Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

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Reactividad Vasomotora Cerebral en un Grupo de Voluntarios Sanos a Más De 2000 Metros de Altura. Estudio con Doppler Transcraneal Cerebral. Vasomotor Reactivity In A Group Of Healthy Volunteers At An Altitude Of More Than 2000 Meters. Transcranial Doppler Study

Introduction. Cerebral vasoreactivity (CVR) is the mechanism that maintains stable cerebral blood flow in response to cerebral metabolic variations or systemic blood pressure. The reference method for studying CVR is transcranial Doppler (TCD) using a vasodilator stimulus. A simple alternative to perform is the apnea test, but its results can be influenced by physiological variables and the height at which the subject is.

The objective of this study was to determine normal CVR values in a group of people residing in Quito.

Material and Methods. 48 people without a history of disease were examined. Flow parameters in the middle cerebral and basilar arteries were recorded. With the results of the apnea test, the percentage increase in flow velocity and the Breath Holding Index were calculated. This data was analyzed by sex and the age group.

Results. The average age was 34.8 years, with a predominance of those under 40 years of age and women (70.8%). Higher Vmf were recorded in women. CVR was significantly higher in the MCA (p 0.000) and lower in women. With age, flow parameters and apnea test results did not demonstrate significant differences.

Conclusions. In the cohort examined, the hemodynamic parameters recorded during the apnea test offer different results than those published in other series. The lower RVC appears to be influenced by altitude and sex.

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Palabras clave: altura, Doppler transcraneal, reactividad vasomotora cerebral, test apnea, ultrasonido,

Keywords: altitude, apnea test, cerebral vasoreactivity, Transcranial Doppler, ultrasound,

Fístula Carótido Cavernosa. Utilidad del ultrasonido Doppler en el diagnóstico. Cavernous carotid fistula. Utility of Doppler ultrasound in diagnosis.

Introduction. Carotid cavernous fistulas are infrequent vascular malformations that generate a pathological arteriovenous shunt, which compromises ocular function. The definitive diagnosis is established by cerebral arteriography. However, its invasive nature limits its use in follow-up. The aim of this work is to illustrate the value of the study with transcranial doppler ultrasound for the diagnosis of cavernous carotid fistulas and to describe the flow parameters that could be modified. Patients. A retrospective review of the clinical histories of the patients treated with a diagnosis of cavernous carotid fistula was carried out in the stroke unit of the Hermanos Ameijeiras Hospital in Havana, between January 2005 and May 2014. Demographic and disease variables were collected, as well as the results of imaging and ultrasound studies. Results. We describe the clinical and imaging characteristics of three patients in whom carotid cavernous fistula was confirmed. In the two patients with direct communications, an increase of the mean flow velocity in the ophthalmic vein, arterialized, with decrease in pulsatility were registered; in addition to an increase in the diastolic peak velocity in the internal carotid artery ipsilateral to the fistula. In the patient with the indirect fistula the changes were less marked. Conclusion. The ultrasound study was useful in the diagnosis of carotid cavernous fistulas, showing differences in the flow parameters that can be used to classify the fistulas.

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Palabras clave: Doppler transcraneal, Fistula arteriovenosa dural, Fistula carótido cavernosa, Ictus, ultrasonido,

Keywords: Cavernous carotid fistula, dural arteriovenous fistula, Ictus, Transcranial Doppler, ultrasound,
 
 
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