Resumen
OBJETIVO:Describir aspectos generales en relación con los eventos cerebrovasculares (ECV) isquémicos, así como los principales factores pronósticos que se han relacionado con el desenlace y la recuperación funcional posterior al evento cerebrovascular.
MATERIALES Y MÉTODOS:Se realizó una revisión narrativa utilizando bases de datos (PubMed, Science Direct, MEDLINE), plataformas virtuales (National Institutes of Health) y publicaciones del Acta Neurológica Colombiana.
RESULTADOS:Ser mujer, la edad avanzada, la inatención (negligencia), la gravedad del compromiso cognitivo y de la función ejecutiva, la desnutrición, y comorbilidades como la neumonía se asocian con un peor pronóstico en los 90 días posteriores al evento. Las alteraciones en la esfera mental (delirio), alteración de la conciencia, hemiplejia o parálisis de la mirada conjugada y el origen cardioembólico del ECV son algunos de los factores asociados con la mortalidad. La lateralidad hemisférica es una variable importante a tener en cuenta para valorar el pronóstico y la discapacidad funcional residual posevento; sin embargo, la evidencia actual es poco concluyente y algo contradictoria en relación con su rol como factor pronóstico.
CONCLUSIONES:Es importante un diagnóstico temprano y una intervención adecuada de los pacientes afectados con ECV isquémico, así como el control precoz de los factores modificables de mal pronóstico. Entre los no modificables, la lateralidad hemisférica podría ser más bien un criterio de selección para un programa de rehabilitación específico y personalizado, pues indudablemente existe un compromiso cognitivo y del lenguaje que difiere sustancialmente en relación con la ubicación topográfica de la lesión.
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