{"id":7091,"date":"2026-02-12T16:09:03","date_gmt":"2026-02-12T13:09:03","guid":{"rendered":"https:\/\/wiki.voka.io\/diseases\/uncategorized\/contusao-cerebral\/"},"modified":"2026-06-25T12:15:42","modified_gmt":"2026-06-25T09:15:42","slug":"contusao-cerebral","status":"publish","type":"diseases_post","link":"https:\/\/wiki.voka.io\/pt\/doencas\/sistema-nervoso-central-e-periferico\/contusao-cerebral\/","title":{"rendered":"Contus\u00e3o cerebral: etiologia, classifica\u00e7\u00e3o, quadro cl\u00ednico, diagn\u00f3stico, tratamento"},"content":{"rendered":"<p><?xml encoding=\"UTF-8\" ?><\/p>\n<p class=\"wp-block-paragraph\">Traumatismo cranioencef\u00e1lico \u00e9 uma patologia caracterizada por danos ao cr\u00e2nio e ao conte\u00fado intracraniano causados \u200b\u200bpela energia mec\u00e2nica. <\/p>\n<p class=\"wp-block-paragraph\">O traumatismo cranioencef\u00e1lico representa 35% de todas as les\u00f5es traum\u00e1ticas no corpo, e a taxa de mortalidade por TCE, segundo diversas fontes, pode chegar a 60%.<\/p>\n<p class=\"wp-block-paragraph\">A contus\u00e3o cerebral \u00e9 uma forma de traumatismo cranioencef\u00e1lico focal que causa danos irrevers\u00edveis ao par\u00eanquima encef\u00e1lico devido a altera\u00e7\u00f5es micro e macrovivasculares. O traumatismo cranioencef\u00e1lico \u00e9 acompanhado por edema, les\u00f5es por esmagamento e hematomas cerebrais, levando \u00e0 destrui\u00e7\u00e3o irrevers\u00edvel do tecido cerebral.<\/p>\n<p class=\"wp-block-paragraph\">As contus\u00f5es cerebrais de diversos graus ocorrem em 17% a 50% dos casos de traumatismo cranioencef\u00e1lico grave e podem representar uma forma independente de TCE ou ocorrer em conjunto com outras les\u00f5es cerebrais. A taxa de mortalidade por contus\u00f5es cerebrais \u00e9 de 30 a 40% e est\u00e1 diretamente correlacionada \u00e0 presen\u00e7a de les\u00f5es cerebrais concomitantes.<\/p>\n<h2 class=\"wp-block-heading\" id=\"etiologia-das-contusoes-cerebrais\">Etiologia das contus\u00f5es cerebrais<\/h2>\n<p class=\"wp-block-paragraph\">A etiologia das contus\u00f5es cerebrais est\u00e1 diretamente correlacionada \u00e0s causas de traumatismo cranioencef\u00e1lico em adultos e crian\u00e7as. As principais causas de traumatismo cranioencef\u00e1lico incluem:<\/p>\n<ul class=\"wp-block-list\">\n<li>Acidentes de tr\u00e2nsito;<\/li>\n<li>Quedas;<\/li>\n<li>Ferimentos violentos;<\/li>\n<li>Les\u00f5es esportivas.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\" id=\"patogenese-das-contusoes-cerebrais\">Patog\u00eanese das contus\u00f5es cerebrais<\/h2>\n<p class=\"wp-block-paragraph\">O mecanismo patogen\u00e9tico do desenvolvimento das contus\u00f5es cerebrais \u00e9 descrito pela teoria do golpe-contragolpe, que foca na transfer\u00eancia direta de energia mec\u00e2nica para as estruturas \u00f3sseas r\u00edgidas do cr\u00e2nio, resultando na forma\u00e7\u00e3o de foco de les\u00e3o cerebral na \u00e1rea de aplica\u00e7\u00e3o da energia cin\u00e9tica. <\/p>\n<p class=\"wp-block-paragraph\">As contus\u00f5es cerebrais que ocorrem diretamente no local de contato com o agente traum\u00e1tico s\u00e3o causadas pelo contato entre o c\u00e9rebro e os ossos r\u00edgidos do cr\u00e2nio. Al\u00e9m disso, devido \u00e0 propaga\u00e7\u00e3o de energia no tecido cerebral e \u00e0 altera\u00e7\u00e3o do gradiente de press\u00e3o, ocorre uma contus\u00e3o no local oposto ao ponto de golpe devido \u00e0s intera\u00e7\u00f5es de cavita\u00e7\u00e3o (o local de contragolpe).<\/p>\n<p class=\"wp-block-paragraph\">Ap\u00f3s a forma\u00e7\u00e3o do foco prim\u00e1rio da contus\u00e3o e a morte de algumas c\u00e9lulas nervosas nesse foco, ocorre a lise e a libera\u00e7\u00e3o de quimiocinas e interleucinas, esp\u00e9cies reativas de oxig\u00eanio e proteases pelas c\u00e9lulas. Essas subst\u00e2ncias comprometem a permeabilidade da barreira hematoencef\u00e1lica, levando \u00e0 forma\u00e7\u00e3o de edema cerebral.<\/p>\n<p class=\"wp-block-paragraph\">Os radicais livres liberados danificam o DNA e comprometem a fun\u00e7\u00e3o mitocondrial, resultando em aumento do edema celular e consequente morte de neur\u00f4nios e neur\u00f3glia.<\/p>\n<p class=\"wp-block-paragraph\">O desenvolvimento do edema cerebral inicia-se com o edema vasog\u00eanico devido ao dano \u00e0 barreira hematoencef\u00e1lica, que se desenvolve aproximadamente 12 a 24 horas ap\u00f3s a les\u00e3o. Em seguida, evolui para edema citot\u00f3xico gra\u00e7as \u00e0 forma\u00e7\u00e3o de edema de c\u00e9lulas da glia e neur\u00f4nios causado pela libera\u00e7\u00e3o de radicais livres e sua subsequente morte. A progress\u00e3o desse processo \u00e9 observada entre 7 e 10 dias ap\u00f3s a les\u00e3o.