Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider
Encefalopatia hiperamonêmica associada ao valproato na hemorragia subaracnóidea: um diagnóstico a considerar
Resumen:
Subarachnoid hemorrhage is a prevalent disease with high morbidity and mortality. Numerous complications contribute to brain injury and defy the clinical practitioner on diagnosis and management. Valproate-associated hyperammonemic encephalopathy is a rare, underdiagnosed, serious and important entity to consider. We present a case of a patient with subarachnoid hemorrhage who received anticonvulsant prophylaxis with valproate and developed neuroworsening associated with high levels of ammoniemia and periodic discharge electroencephalographic patterns without other identifiable causes. Discontinuing valproic acid treatment and normalization of ammoniemia resulted in improvement in clinical and electroencephalographic neurological status.
A hemorragia subaracnóidea é uma doença prevalente com alta morbidade e mortalidade. Inúmeras complicações contribuem para a lesão cerebral e desafiam o médico no diagnóstico e tratamento. A encefalopatia hiperamonêmica associada ao valproato é uma entidade rara, subdiagnosticada, grave e importante a ser considerada. Apresentamos o caso de um paciente com hemorragia subaracnóidea que recebeu profilaxia anticonvulsivante com valproato e evoluiu com piora neurológica associada a níveis plasmáticos elevados de amônia e descargas periódicas no eletroencefalograma, sem outras causas identificáveis. A interrupção do tratamento com ácido valproico e a normalização dos níveis plasmáticos de amônia resultaram em melhora do quadro neurológico e eletroencefalográfico.
| 2022 | |
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Valproic acid Anticonvulsants Subarachnoid hemorrhage Patient discharge Brain injuries Hyperammonemia Morbidity Ácido valproico Anticonvulsivantes Hemorragia subaracnoide Alta do paciente Lesões cerebrais Hiperamonemia Morbidade HEMORRAGIA SUBARACNOIDEA DIAGNÓSTICO TERAPÉUTICA ADMINISTRACIÓN DEL TRATAMIENTO FARMACOLÓGICO HUMANOS EFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOS |
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| Inglés | |
| Universidad de la República | |
| COLIBRI | |
| https://hdl.handle.net/20.500.12008/55344 | |
| Acceso abierto | |
| Licencia Creative Commons Atribución (CC - By 4.0) |
| _version_ | 1872865105681580032 |
|---|---|
| author | Fuellis, Vivian |
| author2 | Grille, Pedro Verga, Federico Urbán Alfaro, Luis Grasiuso, Lucciano Barbato, Marcelo |
| author2_role | author author author author author |
| author_facet | Fuellis, Vivian Grille, Pedro Verga, Federico Urbán Alfaro, Luis Grasiuso, Lucciano Barbato, Marcelo |
| author_role | author |
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| collection | COLIBRI |
| dc.contributor.filiacion.none.fl_str_mv | Fuellis Vivian, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos Grille Pedro, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos Verga Federico, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos Urbán Alfaro Luis, Universidad de la República (Uruguay). Facultad de Medicina. Hospital de Clínicas. Servicio de Neurología Grasiuso Lucciano, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos Barbato Marcelo, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos |
