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
Factores de riesgo
- idade >60 anos
- obesidade
- hipertensão
- tabagismo
- diabetes mellitus
- hipercolesterolemia
- abuso de álcool
- doença renal crônica
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
Pruebas diagnósticas que deben considerarse
- sorologia para sífilis
- teste de anticoagulante lúpico, de antifosfolipídeos e de fator antinuclear
- ultrassonografia duplex das carótidas
- ecocardiograma
Algoritmo de tratamiento
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
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
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.
Differentials
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- Doença de Alzheimer (DA)
- Comprometimento cognitivo leve (CCL)
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