<\/p>\n<p class=\"wp-block-paragraph\">As contus\u00f5es mais comuns ocorrem nas regi\u00f5es inferior e inferolateral dos lobos frontal e temporal do c\u00e9rebro. Essas \u00e1reas s\u00e3o as mais vulner\u00e1veis \u200b\u200b\u00e0 forma\u00e7\u00e3o de contus\u00f5es devido \u00e0s peculiaridades da estrutura anat\u00f4mica do cr\u00e2nio e \u00e0 dispers\u00e3o da energia cin\u00e9tica na \u00e1rea das estruturas da fossa craniana anterior e m\u00e9dia. <\/p>\n<p class=\"wp-block-paragraph\">Um fator adicional \u00e9 a deforma\u00e7\u00e3o local do cr\u00e2nio, j\u00e1 que durante os experimentos, as regi\u00f5es orbital, temporal e esfenoidal do cr\u00e2nio exibem vibra\u00e7\u00f5es mais pronunciadas quando submetidas a impactos.<\/p>\n<h2 class=\"wp-block-heading\" id=\"classificacao-das-contusoes-cerebrais\">Classifica\u00e7\u00e3o das contus\u00f5es cerebrais<\/h2>\n<p class=\"wp-block-paragraph\">Do ponto de vista do substrato morfol\u00f3gico e do quadro cl\u00ednico, as contus\u00f5es cerebrais s\u00e3o divididas em contus\u00f5es leves, moderadas e graves.<\/p>\n<figure class=\"wp-block-video\" id=\"animacao-3d-contusoes-cerebrais\"><video controls><source data-src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/en\/neurology\/cerebral-contusion\/cerebral-contusions.webm\" type=\"video\/webm\"><\/source><\/video><figcaption class=\"wp-element-caption\">Anima\u00e7\u00e3o 3D: contus\u00f5es cerebrais<\/figcaption><\/figure>\n<h3 class=\"wp-block-heading\" id=\"contusao-cerebral-leve\">Contus\u00e3o cerebral leve<\/h3>\n<p class=\"wp-block-paragraph\">Assim, a contus\u00e3o leve \u00e9 \u200b\u200bcaracterizada por:<\/p>\n<ul class=\"wp-block-list\">\n<li>Perda de consci\u00eancia de curta dura\u00e7\u00e3o que pode durar alguns minutos;<\/li>\n<li>Rea\u00e7\u00f5es vegetativas;<\/li>\n<li>Leves dist\u00farbios neurol\u00f3gicos na forma de incoordena\u00e7\u00e3o;<\/li>\n<li>Nistagmo. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">Em estudos instrumentais, as contus\u00f5es leves s\u00e3o visualizadas na tomografia computadorizada. Elas s\u00e3o caracterizadas pela presen\u00e7a de uma \u00e1rea de baixa densidade no tecido cerebral (densidade aproximada de 16 a 20 HU). <\/p>\n<p class=\"wp-block-paragraph\">Um exame mais detalhado nessa \u00e1rea, incluindo resson\u00e2ncia magn\u00e9tica, pode visualizar focos de micro-hemorragias. Na maioria das vezes, essas altera\u00e7\u00f5es desaparecem 2 semanas ap\u00f3s a les\u00e3o e n\u00e3o deixam sequelas p\u00f3s-traum\u00e1ticas.<\/p>\n<h3 class=\"wp-block-heading\" id=\"contusao-cerebral-moderada\">Contus\u00e3o cerebral moderada<\/h3>\n<p class=\"wp-block-paragraph\">A contus\u00e3o moderada \u00e9 \u200b\u200bcaracterizada pela:<\/p>\n<ul class=\"wp-block-list\">\n<li>Presen\u00e7a de pequenas hemorragias, claramente vis\u00edveis em exames de imagem cerebral, com preserva\u00e7\u00e3o da diferencia\u00e7\u00e3o dos sulcos e giros.<\/li>\n<li>Perda de consci\u00eancia que pode durar de dezenas de minutos a v\u00e1rias horas<\/li>\n<li>Gama completa de dist\u00farbios neurol\u00f3gicos focais: mentais, motores, sensoriais, etc. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A imagem cerebral dessas contus\u00f5es geralmente revela pequenos focos de impregna\u00e7\u00e3o hemorr\u00e1gica nas \u00e1reas de tecido cerebral danificado.<\/p>\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/en\/neurology\/cerebral-contusion\/1-moderate-cerebral-contusion.webp\" alt=\"Contus\u00e3o cerebral moderada\"><figcaption class=\"wp-element-caption\">Contus\u00e3o cerebral moderada \u2013 <a href=\"https:\/\/catalog.voka.io\/en\/models\/97a4b7e8-5664-40a7-b1d9-91b94133dd54\/2f9fc6be-32a9-4b79-bfc5-2a3dbf771dd0\/cb4b7180-0d40-4d77-b0aa-818c28271f6f\/8b3112ad-a134-4eab-b4bd-32661679391a\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">modelo 3D<\/a><\/figcaption><\/figure>\n<h3 class=\"wp-block-heading\" id=\"contusao-cerebral-grave\">Contus\u00e3o cerebral grave<\/h3>\n<p class=\"wp-block-paragraph\">A contus\u00e3o cerebral grave \u00e9 clinicamente caracterizada pela perda de consci\u00eancia que pode durar de algumas horas a algumas semanas, sendo acompanhada por d\u00e9ficits neurol\u00f3gicos graves com predomin\u00e2ncia de sintomas no tronco encef\u00e1lico. <\/p>\n<p class=\"wp-block-paragraph\">Na imagem cerebral, essas contus\u00f5es apresentam focos de alta densidade tecidual com \u00e1reas de baixa densidade, representadas pelo detrito cerebral.