ABSTRACT: Tumor embolization is a well-described cause of unexpected death in human oncologic patients; however, it is poorly explored in veterinary medicine. We report a case of pulmonary tumor embolization in a dog with sudden death. During necropsy, a neoplastic mass was observed replacing the left adrenal gland and forming an intravascular thrombus within the central adrenal vein. A large embolus occluded the left pulmonary artery. The adrenal mass was histologically confirmed as a pheochromocytoma, and the embolus was constituted of neoplastic cells. Multiple smaller neoplastic emboli were observed within the pulmonary artery branches. Tumor embolization should be considered as a possible cause of sudden death in dogs, particularly in oncologic patients. ABSTRACT welldescribed well described patients however medicine necropsy vein pheochromocytoma cells branches dogs

RESUMO: Embolismo tumoral é uma causa bem descrita de morte súbita em pacientes oncológicos humanos, entretanto, é pobremente explorado em medicina veterinária. Descreve-se um caso de embolização pulmonar neoplásica em um cão com morte súbita. Na necropsia, uma massa neoplásica foi observada substituindo a adrenal esquerda e formando um trombo intravascular na veia central da adrenal. Um êmbolo foi observado ocluindo a artéria pulmonar esquerda. A massa da adrenal foi histologicamente confirmada como um feocromocitoma, e o êmbolo era constituído de células neoplásicas. Múltiplos êmbolos neoplásicos menores foram observados histologicamente nas ramificações da artéria pulmonar. O Embolismo tumoral deve ser considerado como possível causa de morte súbita em cães, particularmente em pacientes oncológicos. RESUMO humanos entretanto veterinária Descrevese Descreve se necropsia feocromocitoma neoplásicas cães

Abstract Introduction: Primary pleomorphic pulmonary angiosarcomas are extremely rare tumors which could be easily mistaken for pulmonary emboli. Background and findings: We describe the successful perioperative management of a patient with a pulmonary arterial mass which turned out to be a primary pulmonary angiosarcoma. The severe pulmonary hypertension was a particular challenge compounded with the site and adhesions of the tumor, and pulmonary hemorrhage. The procedure was successfully performed with strict hemodynamic control ensuring stable systemic and pulmonary arterial pressures using perioperative transesophageal echocardiography to continuously monitor cardiac function, along with other standard cardiac surgical monitors including depth of anesthesia monitoring. Conclusion: Tight hemodynamic control, ensuring stable pulmonary arterial pressures using perioperative echocardiography, and thorough preparation with measures to reduce and prevent increase in pulmonary arterial pressure along with close communication within the multidisciplinary team are essential for successful management of patients with this pathology. Introduction emboli findings angiosarcoma tumor hemorrhage function monitoring Conclusion pathology

ABSTRACT Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular connections between pulmonary arteries and veins, often associated with hereditary hemorrhagic telangiectasia (HHT). Most PAVMs are asymptomatic, but life-threatening complications like pulmonary hemorrhage, brain abscesses, and paradoxical emboli can emerge, so prompt diagnosis and treatment are crucial. We report a case of sudden pediatric death in a two-year-old female with no past medical history. Initial vomiting and fast deterioration resulted in a sudden cardiac arrest. The postmortem examination found histological evidence of consistent, extensive lung damage. The absence of the characteristic symptoms made for some challenges when it came to diagnosis, showing precisely that in early life, you could well have many difficulties in catching PAVMs. This case highlights the need to take PAVMs into account as a potential cause of sudden death, particularly when there are no conspicuous symptoms. Awareness among forensic pathologists and consideration of genetic analysis for HHT in such cases is crucial for accurate diagnosis and management. (PAVMs veins HHT. . (HHT) asymptomatic lifethreatening life threatening hemorrhage abscesses emerge twoyearold two year old history arrest consistent damage management (HHT

ABSTRACT Candida endocarditis is a very serious manifestation of candida infections, and it has increased in incidence over the past years. Of these, C. parapsilosis has been described as a cause of endocarditis in native valves of intravenous drug users and prosthetic valves. We report the case of a female that developed a cerebrovascular accident secondary to emboli from aortic prosthetic valve C. parapsilosis endocarditis, despite apparently normal echocardiography. She received antifungal therapy without surgical intervention.

