Avc e Estudo de Caso

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<div class="outer_page only_ie6_border" id="outer_page_1" style="width:902px; height:1167px; "> <div class="newpage" id="page1" style="width: 902px; height:1167px"> <div class=text_layer style="z-index:2"><div class=ie_fix> <div class="ff0" style="font-size:84px"> <span class=a style="left:787px;top:489px"></span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:818px;top:887px;word-spacing:-1px;color:#000080">Traba lho realizado por:</span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:818px;top:969px;word-spacing:-1px;color:#000080">Julia na V. S Zinni</span><span class=a style="left:2359px;top:887px;word-spacing:-1px ;color:#000080">Formada em Fisioterapia pela Universidade</span><span class=a st yle="left:2491px;top:969px;word-spacing:-2px;color:#000080">Camilo Castelo Branc o - <span class=w8></span>UNICASTELO</span></div> <div class="ff9" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:1436px;letter-spacing :1px;color:#ffffff">ACIDEN</span></span> </div> <div class="ff1" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:1752px;color:#ffffff" >T</span></span> </div> <div class="ff9" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:1805px;color:#ffffff" >E</span></span> </div> <div class="ff1" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:1883px;color:#ffffff" >V</span></span> </div> <div class="ff9" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:1941px;letter-spacing :1px;color:#ffffff">ASCULAR</span></span> </div> <div class="ff1" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:2345px;color:#ffffff" ></span></span> </div> <div class="ff9" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:2369px;letter-spacing :1px;color:#ffffff">CEREBRAL</span></span> </div> <div class="ff1" style="font-size:91px"> <span class=g style="top:1237px"><span class=a style="left:2854px;color:#ffffff" >(</span></span> </div> <div class="ff9" style="font-size:91px"> <span class=a style="left:2884px;top:1237px;color:#ffffff">A</span></div> <div class="ff1" style="font-size:91px"> <span class=a style="left:2941px;top:1237px;color:#ffffff">V</span></div> <div class="ff9" style="font-size:91px"> <span class=a style="left:2997px;top:1237px;color:#ffffff">C)</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3084px;top:1227px"></span></div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1464px"><span class=a style="left:1984px;color:#800000"
>1-</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1464px"><span class=a style="left:2046px;color:#800000" ></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1464px"><span class=a style="left:2065px;color:#800000" >IN</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2134px;top:1464px;color:#800000">T</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2175px;top:1464px;color:#800000">RODUO</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2534px;top:1464px;color:#800000"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:824px;top:1623px;word-spacing:-1px">A interrupo do fluxo sangneo, em determ<span class=w6></span>inada parte do crebro, resulta <span class= w6></span>em sbita leso</span><span class=a style="left:825px;top:1703px">da mesma , ocasionando o conjunto de sintomas que caracterizam o "derrame". freqente o</sp an><span class=a style="left:847px;top:1782px;word-spacing:-2px">uso de outros n ome<span class=w6></span>s, tais como: c<span class=w6></span>hoque, apoplexia, espasmo cerebral<span class=w6></span>, trombos<span class=l style="margin-left: -14px">e cerebral e</span></span><span class=a style="left:1846px;top:1862px">ac idente vascular cerebral.</span><span class=a style="left:894px;top:2021px">O te rmo AVC denota a instalao sbita da afeco, e representa um dos aspectos mais</span><sp an class=a style="left:827px;top:2101px">graves da doena que o paciente se v obrig ado a enfrentar, ou seja, o profundo choque qu</span><span class=a style="left:8 59px;top:2180px;word-spacing:-1px">o mesmo sofre, ao <span class=w6></span>perce ber que, de um <span class=l7>momento para outro, e sem aviso prvio, <span class= w6></span>perdeu a</span></span><span class=a style="left:833px;top:2260px">capa cidade funcional de metade do seu corpo, aquela que fica ao lado oposto ao da se de da</span><span class=a style="left:825px;top:2339px;word-spacing:-2px">leso (a e<span class=w6></span>xplicao desse fato <span class=w6></span> o cruzamento das <span class=w6></span>fibras que emergem do <span class=w7></span>crebro, dirigin do<span class=l style="margin-left:-16px">-</span></span><span class=a style="le ft:1712px;top:2419px;word-spacing:-2px">se para a met<span class=w6></span>ade o posta do corpo).</span><span class=a style="left:891px;top:2578px">O paciente pe rde o controle dos movimentos e seus membros lhe recusam a obedincia.</span><span class=a style="left:967px;top:2660px;word-spacing:-1px">No de se estranhar, pois , que <span class=w6></span>ele se apresente deprimido, irritadio, s vezes at</span ><span class=a style="left:942px;top:2739px;word-spacing:-2px">agressivo: ele es t <span class=w6></span>profundamente apreensivo, j<span class=w6></span> que i<sp an class=w6></span>ncapaz de prover s <span class=l11>prprias</span></span><span c lass=a style="left:1324px;top:2819px;word-spacing:-1px">necessidades, ou de enf< span class=w7></span>rentar as tarefas normais cotidianas.