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Aneurisma Gigante en arteria comunicante anterior: Reporte de Caso

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


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    <dct:title>Aneurisma Gigante en arteria comunicante anterior: Reporte de Caso</dct:title>
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    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#gYear">2018</dct:issued>
    <dcat:keyword>Aneurisma gigante</dcat:keyword>
    <dcat:keyword>Aneurisma sacular</dcat:keyword>
    <dcat:keyword>Hemorragia subaracnoidea aneurismática</dcat:keyword>
    <dcat:keyword>Arteria comunicante anterior</dcat:keyword>
    <dcat:keyword>Clipaje</dcat:keyword>
    <dcat:keyword>Giant aneurysm</dcat:keyword>
    <dcat:keyword>Saccular aneurysm</dcat:keyword>
    <dcat:keyword>Aneurysmal subarachnoid hemorrhage</dcat:keyword>
    <dcat:keyword>Anterior communicating artery</dcat:keyword>
    <dcat:keyword>Clipping</dcat:keyword>
    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#date">2018-07-08</dct:issued>
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    <dct:description>&lt;p&gt;&lt;strong&gt;RESUMEN&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Los aneurismas son lesiones adquiridas relacionadas con estr&amp;eacute;s hemodin&amp;aacute;mico de las paredes de los vasos sangu&amp;iacute;neas, com&amp;uacute;nmente originados en las bifurcaciones arteriales. Presentan una incidencia entre el 0.4% y el 6% en la poblaci&amp;oacute;n general, sin embargo, un gran n&amp;uacute;mero de estos casos suelen pasar desapercibidos.&amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; El riesgo de ruptura de los aneurismas depende de su localizaci&amp;oacute;n, tama&amp;ntilde;o, forma e historia previa de HSA. La mayor&amp;iacute;a de los aneurismas intracraneales son asintom&amp;aacute;ticos a menos que presenten una ruptura, por lo que generalmente se encuentran en forma incidental. La aparici&amp;oacute;n de signos y s&amp;iacute;ntomas es de instauraci&amp;oacute;n s&amp;uacute;bita; en un individuo que por lo general no presentaba alteraciones neurol&amp;oacute;gicas previas. El inicio de los s&amp;iacute;ntomas frecuentemente est&amp;aacute; precedido por una actividad f&amp;iacute;sica intensa. &amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; Paciente femenino de 48 a&amp;ntilde;os de edad residente de Tulancingo Hidalgo con diagn&amp;oacute;stico principal de Hemorragia subaracnoidea Fisher III, Hunt y Hess II, WFNS II, formaci&amp;oacute;n de aneurisma gigante en arteria comunicante anterior; confirmado por TAC y angio TAC; tratamiento definitivo: craneotom&amp;iacute;a pterional izquierda m&amp;aacute;s colocaci&amp;oacute;n de clipaje en aneurisma hipofisiario gigante; cuyo desenlace final es el deceso 7 d&amp;iacute;as posteriores al acto quir&amp;uacute;rgico.&amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; La craneotom&amp;iacute;a y el clipaje directo de un aneurisma intracraneal sin ruptura ha probado ser altamente efectivo para la obliteraci&amp;oacute;n, sin embargo, la morbimortalidad postquir&amp;uacute;rgica en pacientes con m&amp;uacute;ltiples factores de riesgo es elevada y se relaciona con un mal pron&amp;oacute;stico.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt; &lt;p&gt;&lt;strong&gt;ABSTRACT&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;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.&amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; 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. &amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; 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.&amp;nbsp;&lt;br&gt; &amp;nbsp;&lt;br&gt; 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.&lt;/p&gt;</dct:description>
    <dct:description xml:lang="">{"references": ["Vlak MHM, Algra A, Brandenburg R, Rinkel GJE. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. The Lancet Neurology. 2011;10(7):626-36.", "Burgener FA, Burgener FA. Diagn\u00f3stico diferencial mediante resonancia magn\u00e9tica: Ediciones Journal; 2005.", "Osborn AG, Winthrop S. Neurorradiolog\u00eda diagn\u00f3stica: Harcourt Brace de Espa\u00f1a; 1998.", "Higashida RT, Lahue BJ, Torbey MT, Hopkins LN, Leip E, Hanley DF. Treatment of unruptured intracranial aneurysms: a nationwide assessment of effectiveness. AJNR Am J Neuroradiol. 2007;28(1):146-51.", "Social Imds. Detecci\u00f3n, diagn\u00f3stico, tratamiento y pronostico del aneurisma cerebral sin rotura, gu\u00eda de pr\u00e1ctica cl\u00ednica. 2011.", "Hoyos-Castillo JD, Moscote-Salazar LR. Hemorragia subaracnoidea aneurism\u00e1tica con mal grado cl\u00ednico: Revisi\u00f3n cl\u00ednica. Revista Mexicana de Neurociencia. 2016;17(1):50-64.", "Brown RD, editor Unruptured intracranial aneurysms. Seminars in neurology; 2010: Thieme Medical Publishers.", "Wermer MJ, van der Schaaf IC, Algra A, Rinkel GJ. Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics: an updated metaanalysis. Stroke. 2007;38(4):1404-10.", "Wiebers DO. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. The Lancet. 2003;362(9378):103-10.", "Salvador G-M, Maximiano Z-MA, Carlos PRJ, del Carmen CGM, Liliana G-O, Jos\u00e9 G-S. Aneurismas intracraneales: aspectos moleculares y gen\u00e9ticos relacionados con su origen y desarrollo. Revista Mexicana de Neurociencia. 2009;10 (6):453-8.", "Robert J Singer M, Christopher S Ogilvy M, Guy Rordorf M. Unruptured intracranial aneurysms: Up to date; 2013 [updated Sept 26 2013. Available from: https://www.uptodate.com/contents/unruptured-intracranialaneurysms", "Jou LD, Lee DH, Morsi H, Mawad ME. Wall shear stress on ruptured and unruptured intracranial aneurysms at the internal carotid artery. AJNR Am J Neuroradiol. 2008;29 (9):1761-7.", "Nieto MSG. Aneurismas Intracraneales Gigantes. Neuroeje. 2004;18(1).", "Salud Md, Chile Rd. Guia clinica hemorragia subaracnoidea secundaria a rotura de aneurismas cerebrales. Gu\u00eda cl\u00ednica. 2007.", "Garc\u00eda PLR, Garc\u00eda DR. Hemorragia subaracnoidea: epidemiolog\u00eda, etiolog\u00eda, fisiopatolog\u00eda y diagn\u00f3stico. Revista Cubana de Neurolog\u00eda y Neurocirug\u00eda. 2011;1(1):59-73.", "Robert J Singer M, Christopher S Ogilvy M, Guy Rordorf M. Treatment of cerebral aneurysms: Up To date 2013 [updated OCT 18 2013. Available from: https://www.uptodate.com/contents/treatment-of-cerebralaneurysms?soure=search_result&amp;search=treatment%20of%20intracranial%20aneurysms&amp;selectedTitle=1~128"]}</dct:description>
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