Revistas / Revista Setiembre Diciembre 2019 / Reporte de Caso

Síndrome de Wallenberg asociado a hipoplasia de arteria vertebral unilateral en una paciente mujer joven

REV.RADIOLOGIADICIEMBRE201

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Kevin Salas-Vera
Médico residente de Radiología Oncosalud, Universidad Peruana Cayetano Heredia

César Ramírez-Cotrina
Médico radiólogo. Docente de la Universidad Peruana Cayetano Heredia. Jefe del departamento de Radiología del Hospital Nacional Cayetano Heredia

Resumen

Mujer de 44 años, sin factores de riesgo asociados para desarrollar eventos isquémicos, que se presentó en el departamento de Emergencia del Hospital Cayetano Heredia, con un cuadro agudo, en relación a síndrome de Wallenberg o medular lateral. A la paciente se le realizó estudios de tomografía (TC), resonancia magnética (RM) y ultrasonido Doppler (US). La TC no fue contributoria, salvo hallazgo retrospectivo de discreta disminución de diámetro del segmento V3 de la arteria vertebral derecha. La RM indicó evento isquémico medular lateral en la paciente y el US demostró hipoplasia de la arteria vertebral (HAV) unilateral. Conclusiones. La HAV en un paciente asintomático sin riesgos de eventos isquémicos asociados, está muy probablemente relacionado como factor independiente de riesgo infarto en territorio de la circulación posterior.

Palabras clave

hipoplasia arteria vertebral, síndrome Wallenberg, isquemia medular lateral.

Ultrasound as an aid in puncture and the positioning of the probes for endovascular vein treatment

Abstract

Patient female, aged 44 years, without risk factors associated to ischemic events, presented to the emergency department of the Cayetano Heredia Hospital, with an acute process of Wallenberg syndrome or lateral medullary syndrome. The patient underwent images studies like tomography scan (CT), magnetic resonance imaging (MRI) and ultrasound Doppler (US). The CT was negative in our patient, except for a retrospective finding, that was a slight reduction of diameter of V3 segment of vertebral artery affected. The MRI concluded in a diagnosis of lateral medullary ischemia and the US finding was unilateral vertebral artery hypoplasia (VAH). Conclusions. The VAH in an asymptomatic patient without risk factors to develop ischemic events is strongly considered like an independent risk factor to develop posterior circulation strokes.

Keywords

vertebral artery hypoplastic, Wallenberg syndrome, lateral medullary ischemia.

Bibliografía

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