| dc.creator.none.fl_str_mv | Fuellis, Vivian Grille, Pedro Verga, Federico Urbán Alfaro, Luis Grasiuso, Lucciano Barbato, Marcelo |
| dc.date.accessioned.none.fl_str_mv | 2026-06-02T19:08:02Z |
| dc.date.available.none.fl_str_mv | 2026-06-02T19:08:02Z |
| dc.date.issued.none.fl_str_mv | 2022 |
| dc.description.abstract.none.fl_txt_mv | Subarachnoid hemorrhage is a prevalent disease with high morbidity and mortality. Numerous complications contribute to brain injury and defy the clinical practitioner on diagnosis and management. Valproate-associated hyperammonemic encephalopathy is a rare, underdiagnosed, serious and important entity to consider. We present a case of a patient with subarachnoid hemorrhage who received anticonvulsant prophylaxis with valproate and developed neuroworsening associated with high levels of ammoniemia and periodic discharge electroencephalographic patterns without other identifiable causes. Discontinuing valproic acid treatment and normalization of ammoniemia resulted in improvement in clinical and electroencephalographic neurological status. A hemorragia subaracnóidea é uma doença prevalente com alta morbidade e mortalidade. Inúmeras complicações contribuem para a lesão cerebral e desafiam o médico no diagnóstico e tratamento. A encefalopatia hiperamonêmica associada ao valproato é uma entidade rara, subdiagnosticada, grave e importante a ser considerada. Apresentamos o caso de um paciente com hemorragia subaracnóidea que recebeu profilaxia anticonvulsivante com valproato e evoluiu com piora neurológica associada a níveis plasmáticos elevados de amônia e descargas periódicas no eletroencefalograma, sem outras causas identificáveis. A interrupção do tratamento com ácido valproico e a normalização dos níveis plasmáticos de amônia resultaram em melhora do quadro neurológico e eletroencefalográfico. |
| dc.format.extent.es.fl_str_mv | 5 p. |
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| dc.identifier.citation.es.fl_str_mv | Fuellis V, Grille P, Verga F y otros. Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider. Revista Brasileira de Terapia Intensiva [en línea]. 2022;34(1):197-201 |
| dc.identifier.doi.none.fl_str_mv | 10.5935/0103-507X.20220014-pt |
| dc.identifier.eissn.none.fl_str_mv | 1982-4335 |
| dc.identifier.uri.none.fl_str_mv | https://hdl.handle.net/20.500.12008/55344 |
| dc.language.iso.none.fl_str_mv | en eng |
| dc.publisher.es.fl_str_mv | Associação de Medicina Intensiva Brasileira |
| dc.relation.none.fl_str_mv | Revista Brasileira de Terapia Intensiva. 2022;34(1):197-201 |
| dc.rights.license.none.fl_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| dc.rights.none.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:COLIBRI instname:Universidad de la República instacron:Universidad de la República |
| dc.subject.es.fl_str_mv | Valproic acid Anticonvulsants Subarachnoid hemorrhage Patient discharge Brain injuries Hyperammonemia Morbidity Ácido valproico Anticonvulsivantes Hemorragia subaracnoide Alta do paciente Lesões cerebrais Hiperamonemia Morbidade |
| dc.subject.other.es.fl_str_mv | HEMORRAGIA SUBARACNOIDEA DIAGNÓSTICO TERAPÉUTICA ADMINISTRACIÓN DEL TRATAMIENTO FARMACOLÓGICO HUMANOS EFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOS |
