Lesão cerebral traumática leve

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Last reviewed: 13 Jan 2026

Last updated: 10 Sep 2025

A lesão cerebral traumática (LCT) leve é um traumatismo cranioencefálico fechado decorrente de um golpe direto na cabeça ou de desaceleração da cabeça por uma força impulsiva que resulta em uma alteração temporária do estado mental.

As causas mais comuns são acidentes com veículos automotores, esportes, agressões e quedas.

É difícil diagnosticar a LCT leve com base nas características da lesão aguda e nos sinais e sintomas de apresentação.

Cefaleia, lentificação e confusão mental e dificuldades com a memória são sintomas típicos. Os sintomas podem flutuar, mas geralmente cedem após 1 semana a 1 mês. A perda de consciência não é necessária para um diagnóstico positivo.

A tomografia computadorizada e a ressonância nuclear magnética costumam ser normais na LCT leve.

Para casos não complicados, o repouso físico e cognitivo geralmente é suficiente.

Definition

A LCT é um traumatismo cranioencefálico fechado decorrente de um golpe direto na cabeça ou de desaceleração da cabeça por uma força impulsiva que resulta em alteração do estado mental.[1] A Escala de Coma de Glasgow continua sendo o principal instrumento para classificar a gravidade da LCT como leve (escala de coma de Glasgow 13–15), moderada (escala de coma de Glasgow 9–12) ou grave (escala de coma de Glasgow ≤8).[2] No entanto, a Escala de coma de Glasgow é confundida por vários fatores, incluindo o uso de drogas e álcool, medicamentos prescritos ou de venda livre, e intubação traqueal.[2] Concussão e LCT leve são termos sobrepostos, mas distintos; a concussão pode ser considerada um subconjunto da LCT leve, que abrange uma variedade de tipos de lesões na extremidade menos grave do espectro de lesão cerebral (o qual inclui a concussão com outras características).[3][4] Atualmente não existem perfis de sintomas distintos, critérios diagnósticos ou biomarcadores objetivos que façam a distinção entre a concussão e a LCT leve.[4] Centers for Disease Control and Prevention: HEADSUP Opens in new window

History and exam

Key diagnostic factors

golpe direto na cabeça ou desaceleração da cabeça por uma força impulsiva
trauma cerebral anterior, uso de substâncias ou abuso de álcool

Full details

Other diagnostic factors

cefaleia
sensação de confusão/lentidão
tontura/problemas de equilíbrio
dificuldades de memória
vômitos/náuseas
dor cervical
exame neurológico físico normal
anormalidades nos exames neuropsicológicos

Full details

Risk factors

traumatismo cranioencefálico
trauma cerebral prévio
uso indevido de bebidas alcoólicas e drogas
pouca força no pescoço

Full details

Diagnostic tests

1st tests to order

diagnóstico clínico

Full details

Tests to consider

tomografia computadorizada (TC) do crânio
ressonância nuclear magnética (RNM) de crânio

Full details

Emerging tests

tomografia por emissão de pósitrons (PET), TC por emissão de fóton único (SPECT)
tecnologias de RNM multimodais

Treatment algorithm

ACUTE

lesão cerebral traumática leve confirmada

Contributors

Authors

Luke C. Henry, PhD

Assistant Professor

Department of Neurological Surgery

Senior Clinical Neuropsychologist

University of Pittsburgh

Pittsburgh

Disclosures

LCH declares that he has no competing interests.

Maria Twichell, MD

Assistant Clinical Professor

Director

General Rehabilitation Unit

UPMC Physical Medicine and Rehabilitation

University of Pittsburgh Medical Center

Pittsburgh

Disclosures

MT declares that she has no competing interests.

Acknowledgements

Dr Luke C. Henry and Dr Maria Twichell would like to gratefully acknowledge Dr Jeffrey Bazarian and Dr Maryse Lassonde, previous contributors to this topic.

Disclosures

JB has been reimbursed by Roche, the manufacturer of an automated assay for serum S-100B, to attend a conference, and has been reimbursed by Banyan Biomarkers and Neuren Pharmaceuticals to help develop their research protocols. JB is also an author of a reference cited in this topic. ML is an author of several references cited in this topic.

Peer reviewers

Eirik Helseth, MD, PhD

Professor and Consultant

Department of Neurosurgery

Ulleval University Hospital

Oslo

Norway

Disclosures

EH declares that he has no competing interests.

Margot Putukian, MD

Director of Athletic Medicine

Princeton University

Princeton

Disclosures

MP is an author of a reference cited in this topic.

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

Maas AIR, Menon DK, Manley GT, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022 Nov;21(11):1004-60.Full text Abstract

Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 2019 Feb;53(4):213-25.Full text Abstract

Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711.Full text Abstract

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Mild Traumatic Brain Injury; Valente JH, Anderson JD, et al. Clinical policy: critical issues in the management of adult patients presenting to the emergency department with mild traumatic brain injury: approved by ACEP Board of Directors, February 1, 2023 clinical policy endorsed by the Emergency Nurses Association (April 5, 2023). Ann Emerg Med. 2023 May;81(5):e63-105.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
- Lesão cerebral traumática (LCT) moderada/grave
- Depression
- Traumas ou lesões gerais ao corpo não envolvendo a cabeça
More Differentials
Guidelines
- Living guideline for pediatric concussion
- Living concussion guidelines: guideline for concussion and prolonged symptoms for adults 18 years of age or older
More Guidelines
Patient information
Concussão (lesão cerebral traumática leve)
More Patient information
Calculators
Escala de coma de Glasgow
Regras Canadenses sobre TC de Crânio para traumatismo cranioencefálico menor
More Calculators
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Lesão cerebral traumática leve

Summary

Definition

History and exam

Key diagnostic factors

Other diagnostic factors

Risk factors

Diagnostic tests

1st tests to order

Tests to consider

Emerging tests

Treatment algorithm

lesão cerebral traumática leve confirmada

Contributors

Authors

Luke C. Henry, PhD

Disclosures

Maria Twichell, MD

Disclosures

Acknowledgements

Disclosures

Peer reviewers

Eirik Helseth, MD, PhD

Disclosures

Margot Putukian, MD

Disclosures

Peer reviewer acknowledgements

Disclosures

References

Key articles

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials

Guidelines

Patient information

Calculators

Log in or subscribe to access all of BMJ Best Practice

Log in or subscribe to access all of BMJ Best Practice

Log in to access all of BMJ Best Practice