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Una combinación peligrosa para el ictus en pacientes jóvenes: Asimilación del atlas y anticuerpos anti β2-microglobulina I
Resumen
Hombre de 45 años de edad que acudió a consulta por lateropulsión a la izquierda y mareos. La tomografía de cráneo mostró infarto cerebelar bilateral. En la resonancia magnética se observaron los mismos hallazgos más una zona hipodensa en el tallo cerebral en relación al otro territorio arterial comprometido. En el estudio de laboratorio fue relevante el hallazgo de anticuerpos anti β2-microglobulina I. En la angiografía cerebral se observaron los territorios obstruidos y una rara malformación de la unión vertebrobasilar, la cual se corroboró con una tomografía con reconstrucción tridimensional; el diagnóstico fue asimilación del atlas. Concluimos que debido a la turbulencia creada en el segmento V3 de la arteria vertebral rodeando el atlas, la presencia de anti β2-microglobulina I fue la posible causa de los infartos en el paciente.
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