Ictus isquémico: avances y proyecciones

Pedro Luis Rodríguez García

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OBJETIVO: Presentar los principales aspectos novedosos y las proyecciones con respecto al manejo del ictus isquémico.

DESARROLLO: Se enfoca el artículo hacia los aspectos recientemente tratados en las revistas especializadas sobre: 1) Las definiciones de los tipos de ictus, 2) Los factores genéticos de riesgo del ictus isquémico, 3) El paradigma de neuro–imagen en el ictus isquémico, 4) La telemedicina para el ictus (tele–ictus), 5) El uso de los antitrombóticos (terapia antiagregante oral dual, manejo periprocedimiento de los antitrombóticos, profilaxis con anticoagulantes orales de acción directa, extensión del tiempo de trombólisis a 4,5 horas después del debut), 6) La evolución de los enfoques hacia las técnicas endovasculares, 7) El aporte de las células madres en el infarto cerebral, 8) Las terapias para el edema cerebral hemisférico maligno, 9) La regulación de las cifras de presión arterial en el ictus, y 10) La identificación de intervenciones farmacológicas (inhibidores selectivos de la recaptación de la serotonina) para ayudar a la recuperación motora.

CONCLUSIONES: Se revisan los principales avances recientes realizados y las proyecciones para la investigación y el manejo en la práctica clínica del ictus isquémico. La consideración de los factores que limitan su introducción es crucial para perfeccionar el cuidado de los pacientes con ictus. Para implementar dichos avances se precisa del incremento de la conciencia y la educación pública sobre el ictus, el perfeccionamiento de los protocolos para los centros de ictus, el desarrollo de los procesos de certificación de los centros de ictus y de las capacidades de tele–ictus, y del soporte económico y legislativo.

Palabras clave

Edema cerebral; Endarterectomía carotídea; Ensayos clínicos; Fluoxetina; Genética; Glibenclamida; Infarto cerebral; Técnicas endovasculares; Ictus; Terapia antiplaquetaria

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