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A descriptive and cross-sectional study of 196 patients with hemorrhagic cerebrovascular disease was carried out at the Saturnino Lora Teaching Provincial Hospital in Santiago de Cuba, who underwent a computerized axial tomography. When relating the tomographic images with the symptoms and signs presented by the patients, foul language was found in all of them; predominance of intraparenchymal hematomas, generally in the basal ganglia and temporal region, as well as prevalence of arterial hypertension among the most important pathological antecedents. It was concluded that computerized axial tomography is a means for accurate diagnosis in medical emergencies for this serious condition.

Descriptors:X-RAY COMPUTERIZED TOMOGRAPHY;CEREBROVASCULAR ACCIDENT/diagnosis;HEMATOMA; SUBARACHNOID HEMORRHAGE; CEREBRAL HEMORRHAGE

Limits:Human MALE;Human,ELDER.

A descriptive and cross sectional study of 196 patients with cerebrovascular hemorrhagic disease was carried out in the "Saturnino Lora" Teaching Provincial Hospital from January, 2004 to the same month of 2005. The prevalence of intraparenchymatous hematomas and hypertension were found when looking at the tomographic images with the symptoms and signs. It was found that computerized axial tomography is a good way to diagnose a serious disorder.

Subject heading:TOMOGRAPHY, X-RAY COMPUTED;STROKE/diagnosis;HEMATOMA;SUBARACHNOID HEMORRHAGE; CEREBRAL HEMORRHAGE

Human bale is AGED

October 23, 2008 was approved and March 12, 2009 was received.

A group of disorders that include heart attack and cerebral and subarachnoid hemorrhages are called strokes.

The Latin ictus-us means blow, and the Anglo-Saxon equivalent is stroke. The sudden nature of the process is perfectly described by both etymological origins. There is 1

Depending on the nature of the disease, CVD can present as either ischemia or hemorrhage, with a proportion of 85% and 15%. 3

Ischemia can be produced by either global orfocal ischemia.

Depending on the duration of the process, it can be either a stroke or a Transient Attack. There is blood in the brain, either in the parenchyma, the interior of the cerebral ventricles, or the subarachnoid space.

4.5 out of 5

Hemorrhagic cerebrovascular disease (CVHD), caused by a ruptured vessel, represents 15-20% of all strokes and can be of different types, according to its location, such as: intraventricular hemorrhage (IVH), intraparenchymal hemorrhage (IPH). ), cerebromeningeal (HCM) and subarachnoid (SAH), although the latter can also be caused by arteriovenous malformations.

Cerebral hemorrhage is classified as lobar, deep, thalamic or capsular involvement, and brainstem and cerebellar.

Risk factors have been classified as defined and possible, taking into account individual characteristics, lifestyle, diseases, and their biological markers, as well as symptoms of structural diseases, which can be detected on physical examination or complimentary explorations.

All this indicates that advanced age, black skin color, alcoholism, weather changes, smoking, dyslipidemia, cardiac disorders, diabetes mellitus, previous cerebrovascular conditions, migraine states, retinal embolism , carotid pulse asynchrony, in addition to stenosis, arteriovenous malformations and aneurysms detected by complementary tests, among others, seem to be conditions that affect the appearance of this disease; however, arterial hypertension is the most important treatable factor, since its control has managed to reduce the occurrence and mortality from stroke. 5.6

It can be said that the number of deaths increases with age and doubles every 5 years.

Between 9 and 10% of all deaths in Cuba are caused by this condition, which is the third cause of death. About 5% of the elderly population is affected by it and more than 90 percent of deaths occur in people over 50 years old.

Approximately 800 people die each year from this cause in Santiago de Cuba, and 50% or more of the people who survive are left with some sequelae. 4-7.

In this regard, in recent decades progress has been made in the study of these conditions as a consequence of a better knowledge of the anatomy and physiology of the cerebral circulation, due to the development of many neuroimaging techniques, such as: encephalic angiography, computerized axial tomography (CT), nuclear magnetic resonance (NMR) and brain scintigraphy with radioisotopes. It is possible to identify the type, extension and location of the brain disease with the help of all of them.

Doppler ultrasound techniques have been devised, with which intracranial and extracranial cerebral flow disorders are recognized, lesions of the vascular tree are located topographically and others of clinical neurophysiology are visualized, which allow detecting areas of neuronal distress, even before the occurrence of the anatomical lesion, that is: there is a new stage of diagnosis in these conditions. 3-6

The facilities provided by CT make it possible to incorporate, for the first time in world medical history, a preventive diagnostic procedure in the 2 main causes of death in Cuba: cardiovascular and cerebral vascular affections, since by means of a simple non-invasive examination determine, with a precision superior to that of any existing method today, the state of the great vessels of the neck and of the coronary and cerebral arteries, as well as whether they are at risk of producing an ischemic cardiac or cerebrovascular lesion .

A descriptive and cross-sectional study of 196 patients with hemorrhagic cerebrovascular disease was carried out during the period from January 2004 to the same month of 2005, at the Saturnino Lora Torres Teaching Clinical-Surgical Hospital in Santiago de Cuba, who were indicated and performed an emergency CT scan on suspicion of this condition, which was carried out in the emergency room or other premises of the institution, to identify it topographically.

