile 4RCtec Cadwell Chile, Santiago de Chile. Chile |
| Año: | 2021 |
| Volumen: | 149 |
| Número: | 9 |
| Paginación: | 1377-1381 |
| País: | Chile |
| Idioma: | Español |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico |
| Resumen en inglés | Subarachnoid hemorrhage (SAH) is a devastating disease, with a mortality rate of 35%. Among patients who survive the initial bleeding, the leading cause of morbidity and mortality is delayed cerebral ischemia (DCI). Electroencephalography (EEG) can detect cerebral ischemia in the early stages. We report a 66-year-old female patient who consulted for ictal headache and impaired consciousness. On admission, she was confused, dysarthric, and with meningeal signs. Brain angio-CT showed SAH FISHER IV and an aneurysm of the left posterior cerebral artery. After excluding the aneurysm (by coiling), the patient recovered the altered consciousness. Continuous EEG monitoring was initiated. On the sixth day of follow up, she had a transient headache and apathy. The brain MRI showed low cerebral blood flow in the left frontotemporal area, without ischemic lesions. On the seventh day, she presented expression aphasia and right facial-brachial paresis. Angiography confirmed severe vasospasm in M1 and M2 segments bilaterally. Pharmacological angioplasty with nimodipine was performed, with an excellent radiological response, although not clinical. A second MRI was carried out on the eighth day, which showed a left insular infarction and generalized vasospasm. A second therapeutic angiography was performed; the patient persisted with aphasia and left central facial paresis. The quantitative EEG analysis performed retrospectively showed a generalized reduction in the spectral edge frequency 95 (SEF95; meaning slowing in the EEG signal) at the fourth day of follow up, three days earlier than the clinical and imaging diagnosis of DCI was established |
| Disciplinas: | Medicina |
| Palabras clave: | Sistema cardiovascular, Neurología, Diagnóstico, Isquemia cerebral, Electroencefalografía, Hemorragia subaracnoidea |
| Keyword: | Cardiovascular system, Neurology, Diagnosis, Brain ischemia, Electroencephalography, Subarachnoid hemorrhage |
| Texto completo: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