| dc.title.none.fl_str_mv | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider Encefalopatia hiperamonêmica associada ao valproato na hemorragia subaracnóidea: um diagnóstico a considerar |
| dc.type.es.fl_str_mv | Artículo |
| dc.type.none.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.version.none.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Subarachnoid hemorrhage is a prevalent disease with high morbidity and mortality. Numerous complications contribute to brain injury and defy the clinical practitioner on diagnosis and management. Valproate-associated hyperammonemic encephalopathy is a rare, underdiagnosed, serious and important entity to consider. We present a case of a patient with subarachnoid hemorrhage who received anticonvulsant prophylaxis with valproate and developed neuroworsening associated with high levels of ammoniemia and periodic discharge electroencephalographic patterns without other identifiable causes. Discontinuing valproic acid treatment and normalization of ammoniemia resulted in improvement in clinical and electroencephalographic neurological status. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | COLIBRI_d12159d0840005bd85539d17e3b316ea |
| identifier_str_mv | Fuellis V, Grille P, Verga F y otros. Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider. Revista Brasileira de Terapia Intensiva [en línea]. 2022;34(1):197-201 10.5935/0103-507X.20220014-pt 1982-4335 |
| instacron_str | Universidad de la República |
| institution | Universidad de la República |
| instname_str | Universidad de la República |
| language | eng |
| language_invalid_str_mv | en |
| network_acronym_str | COLIBRI |
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| oai_identifier_str | oai:colibri.udelar.edu.uy:20.500.12008/55344 |
| publishDate | 2022 |
| reponame_str | COLIBRI |
| repository.mail.fl_str_mv | karina.camps@seciu.edu.uy |
| repository.name.fl_str_mv | COLIBRI - Universidad de la República |
| repository_id_str | 4771 |
| rights_invalid_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| spelling | Fuellis Vivian, Hospital Maciel (Uruguay). Centro de Cuidados IntensivosGrille Pedro, Hospital Maciel (Uruguay). Centro de Cuidados IntensivosVerga Federico, Hospital Maciel (Uruguay). Centro de Cuidados IntensivosUrbán Alfaro Luis, Universidad de la República (Uruguay). Facultad de Medicina. Hospital de Clínicas. Servicio de NeurologíaGrasiuso Lucciano, Hospital Maciel (Uruguay). Centro de Cuidados IntensivosBarbato Marcelo, Hospital Maciel (Uruguay). Centro de Cuidados Intensivos2026-06-02T19:08:02Z2026-06-02T19:08:02Z2022Fuellis V, Grille P, Verga F y otros. Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider. Revista Brasileira de Terapia Intensiva [en línea]. 2022;34(1):197-201https://hdl.handle.net/20.500.12008/5534410.5935/0103-507X.20220014-pt1982-4335Subarachnoid hemorrhage is a prevalent disease with high morbidity and mortality. Numerous complications contribute to brain injury and defy the clinical practitioner on diagnosis and management. Valproate-associated hyperammonemic encephalopathy is a rare, underdiagnosed, serious and important entity to consider. We present a case of a patient with subarachnoid hemorrhage who received anticonvulsant prophylaxis with valproate and developed neuroworsening