{"id":28219,"date":"2017-02-27T11:20:59","date_gmt":"2017-02-27T11:20:59","guid":{"rendered":"http:\/\/2084.59"},"modified":"2017-02-27T11:20:59","modified_gmt":"2017-02-27T11:20:59","slug":"reto-clinico-tallo-cerebral","status":"publish","type":"post","link":"https:\/\/www.icesi.edu.co\/blogs\/blog\/lista\/reto-clinico-tallo-cerebral","title":{"rendered":"Reto Cl\u00ednico Tallo Cerebral"},"content":{"rendered":"<p class=\"western\" lang=\"zxx\">Caso cl\u00ednico #1:<\/p>\n<p class=\"western\" lang=\"zxx\">*Usted se encuentra en el servicio de urgencias examinando a un paciente que consulta por hemiplej\u00eda derecha s\u00fabita. \u00c9stos son sus hallazgos al ex. F\u00edsico:<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Debilidad en el miembro superior e inferior derecho.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Debilidad en la hemicara izquierda.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Imposibilidad para realizar abducci\u00f3n con el ojo izquierdo.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; P\u00e9rdida de la vibraci\u00f3n y la propiocepci\u00f3n en el miembro superior e inferior derecho.<\/p>\n<p class=\"western\" lang=\"zxx\">\u00bfA que nivel del tallo cerebral est\u00e1 la lesi\u00f3n del paciente?<\/p>\n<p class=\"western\" lang=\"zxx\">Caso Cl\u00ednico #2:<\/p>\n<p class=\"western\" lang=\"zxx\">*Una mujer de 48 a\u00f1os asiste a su consultorio por que desde hace tres d\u00edas presenta diplop\u00eda, refiere que los s\u00edntomas iniciaron de forma s\u00fabita. Estos son los hallazgos al ex. F\u00edsico:<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Imposibilidad para la abducci\u00f3n del ojo derecho (movimiento hacia la nariz) y nistagmus la mirar hacia laderecha. Al mirar hacia la derecha los movimientos oculares son normales.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Est\u00e1 hipertensa (189\/94), no hay hemiparesia u otros hallazgos significativos al ex. Fisico.<\/p>\n<p class=\"western\" lang=\"zxx\">\u00bfEn que estructura del tallo cerebral est\u00e1 la lesi\u00f3n del paciente?<\/p>\n<p class=\"western\" lang=\"zxx\">Caso cl\u00ednico #3:<\/p>\n<p class=\"western\" lang=\"zxx\">*En el servicio de urgencias se encuentra un paciente con v\u00e9rtigo, emesis y nistagmus. Estos son los hallazgos al ex. F\u00edsico:<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Ataxia del hemicuerpo izquierdo.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; P\u00e9rdida de la sensibilidad (dolor y temperatura) en la hemicara izquierda.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; S\u00edndrome de Horner ipsilateral izquierdo.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; P\u00e9rdida de la sensibilidad (dolor y temperatura) que afecta el miembro superior y el inferior.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Disartria y disminuci\u00f3n del reflejo nauseoso del lado izqueirdo con elevaci\u00f3n del velo palatino derecho.<\/p>\n<p class=\"western\" lang=\"zxx\"><a name=\"__DdeLink__2_882446875\"><\/a> \u00bfQu\u00e9 nombre recibe este s\u00edndrome? \u00bfEn que sitio del tallo cerebral se encuentra la lesi\u00f3n?<\/p>\n<p class=\"western\" lang=\"zxx\"><a name=\"__DdeLink__2_8824468751\"><\/a><\/p>\n<p class=\"western\" lang=\"zxx\">Caso cl\u00ednicos #4:<\/p>\n<p class=\"western\" lang=\"zxx\">*Un vecino preocupado le cuenta que su sobrino de 17 a\u00f1os present\u00f3 de forma s\u00fabita tinitus en el o\u00eddo derecho y posteriormente sordera ipsilateral. \u00c9stos son los hallazgos al ex. F\u00edsico:<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Ataxia del hemicuerpo derecho (predominantemente del miembro superior derecho).<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Parestesias en la hemicara derecha con p\u00e9rdida del reflejo corneal.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Espasmo en la hemicera derecha.<\/p>\n<p class=\"western\" lang=\"zxx\">Caso cl\u00ednico #5:<\/p>\n<p class=\"western\" lang=\"zxx\">*Un hombre de 54 a\u00f1os prsenta de forma s\u00fabita hemiparesia derecha. \u00c9stos son los hallazgos al ex. F\u00edsico:<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; Hemiperesia derecha.<\/p>\n<p class=\"western\" lang=\"zxx\">&#8211; El ojo izquierdo se encuentra desviado hacia abajo y hacia afuera y la pupila est\u00e1 dilatada.<\/p>\n<p class=\"western\" lang=\"zxx\">\u00bfQu\u00e9 nombre recibe este s\u00edndrome? \u00bfEn que sitio del tallo cerebral se encuentra la lesi\u00f3n?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Caso cl\u00ednico #1: *Usted se encuentra en el servicio de urgencias examinando a un paciente que consulta por hemiplej\u00eda derecha [&hellip;]<\/p>\n","protected":false},"author":42165509,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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