AVC Isquémico – terapêutica na fase aguda
Palavras-chave:
AVC, fibrinolíticos, antiagragantes plaquetários, anticoagolantes, unidades de AVC, terapêutica em fase agudaResumo
O autor faz referência à terapêutica do acidente vascular cerebral isquémico em fase
aguda, nomeadamente aos antiagregantes
plaquetários (AAP), anticoagulantes e fibrinolíticos. Menciona a importância de diversos
elementos a ter em conta nessa fase. Refere os
meios imagiológicos fundamentais ao diagnóstico, correlacionando-os com a terapêutica
fibrinolítica e reflecte sobre o papel dos Internistas na aplicação desta complexa abordagem
terapêutica.
Downloads
Referências
International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19 435 patients with acute ischaemic stroke. The Lancet 1997; 349: 1569-1581.
BM Coull, L S Williams, LB Goldstein et al. Anticoagulants and antiplatelet agents in Acute Ischemic Stroke – Report of the Joint
Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association. STROKE 2002;
: 1934-1942.
Richard Kay, KA Sing Wong, Yuk Ling Yu et al. Low-molecular-weight heparin for the treatment of acute ischemic stroke. The New England
Journal of Medicine 1995; 333: 1588-1593.
The National Institute of Neurological Disorders and Stroke rT-PA Stroke Study Group. Tissue Plasminogen Activator for Acute Ischemic
Stroke. The New England Journal of Medicine 1995; 333: 1581-1587.
Hacke W, Kaste M, Fieschi C et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke.
The European Cooperative Acute Stroke Study (ECASS). JAMA 1995; 274(13): 1017-1025.
Steiner T, Bluhmki E, Kaste M et al. The ECASS 3-hour cohort. Secondary analysis of ECASS data by time stratification. ECASS Study
Group. European Cooperative Acute Stroke Study. Cerebrovascular Diseases 1998;8(4): 198-203.
Werner Hacke, Markku Kaste, Cesare Fieschi et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). The Lancet 1998; 352(9136): 1245-1251.
Clark W M, Wissman S, Albers G W et al. Recombinant tissue-plasminogen activator (Alteplase) for ischemic Stroke 3 to 5 hours after
symptoms onset. The ATLANTIS Study: a randomised controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in
Ischemic Stroke. JAMA 1999; 282(21): 2019-2026.
Gregory W Albers, Wayne M Clark, Kenneth P Madden et al. ATLANTIS trial - Results for patients treated within 3 hours of stroke onset.
STROKE 2002; 33: 493-496.
Henrik S Jorgensen, Hirofumi Nakayma, Hans O Raaschou et al. The effect of a stroke unit: Reductions in mortality discharge rate to
nursing home length of hospital stay and cost. STROKE 1995; 26: 1178-1182.
L P Kammersgaard, HS Jorgensen, JA Rungby et al. Admission body temperature predicts long-term mortality after acute stroke. The Copenhagen Stroke Study. STROKE 2002; 33: 1759.
C M Burchfiel, JD Curb, BL Rodriguez et al. Glucose intolerance and 22-year stroke incidence. The Honolulu Heart Program. STROKE
; 25: 951-957.
S Goya Wannamethee, Ivan J Perry, A Gerald Shaper. Nonfasting serum glucose and insulin concentrations and the risk of stroke. STROKE
; 30: 1780-1786.
Andrew M Demchuk, Lewis B Morgenstern, Derk W Krieger et al. Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic stroke. STROKE 1999; 30: 34-39.
A Bruno, SR Levine, M R Frankel et al. Admission glucose level and clinical outcomes in the NINDS rT-Pa stroke trial. Neurology 2002;
: 669-674.
P A Barber, DG Darby, PM Desmond et al. Identification of major ischemic change. Diffusion-weighted imaging versus computed tomography. STROKE 1999; 30: 2059-2065.
Magdy Selim, John N Fink, Sandeep Kumar et al. Predictors of hemorrhagic transformation after intravenous recombinant tissue plasminogen activator. STROKE 2002; 33: 2047-2052.
Juan F Arenillas, Álex Rovira, Carlos A Molina et al. Prediction of early neurological deterioration using difusion and perfusion-weighted
imaging in hyperacute middle cerebral artery ischemic stroke. STROKE 2002; 33: 2197-2203.
J B Fiebach, PD Schellinger, O Jansen et al. CT and Diffusion-Weighted MR imaging in randomised order – Diffusion-Weighted Imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. STROKE 2002; 33: 2206-2210.
Turgut Tatlisumak. With Acute Stroke? Why should men divide if fate has united. STROKE 2002: 33: 2144-2145
Ficheiros Adicionais
Publicado
Como Citar
Edição
Secção
Licença
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
Acesso livre