Accidente cerebrovascular de la arteria basilar: cannabis como factor de riesgo en jóvenes

dc.contributor.authorTapias Cáceres, Kevin Aarón
dc.contributor.authorSuarez Plata, José Daniel
dc.contributor.authorQuintero Oliveros, Silvia Tatiana
dc.date.accessioned2024-07-30T14:36:43Z
dc.date.available2024-07-30T14:36:43Z
dc.date.issued2021-06-03
dc.description.abstractLa arteria basilar se forma de las arterias vertebrales, cursa sobre el puente y se bifurca originando las arterias cerebrales posteriores. Irriga parte del tronco encefálico, cerebelo, tálamo y los lóbulos occipitales y temporales cerebrales. Su obstrucción es rara (1% de los accidentes isquémicos), puede ocurrir en cualquier parte de su trayecto, con cuadro clínico diverso. En jóvenes se añaden otros factores de riesgo distintos a los cardiovasculares, se incluye el consumo de sustancias psicoactivas. El objetivo de este artículo es presentar el caso de un adulto joven, su evolución posterior a la intervención endovascular y la asociación, pasada por alto, al consumo de cannabinoides. Caso clínico. Individuo de 23 años con 14 horas de parálisis facial periférica derecha, diplopía, disartria, hemiparesia e hiperreflexia izquierda, disfagia, náuseas y emesis. Tomografía Axial Computarizada de cráneo simple sin alteraciones. Posteriormente, al realizarse resonancia magnética nuclear, se evidencia isquemia pontomesencefálica y focos isquémicos agudos lacunares en lóbulos cerebelosos. Se consideró comprometido el territorio de la arteria basilar, por lo que se realizó angiotomografía que evidenció una obstrucción crítica de dicho vaso a nivel del tercio distal. Se realizó trombectomía con stent-retriever con recanalización total de la arteria basilar con flujo en toda su extensión. Al egreso fue clasificado como TOAST idiopático. Conclusiones. Las escalas etiológicas para stroke creadas para adultos mayores sobreestiman la etiología idiopática en pacientes jóvenes, lo cual puede ocasionar que el consumo de cannabis sea pasado por alto como causante pese a la asociación reportada por la literatura.spa
dc.description.abstractenglishThe basilar artery is formed from the vertebral arteries, runs over the pons and bifurcates, originating the posterior cerebral arteries. It irrigates part of the brainstem, cerebellum, thalamus, and the occipital and temporal lobes of the brain. Its obstruction is rare (1% of ischemic accidents), it can occur in any part of its path, with a diverse clinical condition. In young people, other risk factors other than cardiovascular ones are added; psychoactive substance use is included. The objective of this article is to present the case of a young adult, his evolution after endovascular intervention and the association, overlooked, to the consumption of cannabinoids. Clinical case. 23-year-old man with 14 hours of right peripheral facial paralysis, diplopia, dysarthria, left hyperreflexia and hemiparesis, dysphagia, nausea and emesis. Simple skull Computerized Axial Tomography without alterations. Subsequently, when a nuclear magnetic resonance was performed, pontomesencephalic ischemia and acute lacunar ischemic foci in the cerebellar lobes were evidenced. The basilar artery territory was considered compromised, so a CT angiography was performed, which revealed a critical obstruction of said artery at the level of the distal third. A stent-retriever thrombectomy was performed with total recanalization of the basilar artery with flow in its entirety. Upon discharge, he was classified as “idiopathic” according to the TOAST classification. Conclusions. The etiological scales for stroke created for older adults overestimate idiopathic etiology in young patients, which may cause cannabis use to be overlooked as a cause despite the association reported in the literature.eng