<\/p>\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/storage.googleapis.com\/dev_wiki_voka_io_303011\/articles\/en\/neurology\/cerebral-contusion\/2-severe-cerebral-contusion.webp\" alt=\"Contus\u00e3o cerebral grave\"><figcaption class=\"wp-element-caption\">Contus\u00e3o cerebral grave \u2013 <a href=\"https:\/\/catalog.voka.io\/en\/models\/97a4b7e8-5664-40a7-b1d9-91b94133dd54\/2f9fc6be-32a9-4b79-bfc5-2a3dbf771dd0\/cb4b7180-0d40-4d77-b0aa-818c28271f6f\/b7e09ae4-2d6f-414b-843c-ca541297e56b\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">modelo 3D<\/a><\/figcaption><\/figure>\n<h3 class=\"wp-block-heading\" id=\"classificacao-por-tipo-de-foco-na-tc\">Classifica\u00e7\u00e3o por tipo de foco na TC<\/h3>\n<p class=\"wp-block-paragraph\">Existe tamb\u00e9m uma classifica\u00e7\u00e3o de contus\u00f5es cerebrais que reflete exclusivamente os achados de imagem cerebral.<\/p>\n<p class=\"wp-block-paragraph\">Nessa classifica\u00e7\u00e3o, as contus\u00f5es s\u00e3o divididas em:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Contus\u00e3o tipo 1<\/strong> \u2013 \u00e9 caracterizada pela presen\u00e7a na TC de foco de baixa densidade (+18-25 HU).<\/li>\n<li><strong>Contus\u00e3o tipo 2<\/strong> \u2013 \u00e9 caracterizada pela presen\u00e7a na TC de pequenos focos hemorr\u00e1gicos n\u00e3o compactos com densidade cerca de 50 HU.<\/li>\n<li><strong>Contus\u00e3o tipo 3<\/strong> \u2013 consiste em \u00e1reas de densidade aumentada de forma n\u00e3o uniforme, com um arranjo compacto de focos de transforma\u00e7\u00e3o hemorr\u00e1gica, pequenos e m\u00e9dios, com densidade de cerca de 64-76 HU.<\/li>\n<li><strong>Contus\u00e3o tipo 4<\/strong> \u2013 foco \u00fanico ou m\u00faltiplos de formato oval homog\u00eaneo aumentado, com densidade de at\u00e9 76 HU. <\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\" id=\"apresentacao-clinica\">Apresenta\u00e7\u00e3o cl\u00ednica <\/h2>\n<p class=\"wp-block-paragraph\">O quadro cl\u00ednico das contus\u00f5es cerebrais \u00e9 diretamente determinado pelos sintomas neurol\u00f3gicos gerais e focais.<\/p>\n<p class=\"wp-block-paragraph\">Os sintomas gerais incluem:<\/p>\n<ul class=\"wp-block-list\">\n<li>Dor de cabe\u00e7a;<\/li>\n<li>Vertigem;<\/li>\n<li>N\u00e1usea;<\/li>\n<li>V\u00f4mito;<\/li>\n<li>Perda de consci\u00eancia. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A perda de consci\u00eancia \u00e9 um crit\u00e9rio cl\u00ednico que correlaciona com a gravidade da contus\u00e3o cerebral. A perda de consci\u00eancia ap\u00f3s a les\u00e3o pode durar de alguns segundos a v\u00e1rias semanas.<\/p>\n<p class=\"wp-block-paragraph\">A manifesta\u00e7\u00e3o de sintomas neurol\u00f3gicos focais depende diretamente da localiza\u00e7\u00e3o do foco da contus\u00e3o.<\/p>\n<p class=\"wp-block-paragraph\">Quanto se trata das contus\u00f5es cerebrais, os locais mais comuns s\u00e3o os lobos frontal (40-50%) e temporal (35-45%).<\/p>\n<p class=\"wp-block-paragraph\">Assim, quando os hematomas est\u00e3o localizados nos lobos frontais, o quadro cl\u00ednico pode consistir em:<\/p>\n<ul class=\"wp-block-list\">\n<li>Transtornos mentais;<\/li>\n<li>Dist\u00farbios da fala, como na afasia expressiva;<\/li>\n<li>Paralisia oculomotora;<\/li>\n<li>Anosmia. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">Em caso de dano cortical, podem ocorrer:<\/p>\n<ul class=\"wp-block-list\">\n<li>Mono e hemiparesia; <\/li>\n<li>Paralisia dos m\u00fasculos faciais; <\/li>\n<li>Paralisia do nervo hipoglosso.<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">Danos ao lobo temporal s\u00e3o caracterizados por:<\/p>\n<ul class=\"wp-block-list\">\n<li>Afasia sensorial;<\/li>\n<li>Dist\u00farbios da atividade nervosa superior (alexia, acalculia, agrafia);<\/li>\n<li>Hemianopsia hom\u00f4nima devido a danos no trato \u00f3ptico.<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">O lobo parietal \u00e9 um local bem raro para contus\u00f5es cerebrais devido \u00e0 sua localiza\u00e7\u00e3o superficial, distante da base do cr\u00e2nio. As contus\u00f5es nessa \u00e1rea se formam principalmente pelo mecanismo de golpe, e n\u00e3o de contragolpe. O quadro cl\u00ednico de sintomas neurol\u00f3gicos focais das contus\u00f5es nessa \u00e1rea \u00e9 caracterizado pelos transtornos do processamento sensorial.