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Demência vascular

Última revisión: 30 Nov 2025
Última actualización: 17 Apr 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • história de acidente vascular cerebral (AVC)
  • dificuldade na resolução de problemas
  • apatia
  • desinibição
  • lentidão no processamento de informações
  • atenção prejudicada
  • deficit de memória de evocação
  • reflexos de liberação frontal
  • sinais neurológicos focais
  • marcha e equilíbrio comprometidos
Todos los datos

Factores de riesgo

  • idade >60 anos
  • obesidade
  • hipertensão
  • tabagismo
  • diabetes mellitus
  • hipercolesterolemia
  • abuso de álcool
  • doença renal crônica
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • Hemograma completo
  • velocidade de hemossedimentação
  • nível glicêmico
  • testes de funções hepática e renal
  • cianocobalamina (vitamina B12)
  • folato
  • função tireoidiana
  • ressonância nuclear magnética (RNM) cerebral
  • eletrocardiograma (ECG)
  • exame neuropsicológico
Todos los datos

Pruebas diagnósticas que deben considerarse

  • sorologia para sífilis
  • teste de anticoagulante lúpico, de antifosfolipídeos e de fator antinuclear
  • ultrassonografia duplex das carótidas
  • ecocardiograma
Todos los datos

Algoritmo de tratamiento

En curso

doença isquêmica aterosclerótica

doença cardioembólica

Colaboradores

Autores

Peter Passmore, BSc, MB, BCh, BAO, MD, FRCP (Lond, Glasg), FRCPI

Professor of Ageing and Geriatric Medicine

Queen's University Belfast

Belfast

UK

Divulgaciones

PP declares that he has no competing interests.

Agradecimientos

Dr Peter Passmore would like to gratefully acknowledge Dr David Wilson, Dr Grant Bateman, and Dr Velandai Srikanth, previous contributors to this topic.

Divulgaciones

DW has received educational grants from Shire. GB and VS declare that they have no competing interests.

Revisores por pares

Roy J. Goldberg, MD, FACP, AGSF, CMD

Medical Director

Kings Harbor Multicare Center

New York

NY

Divulgaciones

RJG declares that he has no competing interests.

Craig N. Sawchuk, PhD

Affiliate Assistant Professor

Department of Psychiatry and Behavioral Sciences

University of Washington Medical Center

Seattle

WA

Divulgaciones

CNS declares that he has no competing interests.

Bryan Bernard, PhD

Assistant Professor and Clinical Neuropsychologist

Department of Neurological Sciences

Rush University Medical Center

Chicago

IL

Divulgaciones

BB declares that he has no competing interests.

Agradecimiento de los revisores por pares

Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.

Divulgaciones

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Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Hachinski V, Iadecola C, Petersen RC, et al. National Institute of Neurological Disorders and Stroke - Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006 Sep;37(9):2220-41.Full text  Abstract

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

American College of Radiology. ACR appropriateness ​criteria: dementia. 2024 [internet publication].Full text

Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021 Jul;52(7):e364-467.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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