Accidente cerebrovascular isquémico en pacientes con trombo intracavitario: Experiencia con tratamientos distintos en fase aguda

• Gerardo Oberreuter ^[1] ; Natalia Silva ^[1] ; Sheila Caba ^[2] ; Marcelo Morales ^[2] ; Elena Nieto ^[2] ; Carlos Guevara ^[2]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 142, Nº. 9, 2014, págs. 1200-1204
• Idioma: español
• Títulos paralelos:
  • Management of ischemic strokes derived from intraventricular thrombi: Report of two cases
• Enlaces
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• Resumen

  • The origin of 20% of ischemic strokes is a left ventricular thrombus. We report two patients with strokes originating from cardiac thrombi, treated in two different ways. A 42-year-old diabetic man admitted with a left parietal and occipital stroke. An echocardiogram showed a left ventricular thrombus. The patient was subjected to a surgical cardiac revascularization procedure and left ventricular thrombectomy. The postoperative evolution was uneventful and the patient was discharged on oral anticoagulation. On ambulatory follow up, no neurological deterioration was evidenced. A 38-year-old male admitted with an acute ischemic stroke, was subjected to thrombolysis with human plasminogen activator. An echocardiogram showed a left ventricular thrombus, considered the cause of the stroke. The patient was anticoagulated with heparin and discharged ten days after admission with oral anticoagulation. A new echocardiogram performed one month later, did not show the left ventricular thrombus.