<\/p>\n<p class=\"wp-block-paragraph\">Danos ao lobo occipital do c\u00e9rebro tamb\u00e9m s\u00e3o bem raros devido \u00e0s propriedades de absor\u00e7\u00e3o de choque do tent\u00f3rio cerebelar. No caso de les\u00e3o nesse lobo, muitas vezes ocorrem a agnosia visual e a hemianopsia hom\u00f4nima at\u00e9 a cegueira cortical completa, se ambos os lobos occipitais sejam danificados.<\/p>\n<p class=\"wp-block-paragraph\">Geralmente, as contus\u00f5es cerebelares s\u00e3o formadas pelo mecanismo de impacto, sendo caracterizadas pelo desenvolvimento de hipotens\u00e3o arterial unilateral ou bilateral e pela incoordena\u00e7\u00e3o motora.<\/p>\n<h2 class=\"wp-block-heading\" id=\"diagnostico-de-contusoes-cerebrais\">Diagn\u00f3stico de contus\u00f5es cerebrais<\/h2>\n<p class=\"wp-block-paragraph\">Ap\u00f3s a admiss\u00e3o do paciente no pronto-socorro, o algoritmo de diagn\u00f3stico de contus\u00f5es cerebrais consiste nas etapas a seguir:<\/p>\n<h3 class=\"wp-block-heading\" id=\"1-avaliacao-do-nivel-de-consciencia-de-acordo-com-a-escala-de-coma-de-glasgow-ecg\">1. Avalia\u00e7\u00e3o do n\u00edvel de consci\u00eancia de acordo com a Escala de coma de Glasgow (ECG)<\/h3>\n<p class=\"wp-block-paragraph\">Essa etapa permite determinar o n\u00edvel de consci\u00eancia do paciente e avaliar a gravidade da les\u00e3o cerebral e tamb\u00e9m as poss\u00edveis op\u00e7\u00f5es de tratamento (cir\u00fargico ou conservador).<\/p>\n<h3 class=\"wp-block-heading\" id=\"2-anamnese\">2. Anamnese<\/h3>\n<p class=\"wp-block-paragraph\">\u00c9 necess\u00e1rio pergundar sobre h\u00e1 quanto tempo a les\u00e3o aconteceu, qual foi o mecanismo da les\u00e3o e tamb\u00e9m se houve perda de consci\u00eancia ap\u00f3s a les\u00e3o.<\/p>\n<p class=\"wp-block-paragraph\">Essa etapa permite determinar a din\u00e2mica do desenvolvimento dos sintomas e prever poss\u00edveis les\u00f5es com base no mecanismo da les\u00e3o. Em certos mecanismos de les\u00e3o (por exemplo, uma queda de altura), \u00e9 importante considerar a possibilidade de les\u00f5es combinadas na cabe\u00e7a e em outras partes do corpo, o que pode afetar o progn\u00f3stico.<\/p>\n<h3 class=\"wp-block-heading\" id=\"3-exame-visual-do-paciente\">3. Exame visual do paciente<\/h3>\n<p class=\"wp-block-paragraph\">Inclui um exame da regi\u00e3o da cabe\u00e7a e a presen\u00e7a de les\u00f5es concomitantes nos tecidos moles em outras \u00e1reas do corpo al\u00e9m da cabe\u00e7a.<\/p>\n<p class=\"wp-block-paragraph\">Essa etapa permite identificar a localiza\u00e7\u00e3o de les\u00f5es de tecidos moles na cabe\u00e7a, ajudando a avaliar a poss\u00edvel localiza\u00e7\u00e3o de uma contus\u00e3o cerebral. Al\u00e9m disso, a etapa \u00e9 importante para o cuidado do paciente, o tratamento da contus\u00e3o de tecidos moles e a realiza\u00e7\u00e3o de desbridamento cir\u00fargico, se necess\u00e1rio.<\/p>\n<h3 class=\"wp-block-heading\" id=\"4-exame-neurologico-do-paciente\">4. Exame neurol\u00f3gico do paciente<\/h3>\n<p class=\"wp-block-paragraph\">S\u00e3o avaliados os sintomas cerebrais gerais, focais e men\u00edngeos.<\/p>\n<p class=\"wp-block-paragraph\">A etapa permite realizar um diagn\u00f3stico t\u00f3pico preliminar da les\u00e3o cerebral para determinar as indica\u00e7\u00f5es para a imagem cerebral. Se o paciente apresentar sintomas cerebrais gerais, focais ou men\u00edngeos, a imagem cerebral \u00e9 indicada.<\/p>\n<h3 class=\"wp-block-heading\" id=\"5-imagem-cerebral\">5. Imagem cerebral<\/h3>\n<p class=\"wp-block-paragraph\">A tomografia computadorizada do c\u00e9rebro \u00e9 o \u201cpadr\u00e3o ouro\u201d para o diagn\u00f3stico de traumatismo cranioencef\u00e1lico, incluindo as contus\u00f5es cerebrais.<\/p>\n<p class=\"wp-block-paragraph\">As vantagens da tomografia do c\u00e9rebro em compara\u00e7\u00e3o com outros m\u00e9todos de imagem (incluindo a resson\u00e2ncia magn\u00e9tica) incluem a rapidez do exame, a capacidade de avaliar com precis\u00e3o a localiza\u00e7\u00e3o, a extens\u00e3o e a natureza da les\u00e3o cerebral, a capacidade de avaliar danos \u00f3sseos concomitantes e tamb\u00e9m a capacidade de examinar rapidamente outras partes do corpo para excluir uma poss\u00edvel presen\u00e7a de les\u00f5es concomitantes.