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Dr, Jesús Porta-Etessam

Servicio de Neurología
Universidad Complutense
Hospital Clínico San Carlos de 
Madrid

Instituto de Neurociencias Aplicadas

C/ La granja, 8. Madrid

Consulta 5.5

Citaciones: 91 299 12 99

Redes sociales :

Noticias destacadas

Neurología

Evolución a largo plazo de la hidrocefalia crónica del adulto idiopática tratada con válvula de derivación ventrículo-peritoneal
I. Illán-Gala, J. Pérez-Lucas, A. Martín-Montes, J. Máñez-Miró, J. Arpa, G. Ruiz-Ares Neurologia 2017;32:205-12 Resumen - Texto completo - PDF


Hemorragia subaracnoidea espontánea de la convexidad cerebral: una serie clínica de 3 pacientes asociada con angiopatía amiloide cerebral
D.A. García Estévez, R.M. García-Dorrego, B. Nieto-Baltar, M. Marey-Garrido, T. Hierro-Torner Neurologia 2017;32:213-8 Resumen - Texto completo - PDF


Diagnostic value of prehospital ECG in acute stroke patients
Objective: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. Methods: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit. Results: Overall, 259 patients with prehospital ECG recording were included in the study (90.3% ischemic stroke, 9.7% intracerebral hemorrhage). Atrial fibrillation (AF) was detected in 25.1% of patients, second-degree or greater atrioventricular block in 5.4%, significant ST-segment elevation in 5.0%, and ventricular ectopy in 9.7%. In 18 patients, a diagnosis of new-onset AF with direct clinical consequences for the evaluation and secondary prevention of stroke was established by the prehospital recordings. In 2 patients, the AF episodes were limited to the prehospital period and were not detected by ECG on admission or during subsequent monitoring at the stroke unit. Of 126 patients (48.6%) with relevant abnormalities in the prehospital ECG, 16.7% received medical antiarrhythmic therapy during transport to the hospital, and 6.4% were transferred to a cardiology unit within the first 24 hours in the hospital. Conclusions: In a selected cohort of patients with stroke, the in-field recordings of the ECG detected a relevant rate of cardiac arrhythmia. The results can add to the in-hospital evaluation and should be considered in prehospital care of acute stroke.
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Favorable outcome in patients with intracranial hemorrhage due to ruptured brain AVM
Despite all efforts, intracranial hemorrhage still has a dismal prognosis, with up to 61% mortality after 2 years.1 Several authors have concluded that intracranial hemorrhage due to a brain arteriovenous malformation (AVM) has a better clinical outcome.1–3 Only one study specifically addressed this issue and used a relatively small sample, comparing the outcome of 90 patients with a ruptured AVM from the Scottish Intracranial Vascular Malformation Study to the outcome of 60 patients with a spontaneous intracranial bleeding included in the Oxford Vascular Study.1 Those investigators found better outcomes after AVM-related hemorrhages independently of patient age and other known predictors of intracranial hemorrhage outcome. This difference in outcome warrants a thorough radiologic investigation in every patient presenting with an intracranial hemorrhage.
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Dr Jesús Porta-Etessam. Madrid