Summary
Definition
History and exam
Key diagnostic factors
- 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
Risk factors
- idade >60 anos
- obesidade
- hipertensão
- tabagismo
- diabetes mellitus
- hipercolesterolemia
- abuso de álcool
- doença renal crônica
Diagnostic investigations
1st investigations to order
- 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
Investigations to consider
- sorologia para sífilis
- teste de anticoagulante lúpico, de antifosfolipídeos e de fator antinuclear
- ultrassonografia duplex das carótidas
- ecocardiograma
Treatment algorithm
doença isquêmica aterosclerótica
doença cardioembólica
Contributors
Authors
Peter Passmore, BSc, MB, BCh, BAO, MD, FRCP (Lond, Glasg), FRCPI
Professor of Ageing and Geriatric Medicine
Queen's University Belfast
Belfast
UK
Disclosures
PP declares that he has no competing interests.
Acknowledgements
Dr Peter Passmore would like to gratefully acknowledge Dr David Wilson, Dr Grant Bateman, and Dr Velandai Srikanth, previous contributors to this topic.
Disclosures
DW has received educational grants from Shire. GB and VS declare that they have no competing interests.
Peer reviewers
Roy J. Goldberg, MD, FACP, AGSF, CMD
Medical Director
Kings Harbor Multicare Center
New York
NY
Disclosures
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
Disclosures
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
Disclosures
BB declares that he has no competing interests.
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