<\/p>\n<p class=\"wp-block-paragraph\">Na tomografia computadorizada, contus\u00f5es cerebrais apresentam v\u00e1rias caracter\u00edsticas:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Localiza\u00e7\u00e3o da contus\u00e3o<\/strong> nas regi\u00f5es corticais ou basais do c\u00e9rebro;<\/li>\n<li>O <strong>tamanho da contus\u00e3o<\/strong> varia de pequenas \u00e1reas hiperdensas no c\u00f3rtex cerebral a grandes \u00e1reas hiperdensas;<\/li>\n<li><strong>Presen\u00e7a de uma \u00e1rea hipodensa ao redor do foco da contus\u00e3o<\/strong>, que \u00e9 explicada pela forma\u00e7\u00e3o inicial de edema vasog\u00eanicoe e, posteriormente, pela adi\u00e7\u00e3o de edema cerebral citot\u00f3xico.<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A densidade caracter\u00edstica dos focos hiperdensos de contus\u00f5es na tomografia computadorizada varia de 45 a 64 UH.<\/p>\n<p class=\"wp-block-paragraph\">A resson\u00e2ncia magn\u00e9tica (RM) geralmente n\u00e3o \u00e9 usada no diagn\u00f3stico de contus\u00f5es cerebrais, mas pode ser realizada para avaliar a progress\u00e3o das contus\u00f5es. Assim, as contus\u00f5es cerebrais na RM s\u00e3o caracterisadas pelo:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Modo T1<\/strong> \u2013 sinal hiperintenso;<\/li>\n<li><strong>Modo T2<\/strong> \u2013 sinal hipointenso;<\/li>\n<li><strong>Modo SWI<\/strong> \u2013 sinal hiperintenso.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\" id=\"6-diagnostico-laboratorial\">6. Diagn\u00f3stico laboratorial<\/h3>\n<p class=\"wp-block-paragraph\">S\u00e3o necess\u00e1rios o hemograma completo, a urin\u00e1lise, o coagulograma, a avaliza\u00e7\u00e3o bioqu\u00edmica do sangue e o tipo sangu\u00edneo + fator Rh.<\/p>\n<p class=\"wp-block-paragraph\">Esses exames n\u00e3o confirmam nem permitem suspeitar as contus\u00f5es cerebrais, mas ajudam a avaliar o estado geral do paciente, dist\u00farbios de coagula\u00e7\u00e3o concomitantes e preparar o paciente para uma poss\u00edvel interven\u00e7\u00e3o cir\u00fargica.<\/p>\n<h2 class=\"wp-block-heading\" id=\"tratamento-de-contusoes-cerebrais\">Tratamento de contus\u00f5es cerebrais<\/h2>\n<h3 class=\"wp-block-heading\" id=\"terapia-medicamentosa\">Terapia medicamentosa<\/h3>\n<p class=\"wp-block-paragraph\">O tratamento conservador das contus\u00f5es cerebrais consiste principalmente na manuten\u00e7\u00e3o de uma press\u00e3o da perfus\u00e3o adequada no c\u00e9rebro, que pode variar devido a aumento da press\u00e3o intracraniana causado pelo foco de contus\u00e3o em desenvolvimento ou j\u00e1 formado.<\/p>\n<p class=\"wp-block-paragraph\">Em todas as etapas, devem ser observados:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Manuten\u00e7\u00e3o das fun\u00e7\u00f5es vitais<\/strong> do corpo;<\/li>\n<li><strong>Al\u00edvio da dor<\/strong> (anti-inflamat\u00f3rios n\u00e3o esteroides, analg\u00e9sicos narc\u00f3ticos);<\/li>\n<li><strong>Terapia anticonvulsiva<\/strong> (a prescri\u00e7\u00e3o de anticonvulsivantes \u00e9 recomendada apenas em caso de sinais de convuls\u00f5es, mas esse tipo de medicamentos n\u00e3o \u00e9 recomendado para fins profil\u00e1ticos).<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">Todos os pacientes com n\u00edvel de consci\u00eancia inferior a 8 pontos na ECG, com ou sem substrato na tomografia computadorizada (na presen\u00e7a de sintomas neurol\u00f3gicos de descerebra\u00e7\u00e3o) devem ter o sensor de press\u00e3o intracraniana.<\/p>\n<p class=\"wp-block-paragraph\">Quando o monitoramento da press\u00e3o intracraniana indica um aumento persistente da press\u00e3o intracraniana, para corrig\u00ed-la s\u00e3o usados:<\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Sedativos<\/strong> (em pacientes com traumatismo cranioencef\u00e1lico, \u00e9 prefer\u00edvel usar ao propofol). Derivados de barbit\u00faricos em altas doses s\u00e3o utilizados apenas em casos de hipertens\u00e3o intracraniana refrat\u00e1ria, resistente ao tratamento conservador e cir\u00fargico;<\/li>\n<li><strong>Diur\u00e9ticos osm\u00f3ticos<\/strong> (s\u00e3o usados com ou sem monitoramento da PIC no caso de sinais de desenvolvimento de hernia\u00e7\u00f5es cerebrais que amea\u00e7am a vida e deteriora\u00e7\u00e3o progressiva do estado neurol\u00f3gico do paciente);<\/li>\n<li><strong>Hiperventila\u00e7\u00e3o<\/strong>;<\/li>\n<li><strong>Hipotermia<\/strong>.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\" id=\"tratamento-cirurgico\">Tratamento cir\u00fargico<\/h3>\n<p class=\"wp-block-paragraph\">O tratamento cir\u00fargico de contus\u00f5es cerebrais visa principalmente a redu\u00e7\u00e3o da press\u00e3o intracraniana para garantir a perfus\u00e3o cerebral adequada e prevenir s\u00edndromes de deslocamento cerebral com risco de vida.