45.9% of patients with hemorrhagic cerebrovascular disease were older than 70 years old, with a predominance of males.

Table 1. The patients are age and sex.

The majority of them had more than one associated disease, and 140 of them suffered from arterial hypertension.

Table 2 is the second one. According to pathological history, patients with hemorrhagic CVD.

22.4% of this entity is related to diabetes. Some patients in the study had a history of some malformations, but they are more related to subarachnoid hemorrhage, so it is valid to point that out.

A large number of patients had positive results obtained by the computed toms and had been admitted with some of these manifestations. Only a small percentage of them were negative.

Intraparenchymal hematomas (IPH) were found more frequently, followed by subarachnoid hemorrhage (SAH) and others.

The table has 4. The patients are according to the tomographic result.

In the places found in the HIP, temporal lobars dominated, with 21.5%) and putaminal hematomas coming in second. The percentage was 15.9%).

Table 5. Topographic locations of intraparenchymal hematomas.

It is mandatory to accurately establish the diagnosis of a patient with a disease like hemorrhagic cerebrovascular disease, and it is also very important to have a basic neuroscience study. 8.

The incidence rates for cerebrovascular hemorrhagic disease double every decade after 35 years to 75 years, but in most cases 9 occur after 65.

Fewell 10 refers to the same thing every 10 years. Alterations in the intracerebral vessel walls, such as hyaline arteriosclerosis or lipohyalinosis, can lead to the formation of Charcot-Bouchard microaneurysms, which can lead to the development of cardiovascular disease.

Most authors agree that the prevalence of AHT increases with age, and the latter is a risk factor for said condition, however, in other reviewed bibliographies 5, 7, 12 it is stated that cerebrovascular diseases are more common in the middle and advanced ages of life.

The incidence and prevalence of cerebrovascular diseases increase with age, especially after the age of 65, with a slight majority in the male sex.

The ratio between men and women is 3:1, with differences in the type of cerebrovascular disease, since men are more prone to suffer from cerebral infarcts, while women are less prone. Both of them are vulnerable to intraparenchymal hemorrhage.

Harrison 13 believes that being male is a risk factor for experiencing AHT and that the vasoprotective role of premenopausal estrogen levels in women acts against arteriosclerosis; element that is associated with a more favorable analytical profile of lipids and a better functioning of the endothelium.

According to the documents reviewed, hypertension is the most important risk factor in the appearance of hemorrhagic cerebrovascular disease and between 35 and 70% of patients with AHT experience a stroke.

The results of the study in Spain show that people with a history of hypertension have a 70% risk of having a CVD. The risk of presenting a disease of this type is increased by elevated blood pressures.

With increasing age, the risk of suffering from cerebrovascular disease increases, regardless of other factors.

As people get older, they have a higher incidence of high blood pressure. Cerebral atherogenesis is more frequent and severe in hypertensive patients because of the repercussion on target organs that are related to the intensity and years of evolution.

Méndez 16 estimates that the risk of stroke triples or five times in the diabetic population due to its repercussion as a first-order atherogenic factor, mainly due to alterations in atherogenic lipoproteins, which facilitate thrombus formation due to increased platelet aggregation. and glycolysis of arterial wall proteins, which has led to the hypothesis that the frequency of intracranial atherosclerosis identified by signs of stenosis on transcranial Doppler ultrasound is significantly higher in diabetics.

It has been stated that the image is obtained immediately after the injury is made, which allows a very reliable diagnosis to be made.

Ceremeningeal hemorrhages can appear in hypertensive patients initially with symptoms and then later with meningeal or ventricular involvement. It can occur in massive subarachnoid hemorrhages due to the damage done to the intracranial aneurysms, which can cause blood to break through the brain parenchyma, although they are more frequent when it is caused by rebleeding.

In the United States, intraparenchymal hematomas are a common problem and have increased in incidence compared to previous decades.

In Spain, it is the first cause of death due to specific conditions in women, and it accounts for 20% of stroke cases. 16.

It is estimated that 1 in 100,000 inhabitants suffer from subarachnoid hemorrhage each year, and it is more common in men than in women. 4, 6

In the case of 327 patients, Berlix and Toraw 17 found similar locations to those in the study, with the exception of the temporal lobes.

In this work, putaminal hematomas were placed in third order. Adams 19 reports that approximately one third of all HIPEs (35-50%) are detected at this level due to chronic arterial hypertension and are caused by ruptures of the perforating branches of the middle cerebral artery or the anterior cerebral artery; however, it is specified that if the cause is chronic arterial hypertension, the predominant location is in the basal ganglia (15.3%). Several researchers 19 and 20 point out that lobar hemorrhages occur in a similar magnitude to putaminal and basal ganglia hemorrhages, which may be related to the age of the patient.

When it comes to patients with emergencies, computerized axial tomography is an accurate means of diagnosis.

There are limits of temporary arterial occlusion. New trends of cerebrovascular malformations, Vienna:Springer Verlang 2003:18084.

2. Tumion T, Ultasun F, and Villanueva JA.

There are hematomas from non-hypertensive causes. J.R. Prous was in Barcelona in 2003

Diez Tejedor E.Stroke, classification and diagnostic criteria is a guide for the treatment and prevention of stroke.

TheSemiology of the adult nervous system was written by Estévez A.

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