associated with high levels of ammoniemia and periodic discharge electroencephalographic patterns without other identifiable causes. Discontinuing valproic acid treatment and normalization of ammoniemia resulted in improvement in clinical and electroencephalographic neurological status.A hemorragia subaracnóidea é uma doença prevalente com alta morbidade e mortalidade. Inúmeras complicações contribuem para a lesão cerebral e desafiam o médico no diagnóstico e tratamento. A encefalopatia hiperamonêmica associada ao valproato é uma entidade rara, subdiagnosticada, grave e importante a ser considerada. Apresentamos o caso de um paciente com hemorragia subaracnóidea que recebeu profilaxia anticonvulsivante com valproato e evoluiu com piora neurológica associada a níveis plasmáticos elevados de amônia e descargas periódicas no eletroencefalograma, sem outras causas identificáveis. A interrupção do tratamento com ácido valproico e a normalização dos níveis plasmáticos de amônia resultaram em melhora do quadro neurológico e eletroencefalográfico.Submitted by Almiñana María Cecilia (marialminana@gmail.com) on 2026-06-01T13:59:34Z No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Valproate associated hyperammonemic encephalopathy.pdf: 2299643 bytes, checksum: e0805b28cda40dab008eb46e76814886 (MD5)Approved for entry into archive by Almiñana María Cecilia (marialminana@gmail.com) on 2026-06-01T18:20:44Z (GMT) No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Valproate associated hyperammonemic encephalopathy.pdf: 2299643 bytes, checksum: e0805b28cda40dab008eb46e76814886 (MD5)Made available in DSpace by Luna Fabiana (fabiana.luna@seciu.edu.uy) on 2026-06-02T19:08:02Z (GMT). No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Valproate associated hyperammonemic encephalopathy.pdf: 2299643 bytes, checksum: e0805b28cda40dab008eb46e76814886 (MD5) Previous issue date: 20225 p.application/pdfenengAssociação de Medicina Intensiva BrasileiraRevista Brasileira de Terapia Intensiva. 2022;34(1):197-201Las obras depositadas en el Repositorio se rigen por la Ordenanza de los Derechos de la Propiedad Intelectual de la Universidad de la República.(Res. Nº 91 de C.D.C. de 8/III/1994 – D.O. 7/IV/1994) y por la Ordenanza del Repositorio Abierto de la Universidad de la República (Res. Nº 16 de C.D.C. de 07/10/2014)info:eu-repo/semantics/openAccessLicencia Creative Commons Atribución (CC - By 4.0)Valproic acidAnticonvulsantsSubarachnoid hemorrhagePatient dischargeBrain injuriesHyperammonemiaMorbidityÁcido valproicoAnticonvulsivantesHemorragia subaracnoideAlta do pacienteLesões cerebraisHiperamonemiaMorbidadeHEMORRAGIA SUBARACNOIDEADIAGNÓSTICOTERAPÉUTICAADMINISTRACIÓN DEL TRATAMIENTO FARMACOLÓGICOHUMANOSEFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOSValproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to considerEncefalopatia hiperamonêmica associada ao valproato na hemorragia subaracnóidea: um diagnóstico a considerarArtículoinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:COLIBRIinstname:Universidad de la Repúblicainstacron:Universidad de la RepúblicaFuellis, VivianGrille, PedroVerga, FedericoUrbán Alfaro, LuisGrasiuso, LuccianoBarbato, 