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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.3A São Paulo Sept. 1997

http://dx.doi.org/10.1590/S0004-282X1997000300010 

Hemorragia subaracnoídea com tomografia de crânio sem sinais de sangramento

 

Subarachnoidal hemorrhage with cranial tomography without bleeding signals

 

 

Silvio FranciscoI; João Baptista dos Reis-FilhoII; Afonso Carlos NevesIII

ISetor de LCR da Disciplina de Neurologia da UNIFESP - Escola Paulista de Medicina: Pós-Graduando da Disciplina de Neurologia
IISetor de LCR da Disciplina de Neurologia da UNIFESP - Escola Paulista de Medicina: Professor Adjunto da Disciplina de Neurologia e Chefe do Setor de LCR
IIISetor de LCR da Disciplina de Neurologia da UNIFESP - Escola Paulista de Medicina: Médico da Disciplina de Neurologia e Chefe do PS de Neurologia

 

 


RESUMO

Foram observados 23 casos de pacientes com suspeita clínica de hemorragia subaracnoídea (HSA), com tomografia de crânio (CT) sem sinais de sangramento, com diagnóstico definitivo realizado por exame de líquido cefalorraquiano(LCR). Desses, 20 casos foram submetidos a angiografia cerebral. Estabeleceu-se a classificação clínica de Hunt & Hess. Os principais achados neste estudo foram:1) um terço dos pacientes apresentou intervalo de tempo entre o ictus e a realização da CT e do LCR entre 24 e 48 horas, período de maior sensiblidade da CT; 2) dos pacientes estudados com angiografia cerebral, 55% tiveram o diagnóstico de aneurisma com predomínio no território de carótida e cerebral anterior; 3) o grau clínico dominante foi Hunt & Hess I e II. Todos os achados encontrados demonstraram a necessidade da realização de LCR em suspeita de HSA sem sinais de sangramento na CT.

Palavras-chave: hemorragia subaracnoídea, líquido cefalorraquiano, tomografia computadorizada.


ABSTRACT

We observed 23 pacients with clinical hypothesis of subarachnoidal hemorrhage (SAH) having cranial tomography (CT) without bleeding signals. The final diagnosis of SAH was made upon the cerebrospinal fluid (CSF) results. Twenty cases were submitted to brain angiography. They were focused under the clinical classification of Hunt & Hess. The main results were: 1) 1/3 of patients had interval time between 24 and 48 hours after ictus and before CT and CSF making; this was the most sensitive CT time; 2) 55% of patients with brain angiography had aneurysm predominantly in the carotid and anterior cerebral artery territory; 3) the dominant clinical degree was Hunt & Hess I e II. Conclusion: the results demonstrate the need of CSF test in case of SAH clinical diagnosis with CT showing no bleeding signals.

Key words: subarachnoidal hemorrhage, cerebrospinal fluid, computerized tomography.


 

 

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Full text available only in PDF format.

 

 

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Aceite: 5-março-1997.

 

 

Dr. Silvio Francisco - Rua Itapeva 500 conj 3B - 01332-900 São Paulo SP - Brasil.

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