</span><span class=a s tyle="left:861px;top:2976px">O AVC pode ser causado pela hemorragia dentro da ma ssa cerebral, tendo como ponto de</span><span class=a style="left:820px;top:3056 px">partida a ruptura de um vaso sangneo; outras vezes, ele causado pelo bloqueio devido a</span><span class=a style="left:903px;top:3135px;word-spacing:-1px">esp essamento da parede interna de uma art<span class=w6></span>ria que irriga o crebr o, ou por um cogul<span class=w6></span>o</span><span class=a style="left:861px;t op:3215px;word-spacing:-2px">sangneo que se <span class=w6></span>formou no i<span class=w6></span>nterior do corao (ou <span class=w7></span>de uma artria), <span c lass=w6></span>deslocando<span class=l style="margin-left:-19px">-se do seu</spa n></span><span class=a style="left:1533px;top:3296px">ponto de origem e "caminha ndo" at o crebro.</span><span class=a style="left:850px;top:3455px;word-spacing:-1 px">No primeiro caso, a leso provocada pel<span class=w6></span>a <span class=l6> prpria hemorragia. A hemorragia no interior <span class=w6></span>do</span></span
><span class=a style="left:856px;top:3535px">crebro significa que a ruptura de al gum vaso sangneo provocou o vazamento de sangue</span><span class=a style="left:99 5px;top:3615px;word-spacing:-1px">em meio as clulas cerebrai<span class=w6></span >s, causando destruio local: a hemorragia cerebral.</span><span class=a style="lef t:2260px;top:3694px"></span><span class=a style="left:873px;top:3772px;word-spaci ng:-2px">No segundo caso, <span class=w6></span>temos um cogulo <span class=w8></ span>que <span class=l9>se desloca, chamado <span class=w6></span>mbolo: instalase o AVC,</span></span><span class=a style="left:833px;top:3852px;word-spacing:1px">quando o mbolo ocupa <span class=w6></span>uma posio em que efetivamente inter rompe a irrigao <span class=w6></span>sangnea</span><span class=a style="left:944px; top:3933px;word-spacing:-1px">de parte do crebro. <span class=w6></span>o bloquei o da irrigao sangnea, que resulta <span class=w6></span>do espessamento</span><span class=a style="left:831px;top:4013px;word-spacing:-1px">progressivo da parede de uma <span class=w6></span>artria d<span class=l8>e importncia vital, ou da migrao d e <span class=w6></span>em cogulo ou</span></span><span class=a style="left:1252p x;top:4092px;word-spacing:-1px">mbolo, recebe o nome de <span class=w6></span>tro mbose cerebral ou AVC Isqumico.</span><span class=a style="left:958px;top:4251px" >Seja qual for a causa, as conseqncias se instalam sempre com rapidez dramtica,</sp an><span class=a style="left:856px;top:4331px;word-spacing:-2px">provocando efei tos devastadores <span class=w6></span>no tocante <span class=w6></span> capacida de fs<span class=l12>ica, e ao <span class=w7></span>estado emocional do</span></ span><span class=a style="left:2118px;top:4411px">paciente.</span></div> <div class="ff7" style="font-size:61px"> <span class=a style="left:1975px;top:4663px;color:#800000">2</span></div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2014px;color:#800000" >-</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2056px;color:#800000" >T</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2097px;color:#800000" >IPOS</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2262px;color:#800000" ></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2281px;color:#800000" >DE</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2377px;color:#800000" ></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4651px"><span class=a style="left:2396px;color:#800000" >A</span></span> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2444px;top:4651px;color:#800000">V</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2490px;top:4651px;color:#800000">C</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2539px;top:4651px;color:#800000"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1980px;top:4808px;word-spacing:-1px">a) AVC Isqumico</s
pan></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2539px;top:4808px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:928px;top:4968px;word-spacing:-1px">Os neurnios so muito <span class=w6></span>sensveis a alteraes no fluxo sangneo cerebral. As cl<span class =w6></span>ulas</span><span class=a style="left:988px;top:5047px;word-spacing:-1 px">cerebrais morrem alguns minutos aps a int<span class=w6></span>errupo completa do fluxo sangneo.</span><span class=a style="left:863px;top:5127px;word-spacing:-1 px">Entretanto, apesar de ocorrer uma ocl<span class=w6></span>uso completa de um vaso cerebral durante um <span class=w6></span>AVC</span><span class=a style="l eft:905px;top:5208px">isqumico agudo, persiste algum grau de perfuso, mesmo no cen tro da regio cerebral</span></div> </div> </div> <div class=image_layer style="z-index: 1"> <div class=ie_fix> <img class="absimg" style="left:161px;top:164px;width:580px;height:119px;clip:re ct(1px 579px 108px 1px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images/1-9 73ade2e21.png"/> <img class="absimg" style="left:635px;top:314px;width:580px;height:119px;clip:re ct(110px 105px 118px 99px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images/ 1-973ade2e21.png"/> <img class="absimg" style="left:628px;top:505px;width:580px;height:119px;clip:re ct(110px 112px 118px 107px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images /1-973ade2e21.png"/> </div> </div> <div class=image_layer style="z-index: 3"> <div class=ie_fix> <img class="absimg" style="left:410px;top:864px;width:580px;height:119px;clip:re ct(110px 97px 112px 1px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images/1973ade2e21.png"/> </div> </div> </div>
