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Demência vascular

Last reviewed: 16 Aug 2025
Last updated: 17 Apr 2025

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
Full details

Risk factors

  • idade >60 anos
  • obesidade
  • hipertensão
  • tabagismo
  • diabetes mellitus
  • hipercolesterolemia
  • abuso de álcool
  • doença renal crônica
Full details

Diagnostic tests

1st tests 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
Full details

Tests to consider

  • sorologia para sífilis
  • teste de anticoagulante lúpico, de antifosfolipídeos e de fator antinuclear
  • ultrassonografia duplex das carótidas
  • ecocardiograma
Full details

Treatment algorithm

ONGOING

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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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