Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- deficit neurológico focal de início súbito
- convulsões
- rebaixamento do nível de consciência
Other diagnostic factors
- cefaleia de início súbito
- náuseas
- vômitos
- confusão
- cefaleias de início gradativo
- hipertensão
- coma
- deficit neurológico focal de início gradual
- disfunção cognitiva
Risk factors
- 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)
Diagnostic tests
1st tests to order
- tomografia computadorizada (TC) cerebral
- ressonância nuclear magnética (RNM) cranioencefálica
Tests to consider
- 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
Emerging tests
- angiotomografia 4D (ATG)/angiografia por ressonância magnética (ARM)
Treatment algorithm
hematoma associado com efeito de massa significativo
não candidato à cirurgia
candidato à cirurgia
gestante
Contributors
Authors
Mervyn Lim, MBBS, MRCS, MPH
Senior Resident
Department of Neurosurgery
National University Health System
Singapore
Disclosures
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
Disclosures
LY declares that he has no competing interests.
Benjamin Tan, MBBS, MRCP, MMed
Associate Consultant
Department of Medicine (Neurology)
National University Health System
Singapore
Disclosures
BT declares that he has no competing interests.
Adriel Leong, MBBS, MRCS
Senior Resident
Department of Neurosurgery
National University Health System
Singapore
Disclosures
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
Disclosures
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
Disclosures
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
Disclosures
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
Disclosures
AG declares that he has no competing interests.
Acknowledgements
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.
Disclosures
CM, CEG, and RJE declare that they have no competing interests.
Peer reviewers
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.
鉴别诊断
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- Hemangioma cavernoso
- Fístula arteriovenosa dural
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