RESUMEN La endocarditis por Candida spp. es una manifestación muy grave de las infecciones por este patógeno y su incidencia ha ido aumentando en los últimos años. La Candida parapsilosis se ha descrito como causa de endocarditis en válvulas nativas de usuarios de drogas intravenosas y prótesis valvulares. Presentamos el caso de una mujer que desarrolló un accidente cerebrovascular secundario a émbolos fúngicos procedentes de una prótesis valvular aórtica infectada por C. parapsilosis, a pesar de un ecocardiograma sin vegetaciones. La paciente recibió tratamiento antifúngico sin necesidad de intervención quirúrgica.

Resumen El síndrome de Lemierre, también denominado trom boflebitis séptica de la vena yugular interna, necrobaci losis o sepsis postanginal es una infección que inicia en el espacio orofaríngeo, se complica con tromboflebitis séptica de la vena yugular interna y metástasis infeccio sas. La rápida progresión a cuadros clínicos graves que comprometen la vida del paciente y su baja frecuencia justifican la divulgación de casos clínicos. Se presenta el caso de una mujer de 27 años de edad, que a las 48 horas de completar el tratamiento con fenoximetilpenicilina por una infección odontógena evolucionó con edema facial y trismus. En la angio-TC de macizo craneofacial se evidenció extenso trombo en la vena yugular interna y en la tomografía computarizada de tórax, embolias sépticas pulmonares. El tratamiento consistió en antibió ticos endovenosos de amplio espectro y anticoagulación de manera precoz.

Abstract Lemierre’s syndrome, also called septic thrombo phlebitis of the internal jugular vein, necrobacillosis or postanginal sepsis, is an infection that begins in the oropharyngeal space, is complicated by septic throm bophlebitis of the internal jugular vein and infectious metastases. The rapid progression to serious clinical conditions that compromise the patient’s life and its low frequency justify the disclosure of clinical cases. We present the case of a 27-year-old woman who de veloped facial edema and trismus 48 hours after com pleting treatment with phenoxymethylpenicillin for an odontogenic infection. An angio-CT of the craniofacial massif revealed an extensive thrombus in the internal jugular vein and a computed tomography of the chest showed septic pulmonary emboli. Treatment consisted of broad-spectrum intravenous antibiotics and early anticoagulation.

Abstract Introduction: Mycotic or primary infected aortic aneurysms comprise aproximately 1.3% of all aortic aneurysms and may be caused by septic emboli to the vasa vasorum, by haematogenous spread during bacteraemia or by direct extension of an adjacent infection leading to an infectious degeneration of the arterial wall and aneurysm formation. The objective of this report is to describe a clinical case of a complicated mycotic aortic aneurysm. Case report: A male, 69-year-old patient, with medical background of diabetes, hypertension and a bladder carcinoma (surgically ressected 5 years before, complicated at the time with an E.coli septicaemia), presented at the ER with generalised malaise, asthenia, anorexia, abdominal pain, diarrhea and fever, with 1 week of evolution. At admission, clinical examination revealed poor general condition, fever (39ºC), noral blood pressure, and the abdominal examination showed no abnormalities. Laboratory results revealed an stable haemoglobin of 13 g/dL, leukocytosis (19850/UI) and neutrophilia (90%), an a C Reactive Protein of 350mg/dl. A Computed Tomography Angiography (CTA) revealed a 3,5 cm saccular juxtarenal AAA, with peri and intra-aortic gas, strongly suggestive of an mycotic AAA (MAA). Hospitalization was indicated and a septic and immunologic screening was perfomed. The patient started a broad-spectrum antibiotic with meropenem and vancomycin and clinical, laboratory and hemodynamic surveillance. Blood and urine cultures revealed a E.Coli infection, and directed antibiotic was started. After 10 days os hospitalization, the patient was haemodinamic stable, presented no fever or abdominal pain, however inflammatory parameters remained elevated, and a new CTA that showed a daunting increase of 4 cm of the AAA (7,5 cm) with signs of contained ruture. An emergency intervention was decided and the patient underwent an thoracophrenolaparotomy and aorto-aortic interposition with bovine pericardium patch. After 24h of surgery the patient died of septic shock. Conclusion: MAA is a rare and threatening disease with rapid progression and high mortality. Even with broad-spectrum antibiotic and rapid surgical response, the tragic outcome is often the unavoidable result

