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Resultados del tratamiento quirúrgico de pacientes con aneurismas de la arteria cerebral media
Resumen
Introducción: Los aneurismas de la arteria cerebral media son responsables de forma habitual de sangrados intracraneales y constituyen una localización frecuente de aneurismas. Su estrecha relación arterial y venosa en la cisterna de Silvio se acompaña de una elevada complejidad. El grapado quirúrgico presenta una elevada efectividad.
Objetivo: Describir los resultados quirúrgicos de los aneurismas de la arteria cerebral media operados mediante presillamiento microquirúrgico.
Método: Se realizó un estudio descriptivo, prospectivo que incluyó a 50 pacientes del Hospital Hermanos Ameijeiras operados por aneurisma cerebrales de la arteria cerebral media mediante presillamiento microquirúrgico. Se realizó una craneotomÃa pterional, minipterional y el grapado del aneurisma. Las variables estudiadas fueron: ClÃnicas, del aneurisma cerebral y posoperatorias con mayor importancia relacionada con las complicaciones y la escala de coma de Glasgow para resultados. Para el análisis de los datos se utilizaron frecuencias absolutas y relativas como medidas resumen.
Resultados: Existió predominio de aneurismas no rotos (66,0 %) de tamaño grande (42,0 %) y localizados en la la bifurcación de la arteria cerebral media (94,0 %). Se empleó la craneotomÃa minipterional en el 74,0 %. En relación con las principales complicaciones, se reporta vasoespasmo (8,0 %), hidrocefalia (6,0 %) e infarto cerebral (4,0 %). Según la escala de coma de Glasgow para resultados, existió mayor presencia del grado 5 (78,0 %).
Conclusiones: El presillamiento microquirúrgico en pacientes con aneurismas de la arteria cerebral media se acompaña de presillamiento total y escasas complicaciones posoperatorias.
Palabras clave
Referencias
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