Aterosclerosis e isquemia cerebral. Un proceso sistémico
IntroductionAtherosclerosis is a systemic process in which all the arteries in our body participate. It is often silent until its progression affects an organ, which then leads to a cerebral infarction, a myocardial infarction or peripheral vascular disease.
DevelopmentWe verified this systemic affectation in three different aspects: the risk factors that are common to atherosclerosis of any location; the previous alteration of other vascular topographies different from the current disease, and the frequent presentation of a new topography of the vascular disease, mainly coronary. The authors analyze the evolution of our knowledge about cerebral ischemia and the atherosclerotic process. Atherosclerosis of the intracranial arteries causing thrombosis was considered for years as the main cause of cerebral infarctions, but it has been shown that it is an unusual cause, the most frequent cause being atheromatosis of the extracranial arteries causing stenosis, ulceration or thrombosis. The aorta, the artery that is altered earlier and more intensely by the atherosclerotic process, is a frequent cause of cerebral infarction of undetermined etiology. Embolic etiology of cardiac origin is generally due to valvulopathies and rhythm disorders and, less frequently, to myocardial ischemia.
ConclusionAtherosclerosis of the limb arteries is an indicator of systemic atherosclerosis but not a common etiologic factor for cerebral infarction
Introduction Atherosclerosis is a systemic process in which all the arteries in our body participate. It is often silent until its progression affects an organ, which then leads to a cerebral infarction, a myocardial infarction or peripheral vascular disease. Development We verified this systemic affectation in three different aspects: the risk factors that are common to atherosclerosis of any location; the previous alteration of other vascular topographies different from the current disease, and the frequent presentation of a new topography of the vascular disease, mainly coronary. The authors analyze the evolution of our knowledge about cerebral ischemia and the atherosclerotic process. Atherosclerosis of the intracranial arteries causing thrombosis was considered for years as the main cause of cerebral infarctions, but it has been shown that it is an unusual cause, the most frequent cause being atheromatosis of the extracranial arteries causing stenosis, ulceration or thrombosis. The aorta, the artery that is altered earlier and more intensely by the atherosclerotic process, is a frequent cause of cerebral infarction of undetermined etiology. Embolic etiology of cardiac origin is generally due to valvulopathies and rhythm disorders and, less frequently, to myocardial ischemia. Conclusion Atherosclerosis of the limb arteries is an indicator of systemic atherosclerosis but not a common etiologic factor for cerebral infarction
Desarrollo Comprobamos esta afectación sistémica en tres aspectos distintos: los factores de riesgo que son comunes a la aterosclerosis de cualquier localización; la alteración previa de otras topografías vasculares distintas a la enfermedad actual, y la frecuente presentación de una nueva topografía de la enfermedad vascular, principalmente la coronaria. Los autores analizan la evolución de nuestros conocimientos sobre la isquemia cerebral y el proceso ateroscleroso. La aterosclerosis de las arterias intracraneales determinante de trombosis fue considerada durante años como la causa principal de los infartos cerebrales, pero se ha demostrado que es una causa inhabitual, siendo la causa más frecuente la ateromatosis de las arterias extracraneales determinante de estenosis, ulceración o trombosis. La aorta, la arteria que se altera de forma más precoz e intensa por el proceso ateroscleroso, es causa frecuente del infarto cerebral de etiología no determinada. La etiología embólica de origen cardíaco se debe generalmente a valvulopatías y trastornos del ritmo y, en menor frecuencia, a isquemia miocárdica.
Conclusión La aterosclerosis de las arterias de las extremidades es un indicador de aterosclerosis sistémica pero no un factor etiológico habitual del infarto cerebral
