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Hemorragia subaracnoide

最后审阅: 2 Jun 2025
最后更新: 20 Dec 2024

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
完整详情

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
完整详情

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
完整详情

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)
完整详情

需考虑的检查

  • punção lombar (PL)
  • angiografia digital por subtração (ADS)
  • angiotomografia (ATG)
  • angiografia por ressonância magnética (ARM)
完整详情

治疗流程

急症处理

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

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

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.
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  • Guidelines

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  • Patient information

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