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Relatório de estágio em ultrassonografia vascular no serviço de neurologia do hospital de Vila Franca de Xira
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Introdução: A ultrassonografia cerebrovascular constitui uma técnica de primeira linha no diagnóstico e monitorização das doenças cerebrovasculares, permitindo avaliar de forma não invasiva a hemodinâmica cerebral e orientar decisões clínicas e terapêuticas. Objetivo: Este estágio, realizado na Unidade de Neurossonologia do Hospital de Vila Franca de Xira, no âmbito do Mestrado em Fisiologia Clínica, teve como objetivos a consolidação de competências técnicas em ultrassonografia vascular, a caracterização da casuística de exames efetuados e a análise de casos clínicos relevantes em Portugal para implementação dos conhecimentos na realidade angolana.
Resultados: Foram avaliados 214 exames de ultrassonografia cerebrovascular, com predomínio do EcoDoppler carotídeo, vertebral e transcraniano. Mais de metade dos exames não revelou alterações significativas, mas foram identificadas placas de ateroma e estenoses significativas, incluindo situações críticas que motivaram intervenções de revascularização.
Foram ainda estudados 2 casos clínicos, nomeadamente uma estenose crítica da artéria carótida interna esquerda e um doente com drepanocitose associada a acidente vascular cerebral, que evidenciam a importância do diagnóstico precoce e da integração multidisciplinar.
Discussão: O estágio em Neurossonologia consolidou competências técnicas e raciocínio clínico, evidenciando a relevância do EcoDoppler no diagnóstico, acompanhamento e decisão terapêutica. Observou-se predominância de pacientes idosos com fatores de risco clássicos e maior incidência de lesões em território da ACM. A experiência reforçou o valor da Neurosonologia, destacando seu potencial transformador em contextos com recursos limitados.
Conclusão: A ultrassonografia cerebrovascular revelou-se essencial no diagnóstico e monitorização de doenças vasculares, permitindo consolidar competências técnicas e raciocínio clínico. A análise de casos evidenciou sua relevância no acompanhamento do doente e na tomada de decisões terapêuticas. Apesar de limitações, confirmou-se o EcoDoppler como ferramenta indispensável para uma prática clínica eficaz e fundamentada.
Introduction: Cerebrovascular ultrasonography is a first-line technique for the diagnosis and monitoring of cerebrovascular diseases, allowing non-invasive assessment of cerebral hemodynamics and guiding clinical and therapeutic decisions. Objective: This internship, conducted at the Neurosonology Unit of Hospital de Vila Franca de Xira within the Master’s in Clinical Physiology, aimed to consolidate technical skills in vascular ultrasonography, characterize the casuistic of performed exams, and analyze relevant clinical cases in Portugal to apply the acquired knowledge to the Angolan context. Results: A total of 214 cerebrovascular ultrasonography exams were evaluated, predominantly carotid, vertebral, and transcranial Doppler. Over half of the exams showed no significant abnormalities (50.9%), but atheromatous plaques were identified in 26.6% of cases and significant stenoses (≥50%) in 10.7%, including critical situations that required revascularization interventions. Illustrative clinical cases were also studied, including a critical left internal carotid artery stenosis and a patient with sickle cell disease associated with stroke, highlighting the importance of early diagnosis and multidisciplinary integration. Discussion: The internship in Neurosonology consolidated technical skills and clinical reasoning, highlighting the relevance of EcoDoppler in diagnosis, patient monitoring, and therapeutic decision-making. There was a predominance of elderly patients with classic risk factors and a higher incidence of lesions in the MCA territory. The experience reinforced the value of Neurosonology, emphasizing its transformative potential in resource-limited settings. Conclusion: Cerebrovascular ultrasonography proved essential for the diagnosis and monitoring of vascular diseases, enabling the consolidation of technical skills and clinical reasoning. Case analysis demonstrated its relevance in patient follow-up and therapeutic decision-making. Despite some limitations, EcoDoppler was confirmed as an indispensable tool for effective and evidence-based clinical practice.
Introduction: Cerebrovascular ultrasonography is a first-line technique for the diagnosis and monitoring of cerebrovascular diseases, allowing non-invasive assessment of cerebral hemodynamics and guiding clinical and therapeutic decisions. Objective: This internship, conducted at the Neurosonology Unit of Hospital de Vila Franca de Xira within the Master’s in Clinical Physiology, aimed to consolidate technical skills in vascular ultrasonography, characterize the casuistic of performed exams, and analyze relevant clinical cases in Portugal to apply the acquired knowledge to the Angolan context. Results: A total of 214 cerebrovascular ultrasonography exams were evaluated, predominantly carotid, vertebral, and transcranial Doppler. Over half of the exams showed no significant abnormalities (50.9%), but atheromatous plaques were identified in 26.6% of cases and significant stenoses (≥50%) in 10.7%, including critical situations that required revascularization interventions. Illustrative clinical cases were also studied, including a critical left internal carotid artery stenosis and a patient with sickle cell disease associated with stroke, highlighting the importance of early diagnosis and multidisciplinary integration. Discussion: The internship in Neurosonology consolidated technical skills and clinical reasoning, highlighting the relevance of EcoDoppler in diagnosis, patient monitoring, and therapeutic decision-making. There was a predominance of elderly patients with classic risk factors and a higher incidence of lesions in the MCA territory. The experience reinforced the value of Neurosonology, emphasizing its transformative potential in resource-limited settings. Conclusion: Cerebrovascular ultrasonography proved essential for the diagnosis and monitoring of vascular diseases, enabling the consolidation of technical skills and clinical reasoning. Case analysis demonstrated its relevance in patient follow-up and therapeutic decision-making. Despite some limitations, EcoDoppler was confirmed as an indispensable tool for effective and evidence-based clinical practice.
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ultrassonografia cerebrovascular EcoDoppler acidente vascular cerebral estenose carotídea cerebrovascular ultrasonography Doppler ultrasound stroke carotid stenosis