<\/p>\n<p class=\"wp-block-paragraph\">Indica\u00e7\u00f5es para tratamento cir\u00fargico de contus\u00f5es cerebrais com localiza\u00e7\u00e3o supratentorial:<\/p>\n<ul class=\"wp-block-list\">\n<li>Foco de contus\u00e3o com volume superior a 50 cm\u00b3;<\/li>\n<li>Deslocamento axial das estruturas medianas de 5 mm ou mais;<\/li>\n<li>Compress\u00e3o das cisternas basais;<\/li>\n<li>Compress\u00e3o do ventr\u00edculo III.<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A interven\u00e7\u00e3o cir\u00fargica, neste caso, limita-se \u00e0 craniotomia e \u00e0 ressec\u00e7\u00e3o de focos de contus\u00f5es cerebrais.<\/p>\n<p class=\"wp-block-paragraph\">Em hematomas cerebrais, as indica\u00e7\u00f5es para o tratamento cir\u00fargico incluem:<\/p>\n<ul class=\"wp-block-list\">\n<li>Hematoma maior que 40 ml no lobo frontal;<\/li>\n<li>Hematoma maior que 20 ml no lobo temporal;<\/li>\n<li>Deslocamento axial de 5 mm ou mais. <\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">A interven\u00e7\u00e3o cir\u00fargica, neste caso, tamb\u00e9m inclui a craniotomia e a ressec\u00e7\u00e3o dos focos de contus\u00f5es cerebrais.<\/p>\n<p class=\"wp-block-paragraph\">Em contus\u00f5es maiores, progress\u00e3o dos focos de contus\u00e3o para signific\u00e2ncia cir\u00fargica, com volume de hematoma cerebral maior que 140 ml e n\u00edvel de consci\u00eancia do paciente inferior a 8 pontos pela Escala de Glasgow, \u00e9 indicada a craniotomia descompressiva com a ressec\u00e7\u00e3o dos focos de contus\u00e3o. <\/p>\n<p class=\"wp-block-paragraph\">As indica\u00e7\u00f5es para tratamento cir\u00fargico de contus\u00f5es cerebrais com localiza\u00e7\u00e3o subtentorial incluem:<\/p>\n<ul class=\"wp-block-list\">\n<li>Foco de contus\u00e3o cerebelar superior a 20 ml;<\/li>\n<li>Sinais de hidrocefalia obstrutiva;<\/li>\n<li>Deslocamento do ventr\u00edculo IV.<\/li>\n<\/ul>\n<p class=\"wp-block-paragraph\">O tratamento cir\u00fargico envolve a evacua\u00e7\u00e3o e a remo\u00e7\u00e3o do local da contus\u00e3o por meio de craniotomia. Caso n\u00e3o haja regress\u00e3o da hidrocefalia obstrutiva, \u00e9 necess\u00e1ria a instala\u00e7\u00e3o de drenagem ventricular externa.<\/p>\n<div>\n<h2 class=\"faq-title h2-article\" id=\"faq\">FAQ<\/h2>\n<div class=\"faq-section\">\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">1. O que \u00e9 a contus\u00e3o cerebral?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Trata-se de tipo de les\u00e3o cerebral traum\u00e1tica focal que causa danos irrevers\u00edveis ao par\u00eanquima cerebral, resultando nas les\u00f5es por esmagamento, nos hematomas cerebrais e no edema.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">2. Como a contus\u00e3o difere de outras formas de traumatismo craneoencef\u00e1lico?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Ao contr\u00e1rio da concuss\u00e3o ou da les\u00e3o axonal difusa, a contus\u00e3o cerebral \u00e9 caracterizada por danos ao tecido cerebral morfologicamente confirmados que s\u00e3o vis\u00edveis na imagem cerebral.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">3. Quais s\u00e3o as principais causas de contus\u00f5es?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Acidentes de tr\u00e2nsito, quedas, les\u00f5es violentas e les\u00f5es esportivas.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">4. Como a contus\u00e3o cerebral se desenvolve?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Pelo mecanismo de golpe e contragolpe: dano direto no local do contato com o agente traum\u00e1tico e dano secund\u00e1rio na \u00e1rea oposta devido a processos de cavita\u00e7\u00e3o e altera\u00e7\u00f5es no gradiente de press\u00e3o.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">5. O que acontece ao tecido cerebral ap\u00f3s a contus\u00e3o?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">As c\u00e9lulas danificadas liberam mediadores da inflama\u00e7\u00e3o, radicais livres e enzimas, rompendo a barreira hematoencef\u00e1lica, causando o edema e resultando na morte de neur\u00f4nios e c\u00e9lulas da glia.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">6. Quais s\u00e3o os locais de contus\u00f5es mais comuns?