Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- cefaleia
Other diagnostic factors
- convulsões
- rigidez da nuca
- nível de consciência reduzido
- deficit neurológico focal
Risk factors
- tabagismo
- consumo moderado a elevado de bebidas alcoólicas
- história familiar de hemorragia subaracnoidea
- hemorragia subaracnoide prévia
- doença hereditária do tecido conjuntivo
- hipertensão
- trauma cranioencefálico
- infecção intracraniana
- tumor
- malformações ou fístulas arteriovenosas
- abuso de medicamentos
Diagnostic investigations
1st investigations to order
- tomografia computadorizada (TC) de crânio
- angiograma por cateter convencional
- Angiotomografia
- angiografia por ressonância magnética (ARM)
Investigations to consider
- punção lombar
Treatment algorithm
aneurisma não roto
aneurisma rompido
Contributors
Authors
Brendan Eby, MD
Assistant Professor
Departments of Neurology, Neurosurgery, and Radiology
Washington University School of Medicine
St. Louis
MO
Disclosures
BE has been a paid speaker at a national neurointervention fellows course sponsored by Penumbra Inc; the talk was unrelated to the sponsor's products or services.
Acknowledgements
Dr Eby would like to gratefully acknowledge Dr Grasso and Dr Michael Chen, the previous contributors to this topic.
Disclosures
MC is an author of a reference cited in this topic.
Peer reviewers
David Altschul, MD
Chief of Neurovascular Surgery
Montefiore Medical Center
New York
NY
Disclosures
DA 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.
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
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
Expert Panel on Neurological Imaging., Ledbetter LN, Burns J, et al. ACR Appropriateness Criteria® Cerebrovascular diseases - aneurysm, vascular malformation, and subarachnoid hemorrhage. J Am Coll Radiol. 2021 Nov;18(11s):S283-S304.Full text Abstract
Etminan N, de Sousa DA, Tiseo C, et al. European Stroke Organisation (ESO) guidelines on management of unruptured intracranial aneurysms. Eur Stroke J. 2022 Sep;7(3):V.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
- Malformação arteriovenosa
- Hemorragia intracerebral hipertensiva
- Trombose venosa cerebral
More DifferentialsGuidelines
- Guidelines for the management of patients with aneurysmal subarachnoid hemorrhage
- Guidelines on management of unruptured intracranial aneurysms
More GuidelinesPatient information
AVC: tratamento
More Patient information
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