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<div class="outer_page only_ie6_border" id="outer_page_2" style="width:902px; height:1167px; "> <div class="newpage" id="page2" style="width: 902px; height:1167px"> <div class=text_layer style="z-index:2"><div class=ie_fix> <div class="ff5" style="font-size:77px"> <span class=a style="left:870px;top:498px;word-spacing:-1px">isqumica, em virtude do fluxo colateral e <span class=w6></span>de variaes nos gradientes de presso tec i<span class=w6></span>dual</span><span class=a style="left:981px;top:578px;word -spacing:-1px">locais. As clulas variam de neurni<span class=w6></span>os com leses irreversveis no centro da regio</span><span class=a style="left:939px;top:657px"> isqumica at neurnios com leses reversveis na periferia (a penumbra). O grau e a</span ><span class=a style="left:924px;top:737px">durao da ocluso determinam a viabilidad e das clulas na penumbra. Teoricamente,</span><span class=a style="left:852px;top :817px;word-spacing:-1px">quanto mais precoce a reperfuso, maior a probabilidade de <span class=w6></span>sobrevivncia da clula. O uso</span><span class=a style="l eft:833px;top:896px;word-spacing:-2px">recente de terapi<span class=w6></span>a tromboltica intravenosa e intra-arterial no AVC isqumico <span class=w6></span>bas eia-se neste</span><span class=a style="left:2067px;top:976px">fundamento.</span ><span class=a style="left:1941px;top:1137px">b) AVC Hemorrgico</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2580px;top:1136px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:928px;top:1294px;word-spacing:-1px">Na hemorragia intr acerebral e subaracnide, oc<span class=w6></span>orr<span class=l9>em a ruptura d e um <span class=w6></span>vaso sangneo</span></span><span class=a style="left:901 px;top:1374px">cerebral com um aumento drstico na presso intracraniana e uma reduo n a perfuso</span><span class=a style="left:825px;top:1453px">cerebral global que p ode durar alguns minutos. Aps essas alteraes imediatas, ocorre uma</span><span clas s=a style="left:852px;top:1533px;word-spacing:-1px">melhora gradual na presso int racrani<span class=w6></span>ana e na p<span class=l9>resso de perfuso, apesar des ses valores</span></span><span class=a style="left:866px;top:1613px">no retornare m aos valores de base. Ocorre uma reduo acentuada da perfuso cerebral</span><span c lass=a style="left:848px;top:1692px;word-spacing:-1px">prxima ao hematoma e <span class=w6></span>por isso provavelmente se deve compresso loc<span class=w6></spa n>al. As regies do</span><span class=a style="left:891px;top:1773px;word-spacing: -1px">crebro afastadas do sangramento tambm <span class=w6></span>a<span class=l11 >presentam alteraes da perfuso, <span class=w6></span>que so</span></span><span clas s=a style="left:861px;top:1853px">atribudas vasoconstrio causada pela liberao qumica e produtos de degradao do</span><span class=a style="left:1724px;top:1933px">sangu e ou por mediao neuronal.</span></div> <div class="ff7" style="font-size:61px">
<span class=a style="left:1568px;top:2182px">2.</span></div> <div class="ff9" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:1627px">1-</span></sp an> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:1689px"></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:1708px">Ac</span></sp an> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:1795px;word-spacing:1px">idente vas</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:2134px">cu</span></sp an> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:2216px">lar</span></sp an> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:2320px">c</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:2359px;word-spacing:1px">erebral isq</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:2169px"><span class=a style="left:2709px">um</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2852px;top:2169px">i</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2872px;top:2169px">c</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2909px;top:2169px">o</span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:836px;top:2329px;word-spacing:-1px">O AVC isqumico asso cia-se ao processo aterotrombtico no territrio carotdeo e basilar ou</span><span cl ass=a style="left:944px;top:2410px;word-spacing:-1px">a embolia cardaca. A hemorr agia intracerebral pode <span class=w7></span>estar associada a malformaes</span>< span class=a style="left:889px;top:2490px">vasculares e ao uso de drogas em indi vduos com idade inferior a 40 anos; a hipertenso</span><span class=a style="left:1 299px;top:2569px;word-spacing:-2px">arterial predomina no <span class=w7></span> grupo mais afetado entre os 40-69 anos.</span><span class=a style="left:1798px;t op:2729px">a) AVC Isqumico Trombtico</span></div> </div> </div> <div class=text_layer style="z-index:4"><div class=ie_fix> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:1621px">C</span></spa n> </div>