dc.description.abstractotherA artéria basilar é formada pelas artérias vertebrais, passa pela ponte e se bifurca, originando as artérias cerebrais posteriores. Irriga parte do tronco cerebral, cerebelo, tálamo e os lobos occipital e temporal do cérebro. Sua obstrução é rara (1% dos acidentes isquêmicos), podendo ocorrer em qualquer parte de seu trajeto, com quadro clínico diverso. Nos jovens, são adicionados outros fatores de risco além dos cardiovasculares, incluindo o consumo de substâncias psicoativas. O objetivo deste artigo é apresentar o caso de um adulto jovem, sua evolução após a intervenção endovascular e a associação, despercebida, ao consumo de canabinoides. Caso clínico. Indivíduo de 23 anos com 14 horas de paralisia facial periférica direita, diplopia, disartria, hemiparesia e hiperreflexia esquerda, disfagia, náuseas e vômitos. Tomografia axial computadorizada de crânio simples sem alterações. Posteriormente, quando foi realizada a ressonância magnética nuclear, foram evidenciados isquemia pontomesencefálica e focos agudos de isquemia lacunar nos lobos cerebelares. O território da artéria basilar foi considerado comprometido, por isso foi realizada uma angiotomografia, que revelou uma obstrução crítica do referido vaso no terço distal. Foi realizada trombectomia stent-retriever com recanalização total da artéria basilar com fluxo em sua totalidade. No momento da alta, foi classificado como TOAST idiopática. Conclusões. As escalas etiológicas para AVC criadas para idosos superestimam a etiologia idiopática em pacientes jovens, o que pode fazer com que o uso de cannabis seja negligenciado como causa, apesar da associação relatada na literatura.por
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.29375/01237047.3671
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga UNABspa
dc.identifier.issni-ISSN 0123-7047spa
dc.identifier.issne-ISSN 2382-4603spa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/25805
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.relationhttps://revistas.unab.edu.co/index.php/medunab/article/view/3671/3448spa
dc.relation.referencesForero PL, Ballesteros LE, Ramírez LM. Expresión morfológica de la arteria basilar. Un estudio con material de autopsia de individuos colombianos. Int J Morphol [Internet]. 2013 [citado el 7 de agosto de 2020]; 31(3):1090-6. doi: https://doi.org/10.4067/ S0717-95022013000300050
dc.relation.referencesArenillas Lara JF. Trombosis aguda de la arteria basilar. Neurología [Internet]. 2010;25(SUPPL. 1):18–23. doi: https://doi.org/10.1016/S0213-4853(10)70046-3
dc.relation.referencesMattle HP, Arnold M, Lindsberg PJ, Schonewille WJ, Schroth G. Basilar artery occlusion. Lancet Neurol [Internet]. 2011 Nov [citado el 7 de agosto de 2020]; 10(11):1002-14. doi: https://doi.org/10.1016/S1474-4422(11)70229-0
dc.relation.referencesPutaala J. Ischemic stroke in the young: Current perspectives on incidence, risk factors, and cardiovascular prognosis. Eur Stroke J [Internet]. 2016 [citado el 7 de agosto de 2020]; 1(1):28-40. doi: https://doi.org/10.1177/2396987316629860
dc.relation.referencesvan Alebeek ME, Arntz RM, Ekker MS, Synhaeve NE, Maaijwee NAMM, Schoonderwaldt H, et al. Risk factors and mechanisms of stroke in young adults: The FUTURE study. J Cereb Blood Flow Metab [Internet]. 2018 Sep 1 [citado el 7 de agosto de 2020];38(9):1631- 41. doi: https://doi.org/10.1177/0271678X17707138
dc.relation.referencesRumalla K, Reddy AY, Mittal MK. Recreational marijuana use and acute ischemic stroke: A populationbased analysis of hospitalized patients in the United States. J Neurol Sci [Internet]. 2016 May 15 [citado el 7 de agosto de 2020];364:191-6. doi: https://doi. org/10.1016/j.jns.2016.01.066
dc.relation.referencesGómez Ochoa SA. Ictus y consumo de cannabis en pacientes sin factores de riesgo cardiovascular: revisión sistemática de casos clínicos. Neurologia [Internet]. 2017 [citado 07 de agosto de 2020]; Disponible en: https://www.elsevier.es/es-revista-neurologia-295- avance-resumen-ictus-consumo-cannabis-pacientessin- S0213485317303626
dc.relation.referencesBarber PA. Cannabis and Stroke. En: Preedy V, editor. Handbook of Cannabis and Related Pathologies: Biology, Pharmacology, Diagnosis, and Treatment [Internet]. London: Elsevier Academic Press; 2017. 486–493 p. doi: https://doi.org/10.1016/B978-0-12- 800756-3.00059-4
dc.relation.referencesSchonewille WJ, Wijman CAC, Michel P, Rueckert CM, Weimar C, Mattle HP, et al. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol [Internet]. 2009 Aug 1 [Citado 07 de agosto de 2020];8(8):724–30. doi: https://doi.org/10.1016/ S1474-4422(09)70173-5
dc.relation.referencesSchulz UG, Fischer U. Posterior circulation cerebrovascular syndromes: diagnosis and management. J Neurol Neurosurg Psychiatry [Internet]. 2017 Jan 1 [Citado 7 de agosto de 2020];88(1):45–53. doi: https://doi.org/10.1136/ jnnp-2015-311299
dc.relation.referencesGory B, Mazighi M, Labreuche J, Blanc R, Piotin M, Turjman F, et al. Predictors for Mortality after Mechanical Thrombectomy of Acute Basilar Artery Occlusion. Cerebrovasc Dis [Internet]. 2018 Mar 1 [Citado 07 agosto de 2020];45(1–2):61–7. doi: https://doi.org/10.1159/000486690