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16:08:02.631oai:colibri.udelar.edu.uy:20.500.12008/55344VGVybWlub3MgeSBjb25kaWNpb25lcyByZWxhdGl2YXMgYWwgZGVwb3NpdG8gZGUgb2JyYXMKCgpMYXMgb2JyYXMgZGVwb3NpdGFkYXMgZW4gZWwgUmVwb3NpdG9yaW8gc2UgcmlnZW4gcG9yIGxhIE9yZGVuYW56YSBkZSBsb3MgRGVyZWNob3MgZGUgbGEgUHJvcGllZGFkIEludGVsZWN0dWFsICBkZSBsYSBVbml2ZXJzaWRhZCBEZSBMYSBSZXDDumJsaWNhLiAoUmVzLiBOwrogOTEgZGUgQy5ELkMuIGRlIDgvSUlJLzE5OTQg4oCTIEQuTy4gNy9JVi8xOTk0KSB5ICBwb3IgbGEgT3JkZW5hbnphIGRlbCBSZXBvc2l0b3JpbyBBYmllcnRvIGRlIGxhIFVuaXZlcnNpZGFkIGRlIGxhIFJlcMO6YmxpY2EgKFJlcy4gTsK6IDE2IGRlIEMuRC5DLiBkZSAwNy8xMC8yMDE0KS4gCgpBY2VwdGFuZG8gZWwgYXV0b3IgZXN0b3MgdMOpcm1pbm9zIHkgY29uZGljaW9uZXMgZGUgZGVww7NzaXRvIGVuIENPTElCUkksIGxhIFVuaXZlcnNpZGFkIGRlIFJlcMO6YmxpY2EgcHJvY2VkZXLDoSBhOiAgCgphKSBhcmNoaXZhciBtw6FzIGRlIHVuYSBjb3BpYSBkZSBsYSBvYnJhIGVuIGxvcyBzZXJ2aWRvcmVzIGRlIGxhIFVuaXZlcnNpZGFkIGEgbG9zIGVmZWN0b3MgZGUgZ2FyYW50aXphciBhY2Nlc28sIHNlZ3VyaWRhZCB5IHByZXNlcnZhY2nDs24KYikgY29udmVydGlyIGxhIG9icmEgYSBvdHJvcyBmb3JtYXRvcyBzaSBmdWVyYSBuZWNlc2FyaW8gIHBhcmEgZmFjaWxpdGFyIHN1IHByZXNlcnZhY2nDs24geSBhY2Nlc2liaWxpZGFkIHNpbiBhbHRlcmFyIHN1IGNvbnRlbmlkby4KYykgcmVhbGl6YXIgbGEgY29tdW5pY2FjacOzbiBww7pibGljYSB5IGRpc3BvbmVyIGVsIGFjY2VzbyBsaWJyZSB5IGdyYXR1aXRvIGEgdHJhdsOpcyBkZSBJbnRlcm5ldCBtZWRpYW50ZSBsYSBwdWJsaWNhY2nDs24gZGUgbGEgb2JyYSBiYWpvIGxhIGxpY2VuY2lhIENyZWF0aXZlIENvbW1vbnMgc2VsZWNjaW9uYWRhIHBvciBlbCBwcm9waW8gYXV0b3IuCgoKRW4gY2FzbyBxdWUgZWwgYXV0b3IgaGF5YSBkaWZ1bmRpZG8geSBkYWRvIGEgcHVibGljaWRhZCBhIGxhIG9icmEgZW4gZm9ybWEgcHJldmlhLCAgcG9kcsOhIHNvbGljaXRhciB1biBwZXLDrW9kbyBkZSBlbWJhcmdvIHNvYnJlIGxhIGRpc3BvbmliaWxpZGFkIHDDumJsaWNhIGRlIGxhIG1pc21hLCBlbCBjdWFsIGNvbWVuemFyw6EgYSBwYXJ0aXIgZGUgbGEgYWNlcHRhY2nDs24gZGUgZXN0ZSBkb2N1bWVudG8geSBoYXN0YSBsYSBmZWNoYSBxdWUgaW5kaXF1ZSAuCgpFbCBhdXRvciBhc2VndXJhIHF1ZSBsYSBvYnJhIG5vIGluZnJpZ2UgbmluZ8O6biBkZXJlY2hvIHNvYnJlIHRlcmNlcm9zLCB5YSBzZWEgZGUgcHJvcGllZGFkIGludGVsZWN0dWFsIG8gY3VhbHF1aWVyIG90cm8uCgpFbCBhdXRvciBnYXJhbnRpemEgcXVlIHNpIGVsIGRvY3VtZW50byBjb250aWVuZSBtYXRlcmlhbGVzIGRlIGxvcyBjdWFsZXMgbm8gdGllbmUgbG9zIGRlcmVjaG9zIGRlIGF1dG9yLCAgaGEgb2J0ZW5pZG8gZWwgcGVybWlzbyBkZWwgcHJvcGlldGFyaW8gZGUgbG9zIGRlcmVjaG9zIGRlIGF1dG9yLCB5IHF1ZSBlc2UgbWF0ZXJpYWwgY3V5b3MgZGVyZWNob3Mgc29uIGRlIHRlcmNlcm9zIGVzdMOhIGNsYXJhbWVudGUgaWRlbnRpZmljYWRvIHkgcmVjb25vY2lkbyBlbiBlbCB0ZXh0byBvIGNvbnRlbmlkbyBkZWwgZG9jdW1lbnRvIGRlcG9zaXRhZG8gZW4gZWwgUmVwb3NpdG9yaW8uCgpFbiBvYnJhcyBkZSBhdXRvcsOtYSBtw7psdGlwbGUgL3NlIHByZXN1bWUvIHF1ZSBlbCBhdXRvciBkZXBvc2l0YW50ZSBkZWNsYXJhIHF1ZSBoYSByZWNhYmFkbyBlbCBjb25zZW50aW1pZW50byBkZSB0b2RvcyBsb3MgYXV0b3JlcyBwYXJhIHB1YmxpY2FybGEgZW4gZWwgUmVwb3NpdG9yaW8sIHNpZW5kbyDDqXN0ZSBlbCDDum5pY28gcmVzcG9uc2FibGUgZnJlbnRlIGEgY3VhbHF1aWVyIHRpcG8gZGUgcmVjbGFtYWNpw7NuIGRlIGxvcyBvdHJvcyBjb2F1dG9yZXMuCgpFbCBhdXRvciBzZXLDoSByZXNwb25zYWJsZSBkZWwgY29udGVuaWRvIGRlIGxvcyBkb2N1bWVudG9zIHF1ZSBkZXBvc2l0YS4gTGEgVURFTEFSIG5vIHNlcsOhIHJlc3BvbnNhYmxlIHBvciBsYXMgZXZlbnR1YWxlcyB2aW9sYWNpb25lcyBhbCBkZXJlY2hvIGRlIHByb3BpZWRhZCBpbnRlbGVjdHVhbCBlbiBxdWUgcHVlZGEgaW5jdXJyaXIgZWwgYXV0b3IuCgpBbnRlIGN1YWxxdWllciBkZW51bmNpYSBkZSB2aW9sYWNpw7NuIGRlIGRlcmVjaG9zIGRlIHByb3BpZWRhZCBpbnRlbGVjdHVhbCwgbGEgVURFTEFSICBhZG9wdGFyw6EgdG9kYXMgbGFzIG1lZGlkYXMgbmVjZXNhcmlhcyBwYXJhIGV2aXRhciBsYSBjb250aW51YWNpw7NuIGRlIGRpY2hhIGluZnJhY2Npw7NuLCBsYXMgcXVlIHBvZHLDoW4gaW5jbHVpciBlbCByZXRpcm8gZGVsIGFjY2VzbyBhIGxvcyBjb250ZW5pZG9zIHkvbyBtZXRhZGF0b3MgZGVsIGRvY3VtZW50byByZXNwZWN0aXZvLgoKTGEgb2JyYSBzZSBwb25kcsOhIGEgZGlzcG9zaWNpw7NuIGRlbCBww7pibGljbyBhIHRyYXbDqXMgZGUgbGFzIGxpY2VuY2lhcyBDcmVhdGl2ZSBDb21tb25zLCBlbCBhdXRvciBwb2Ryw6Egc2VsZWNjaW9uYXIgdW5hIGRlIGxhcyA2IGxpY2VuY2lhcyBkaXNwb25pYmxlczoKCgpBdHJpYnVjacOzbiAoQ0MgLSBCeSk6IFBlcm1pdGUgdXNhciBsYSBvYnJhIHkgZ2VuZXJhciBvYnJhcyBkZXJpdmFkYXMsIGluY2x1c28gY29uIGZpbmVzIGNvbWVyY2lhbGVzLCBzaWVtcHJlIHF1ZSBzZSByZWNvbm96Y2EgYWwgYXV0b3IuCgpBdHJpYnVjacOzbiDigJMgQ29tcGFydGlyIElndWFsIChDQyAtIEJ5LVNBKTogUGVybWl0ZSB1c2FyIGxhIG9icmEgeSBnZW5lcmFyIG9icmFzIGRlcml2YWRhcywgaW5jbHVzbyBjb24gZmluZXMgY29tZXJjaWFsZXMsIHBlcm8gbGEgZGlzdHJpYnVjacOzbiBkZSBsYXMgb2JyYXMgZGVyaXZhZGFzIGRlYmUgaGFjZXJzZSBtZWRpYW50ZSB1bmEgbGljZW5jaWEgaWTDqW50aWNhIGEgbGEgZGUgbGEgb2JyYSBvcmlnaW5hbCwgcmVjb25vY2llbmRvIGEgbG9zIGF1dG9yZXMuCgpBdHJpYnVjacOzbiDigJMgTm8gQ29tZXJjaWFsIChDQyAtIEJ5LU5DKTogUGVybWl0ZSB1c2FyIGxhIG9icmEgeSBnZW5lcmFyIG9icmFzIGRlcml2YWRhcywgc2llbXByZSB5IGN1YW5kbyBlc29zIHVzb3Mgbm8gdGVuZ2FuIGZpbmVzIGNvbWVyY2lhbGVzLCByZWNvbm9jaWVuZG8gYWwgYXV0b3IuCgpBdHJpYnVjacOzbiDigJMgU2luIERlcml2YWRhcyAoQ0MgLSBCeS1ORCk6IFBlcm1pdGUgZWwgdXNvIGRlIGxhIG9icmEsIGluY2x1c28gY29uIGZpbmVzIGNvbWVyY2lhbGVzLCBwZXJvIG5vIHNlIHBlcm1pdGUgZ2VuZXJhciBvYnJhcyBkZXJpdmFkYXMsIGRlYmllbmRvIHJlY29ub2NlciBhbCBhdXRvci4KCkF0cmlidWNpw7NuIOKAkyBObyBDb21lcmNpYWwg4oCTIENvbXBhcnRpciBJZ3VhbCAoQ0Mg4oCTIEJ5LU5DLVNBKTogUGVybWl0ZSB1c2FyIGxhIG9icmEgeSBnZW5lcmFyIG9icmFzIGRlcml2YWRhcywgc2llbXByZSB5IGN1YW5kbyBlc29zIHVzb3Mgbm8gdGVuZ2FuIGZpbmVzIGNvbWVyY2lhbGVzIHkgbGEgZGlzdHJpYnVjacOzbiBkZSBsYXMgb2JyYXMgZGVyaXZhZGFzIHNlIGhhZ2EgbWVkaWFudGUgbGljZW5jaWEgaWTDqW50aWNhIGEgbGEgZGUgbGEgb2JyYSBvcmlnaW5hbCwgcmVjb25vY2llbmRvIGEgbG9zIGF1dG9yZXMuCgpBdHJpYnVjacOzbiDigJMgTm8gQ29tZXJjaWFsIOKAkyBTaW4gRGVyaXZh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públicahttps://udelar.edu.uy/https://www.colibri.udelar.edu.uy/oai/requestkarina.camps@seciu.edu.uyUruguayopendoar:47712026-06-02T19:08:02COLIBRI - Universidad de la Repúblicafalse |
| spellingShingle | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider Fuellis, Vivian Valproic acid Anticonvulsants Subarachnoid hemorrhage Patient discharge Brain injuries Hyperammonemia Morbidity Ácido valproico Anticonvulsivantes Hemorragia subaracnoide Alta do paciente Lesões cerebrais Hiperamonemia Morbidade HEMORRAGIA SUBARACNOIDEA DIAGNÓSTICO TERAPÉUTICA ADMINISTRACIÓN DEL TRATAMIENTO FARMACOLÓGICO HUMANOS EFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOS |
| status_str | publishedVersion |
| title | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| title_full | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| title_fullStr | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| title_full_unstemmed | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| title_short | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| title_sort | Valproate-associated hyperammonemic encephalopathy in subarachnoid hemorrhage: a diagnosis to consider |
| topic | Valproic acid Anticonvulsants Subarachnoid hemorrhage Patient discharge Brain injuries Hyperammonemia Morbidity Ácido valproico Anticonvulsivantes Hemorragia subaracnoide Alta do paciente Lesões cerebrais Hiperamonemia Morbidade HEMORRAGIA SUBARACNOIDEA DIAGNÓSTICO TERAPÉUTICA ADMINISTRACIÓN DEL TRATAMIENTO FARMACOLÓGICO HUMANOS EFECTOS COLATERALES Y REACCIONES ADVERSAS RELACIONADOS CON MEDICAMENTOS |
| url | https://hdl.handle.net/20.500.12008/55344 |
