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Accident Vascular Cerebral

Accident Vascular Cerebral

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Published by Ana Marcu
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Published by: Ana Marcu on Jun 29, 2013
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12/03/2013

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Accident vascular cerebral

• Accident ischemic sau hemoragic ? • Daca e ischemie : tromboliza ? • Daca e hemoragic : care e etiologia si tratamentul cauzei • Urgenta extrema este ischemia • Urgenta rapida esta hemoragia

Accident vascular cerebral • Diagnostic diferential • Diagnostic pozitiv • Este o ocluzie a unei artere cerebrale ? • Este indicata tromboliza ? .

• pierderea diferentierii intre substanta alba si substanta cenusie superficial sau profund.SEMIOLOGIA CT A MODIFICARILOR de DENSITATE ale PARENCHIMULUI CEREBRAL • hiperdensitate a unei artere cerebrale. • stergerea santurilor intergirale intrun teritoriu arterial. .

EDEMUL CITOTOXIC in stadiile supra-acute H8 H4 H5 Sensibilitate 100 % Hipodensitate «mici» semne de ischemie ? .

48 heures Accident ischemic la 3 ore TDM FLAIR Diffusion ADC .

Accident ischemic la 3 ore Flair Diffusion Perfusion Evolutia fara tratament dupa 2 zile .

CT • Diagnostic pozitiv : semne tardive – Disparitia disocierii intre substanta gri si cea alba • Diagnostic dif.: hemoragie • Ocluzia arterei : angio-CT • Indicatie de tromboliza : CT de perfuzie .

Dédifférenciation gris-blanc .

Ischémie : H5 Angioscanner : siège de l ’occlusion .

Ischémie : J2 .

Ischémie > 3ème semaine .

Holter – Leziuni cardiace : ecocardiografia transtoracica/transoesofagiana .Cautarea etiologiei • la 24 – 48 h • Artere cervicale si cerebrale: – Echo-Doppler – Angio-scanner • Etiologie cardiaca : – Trouburari de ritm : ECG.

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