Catástrofes neurológicas
Trombosis aguda de la arteria basilar
Acute basilar artery thrombosis
J.F. Arenillas Lara
Unidad de Ictus, Servicio de Neurología, Hospital Clínico Universitario, Valladolid, España
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García-Moncó" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.C." "apellidos" => "García-Moncó" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485310700451?idApp=UINPBA00004N" "url" => "/02134853/00000025000000S1/v1_201305151047/S0213485310700451/v1_201305151047/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Catástrofes neurológicas</span>" "titulo" => "Trombosis aguda de la arteria basilar" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "18" "paginaFinal" => "23" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J.F. Arenillas Lara" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J.F." "apellidos" => "Arenillas Lara" "email" => array:1 [ 0 => "juanfarenillas@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Ictus, Servicio de Neurología, Hospital Clínico Universitario, Valladolid, España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Acute basilar artery thrombosis" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec157314" "palabras" => array:4 [ 0 => "Ictus" 1 => "Pronóstico" 2 => "Trombosis basilar" 3 => "Cuidados neurocríticos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec157315" "palabras" => array:4 [ 0 => "Stroke" 1 => "Outcome" 2 => "Basilar thrombosis" 3 => "Neurocritical care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La trombosis aguda de la arteria basilar (TAB) ha sido considerada una catástrofe neurológica. Únicamente alrededor de un 20% de los pacientes alcanza un buen pronóstico con tratamiento convencional. Es importante establecer una sospecha diagnóstica precoz para evitar un retraso en el inicio del tratamiento. La evaluación diagnóstica incluye confirmación de la oclusión basilar y estimación de la viabilidad del tejido isquémico, y puede realizarse con resonancia magnética multiparamétrica o con angiotomografía computarizada combinada con sus imágenes fuente. La recanalización arterial precoz determina la posibilidad de alcanzar un buen pronóstico; sin embargo, se desconoce cuál es el mejor tratamiento de la TAB. No se ha demostrado que la trombólisis intraarterial sea superior a la intravenosa, de modo que en ausencia de contraindicaciones debe iniciarse cuanto antes la trombólisis intravenosa, que puede ser el tratamiento principal si no se cuenta con acceso al neurointervencionismo. Recientemente se han notificado tasas excelentes de buen pronóstico (50% de independencia funcional) empleando estrategias escalonadas de combinación de varias modalidades terapéuticas (trombólisis intravenosa ultraprecoz seguida de trombectomía mecánica endovascular de rescate). Estos resultados representan una esperanza para pacientes y neurólogos y suponen un reclamo para continuar innovando e investigando en este campo.