ABSTRACT Introduction: 80% of strokes result in ischemic type and at least 20-30% are caused by stenosis of the extracranial carotid artery. Carotid endarterectomy has as its main objective to remove atheromatous plaques, which are sources of emboli for the brain, and improve blood flow to this organ. Objective: To characterize the morbidity of carotid endarterectomy at the "Enrique Cabrera" General Teaching Hospital from 2018 to 2021. Methods: A descriptive, cross-sectional study was conducted in 32 patients, who underwent carotid endarterectomy. Data collection was carried out by reviewing medical records. The study period spanned from January 2018 to January 2021. Results: The male sex predominated (65.6 %) and the mean age was 68.8 years. The most frequent risk factors were high blood pressure and smoking with 75% and 65.6%, respectively. Cerebrovascular disease with minimal sequelae was the most frequent clinical form in 40.6% of cases. A statistically significant association was found between diabetes mellitus and clinical forms, and between peripheral arterial disease and the occurrence of complications. The left carotid was the most affected with 53% and the percentage of stenosis, between 70% and 99%, was found in 55.9% of patients. The following complications were the most common: cranial nerve injury (5.8%) and cervical hematoma (5.8%). Eversion endarterectomy was performed in 97% of cases. Conclusions: The safety and success of carotid endarterectomy were demonstrated. Most of the patients had a satisfactory evolution, and there were few complications and zero mortality.

RESUMEN Introducción: El 80 % de los accidentes cerebrovasculares resulta de tipo isquémico y al menos el 20-30 % está provocado por estenosis de la arteria carótida extracraneal. La endarterectomía carotídea tiene como principal objetivo eliminar las placas de ateroma, que son fuentes de émbolos para el encéfalo, y mejorar el flujo sanguíneo a este órgano. Objetivo: Caracterizar la morbilidad de la endarterectomía carotídea en el Hospital General Docente “Enrique Cabrera” desde 2018 hasta 2021. Métodos: Se realizó un estudio de tipo descriptivo y corte transversal a 32 pacientes, a los cuales se les realizó endarterectomía carotídea. La recolección de los datos se efectuó mediante la revisión de historias clínicas. El período de estudio abarcó desde enero de 2018 hasta enero de 2021. Resultados: Predominó el sexo masculino (65,6 %) y la media de edad fue de 68,8 años. Los factores de riesgo más frecuentes resultaron la hipertensión arterial y el tabaquismo con 75 % y 65,6 %, respectivamente. La enfermedad cerebrovascular con secuela mínima constituyó la forma clínica más frecuente en el 40,6 % de los casos. Se encontró asociación estadísticamente significativa entre diabetes mellitus y formas clínicas, y entre enfermedad arterial periférica y la aparición de complicaciones. La carótida izquierda resultó la más afectada con 53 % y el porcentaje de estenosis, entre 70 % y 99 %, se encontró en el 55,9 % de los pacientes. Con mayor frecuencia se presentaron las complicaciones: lesión de nervios craneales (5,8 %) y hematoma cervical (5,8 %). La endarterectomía por eversión se realizó en el 97 % de los casos. Conclusiones: Se demostró la seguridad y el éxito de la endarterectomía carotídea. La mayoría de los pacientes tuvo una evolución satisfactoria, y se presentaron escasas complicaciones y mortalidad nula.

Resumen En esta publicación se describe el manejo y la evolución clínica de un carcinoma mamario felino (CMF) maligno en una gata mestiza de ocho años de edad con un trastorno congénito. La eficacia de la extirpación de la masa tumoral y el pronóstico del caso se establecieron mediante el examen histológico de rutina postoperatorio. Tras una mastectomía completa se extirpó un bulto de 6 cm de diámetro en la glándula mamaria torácica izquierda de aspecto multinodular y exudado purulento de coloración rojiza. El análisis histopatológico mostró la presencia de numerosos émbolos tumorales linfovasculares y células con alta frecuencia de figuras mitóticas con núcleos hipercromáticos. Estos hallazgos fueron consistentes con una neoplasia agresiva de mal pronóstico, lo que explicaba el fallecimiento de la paciente a las 7 semanas de la cirugía. Los hallazgos histológicos y citológicos son de importancia crítica para los clínicos en el manejo de las neoplasias mamarias más comunes en los gatos, con el fin de aliviar de la mejor manera posible a los animales con cánceres que amenazan su vida. También podría servir como modelo de cáncer para avanzar en el conocimiento de patologías similares en otras especies.

