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Abstract(s)
O AVC é um distúrbio neurológico súbito, associado a isquemia ou hemorragia no
cérebro. Atualmente, o AVC é a principal causa de mortalidade e incapacidade em
Portugal e uma das cinco maiores nos países desenvolvidos de todo o mundo.
A frequência de diagnóstico de outras condições (mimetizadores) como AVC chega a
atingir 25 a 30% da totalidade de diagnósticos de AVC e está associada ao uso
inadequado de instalações destinadas aos cuidados de doentes com AVC e a despesas
com tratamentos desnecessários.
O eficaz e célere diagnóstico de AVC é fundamental para minimizar os riscos de saúde
que lhe estão associados e, em última análise, salvar vidas e otimizar a gestão de
recursos humanos e financeiros.
Assim, o presente trabalho reúne um levantamento de informação sobre os
mimetizadores de AVC, a fim de informar para uma prática baseada em evidências
robustas e recentes que permita a realização de diagnósticos mais precisos e potencie a
gestão adequada dos recursos disponíveis.
Os mimetizadores clínicos de AVC mais frequentes em adultos são: convulsões,
enxaqueca, vertigem, neoplasia, trombose venosa, PRES, hematoma subdural, infeção,
alterações metabólicas e MELAS.
Conclui-se que o uso de scores padronizados na prática clínica para discriminar
mimetizadores e AVC pode ser benéfico. Além disso, o desenvolvimento de pontuações
e ferramentas de suporte à decisão clínica específicos para determinados
mimetizadores é também uma via promissora. O investimento neste âmbito deve
direcionar-se para os mimetizadores mais frequentes, como as convulsões. Por outro
lado, a neuroimagem avançada também pode melhorar a precisão do diagnóstico,
nomeadamente no que respeita à imagem 3D e à ressonância magnética.
Stroke is a sudden neurological disorder, associated with ischemia or hemorrhage in the brain. Currently, stroke is the main cause of mortality and disability in Portugal and one of the five largest in developed countries worldwide. The frequency of diagnosis of other conditions (mimics) such as stroke reaches up to 25 to 30% of all stroke diagnoses and is associated with the inappropriate use of stroke facilities and unnecessary expenses and treatments. The effective and rapid diagnosis of strokes is essential to minimize the health risks associated with them and, ultimately, save lives and optimize the management of resources, human and capital. Thus, the present work closes a survey of information about stroke mimics, to inform a practice based on robust and recent evidence that allows more accurate diagnoses and enhances the adequate management of resources. The most common clinical stroke mimics in adults are: seizures, migraine, vertigo, neoplasia, venous thrombosis, PRES, subdural hematoma, infection, metabolic changes and MELAS. It is concluded that the use of standardized scores in clinical practice to discriminate mimics and strokes can be beneficial. In addition, the development of scores and specific clinical decision support tools for certain mimics is also a promising path. Investment in this area should target the most frequent mimics, such as seizures. On the other hand, advanced neuroimaging can also improve diagnostic accuracy, particularly regarding 3D and Magnetic Resonance Imaging developments.
Stroke is a sudden neurological disorder, associated with ischemia or hemorrhage in the brain. Currently, stroke is the main cause of mortality and disability in Portugal and one of the five largest in developed countries worldwide. The frequency of diagnosis of other conditions (mimics) such as stroke reaches up to 25 to 30% of all stroke diagnoses and is associated with the inappropriate use of stroke facilities and unnecessary expenses and treatments. The effective and rapid diagnosis of strokes is essential to minimize the health risks associated with them and, ultimately, save lives and optimize the management of resources, human and capital. Thus, the present work closes a survey of information about stroke mimics, to inform a practice based on robust and recent evidence that allows more accurate diagnoses and enhances the adequate management of resources. The most common clinical stroke mimics in adults are: seizures, migraine, vertigo, neoplasia, venous thrombosis, PRES, subdural hematoma, infection, metabolic changes and MELAS. It is concluded that the use of standardized scores in clinical practice to discriminate mimics and strokes can be beneficial. In addition, the development of scores and specific clinical decision support tools for certain mimics is also a promising path. Investment in this area should target the most frequent mimics, such as seizures. On the other hand, advanced neuroimaging can also improve diagnostic accuracy, particularly regarding 3D and Magnetic Resonance Imaging developments.
Description
Keywords
Acidente Vascular Cerebral (Avc) Mimetizadore