Download - Acv
![Page 1: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/1.jpg)
ACCIDENTS CEREBRO VASCULARACCIDENTE VASCULAR CEREBRAL
ICTUS CEREBRAL APOPLEGIA CEREBRAL
ATAQUE CEREBRAL
Dr. Pedro Pablo Díaz Vasquez.Fundación Hospital Francés de Santo Domingo .
Centro Medico UCE.
![Page 2: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/2.jpg)
Ataque Cerebral
“ Episodio agudo de origen vascular”
![Page 3: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/3.jpg)
![Page 4: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/4.jpg)
Sintomatología.SENSITIVA MOTORA MIXTA SILENCIOSA TRANSITORIA REGRESIVA EVOLUTIVA ……
![Page 5: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/5.jpg)
ACV isquémico.
Fisiopatología• Oclusión de vasos
sanguíneos Cerebral. Arterial/ Venoso.
• Diferentes grados de oclusión hasta llegar a infarto.
![Page 6: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/6.jpg)
ACV isquémico
A. Daño local: (aterosclerosis).
B. Daño de lesión a distancia : ( embolico ).
![Page 7: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/7.jpg)
ACV isquémico
![Page 8: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/8.jpg)
ACV isquémico
Causas: Vasculares.
Intravasculares. Extravasculares.
![Page 9: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/9.jpg)
ACV isquémico
A. Origen vascular Disminución del gasto cardiaco. Vasoespasmo.
![Page 10: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/10.jpg)
ACV isquémico
B. Origen intravascular:1. Aterotrombotico.
2. Embolicos.
![Page 11: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/11.jpg)
ACV isquémico
C. Origen extravascular: Fenómenos compresivos de la pared vascular.
![Page 12: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/12.jpg)
ACV hemorrágico
![Page 13: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/13.jpg)
ACV hemorrágico
• Ruptura de vaso sanguíneo cerebral:A. Daño arteria congénito o adquirido.B. HTA.
![Page 14: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/14.jpg)
ACV hemorrágico
• Produce daño por triple mecanismo, de ahí su pronostico letal
![Page 15: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/15.jpg)
ACV hemorrágico
![Page 16: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/16.jpg)
ACV hemorrágico
![Page 17: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/17.jpg)
ACV cuadro clínico.
• Varia en función del territorio vascular afectado y del tipo de acv
![Page 18: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/18.jpg)
ACV cuadro clínico.
![Page 19: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/19.jpg)
ACV cuadro clínico.
![Page 20: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/20.jpg)
ACV Riesgos.
• Edad• Antecedentes Familiares.• Diabetes.• HTA.• Cuagulopatias.• Dislipidemia.• Tabaco.• Alcohol.
![Page 21: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/21.jpg)
ACV Riesgos
• Medicamentos: • Anticoagulantes.
• Drogas.– Cocaína– Alcohol.
![Page 22: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/22.jpg)
ACV Diagnostico.
• TAC – IRM.
• Ecocardiograma y Dúplex carotideo.• Laboratorios.
![Page 23: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/23.jpg)
ACV isquemico
• Infartos lacunares y leucoaraiosis
![Page 24: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/24.jpg)
ACV Isquemico
• Infartos profundos• Capsula interna
![Page 25: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/25.jpg)
ACV Isquemicos
• Infarto arteria cerebral media
![Page 26: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/26.jpg)
ACV Isquemicos
• Arteria Cerebral anterior
![Page 27: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/27.jpg)
ACV Isquemicos
• Infartos cerebelosos• UNA URGENCIA
NEUROQUIRURGICA
• Infartos de Tallo cerebral
![Page 28: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/28.jpg)
ACV Isquémico. (tratamiento)
• Importancia del diagnostico temprano .– Salvar vidas.– Reducir discapacidad.
![Page 29: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/29.jpg)
ACV Isquémico. (tratamiento)
• MEDIDAS GENERALES
• Trombolítico.• tpa limite de tres horas !!!!!!– Endovascular.– Aspirinas.– Clopidogrel.
![Page 30: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/30.jpg)
ACV Isquémico. (tratamiento)
• Protección cerebral.• Somazina.• Nootropil.
• Las medidas generales de soporte no han cambiado
• La importancia del manejo de la HTA
![Page 31: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/31.jpg)
ACV Isquémico. (tratamiento)
• A largo plazo.• Importancia de fisioterapia y logoterapia.• Terapia ocupacional.
![Page 32: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/32.jpg)
ACV Isquémico. (Pronostico)
![Page 33: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/33.jpg)
ACV hemorrágico. (tratamiento).
![Page 34: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/34.jpg)
ACV hemorrágico. (tratamiento).
• Indicaciones quirúrgicas.• Sospecha de MAV.• Hematoma de Nucleos grises centrales
![Page 35: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/35.jpg)
ACV Hemorragico • Enclavamiento Subfalciforme e inundacion
ventricular
![Page 36: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/36.jpg)
ACV Hemorragico
• El hematoma lobar
![Page 37: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/37.jpg)
Hemorragia subaracnoidea.(HSA)
![Page 38: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/38.jpg)
(HSA)
![Page 39: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/39.jpg)
(HSA)
• Tratamiento.
– Clínico. HHH – prevenir y tratar el vasoespasmo – Quirúrgico
![Page 40: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/40.jpg)
HSA Aneurismas Tratamiento
• Clipage vs embolisacion
![Page 41: Acv](https://reader036.vdocuments.us/reader036/viewer/2022062303/5588a8afd8b42acd318b45ac/html5/thumbnails/41.jpg)