{"id":23856,"date":"2024-04-10T10:18:40","date_gmt":"2024-04-10T13:18:40","guid":{"rendered":"https:\/\/www.grupomedcof.com.br\/blog\/?p=23856"},"modified":"2025-06-27T08:29:38","modified_gmt":"2025-06-27T11:29:38","slug":"lesoes-intracranianas-entenda-o-mecanismo-e-como-identificar-na-tc","status":"publish","type":"post","link":"https:\/\/www.grupomedcof.com.br\/blog\/lesoes-intracranianas-entenda-o-mecanismo-e-como-identificar-na-tc\/","title":{"rendered":"Les\u00f5es intracranianas: entenda o mecanismo e como identificar na TC"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-transparent ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Sum\u00e1rio<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/lesoes-intracranianas-entenda-o-mecanismo-e-como-identificar-na-tc\/#Contusao_cerebral\" >Contus\u00e3o cerebral<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/lesoes-intracranianas-entenda-o-mecanismo-e-como-identificar-na-tc\/#Seja_um_MedCofer\" >Seja um MedCofer!<\/a><\/li><\/ul><\/nav><\/div>\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/04\/Blog-MedCof-63-1024x576.png\" alt=\"\"\/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>As les\u00f5es intracranianas podem ser originadas de diversas etiologias, sendo que a principal causa de <strong>les\u00e3o intracraniana<\/strong> \u00e9 o trauma cranioencef\u00e1lico (TCE), que causa les\u00e3o no tecido cerebral que incapacita a fun\u00e7\u00e3o cerebral. Seus efeitos podem ser tempor\u00e1rios ou permanentes. Os TCE s\u00e3o, em todo mundo, causa comum de mortes e defici\u00eancias.<\/p>\n\n\n\n<p>\u26a0 \ufe0f LEMBRE<strong>&#8211;<\/strong>SE: Tomografia computadorizada (TC) de cr\u00e2nio \u00e9 o exame determinante no diagn\u00f3stico das les\u00f5es intracranianas.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-contusao-cerebral\"><span class=\"ez-toc-section\" id=\"Contusao_cerebral\"><\/span>Contus\u00e3o cerebral<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c9 o cisalhamento das fibras miel\u00ednicas.<\/li>\n\n\n\n<li>O mecanismo ocorre\u00a0 principalmente por mecanismo de acelera\u00e7\u00e3o\/desacelera\u00e7\u00e3o r\u00e1pida. Geralmente em <strong>\u00e1reas de contato com superf\u00edcies \u00f3sseas irregulares<\/strong> (ex:Lobos frontais inferiores e lobos temporais \u00e2ntero-inferiores)\u00a0<\/li>\n\n\n\n<li>O quadro cl\u00ednico geralmente \u00e9 de altera\u00e7\u00e3o do n\u00edvel de consci\u00eancia.<\/li>\n\n\n\n<li>Na TC (exame inicial de escolha), identificamos focos hiperdensos (hemorragia), isolados ou n\u00e3o, localizados na jun\u00e7\u00e3o entre a subst\u00e2ncia cinzenta e a subst\u00e2ncia branca subcortical. Frequentemente, essas \u00e1reas hemorr\u00e1gicas s\u00e3o circundadas por regi\u00f5es hipodensas, correspondentes a edema vasog\u00eanico associado.<\/li>\n\n\n\n<li>Tratamento geralmente conservador, com monitoramento rigoroso para evitar e diagnosticar precocemente as complica\u00e7\u00f5es.\n<ul class=\"wp-block-list\">\n<li>Monitoriza\u00e7\u00e3o na UTI\u00a0<\/li>\n\n\n\n<li>Vigil\u00e2ncia para complica\u00e7\u00f5es, como: hipertens\u00e3o intracraniana, crise epil\u00e9ptica, outros hematomas associados<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><img decoding=\"async\" src=\"https:\/\/lh7-rt.googleusercontent.com\/docsz\/AD_4nXc5iN6gvn_hycSEBro9E2W0L6oRI38Bevz8tw4oZc3aop7o2xnCos3KufW-KS8RG66p82Y1Yxr_iZ3ZWbbrKV6uHXPLmrLmQLyR0stxTkiP5B7mLBUF6aosJLRT6v_l2HREzkshLA?key=fE4_-taaESKMAmh1SLQ8WQ\" width=\"430.22380952380956\" height=\"501.2\">(Fonte: Radiopaedia).<\/p>\n\n\n\n<p>Descri\u00e7\u00e3o: TC de cr\u00e2nio sem contraste com contus\u00e3o cerebral bifrontal.<\/p>\n\n\n\n<p>\u26a0\ufe0f <strong>LEMBRE-SE:<\/strong> O tratamento costuma ser evitado, pois geralmente a fun\u00e7\u00e3o cerebral n\u00e3o \u00e9 recuperada e o acesso ao local pode ocasionar les\u00f5es em tecidos subjacentes.