Abstract This report describes the handling and clinical evolution of a malignant feline mammary carcinoma (FMC) in an eight-year-old female crossbred cat with a congenital disorder. Hence, the efficacy of tumor mass removal and the case prognosis was established by postoperative routine histological examination. A 6 cm diameter lump in the left thoracic mammary gland of multinodular appearance and purulent exudate with a reddish hue was excised after the entire mastectomy. The histopathological analysis showed the presence of numerous lymphovascular tumor emboli and frequently mitotic cells with hyperchromatic nuclei. These were consistent with an aggressive malignancy with a poor prognosis explaining the patient's death within 7 weeks after surgery. Histology and cytology findings are of critical importance to clinicians in the management of the most common mammary malignancies in cats, to provide the best possible relief to animals with life-threatening cancer. It could also serve as a cancer model for advancing knowledge in congenitally affected humans.

BACKGROUND: A high incidence of thromboembolic phenomena has been widely reported in patients with coronavirus disease 2019 (COVID-19) pneumonia. There is, however, a paucity of data detailing the incidence and characteristics of pulmonary emboli (PE) in COVID-19 patients in the South African setting OBJECTIVES: To describe the incidence and characteristics of PE confirmed by CT pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia admitted to a tertiary hospital in the Western Cape, South Africa METHODS: This was a retrospective-, descriptive study of all adult patients with COVID-19 pneumonia confirmed by polymerase chain reaction (PCR) undergoing CTPA for suspected PE while admitted to Groote Schuur Hospital. The study period was from 01 April 2020 to 30 September 2020 RESULTS: The study cohort consisted of 116 patients, 59% being female, of whom 29% were pregnant or in the postpartum period. The median age for both genders combined was 49.5 years. The overall incidence of PE was 19%, with 20% in our subset of pregnant and postpartum patients. The majority (64%) of PE's were reported as being segmental in anatomical location CONCLUSION: The noteworthy cohort included patients with pulmonary tuberculosis (PTB), HIV as well as pregnant and postpartum patients. The overall incidence of PE was 19% with no significant differences in demographics, comorbidities or D-dimer levels between patients with or without PE. The importance of a high clinical index of suspicion together with the role of CTPA in diagnosing PE in hospitalised COVID-19 patients is emphasised

Abstract: Cardiac tumors may be primary or, more frequently secondary or associated to metastasis. Atril myxoma es the most frequent primary tumor, usually located in the left atrium. Clinical manifestations include those due to mitral valve occlusión, emboli and general non spedific symptoms and signs. Herein we report the clinical case of a 32 year old patient with severe pulmonary hypertension and bilateral pulmonary embolism. The tumor was extirpated, and he received phosphoro-diesterase inhiborts and anticoagulants. Subsequent clinical course was satisfactory. A brief discussion of this condicion is included.

Resumen: Los tumores cardíacos pueden ser primarios o, más frecuentemente secundarios o metastásicos. Entre los tumores primarios es más frecuente el mixoma, cuya ubicación más común es en la aurícula izquierda. Las manifestaciones clínicas son diversas, producidas principalmente por obstrucción mecánica, embolizaciones, y manifestaciones constitucionales. Se comunica el caso de un paciente de 32 años, con cuadro clínico de insuficiencia cardíaca, hipertensión pulmonar severa y tromboembolismo pulmonar bilateral. Se hizo el diagnóstico de mixoma auricular izquierdo. Se resecó el tumor y se manejó la hipertensión pulmonar desde el ingreso al hospital con inhibidores de la fosfodiesterasa asociado a anticoagulación. Se discute el tema dando énfasis a aspectos fisiopatológicos involucrados tanto en la hipertensión pulmonar como en la presencia de tromboembolia pulmonar.

Resumo A forma arterial da síndrome do desfiladeiro torácico é rara e está associada a uma anomalia anatômica, geralmente uma costela cervical. Suas manifestações são muito variadas. Este artigo tem como proposta relatar dois casos de apresentações clínicas distintas: microembolização e aneurisma. Em ambos, uma costela cervical estava presente. O diagnóstico foi realizado através da história, do exame físico, das manobras posturais e das radiografias. A angiotomografia computadorizada proporcionou o detalhe anatômico necessário para o planejamento operatório. O tratamento cirúrgico foi realizado pela abordagem supraclavicular, com sucesso em ambos casos.

Abstract The arterial form of thoracic outlet syndrome is rare and is associated with anatomic anomalies, generally a cervical rib. It has a varied range of manifestations. The aim of this article is to describe two cases with different clinical presentations: microembolization and aneurysm. A cervical rib was present in both cases. Diagnosis was made on the basis of history, physical examination, postural maneuvers, and X-rays. Computed tomography angiography provided the anatomic detail necessary to plan surgery. Surgical treatment was performed via supraclavicular access, successfully, in both cases.