<div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:1671px">a</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:1710px">u</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:1752px;word-spacing:1 px">sas de</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:1989px">A</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2037px">V</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2083px">C</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2132px"></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2152px">I</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2171px">sq</span></sp an> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2251px">um</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2394px">i</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2414px">c</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2453px;word-spacing:1 px;letter-spacing:-1px">o Tro</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:3101px"><span class=a style="left:2622px">m</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2684px;top:3101px">bti</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2812px;top:3101px">c</span></div> <div class="ff1" style="font-size:77px">
<span class=a style="left:2849px;top:3101px">o</span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1252px;top:3595px;word-spacing:-1px">Causas mais comun s</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:1913px;top:3574px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2494px;top:3257px">Aterioesclerose</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2990px;top:3236px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2592px;top:3427px">Vasculites</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2909px;top:3406px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2591px;top:3595px">Disseco</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2911px;top:3574px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2249px;top:3763px;word-spacing:1px">Estados de hiperco agulabilidade</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3250px;top:3742px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2583px;top:3931px">Policitemia</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2918px;top:3910px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1220px;top:4099px">Causas menos comuns</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:1943px;top:4078px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2433px;top:4099px;word-spacing:-1px">Doenas Infecciosas </span><span class=a style="left:867px;top:4402px;word-spacing:-1px">A maior part e dos Acidentes Vasculares Cerebrais causada <span class=w6></span>por trombose vascular, que</span><span class=a style="left:824px;top:4481px">ocorre quando a formao de um cogulo superpe a um estreitamento gradual do vaso ou a</span><span clas s=a style="left:877px;top:4561px;word-spacing:-2px">alteraes no revestimento <span class=w6></span>luminal do vaso. A <span class=w6></span>doena aterioesclertica < span class=w6></span> uma das c<span class=l8>ausas</span></span><span class=a st yle="left:955px;top:4640px;word-spacing:-1px">mais comuns de AVC na atualidade. A <span class=w6></span>Aterioesclerose afeta basicamente as artrias</span><span class=a style="left:939px;top:4720px;word-spacing:-1px">intracranianas e extracr anianas de maior porte <span class=w6></span>e causa hiperplasia e fibrose na re gio</span><span class=a style="left:891px;top:4800px;word-spacing:-2px">subntima, com formao <span class=w6></span>de uma placa. As <span class=w6></span>placas red uzem a <span class=w6></span>luz dos vasos <span class=w6></span>e promove<span class=l style="margin-left:-15px">m</span></span><span class=a style="left:946px ;top:4877px">adeso plaquetria com conseqente trombose vascular. Outras causas de tr ombose</span><span class=a style="left:856px;top:4959px;word-spacing:-1px">inclu em vasculite, disseco, policitemia e estados de hipercoagulabili<span class=w6></s pan>dade. Causas menos</span><span class=a style="left:833px;top:5038px;word-spa cing:-1px">comuns incluem doenas infecciosas, como <span class=w6></span>a Sfilis e a Triquinose, que geram uma l<span class=w6></span>es<span class=l style="marg in-left:-14px">o na</span></span><span class=a style="left:2003px;top:5118px">par ede vascular.</span></div> </div> </div> <div class=image_layer style="z-index: 3"> <div class=ie_fix>
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<div class="outer_page only_ie6_border" id="outer_page_3" style="width:902px; height:1167px; "> <div class="newpage" id="page3" style="width: 902px; height:1167px"> <div class=text_layer style="z-index:2"><div class=ie_fix> <div class="ff5" style="font-size:77px"> <span class=a style="left:863px;top:498px;word-spacing:-1px">Os sinais e sintoma s de AVC trombtico costumam <span class=w6></span>se desenvolver gradualmente ao longo</span><span class=a style="left:836px;top:578px">de minutos a horas e pode
