Extravasación intraventricular de contraste durante la angiografía cerebral en dos pacientes con edema cerebral de diferente etiología
F. San Enieterio, F. Quintana, J.M. Izquierdo, N.O. Colombo, J.M. Coca, J.I. Díaz de Tuesta
Servicio de Neurocirugía. Hospital Universitario. Valladolid
Servicio de Neurocirugía y Sección de Neurorradiología. Hospital Valdecilla. Santander
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Conde Guerri, F. Comuñas González, E. Sinués Porta, M. Arrazola Schlamilch, V. Calatayud Maldonado" "autores" => array:5 [ 0 => array:2 [ "nombre" => "B." "apellidos" => "Conde Guerri" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Comuñas González" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Sinués Porta" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Arrazola Schlamilch" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Calatayud Maldonado" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147390709426?idApp=UINPBA00004B" "url" => "/11301473/0000000100000001/v1_201305150952/S1130147390709426/v1_201305150952/es/main.assets" ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Extravasación intraventricular de contraste durante la angiografía cerebral en dos pacientes con edema cerebral de diferente etiología" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "16" "paginaFinal" => "19" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "F. San Enieterio, F. Quintana, J.M. Izquierdo, N.O. Colombo, J.M. Coca, J.I. Díaz de Tuesta" "autores" => array:6 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "San Enieterio" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Quintana" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Izquierdo" ] 3 => array:2 [ "nombre" => "N.O." "apellidos" => "Colombo" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Coca" ] 5 => array:2 [ "nombre" => "J.I." "apellidos" => "Díaz de Tuesta" ] ] "afiliaciones" => array:2 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Universitario. Valladolid" ] 1 => array:1 [ "entidad" => "Servicio de Neurocirugía y Sección de Neurorradiología. Hospital Valdecilla. Santander" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec156516" "palabras" => array:4 [ 0 => "Extravasación de contraste" 1 => "Angiografía cerebral" 2 => "Edema cerebral" 3 => "Inundación ventricular" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156517" "palabras" => array:4 [ 0 => "Contrast extravasation" 1 => "Cerebral angiography" 2 => "Brain edema" 3 => "Ventricular flood of contrast" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Presentamos dos pacientes aquejados de edema cerebral por distintas etiologías en los que, al realizar el estudio angiográfico, se apreció una extravasación de contraste con inundación del sistema ventricular. En ninguno de ellos se pudieron visualizar malformaciones vasculares, ni en la angiografía, ni en el estudio necrópsico.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">No se conoce un mecanismo etiopatogénico que explique convenientemente este rarísimo fenómeno.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Comparando los datos comunes de nuestros pacientes y otros similares de la literatura, hemos elaborado una hipótesis que intenta explicarlo.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La ruptura vascular puede estar ocasionada por una dislaceración cerebral traumática, edema o por necrosis post-infarto, afectando de manera importante a las arteriolas en proximidad a los ventrículos e incluso a los plexos coroides y a través de estas estructuras vasculares pasa el contraste a los ventrículos; siendo el fenómeno de muy mal pronóstico.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We present two cases of intense brain swelling, caused by cerebral infarct in the first, and by severe craniocerebral trauma in the second, in which contrast extravasation was observed.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Neither the angiography nor the necropsy showed arteriovenous malformations, vascular anomalies or any other obvious cause of the extravasation.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Up to now, there is not a satisfactory explanation of this phenomenon. The traumatic brain injury, brain edema of different etiology and necrosis post-cerebral-infarct, could account for the vascular rupture of the arteríolae in the vicinity of the cerebral ventricles, or perhaps those of the choroid plexuses. Through these small injured arteries, could the contrast pass from the vessels to the ventricles, specially when the ependima is also injured.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">As far as the evolution is concerned, and after considering other cases previously published, we think that the prognosis of this phenomenon is usually ominous.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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