Resumo A infecção pelo coronavírus 2 causador da síndrome respiratória aguda grave (SARS-CoV-2) em humanos foi detectada pela primeira vez em Wuhan, na China, em 2019 e dispersada mundialmente ao longo de 2020. As diferentes manifestações clínicas, com amplo espectro de apresentação, desde infecções assintomáticas até formas graves que podem levar a óbito, são desafiadoras. Este trabalho objetiva descrever uma série de quatro casos de isquemia arterial aguda dos membros superiores em pacientes diagnosticados com COVID-19, os quais foram manejados clinicamente com anticoagulação, antiagregação plaquetária e uso de prostanoides. Dois pacientes receberam alta hospitalar com regressão e delimitação da área isquêmica, sem necessidade de intervenção cirúrgica, e dois pacientes faleceram em decorrência de complicações pulmonares. Uma adequada compreensão da fisiopatologia dessa doença pode favorecer um melhor manejo clínico de suas complicações.

Abstract Infection by coronavirus 2, cause of the severe acute respiratory syndrome (SARS-CoV-2) in humans, was detected for the first time in Wuhan, China, in 2019, and spread globally over the course of 2020. Its different clinical manifestations are challenging, with a wide spectrum of presentations, ranging from asymptomatic infections to severe forms that can result in death. The objective of this study is to describe a series of four cases of acute arterial ischemia involving the upper limbs in patients diagnosed with COVID-19, which were managed clinically with anticoagulation, platelet antiaggregation, and prostanoids. Two patients were discharged from hospital with regression and delimitation of the ischemic zone, without needing surgical intervention, while two patients died from pulmonary complications. Adequate understanding of the pathophysiology of this disease could support better clinical management of its complications.

Resumo Objetivo Este estudo avaliou o risco da síndrome hereditária de câncer de mama e ovário (HBOC, na sigla em inglês) em pacientes com câncer de mama utilizando a ferramenta Familial History Screening 7 (FHS-7), um questionário validado de baixo custo e com alta sensibilidade capaz de rastrear o risco de HBOC na população. Métodos Mulheres diagnosticadas com câncer de mama (n=101) assistidas pelo Sistema Único de Saúde da 8ª Regional de Saúde do estado do Paraná responderam ao questionário FHS-7, e os resultados foram analisados pelo software IBM SPSS for Windows, Version 25.0. (IBM Corp., Armonk, NY, EUA). Resultados A ocorrência do risco de HBOC foi de 19,80% (n=20). Pacientes em risco exibiram características agressivas do tumor como tumores de alto grau (30%), presença de êmbolos angiolinfáticos (35%) e pré-menopausa ao diagnóstico (50%). Associações significantes foram observadas entre a prevalência de tumores de alto grau e diagnóstico abaixo de 50 anos no grupo HBOC (p=0.003). Conclusão Nossos achados sugerem uma possível herança familiar associada a piores características clínicas em mulheres com câncer de mama nessa população, indicando que a investigação de HBOC pode ser realizada, inicialmente, com instrumentos de baixo custo, como o FHS-7.

Abstract Objective This study evaluated the risk of the hereditary breast and ovarian cancer (HBOC) syndrome in patients with breast cancer by using the Family History Screening 7 (FHS-7) tool, a validated low-cost questionnaire with high sensitivity able to screen the HBOC risk in the population. Methods Women diagnosed with breast cancer (n=101) assisted by the Unified Health System at the 8th Regional Health Municipal Office of the state of Paraná answered the FHS-7, and the results were analyzed using IBM SPSS Statistics for Windows, Version 25.0. software (IBM Corp., Armonk, NY, USA). Results The risk of HBOC was 19.80% (n=20). Patients at risk exhibited aggressive tumor characteristics, such as high-grade tumors (30%), presence of angiolymphatic emboli (35%), and premenopausal at diagnosis (50%). Significant associations between the prevalence of high-grade tumors were observed inwomen younger than 50 years at diagnosis with HBOC (p=0.003). Conclusion Our findings suggest a possible family inheritance associated with worse clinical features in women with breast cancer in this population, indicating that HBOC investigation can be initially performed with low-cost instruments such as FHS-7.