m apresentar uma gravidade oscilante, ou seja, melhoras e pioras</span><span cla ss=a style="left:923px;top:657px">do quadro durante esse perodo. Ao serem questio nados, ospacientes com freqncia</span><span class=a style="left:822px;top:737px;wo rd-spacing:-1px">relatam problemas semelhantes, porm transitrios, ocorridos no pas sado e que <span class=w8></span>sugerem um</span><span class=a style="left:872p x;top:817px;word-spacing:-1px">Ataque Isqumico Transitrio na mesma <span class=w6>< /span>distribuio vascular. A gravidade do quadro vai</span><span class=a style="le ft:896px;top:896px;word-spacing:-2px">depender principalmente <span class=w6></s pan>da presena de um<span class=w6></span>a rede de col<span class=l8>aterais cap az de manter <span class=w7></span>algum</span></span><span class=a style="left: 1963px;top:976px;word-spacing:-1px">fluxo para a regio.</span><span class=a style ="left:1828px;top:1137px;word-spacing:-1px">b) AVC Isqumico Emblico</span></div> </div> </div> <div class=text_layer style="z-index:4"><div class=ie_fix> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1487px">C</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1536px">a</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1575px">u</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1618px">sas de</span> </span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1855px">A</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1903px">V</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1949px">C</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:1998px"></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2018px">I</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2037px">sq</span></sp an> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2117px">um</span></spa n> </div> <div class="ff1" style="font-size:77px">
<span class=g style="top:1508px"><span class=a style="left:2260px">i</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2279px">c</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2318px;word-spacing:1px">o de orige</span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2645px">m</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2727px">e</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:1508px"><span class=a style="left:2766px">m</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2826px;top:1508px">bli</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2948px;top:1508px">c</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2987px;top:1508px">a</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3029px;top:1487px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1034px;top:1957px">Causas mais</span><span class=a sty le="left:1112px;top:2037px">comuns</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:1356px;top:2016px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1636px;top:1664px;word-spacing:-2px">Arritmias (F.A.)</ span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2120px;top:1643px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2332px;top:1957px;word-spacing:1px">Causas menos</span ><span class=a style="left:2442px;top:2037px">comuns</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2686px;top:2016px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2904px;top:1749px;word-spacing:-1px">Mixomas Cardacos</ span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3516px;top:1727px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1551px;top:1832px;word-spacing:-1px">Trombo Mural (I.A .M.)</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2226px;top:1811px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1618px;top:2000px">Doena Cardaca</span><span class=a sty le="left:1722px;top:2079px">Reumtica</span></div> <div class="ff0" style="font-size:84px">
<span class=a style="left:2055px;top:2058px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2967px;top:2125px">Miocardiopatias</span><span class=a style="left:3075px;top:2205px">Dilatatas</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3344px;top:2184px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:1687px;top:2247px">Endocardites</span><span class=a st yle="left:1715px;top:2329px">Infecciosas</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2060px;top:2308px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:900px;top:2631px;word-spacing:-1px">Quase 20% dos Acid entes Vasculares Cerebrais so <span class=w6></span>de origem emblica. Na embolia, o</span><span class=a style="left:919px;top:2711px;word-spacing:-1px">material intravascular de origem proximal liberado <span class=w6></span>e passa a ocluir um vaso distal. <span class=w6></span>Ao</span><span class=a style="left:907px; top:2790px;word-spacing:-1px">contrrio do AVC trombtico, no existe doena intr<span c lass=w6></span>nseca no vaso ocludo. Portanto, os</span><span class=a style="left: 861px;top:2870px">mbolos so menos