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Acute basilar artery thrombosis (ABT) has been largely considered a neurological catastrophe. With conventional treatment, only around 20% of patients achieve functional independence. An early presumptive diagnosis is essential to avoid treatment delay. Either multiparametric magnetic resonance imaging or computed tomography angiography source images may represent valid non-invasive tools to confirm ABT and evaluate ischemic tissue viability.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The main determinant of ABT outcome is early recanalization but the most effective therapeutic option remains to be clarified. The BASICS prospective registry showed no superiority of intra-arterial over intravenous thrombolysis. Therefore, in the absence of contraindications, intravenous thrombolysis should be started as soon as possible and can be used as the main therapy when interventional procedures are not available. However, recent case series have reported high rates of functional independence (50%) after staged escalation therapy (ultra-early intravenous thrombolysis followed by on-demand endovascular mechanical thrombectomy). These results represent a hope for patients and neurologists and reinforce the need for innovation and research in this field.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome in patients with basilar artery occlusion treated conventionally" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.J. Schonewille" 1 => "A. Algra" 2 => "J. Serena" 3 => "C.A. Molina" 4 => "L.J. Kappelle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jnnp.2004.049924" "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 26 | 6 | 32 |
| 2024 Octubre | 275 | 40 | 315 |
| 2024 Septiembre | 246 | 52 | 298 |
| 2024 Agosto | 199 | 34 | 233 |
| 2024 Julio | 199 | 39 | 238 |
| 2024 Junio | 247 | 35 | 282 |
| 2024 Mayo | 302 | 44 | 346 |
| 2024 Abril | 219 | 28 | 247 |
| 2024 Marzo | 270 | 35 | 305 |
| 2024 Febrero | 283 | 38 | 321 |
| 2024 Enero | 264 | 31 | 295 |
| 2023 Diciembre | 216 | 32 | 248 |
| 2023 Noviembre | 306 | 42 | 348 |
| 2023 Octubre | 380 | 45 | 425 |
| 2023 Septiembre | 193 | 37 | 230 |
| 2023 Agosto | 210 | 28 | 238 |
| 2023 Julio | 253 | 49 | 302 |
| 2023 Junio | 293 | 50 | 343 |
| 2023 Mayo | 475 | 84 | 559 |
| 2023 Abril | 253 | 51 | 304 |
| 2023 Marzo | 210 | 61 | 271 |
| 2023 Febrero | 173 | 48 | 221 |
| 2023 Enero | 204 | 54 | 258 |
| 2022 Diciembre | 142 | 69 | 211 |
| 2022 Noviembre | 253 | 102 | 355 |
| 2022 Octubre | 166 | 58 | 224 |
| 2022 Septiembre | 233 | 86 | 319 |
| 2022 Agosto | 130 | 76 | 206 |
| 2022 Julio | 135 | 45 | 180 |
| 2022 Junio | 134 | 49 | 183 |
| 2022 Mayo | 146 | 84 | 230 |
| 2022 Abril | 173 | 76 | 249 |
| 2022 Marzo | 214 | 71 | 285 |
| 2022 Febrero | 150 | 58 | 208 |
| 2022 Enero | 194 | 80 | 274 |
| 2021 Diciembre | 133 | 55 | 188 |
| 2021 Noviembre | 169 | 63 | 232 |
| 2021 Octubre | 211 | 96 | 307 |
| 2021 Septiembre | 175 | 66 | 241 |
| 2021 Agosto | 205 | 54 | 259 |
| 2021 Julio | 223 | 51 | 274 |
| 2021 Junio | 132 | 37 | 169 |
| 2021 Mayo | 198 | 67 | 265 |
| 2021 Abril | 570 | 156 | 726 |
| 2021 Marzo | 352 | 167 | 519 |
| 2021 Febrero | 217 | 120 | 337 |
