Acidente Vascular Cerebral (AVC)

2020-04-20 22:11:56

Em muitos casos o Acidente Vascular Cerebral (AVC), popularmente conhecido como derrame, poderia ser evitado através de uma angioplastia ou uma cirurgia na artéria carótida. Nos dois casos o tratamento retira ou exclui o ateroma (placa de gordura) que está causando a obstrução da artéria. Na maioria das vezes o ateroma cresce silenciosamente até ocorrer o AVC que pode deixar sequelas neurológicas irreversíveis como paralisia e dificuldade para falar. A melhor opção é sempre prevenir!

Fonte: SBACVRJ

Anatomia:

artérias carótidas

Causa:

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

Aterosclerose: deposição de placas de gordura e calcio na artéria

Diagnóstico Diferencial:

Kinking de carótida, aneurisma de carótida, tumor glômico de carótida

Epidemiologia:

A doença cerebrovascular extracraniana engloba várias desordens que afetam as artérias que irrigam o cérebro, sendo uma importante causa de AVC e AIT. A principal condição patológica responsável pela doença carotídea extracraniana é a aterosclerose, responsável por cerca de 90% dessas lesões nos países ocidentais. O tratamento cirúrgico da estenose de carótidas pode ser realizado através da endarterectomia de carótida ou angioplastia com stent. Trabalhos demonstram que a abordagem cirúrgica agressiva à doença vascular encefálica pode estar justificada quando a intervenção puder ser realizada com taxas de mortalidade e morbidade aceitavelmente baixas para a longevidade e a qualidade de sobrevida desses pacientes sejam alteradas expressivamente

Fator de risco:

Tabagismo, idade, hipertensão arterial

Evolução natural:

AVC/Derrame

Prevenção Primária:

Não fumar, controlar a pressão arterial, fazer acompanhamento clinico e check-up regular.

Sinais e sintomas:

As pessoas podem ter: dificuldade para caminhar, fraqueza de um lado do corpo, fraqueza muscular, incapacidade de coordenar movimentos musculares, instabilidade, músculos rígidos, paralisia com músculos fracos, problemas de coordenação, paralisia de um lado do corpo ou reflexos hiperativos; perda temporária da visão em um olho, súbita perda da visão, visão dupla ou visão embaçada; dificuldade de fala, fala arrastada ou perda da fala; tontura ou vertigem; formigamento ou redução na sensação de tato; confusão mental ou incapacidade de falar ou entender o próprio idioma; dormência ou fraqueza muscular; afasia de wernicke, dificuldade em engolir, dor de cabeça, fraqueza de um membro ou movimento rápido involuntário dos olhos

Código:

I64

Prognóstico:

O prognóstico é satisfatório, desde que seja feito tratamento clinico e quando necessário intervenção.

Tratamentos possíveis:

Angioplastia
Cirurgia de carótida
Tratamento clínico

Complicações possíveis:

Acidente Vascular cerebral

Cirurgia Vascular: O que você não pode ignorar. Amato, ACM.

Manual do Médico Generalista na Era do Conhecimento. Amato, ACM

Tratado de Clínica Cirúrgica. Moraes, INM

Estilo de Vida. Amato, MCM

Dieta anti-inflamatória estratégica. Amato, ACM