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Nas regi\u00f5es inferiores e inferolaterais dos lobos frontais e temporais, devido \u00e0 anatomia do cr\u00e2nio e \u00e0 natureza espec\u00edfica da transmiss\u00e3o de energia mec\u00e2nica.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">7. Quais s\u00e3o os sinais cl\u00ednicos caracter\u00edsticos de contus\u00f5es?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Sintomas cerebrais gerais (dor de cabe\u00e7a, v\u00f4mito, perda de consci\u00eancia) e focais, dependendo da localiza\u00e7\u00e3o (afasia, paresia, incoordena\u00e7\u00e3o, transtornos visuais).<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">8. Como a contus\u00e3o cerebral \u00e9 diagnosticada?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Para avaliar o estado geral do paciente, s\u00e3o realizados a avalia\u00e7\u00e3o do n\u00edvel de consci\u00eancia pela Escala de Glasgow, a anamnese, o exame neurol\u00f3gico, a tomografia computadorizada do c\u00e9rebro (padr\u00e3o ouro) e, se necess\u00e1rio, a resson\u00e2ncia magn\u00e9tica, al\u00e9m de exames laboratoriais.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">9. Como as contus\u00f5es cerebrais podem ser tratadas sem cirurgia?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Os m\u00e9dicos mant\u00eam fun\u00e7\u00f5es vitais, monitoram a press\u00e3o intracraniana, administram analg\u00e9sicos e, se necess\u00e1rio, usam a terapia anticonvulsivante, os diur\u00e9ticos osm\u00f3ticos, a hiperventila\u00e7\u00e3o e a hipotermia.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">10. Quando o tratamento cir\u00fargico \u00e9 necess\u00e1rio?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">\u00c9 necess\u00e1rio em caso de grandes contus\u00f5es, deslocamento grave de estruturas cerebrais, grandes hematomas cerebrais ou sinais de complica\u00e7\u00f5es com risco de vida.<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<div class=\"faq-item faq-answer-hidden\">\n<div class=\"question-block\">\n<div class=\"faq-question\">\n<p class=\" text-black h5-title\">11. Quais tipos de cirurgias s\u00e3o usados \u200b\u200bem les\u00f5es graves?<\/p>\n<\/div>\n<div class=\"faq-answer text-main-text-color main-text-medium\">Craniotomia com remo\u00e7\u00e3o do foco da contus\u00e3o, craniotomia descompressiva, drenagem ventricular externa (se houver obstru\u00e7\u00e3o do fluxo de l\u00edquor).<\/div>\n<\/div>\n<div class=\"expand-button-wrapper\"><button class=\"text-accent expand-button\">+<\/button><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"sources-list-block sources-list-hidden\" id=\"referencias\">\n<div class=\"sources-list-content\">\n<div class=\"sources-list-title\">\n<p class=\"small-text-bold text-black sources-list-title-text\">Refer\u00eancias<\/p>\n<div class=\"sources-expand-button-wrapper-mobile\">\n<div class=\"sources-expand-button\"><svg width=\"32\" height=\"32\" viewbox=\"0 0 32 32\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M8 12L16 20L24 12\" stroke=\"#8C9AAB\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\n<\/div>\n<\/div>\n<div class=\"sources-list-items\">\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">1.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>VOKA 3D Anatomy & Pathology \u2013 Complete Anatomy and Pathology 3D Atlas (VOKA 3D Anatomia e Patologia \u2013 Atlas 3D completo de anatomia e patologia) [Internet]. VOKA 3D Anatomy & Pathology [VOKA 3D Anatomia & Patologia].<\/cite><\/p>\n<p><span class=\"small-text-medium text-grey\">Available from: https:\/\/catalog.voka.io\/<\/span><\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">2.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Ma\u00ebs AIR, Menon DK, Manley GT. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022;21(11):1004-1060. doi: 10.1016\/S1474-4422(22)00309-X.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">3.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Werner C, Engelhard K. Pathophysiology of traumatic brain injury. Prog Neurobiol. 2007;83(3):284-301. doi: 10.1016\/j.pneurobio.2007.07.001.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">4.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Freire MAM, et al. Cellular and molecular pathophysiology of traumatic brain injury: roles of brain edema, inflammation, excitotoxicity, and oxidative stress. Biology (Basel). 2023;12(8):1139. doi: 10.3390\/biology12081139.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">5.