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Vol. 36. Issue 2.
Pages 75-144 (March - April 2025)
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Vol. 36. Issue 2.
Pages 75-144 (March - April 2025)
Investigación clínica

Marcadores metabolómicos electrolíticos, de gases y el medio interno en el hematoma subdural crónico

Metabolomic markers of electrolytes, gases and internal environment of the content of chronic subdural hematomas
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Angel Jesús Lacerda-Gallardoa,
Corresponding author
, Daisy Abreu-Pérezb, Miguel de Jesús Mazorra Pazoa, Jose Antonio Galveza
a Servicio de Neurocirugía, Hospital General Docente «Roberto Rodríguez», Morón, Ciego de Ávila, Cuba
b Departamento de Postgrado y Ciencia y Técnica, Facultad de Ciencias Médicas de Morón, Morón, Ciego de Ávila, Cuba
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Antecedentes y objetivo

El hematoma subdural crónico es una de las enfermedades más frecuentes en la práctica neuroquirúrgica. El contenido de electrólitos y gases en la colección podría participar en el mecanismo de crecimiento y expansión; sin embargo, no hay evidencias de que hayan sido estudiados antes. El objetivo ha sido identificar los marcadores metabolómicos electrolíticos, de gases y en el medio interno del contenido de los hematomas subdurales crónicos, con posibilidades de participar en su crecimiento y expansión y fundamentar una teoría fisiopatológica que interactúe con las ya existentes.

Material y método

Se realizó un estudio correlacional descriptivo con 53 pacientes operados por hematoma subdural crónico en el Hospital General Docente «Roberto Rodríguez» de Morón, en Ciego de Ávila, Cuba, en el periodo entre enero de 2019 y diciembre de 2023. Los diagnósticos se obtuvieron con tomografía axial computarizada. Se correlacionan los componentes electrolíticos y gasométricos de los hematomas con variables clínicas y de neuroimágenes.

Resultados

Predominaron los enfermos mayores de 70 años (37 [69,81%]) y el sexo masculino (38 [71,70%]). La escala de Markwalder al ingreso evidenció un predominio de los gradosIII en 24 casos (45,28%). La escala de resultados de Glasgow mostró un predominio del gradoV (31 casos [58,49%]).

Conclusiones

Los marcadores metabolómicos electrolíticos y gasométricos de la sangre subdural pueden propiciar el fenómeno de crecimiento y expansión progresivos y tener un efecto sinérgico con el resto de los mecanismos fisiopatológicos.

Palabras clave:
Escala de Markwalder
Gasometría
Hematoma subdural crónico
Tratamiento quirúrgico
Abstract
Background and objective

Chronic subdural hematoma is one of the most common diseases in neurosurgical practice. The content of electrolytes and gases in the collection could participate in the growth and expansion mechanism, however, there is no evidence that they have been studied before. The objective has been to identify electrolyte, gas and internal metabolomic markers of the content of chronic subdural hematomas, with the possibility of participating in their growth and expansion and to substantiate a pathophysiological hypothesis that interacts with existing ones.

Material and method

A descriptive study was carried out with 53 patients operated on for chronic subdural hematoma at the «Roberto Rodríguez Fernández» General Teaching Hospital of Morón in Ciego de Ávila, Cuba, in the period between January 2019 and December 2023. The diagnoses were obtained with computed axial tomography. The electrolyte and blood gas components of hematomas are correlated with clinical and neuroimaging variables.

Results

Patients over 70years of age predominated (37 [69.81%]) and males (38 [71.70%]). The Markwalder scale upon admission showed a predominance of GradeIII in 24 cases (45.28%). The Glasgow outcome scale showed a predominance of GradeV (31 cases [58.49%]).

Conclusions

Electrolyte and gasometric metabolomic markers of subdural blood can promote the phenomenon of progressive growth and expansion and have a synergistic effect with the rest of the pathophysiological mechanisms.

Keywords:
Markwalder Scale
Gasometry
Chronic subdural hematoma
Surgical treatment

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