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Malformação arteriovenosa cerebral

Última revisão: 24 Jun 2024
Última atualização: 17 Mar 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • deficit neurológico focal de início súbito
  • convulsões
  • rebaixamento do nível de consciência
Detalhes completos

Outros fatores diagnósticos

  • cefaleia de início súbito
  • náuseas
  • vômitos
  • confusão
  • cefaleias de início gradativo
  • hipertensão
  • coma
  • deficit neurológico focal de início gradual
  • disfunção cognitiva
Detalhes completos

Fatores de risco

  • familiar (malformação)
  • hemorragias prévias (risco de hemorragia)
  • abuso de drogas (risco de hemorragia)
  • drenagem venosa anormal (risco de hemorragia)
  • MAVs pequenas (risco de hemorragia)
  • MAVs profundas e na fossa posterior (risco de hemorragia)
  • aneurismas coexistentes (risco de hemorragia)
  • gravidez (risco de hemorragia)
  • hipertensão (risco de hemorragia)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • tomografia computadorizada (TC) cerebral
  • ressonância nuclear magnética (RNM) cranioencefálica
Detalhes completos

Investigações a serem consideradas

  • angiografia digital cerebral por subtração
  • angiotomografia cranioencefálica
  • angiografia por ressonância magnética cerebral
  • Hemograma completo
  • exames de coagulação e grupo sanguíneo
  • painel de eletrólitos
  • análise toxicológica de drogas
  • exames funcionais por imagem
  • Wada superseletivo
  • neuropsicologia
  • estudos de perfusão
  • eletroencefalograma
  • campos visuais
Detalhes completos

Novos exames

  • angiotomografia 4D (ATG)/angiografia por ressonância magnética (ARM)

Algoritmo de tratamento

Inicial

hematoma associado com efeito de massa significativo

Aguda

não candidato à cirurgia

candidato à cirurgia

gestante

Colaboradores

Autores

Mervyn Lim, MBBS, MRCS, MPH

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

Declarações

ML declares that he has no competing interests.

Leonard Yeo, MBBS, MRCP, MMed, ASN

Senior Consultant

Department of Medicine (Neurology)

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of SIngapore

Singapore

Declarações

LY declares that he has no competing interests.

Benjamin Tan, MBBS, MRCP, MMed

Associate Consultant

Department of Medicine (Neurology)

National University Health System

Singapore

Declarações

BT declares that he has no competing interests.

Adriel Leong, MBBS, MRCS

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

Declarações

AL declares that he has no competing interests.

Audrey Tan, BSc Medical Sciences (Hons), MBChB, MRCS

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

Declarações

AT declares that he has no competing interests.

Pervinder Bhogal, MBBS

Consultant

Department of Radiology

St Bartholomew's and The Royal London Hospital

London

UK

Declarações

PB declares that he has no competing interests.

Yang Cunli, MBBS, FRCR, MMed, FAMS

Senior Consultant

Department of Diagnostic Imaging

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of Singapore

Singapore

Declarações

YC declares that he has no competing interests.

Anil Gopinathan, MBBS, MD, DNB, FRCR, FAMS

Head of Division of Interventional Radiology

Senior Consultant

Department of Diagnostic Imaging

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of Singapore

Singapore

Declarações

AG declares that he has no competing interests.

Agradecimentos

Dr Leonard Yeo, Dr Benjamin Tan, Dr Adriel Leong, Dr Audrey Tan, Dr Mervyn Lim, Dr Pervinder Bhogal, Dr Yang Cunli, and Dr Anil Gopinathan would like to gratefully acknowledge Dr Charles Matouk, Dr Catherine E. Gilkes, and Dr Richard J. Edwards, previous contributors to this topic, and the additional contribution of Dr Branden Cord and Dr Ryan Hebert.

Declarações

CM, CEG, and RJE declare that they have no competing interests.

Revisores

Bernhard Meyer, MD

Chairman

Professor of Neurosurgery

Department of Neurosurgery

Technical University of Munich

Munich

Germany

Declarações

BM declares that he has no competing interests.

Michael Chen, MD

Assistant Professor of Neurology

Neurosurgery and Radiology

Rush University Medical Center

Chicago

IL

Declarações

MC declares that he has no competing interests.

Jae H. Choi, MD

Research Director

Stroke Center/The Neurological Institute

Columbia-Presbyterian Medical Center

New York

NY

Declarações

JHC declares that he has no competing interests.

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