<\/p>\n\n\n\n<p><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"291\" src=\"https:\/\/lh7-rt.googleusercontent.com\/docsz\/AD_4nXfeYNl1n8RYRz2vQlHZT2I-wgnKqmPTdRr7Ei41TsieO3aLRvyNUzzid3V2nNXUOP56lWy-5ACirOoVVS51-AGlKrulgFlk9Khzr1ojPm0jfCwkcL5XMp4cCRkjVV97IUbvJu-RJg?key=fE4_-taaESKMAmh1SLQ8WQ\">(Fonte: Google Imagens).<strong>Les\u00e3o axonal difusa (LAD)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c9 o cisalhamento das fibras miel\u00ednicas.\u00a0<\/li>\n\n\n\n<li>Geralmente ocorre por mecanismo de acelera\u00e7\u00e3o\/desacelera\u00e7\u00e3o r\u00e1pida.<\/li>\n\n\n\n<li>O quadro cl\u00ednico geralmente \u00e9 de altera\u00e7\u00e3o do n\u00edvel de consci\u00eancia.<\/li>\n\n\n\n<li>Na TC, nesse caso de LAD, n\u00e3o \u00e9 muito sens\u00edvel, sendo a RM de c\u00e2nio melhor para esses casos.\n<ul class=\"wp-block-list\">\n<li>TC pode demonstrar pontos de hemorragia em regi\u00e3o de subst\u00e2ncia branca.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>RM de cr\u00e2nio (padr\u00e3o ouro para LAD):\n<ul class=\"wp-block-list\">\n<li><strong>Micro-hemorragias<\/strong> na subst\u00e2ncia branca profunda<\/li>\n\n\n\n<li>Hiperintensidade em T2\/FLAIR (edema)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Conduta: N\u00e3o h\u00e1 conduta especifica, mas sim controle e monitoramento neurol\u00f3gico.\u00a0<\/li>\n<\/ul>\n\n\n\n<p><img decoding=\"async\" src=\"https:\/\/lh7-rt.googleusercontent.com\/docsz\/AD_4nXdOJnNjrI457l70nGvvZRYXnWkGj3FaN1qYjwI76PInUgHrXd_xQ7IqJYTIiHQJ9CtqA_jKBi1ABk5TjeD48YOx7F_yf2b8OcjkeotTQdW0e_pb2NKg4eTYMc4OnmDOd-KMM4GNYg?key=fE4_-taaESKMAmh1SLQ8WQ\" width=\"327.5402298850575\" height=\"324.4020618556701\">Fonte: radiopaedia<\/p>\n\n\n\n<p>Descri\u00e7\u00e3o: RM de cr\u00e2nio em T2\/FLAIR com hipersinal envolvendo tamb\u00e9m o corpo caloso.&nbsp;<\/p>\n\n\n\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/lh7-rt.googleusercontent.com\/docsz\/AD_4nXdUfVdILPyj8LapgloS53jlHPauv6rOz5r6duMXwYWHqhrgWCYSJ3eWdzAICuLl6fZHA-S7Rvxb-uqLwz-ADQUcA2JJX3tm1wa9E8QiH8U_jseqsWdSGIU_0hpsSr5Gj1YMYAfd?key=fE4_-taaESKMAmh1SLQ8WQ\" width=\"172\" height=\"225\">(Fonte: Google Imagens).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"conquiste-a-aprova\u00e7\u00e3o\"><span class=\"ez-toc-section\" id=\"Seja_um_MedCofer\"><\/span><strong>Seja um MedCofer!<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Quer garantir a sua aprova\u00e7\u00e3o nas provas de resid\u00eancia m\u00e9dica? Ent\u00e3o conhe\u00e7a o&nbsp;<strong>Grupo MedCof&nbsp;<\/strong>e a&nbsp;<a href=\"https:\/\/www.grupomedcof.com.br\/home\/\"><strong>metodologia<\/strong><\/a>&nbsp;que j\u00e1 aprovou<a href=\"https:\/\/www.grupomedcof.com.br\/blog\/presenca-da-medcof-nas-aprovacoes-em-residencia-medica-no-brasil\/\">&nbsp;<strong>mais de 10 mil residentes<\/strong>&nbsp;<\/a>pelo pa\u00eds!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<div class=\"youtube-embed\" data-video_id=\"9Suwq7-iRW8\"><iframe loading=\"lazy\" title=\"Os 10 Mandamentos do Bom Interno | Como Se Destacar nos Est\u00e1gios - Internato MedCof\" width=\"696\" height=\"392\" src=\"https:\/\/www.youtube.com\/embed\/9Suwq7-iRW8?feature=oembed&#038;enablejsapi=1\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>A principal causa de les\u00e3o intracraniana \u00e9 o trauma cranioencef\u00e1lico (TCE),les\u00e3o f\u00edsica no tecido cerebral que incapacita a fun\u00e7\u00e3o cerebral.<\/p>\n","protected":false},"author":10,"featured_media":23857,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[202,222],"tags":[3030],"ppma_author":[3613],"class_list":{"0":"post-23856","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-emergencias","8":"category-radiologia","9":"tag-revisado-por-mariana-trintinalha"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v27.4) - 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