小结
定义
病史和体格检查
关键诊断因素
- presença de fatores de risco
- cefaleia
- fotofobia
- perda de consciência
- paralisia do terceiro nervo craniano
其他诊断因素
- idade >50 anos
- sexo feminino
- raça negra
- náuseas/vômitos
- estado mental alterado
- meningismo
- paralisia unilateral ou bilateral do sexto nervo craniano
- hemorragia intraocular
- deficits neurológicos focais
- convulsões
危险因素
- hipertensão
- tabagismo
- história familiar
- doença renal policística autossômica dominante (DRPAD)
- uso de bebidas alcoólicas
- uso de cocaína
- Síndrome de Marfan
- Síndrome de Ehlers-Danlos
- pseudoxantoma elástico
- neurofibromatose do tipo I
诊断性检查
首要检查
- tomografia computadorizada (TC) do crânio
- Hemograma completo
- coagulograma
- eletrólitos séricos
- troponina I
- glicose sérica
- eletrocardiograma (ECG)
需考虑的检查
- punção lombar (PL)
- angiografia digital por subtração (ADS)
- angiotomografia (ATG)
- angiografia por ressonância magnética (ARM)
治疗流程
todos os pacientes
撰稿人
作者
Salah Keyrouz, MD, FAHA, FCCM
Professor
Neurology and Neurosurgery
Washington University School of Medicine
St. Louis
MO
Раскрытие информации
SK is an author of a reference cited in this topic.
Выражение благодарностей
Dr Salah Keyrouz would like to gratefully acknowledge Dr Michael N. Diringer, a previous contributor to this topic.
Раскрытие информации
MND is an author of a number of references cited in this topic.
Рецензенты
Venkatesh Aiyagari, MD
Associate Professor
Department of Neurology and Rehabilitation
University of Illinois at Chicago
Chicago
IL
Disclosures
VA declares that he has no competing interests.
Peter Martin, MA, BM BCh, MD, FRCP
Consultant Neurologist
Addenbrookes Hospital
Cambridge
UK
Disclosures
PM declares that he has no competing interests.
Giovanni Grasso, M.D., PhD
Aggregate Professor of Neurosurgery
Neurosurgical Clinic
Department of Clinical Neuroscience
University of Palermo
Palermo
Italy
Disclosures
GG declares that he has no competing interests.
References
Key articles
Thompson BG, Brown RD Jr, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015 Aug;46(8):2368-400.Full text Abstract
Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023 Jul;54(7):e314-70.Full text Abstract
Steiner T, Juvela S, Unterberg A, et al. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis. 2013 Feb 7;35(2):93-112.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.
Differentials
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