Acidente Vascular Cerebral no adulto jovem: Estudo prospectivo de 58 doentes
Palavras-chave:
AVC, adulto jovem, epidemiologiaResumo
ntrodução e objectivo: O acidente vascular cerebral (AVC) no
adulto jovem é menos frequente e as causas são mais variadas
justificando, em geral, uma investigação mais exaustiva. O objectivo deste estudo foi avaliar as características demográficas,
tipo de AVC, factores de risco, evolução e mortalidade destes doentes.
Material e Métodos: Estudo prospectivo com duração de 2
anos (2002-2003) envolvendo doentes com idade ≤ 60 anos
admitidos no nosso serviço por AVC. Os doentes com hemorragia
subaracnoideia foram excluídos. O protocolo de estudo incluiu
história clínica, exame físico, tomografia computorizada (TC),
electrocardiograma (ECG), ecocardiograma transtorácico, ecodoppler carotídeo, estudo analítico de factores procoagulantes e
aterogénicos e consultas de seguimento ao 1º e 6º mês após o
evento. Outros exames foram efectuados quando considerados necessários.
Resultados: Estudámos 58 doentes, 30 mulheres (51,7%) e 28
homens (48,3%) com idades compreendidas entre os 32 e os 60
anos (51,9±6,3). A maioria (77,6%) teve AVC isquémico, 20%
AVC hemorrágico e um doente teve trombose de seios venosos.
Os factores de risco mais prevalentes nos doentes com AVC
isquémico foram a HTA (66,7%) e a dislipidemia (64,4%) e nos
doentes com AVC hemorrágico foram a HTA (75%) e o alcoolismo
(58,3%). A mortalidade global foi 13,8%. Apenas 43,1% dos doentes recuperaram sem sequelas.
Conclusões: Para além da idade, os factores de risco clássicos
para aterosclerose foram os principais identificados, embora no
grupo do AVC hemorrágico o 2º factor de risco preponderante
fosse o alcoolismo. A percentagem significativa de sequelas
e mortalidade associadas ao AVC reafirmam a importância do
controlo destes factores na população.
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