dc.relation.referencesLiebeskind DS, Cotsonis GA, Saver JL, Lynn MJ, Turan TN, Cloft HJ, et al. Collaterals dramatically alter stroke risk in intracranial atherosclerosis. Ann Neurol [Internet]. 2011 Jun [Citado 7 agosto 2020];69(6):963–74. doi: https://doi.org/10.1002/ ana.22354
dc.relation.referencesGarg R, Biller J. Neuroimaging Predictors of Clinical Outcome in Acute Basilar Artery Occlusion. Front. Neurol [Internet]. 2017 Jun 19 [Citado 7 agosto de 2020];8:293. doi: https://doi.org/10.3389/ fneur.2017.00293
dc.relation.referencesLee WJ, Jung KH, Ryu YJ, Kim JM, Lee ST, Chu K, et al. Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy. Ann Clin Transl Neurol [Internet]. 2018 Mar 1 [Citado 7 agosto de 2020];5(3):357–68. doi: https://doi.org/10.1002/ acn3.536
dc.relation.referencesAlemseged F, Shah DG, Diomedi M, Sallustio F, Bivard A, Sharma G, et al. The Basilar Artery on Computed Tomography Angiography Prognostic Score for Basilar Artery Occlusion. Stroke [Internet]. 2017 Mar 1 [Citado 7 de agosto 2020];48(3):631–637. doi: https://doi.org/10.1161/ STROKEAHA.116.015492
dc.relation.referencesJung S, Wiest R, Gralla J, McKinley R, Mattle H, Liebeskind D. Relevance of the cerebral collateral circulation in ischaemic stroke: time is brain, but collaterals set the pace. Swiss Med Wkly [Internet]. 2017;147:w14538. doi: https://doi.org/10.4414/ smw.2017.14538
dc.relation.referencesSinger OC, Berkefeld J, Nolte CH, Bohner G, Haring HP, Trenkler J, et al. Mechanical recanalization in basilar artery occlusion: The ENDOSTROKE study. Ann Neurol [Internet]. 2015;77(3):415–24. doi: https://doi.org/10.1002/ana.24336
dc.relation.referencesMak CHK, Ho JWK, Chan KY, Poon WS, Wong GKC. Intra-arterial revascularization therapy for basilar artery occlusion—a systematic review and analysis. Neurosurg Rev [Internet]. 2016;39(4):575– 80. doi: https://doi.org/10.1007/s10143-015-0693-4
dc.relation.referencesCampbell BCV, Parsons MW. Imaging selection for acute stroke intervention. Int J Stroke [Internet]. 2018 Aug 1 [citado 7 de agosto de 2020];13(6):554- 67. doi: https://doi.org/10.1177/1747493018765235
dc.relation.referencesMokin M, Ansari SA, McTaggart RA, Bulsara KR, Goyal M, Chen M, et al. Indications for thrombectomy in acute ischemic stroke from emergent large vessel occlusion (ELVO): report of the SNIS Standards and Guidelines Committee. J Neurointerv Surg [Internet]. 2019 Mar 1 [Citado 7 de agosto de 2020];11(3):215–20. doi: https://doi. org/10.1136/neurintsurg-2018-014640
dc.relation.urihttps://revistas.unab.edu.co/index.php/medunab/issue/view/275spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.sourceVol. 24 Núm. 2 (2021): agosto-noviembre, 2021: Telemedicina, Neoplasias, Cannabis; 262-267spa
dc.subjectTrastornos cerebrovascularesspa
dc.subjectCannabisspa
dc.subjectEmbolia y Trombosis Intracranealspa
dc.subjectReperfusiónspa
dc.subjectArteria Basilarspa
dc.subjectAdulto jovenspa
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsCerebrovascular disorderseng
dc.subject.keywordsCannabiseng
dc.subject.keywordsIntracranial Embolism and Thrombosiseng
dc.subject.keywordsReperfusioneng
dc.subject.keywordsBasilar Arteryeng
dc.subject.keywordsYoung adulteng
dc.subject.keywordsTranstornos cerebrovascularespor
dc.subject.keywordsCannabispor
dc.subject.keywordsEmbolia e Trombose Intracranianapor
dc.subject.keywordsReperfusãopor
dc.subject.keywordsArtéria Basilarpor
dc.subject.keywordsAdulto jovempor
dc.subject.keywordsMedical scienceseng
dc.subject.keywordsLife scienceseng
dc.subject.keywordsHealth scienceseng
dc.subject.keywordsCiências médicaspor
dc.subject.keywordsCiências da vidapor
dc.subject.keywordsCiências da saúdepor
dc.subject.lembCiencias médicasspa
dc.subject.lembCiencias de la vidaspa
dc.subject.proposalCiencias de la saludspa
dc.titleAccidente cerebrovascular de la arteria basilar: cannabis como factor de riesgo en jóvenesspa
dc.title.translatedCerebrovascular accident of basilar artery: Cannabis as a risk factor in young peopleeng
dc.title.translatedAcidente Vascular Cerebral (AVC) da artéria basilar: cannabis como fator de risco em jovenspor
dc.typeArticleeng
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículospa
dc.type.redcolhttp://purl.org/redcol/resource_type/ART

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