ABSTRACT Objective: The use of advanced techniques of computed tomography (CT) has resulted in increased incidentally detected pulmonary embolism in oncology patients undergoing routine cancer staging CT scans. The aim of this study was to compare the symptomatic and incidental pulmonary emboli cases in oncologic patients. Methods: The medical data of the patients diagnosed with pulmonary embolism (ICD: I.26) and had an underlying malignancy were evaluated retrospectively from their hospital records between the years of 2009 and 2013. The results of their right ventricle dilatations were evaluated from the thorax CT. Results: There were 38 women (44.2%) and 48 men (55.8%), totalling 86 patients. Their mean age was 61.7 ± 11.9 years and the median duration of their follow-up was 6 months. Their most common underlying malignancies were gastrointestinal (29.4%), lung (22.4%), genitourinary (21.2%) and breast cancers (10.6%). Their pulmonary thromboembolism was diagnosed incidentally on routine control thorax CT in 39 of the cases (45.3%). When the incidental cases were compared with the symptomatic ones, no statistically significant difference was found with respect to the type of malignancy, history of chemotherapy, the presence of metastasis and evidence of septum flattening on the thorax CT. The presence of bilateral thrombus was found to be increased in the symptomatic cases compared with the incidental ones and the difference was statistically significant (p = 0.026). It was found that the right ventricle/left ventricle ratio was significantly higher in symptomatic cases (p = 0.03) than in the incidental ones. Conclusion: A considerable number of pulmonary thromboemboli episodes could be asymptomatic in malignant patients. It is suggested that the submassive clinical course and preserved right ventricle functions could be the reason for the asymptomatic events.

ABSTRACT Introduction: cerebrovascular diseases are affections due to temporary or permanent functional loss of a part of the central nervous system, generally they are of sudden installation and are caused by arterial occlusions, thrombi, emboli or by rupture of an encephalic artery. Objective: to determine therapeutic results of the application of craniopuncture and somatic acupuncture in hemiplegic patients diagnosed with ischemic stroke. Methods: a quasi-experimental and prospective investigation was carried out at ‟Cmdte. Manuel Fajardo Rivero” Clinico-Surgical University Hospital in Santa Clara, from October 2015 to September 2018. The population consisted of patients admitted to the Internal Medicine and Traditional Medicine services. Two groups were formed: study and control (17 patients in each one). A medical interview to the patients was carried out, Barthel Index was applied and a traditional medical record was drawn up. Both groups received physiotherapeutic treatment and craniopuncture and somatic acupuncture were added to the study group. Results: male patients and the age group from 70 to 79 years predominated. Kidney -yin deficiency prevailed in the sample studied; a greater number of frail autonomous patients was evidenced in the study group, in which 52.9% had a satisfactory evolution of functional capacity, accompanied by a short therapeutic time. Conclusions: hemiplegic patients due to ischemic stroke treated with craniopuncture and somatic acupuncture, showed favorable therapeutic results, in comparison with the group that did not receive this treatment.

RESUMEN Introducción: las enfermedades cerebrovasculares son afecciones por pérdida funcional transitoria o permanente de una parte del sistema nervioso central, generalmente son de instalación súbita, causadas por: oclusiones arteriales, trombos, émbolos o por rotura de una arteria encefálica. Objetivo: determinar los resultados terapéuticos de la aplicación de la craneopuntura y acupuntura somática en pacientes hemipléjicos con diagnóstico de accidente cerebrovascular isquémico. Métodos: se realizó una investigación cuasi-experimental y prospectiva en el Hospital Universitario Clínico Quirúrgico Cmdte. Manuel Fajardo Rivero, Santa Clara, en el período de octubre 2015 a septiembre 2018. La población estuvo constituida por los pacientes ingresados en los servicios de Medicina Interna y Medicina Tradicional. Se conformaron dos grupos: estudio y control (17 pacientes en cada uno). Se realizó una entrevista médica a los pacientes, se aplicó el índice de Barthel y se confeccionó la historia clínica tradicional. Ambos grupos recibieron tratamiento fisioterapéutico y al grupo estudio se le añadió la craneopuntura y la acupuntura somática. Resultados: predominaron los pacientes del sexo masculino y el grupo etario de 70 a 79 años. La deficiencia de yin del riñón prevaleció en la muestra estudiada; se evidenció un mayor número de pacientes autónomos frágiles en el grupo estudio, en el cual, un 52,9 % presentó una evolución de la capacidad funcional satisfactorio, acompañada de un tiempo terapéutico corto. Conclusiones: los pacientes hemipléjicos por accidente cerebrovascular isquémico tratados con craneopuntura y acupuntura somática, mostraron resultados terapéuticos favorables, en comparación con el grupo que no recibió este tratamiento.