| 2021 Enero | 166 | 61 | 227 |
| 2020 Diciembre | 216 | 100 | 316 |
| 2020 Noviembre | 198 | 92 | 290 |
| 2020 Octubre | 194 | 74 | 268 |
| 2020 Septiembre | 301 | 74 | 375 |
| 2020 Agosto | 323 | 111 | 434 |
| 2020 Julio | 289 | 111 | 400 |
| 2020 Junio | 328 | 66 | 394 |
| 2020 Mayo | 302 | 118 | 420 |
| 2020 Abril | 263 | 75 | 338 |
| 2020 Marzo | 272 | 82 | 354 |
| 2020 Febrero | 374 | 79 | 453 |
| 2020 Enero | 261 | 68 | 329 |
| 2019 Diciembre | 272 | 83 | 355 |
| 2019 Noviembre | 373 | 95 | 468 |
| 2019 Octubre | 307 | 100 | 407 |
| 2019 Septiembre | 405 | 144 | 549 |
| 2019 Agosto | 315 | 72 | 387 |
| 2019 Julio | 417 | 100 | 517 |
| 2019 Junio | 383 | 91 | 474 |
| 2019 Mayo | 392 | 190 | 582 |
| 2019 Abril | 510 | 137 | 647 |
| 2019 Marzo | 346 | 122 | 468 |
| 2019 Febrero | 280 | 124 | 404 |
| 2019 Enero | 276 | 96 | 372 |
| 2018 Diciembre | 240 | 66 | 306 |
| 2018 Noviembre | 239 | 79 | 318 |
| 2018 Octubre | 285 | 86 | 371 |
| 2018 Septiembre | 222 | 40 | 262 |
| 2018 Agosto | 166 | 71 | 237 |
| 2018 Julio | 196 | 39 | 235 |
| 2018 Junio | 200 | 57 | 257 |
| 2018 Mayo | 242 | 41 | 283 |
| 2018 Abril | 293 | 58 | 351 |
| 2018 Marzo | 212 | 49 | 261 |
| 2018 Febrero | 686 | 34 | 720 |
| 2018 Enero | 887 | 19 | 906 |
| 2017 Diciembre | 151 | 25 | 176 |
| 2017 Noviembre | 252 | 31 | 283 |
| 2017 Octubre | 198 | 22 | 220 |
| 2017 Septiembre | 235 | 33 | 268 |
| 2017 Agosto | 211 | 40 | 251 |
| 2017 Julio | 164 | 25 | 189 |
| 2017 Junio | 179 | 29 | 208 |
| 2017 Mayo | 318 | 51 | 369 |
| 2017 Abril | 182 | 48 | 230 |
| 2017 Marzo | 227 | 31 | 258 |
| 2017 Febrero | 428 | 38 | 466 |
| 2017 Enero | 244 | 19 | 263 |
| 2016 Diciembre | 193 | 23 | 216 |
| 2016 Noviembre | 276 | 35 | 311 |
| 2016 Octubre | 262 | 41 | 303 |
| 2016 Septiembre | 259 | 52 | 311 |
| 2016 Agosto | 210 | 52 | 262 |
| 2016 Julio | 147 | 15 | 162 |
| 2016 Junio | 168 | 55 | 223 |
| 2016 Mayo | 156 | 63 | 219 |
| 2016 Abril | 131 | 52 | 183 |
| 2016 Marzo | 124 | 45 | 169 |
| 2016 Febrero | 113 | 52 | 165 |
| 2016 Enero | 116 | 25 | 141 |
| 2015 Diciembre | 116 | 48 | 164 |
| 2015 Noviembre | 110 | 33 | 143 |
| 2015 Octubre | 118 | 33 | 151 |
| 2015 Septiembre | 89 | 21 | 110 |
| 2015 Agosto | 114 | 22 | 136 |
| 2015 Julio | 120 | 18 | 138 |
| 2015 Junio | 84 | 23 | 107 |
| 2015 Mayo | 107 | 35 | 142 |
| 2015 Abril | 125 | 25 | 150 |
| 2015 Marzo | 136 | 11 | 147 |
| 2015 Febrero | 113 | 9 | 122 |
| 2015 Enero | 79 | 6 | 85 |
| 2014 Diciembre | 84 | 12 | 96 |
| 2014 Noviembre | 84 | 6 | 90 |
| 2014 Octubre | 103 | 9 | 112 |
| 2014 Septiembre | 101 | 6 | 107 |
| 2014 Agosto | 106 | 6 | 112 |
| 2014 Julio | 102 | 7 | 109 |
| 2014 Junio | 140 | 10 | 150 |
| 2014 Mayo | 89 | 6 | 95 |
| 2014 Abril | 81 | 7 | 88 |
| 2014 Marzo | 90 | 9 | 99 |
| 2014 Febrero | 76 | 4 | 80 |
| 2014 Enero | 117 | 9 | 126 |
| 2013 Diciembre | 64 | 5 | 69 |
| 2013 Noviembre | 118 | 21 | 139 |
| 2013 Octubre | 84 | 16 | 100 |
| 2013 Septiembre | 37 | 23 | 60 |
| 2013 Agosto | 27 | 21 | 48 |
| 2013 Julio | 21 | 3 | 24 |
| 2010 Septiembre | 1459 | 0 | 1459 |
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