aderentes e tm uma tendncia maior a se fragmentar e a se deslocar</span><span class=a style="left:827px;top:2950px">distalmente do que os cogulos secundrios trombose. As fontes mais comuns de mbolos</span><span cla ss=a style="left:822px;top:3029px;word-spacing:-1px">so o corao e os grande<span cl ass=w6></span>s vasos (aorta, cartidas e art<span class=w6></span>rias vertebrais) . As <span class=l12>fontes cardacas</span></span><span class=a style="left:963px ;top:3109px;word-spacing:-1px">de mbolos incluem vegetaes valvulares, trombos m<spa n class=w6></span>urais, mbolos originados por</span><span class=a style="left:886 px;top:3188px;word-spacing:-1px">Fibrilao Atrial, mbolos paradoxais (devidos a CIA ou CIV) <span class=w6></span>ou tumor cardaco. mbolos</span><span class=a style=" left:863px;top:3270px;word-spacing:-2px">artrio-arteriais costumam ocorrer quando <span class=w7></span>um agregado de <span class=w7></span>plaquetas e f<span c lass=l11>ibrina deslocado</span></span><span class=a style="left:894px;top:3349p x;word-spacing:-1px">de uma regio estentic<span class=w6></span>a estreita ou de u ma placa aterioesclertica em <span class=w6></span>um grande vaso.</span><span cl ass=a style="left:841px;top:3429px">Causas menos comuns de mbolos incluem Miocard iopatias Dilatadas, mbolos gordurosos</span><span class=a style="left:1303px;top: 3509px;word-spacing:-1px">e partculas embolizadas por injees de <span class=w6></sp an>drogas intravenosas.</span><span class=a style="left:914px;top:3666px;word-sp acing:-1px">Os Acidentes Vasculares Cerebrais de origem c<span class=w6></span>a rdaca, em geral, tm duas tendncias</span><span class=a style="left:2069px;top:3746p x">importantes:</span><span class=a style="left:1421px;top:3906px">* Tendem a se r mais graves (maior volume de infarto);</span><span class=a style="left:1239px; top:4066px">* Tendem hemorragia (podendo ocorrer em at 71% dos casos).</span><spa n class=a style="left:2260px;top:4145px"></span><span class=a style="left:960px;t op:4225px;word-spacing:-1px">O AVC de origem emblica ocorre de <span class=w6></s pan>modo sbito e no h tendncia para que haja</span><span class=a style="left:1931px; top:4304px;word-spacing:-2px">sintomas pregressos.</span><span class=a style="le ft:1848px;top:4462px;word-spacing:-1px">c) AVC Isqumico Lacunar</span></div> </div> </div> <div class=text_layer style="z-index:6"><div class=ie_fix> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:1678px">C</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:1727px">a</span></spa n> </div>
<div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:1766px">u</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:1809px">sas de</span> </span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2046px">A</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2094px">V</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2140px">C</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2189px"></span></span> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2209px">I</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2228px">sq</span></sp an> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2308px">um</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2451px">i</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2470px">c</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2509px">o</span></spa n> </div> <div class="ff9" style="font-size:77px"> <span class=g style="top:4836px"><span class=a style="left:2569px">L</span></spa n> </div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2612px;top:4836px">a</span></div> <div class="ff9" style="font-size:77px"> <span class=a style="left:2651px;top:4836px">cu</span></div> <div class="ff1" style="font-size:77px"> <span class=a style="left:2730px;top:4836px">nar</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2840px;top:4815px"></span></div> <div class="ff5" style="font-size:77px">
<span class=a style="left:1186px;top:5077px">Causas mais comuns</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:1848px;top:5056px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2251px;top:4992px;word-spacing:-1px">Hipertenso Arteria l Crnica</span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:3121px;top:4971px"></span></div> <div class="ff5" style="font-size:77px"> <span class=a style="left:2423px;top:5160px;word-spacing:-1px">Diabetes Mellitus </span></div> <div class="ff0" style="font-size:84px"> <span class=a style="left:2950px;top:5139px"></span></div> </div> </div> <div class=image_layer style="z-index: 3"> <div class=ie_fix> <img class="absimg" style="left:189px;top:238px;width:524px;height:407px;clip:re ct(1px 523px 252px 1px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images/3-a 8d5ed2a7b.png"/> </div> </div> <div class=image_layer style="z-index: 5"> <div class=ie_fix> <img class="absimg" style="left:215px;top:651px;width:524px;height:407px;clip:re ct(254px 471px 406px 1px)" orig="http://html.scribd.com/1na9cgs2wwihtij/images/3 -a8d5ed2a7b.png"/> </div> </div> </div>
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'MX' 'AR' 'RU' 'NZ' 'JP' 'CL' 'US'

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