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Adatia K, Newcombe VFJ, Menon DK. Contusion progression following traumatic brain injury: a review of clinical and radiological predictors, and influence on outcome. Neurocrit Care. 2021 fev;34(1):312-324. doi: 10.1007\/s12028-020-00994-4.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">6.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Jirlow U. Cerebral contusions \u2013 pathomechanisms, predictive factors, historical perspectives. Narrative review. Uppsala University; 2024.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">7.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Khan MM, De Jesus O. Cerebral contusion. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. <\/cite><\/p>\n<p><span class=\"small-text-medium text-grey\">Dispon\u00edvel em: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562147\/<\/span><\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">8.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Patel PP, et al. Decompressive craniectomy for traumatic brain injury. Review article. 2025.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">9.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Habibi MA, et al. A comprehensive systematic review and meta-analysis: decompressive craniectomy versus craniotomy for acute subdural hematoma. Neurosurg Rev. 2024.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">10.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Poblete RA, et al. Post-traumatic cerebral infarction: a narrative review of incidence, pathophysiology, diagnosis, and treatment. Medicines (Basel). 2024;16(1):6. doi: 10.3390\/medicines16010006.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">11.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Chen G, et al. An updated review for clinical and radiological predictors of traumatic brain injury outcomes. Review article. 2024.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">12.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Wiles MD, et al. Management of traumatic brain injury: a narrative review of recent studies. Anestesia. 2022.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">13.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Brain Trauma Foundation. Guidelines for the management of severe traumatic brain injury: revised guidelines and cost-benefit analysis. 2007.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">14.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>ACS Committee on Trauma. ACS TQP best practices guidelines: the management of traumatic brain injury. American College of Surgeons; 2024.<\/cite><\/p>\n<\/div>\n<\/div>\n<div class=\"source-item\">\n<p class=\"main-text-semibold text-black\">15.<\/p>\n<div class=\"source-item-content\">\n<p class=\"main-text-semibold text-black\"><cite>Head trauma: background, pathophysiology, etiology. eMedicine [Internet]. Medscape; 2024. <\/cite><\/p>\n<p><span class=\"small-text-medium text-grey\">Dispon\u00edvel em: https:\/\/emedicine.medscape.com\/article\/433855-overview<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"sources-expand-button-wrapper\">\n<div class=\"sources-expand-button\"><svg width=\"32\" height=\"32\" viewbox=\"0 0 32 32\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M8 12L16 20L24 12\" stroke=\"#8C9AAB\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><\/path><\/svg><\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Traumatismo cranioencef\u00e1lico \u00e9 uma patologia caracterizada por danos ao cr\u00e2nio e ao conte\u00fado intracraniano causados \u200b\u200bpela energia mec\u00e2nica. O traumatismo cranioencef\u00e1lico representa 35% de todas as les\u00f5es traum\u00e1ticas no corpo, e a taxa de mortalidade por TCE, segundo diversas fontes, pode chegar a 60%. A contus\u00e3o cerebral \u00e9 uma forma de traumatismo cranioencef\u00e1lico focal que [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"template":"","diseases_category":[309],"class_list":["post-7091","diseases_post","type-diseases_post","status-publish","hentry","diseases_category-sistema-nervoso-central-e-periferico"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.0 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Contus\u00f5es cerebrais: sintomas, graus de gravidade, diagn\u00f3stico e tratamento<\/title>\n<meta name=\"description\" content=\"\u0421ontus\u00e3o cerebral \u00e9 um dano irrevers\u00edvel ao tecido cerebral causado pelo traumatismo cranioencef\u00e1lico (TCE). 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