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Fraturas cranianas

Last reviewed: 10 Jun 2025
Last updated: 20 Sep 2023

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • fratura aberta
  • discrepância palpável no contorno do osso
  • sinal de Battle
  • equimose periorbital
  • otorreia sanguinolenta
  • rinorreia liquórica
  • paralisia facial, nistagmo ou parestesia
Detalhes completos

Outros fatores diagnósticos

  • evidências de trauma
  • dor craniana ou cefaleia
  • náuseas
  • estado mental alterado/perda de consciência
  • reflexos pupilares anormais
  • perda auditiva
Detalhes completos

Fatores de risco

  • queda de altura
  • acidente com veículo automotor
  • agressão resultando em trauma cranioencefálico
  • ferimentos por arma de fogo na cabeça
  • sexo masculino
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • TC craniana
Detalhes completos

Investigações a serem consideradas

  • RNM
  • angiografia por ressonância magnética (RM)
  • ensaio da beta-2-transferrina
  • ultrassonografia craniana
  • radiografia simples do crânio
  • radiografia do esqueleto
  • angiotomografia
  • Angiotomografia venosa
Detalhes completos

Algoritmo de tratamento

AGUDA

fratura sem afundamento fechada

fratura com afundamento fechada

fratura aberta

CONTÍNUA

lesão persistente de nervo craniano ou vazamento do liquido cefalorraquidiano (LCR)

Colaboradores

Autores

Demetrios Demetriades, MD, PhD, FACS
Demetrios Demetriades

Professor of Surgery

Director

Division of Trauma and Surgical Intensive Care

LAC+USC Trauma Center

Keck School of Medicine at USC

University of Southern California

Los Angeles

CA

Declarações

DD declares that he has no competing interests.

Leslie Kobayashi, MD, FACS
Leslie Kobayashi

Professor of Surgery

Division of Trauma, Surgical Critical Care and Burns

University of California San Diego

San Diego

CA

Declarações

LK declares that she has no competing interests.

Revisores

Prof Sherard Austin Tatum, MD

Professor Otolaryngology and Pediatrics

SUNY Upstate Medical University

Syracuse

New York

Declarações

SAT declares that he has no competing interests.

Tunji Lasoye, FRCS, FCEM, MA, Med Ed

Consultant and Honorary Senior Lecturer in Emergency Medicine

Clinical Lead

Emergency Department

Director of Medical Education

King's College Hospital

London

UK

Disclosures

TL declares that he has no competing interests.

References

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Key articles

Expert Panel on Neurological Imaging: Shih RY, Burns J, et al. ACR Appropriateness Criteria® head trauma: 2021 update. J Am Coll Radiol. 2021 May;18(5S):S13-36.Full text  Abstract

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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