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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(07): 440-449
DOI: 10.1590/0004-282X20200053
VIEW AND REVIEW

Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology

Tratamento do acidente vascular cerebral agudo e realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19: recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, Sociedade Brasileira de Doenças Cerebrovasculares e Sociedade Brasileira de Neurorradiologia
Francisco José Arruda MONT’ALVERNE 
1   Hospital Geral de Fortaleza, Departamento de Neurorradiologia Intervencionista, Fortaleza CE, Brazil.
,
Fabrício Oliveira LIMA 
2   Hospital Geral de Fortaleza, Unidade de AVC, Fortaleza CE, Brazil.
,
Raul Gomes NOGUEIRA 
3   Emory University School of Medicine, Department of Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Atlanta, Georgia, United States.
,
Carlos Clayton Macedo de FREITAS 
4   Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Medicina de Botucatu, Departamento de Neurologia e Psiquiatria, Botucatu SP, Brazil.
,
Octávio Marques Pontes NETO 
5   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.
,
Gisele Sampaio SILVA 
6   Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo SP, Brazil.
,
Maura Salaroli de OLIVEIRA 
7   Universidade de São Paulo, Departamento de Doenças Infecciosas, São Paulo SP, Brazil.
,
Michel FRUDIT 
8   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neuroradiologia Intervencionista, São Paulo SP, Brazil.
,
Jose Guilherme Mendes Pereira CALDAS 
9   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neuroradiologia Intervencionista, São Paulo SP, Brazil.
,
Daniel Giansante ABUD 
10   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Ribeirão Preto SP, Brazil.
,
Adriana Bastos CONFORTO 
11   Universidade de São Paulo, Hospital das Clínicas, Divisão de Neurologia Clínica, São Paulo SP, Brazil.
,
Fernanda Martins Maia CARVALHO 
12   Universidade de Fortaleza, Curso de Medicina, Programa de Pós-Graduação em Ciências Médicas, Fortaleza CE, Brazil.
,
Francisco Antunes DIAS 
5   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Ribeirão Preto SP, Brazil.
,
Rodrigo BAZAN 
13   Universidade Estadual Paulista, Campus de Botucatu, Departamento de Neurologia, Botucatu SP, Brazil.
,
Wagner Mauad AVELAR 
14   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.
,
Carla Heloísa Cabral MORO 
15   Hospital Municipal de Joinville, Neurológica, Joinville SC, Brazil.
,
Pedro Silva Correa de MAGALHÃES 
15   Hospital Municipal de Joinville, Neurológica, Joinville SC, Brazil.
,
Maramelia MIRANDA 
16   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Leandro de Assis BARBOSA 
17   Hospital Estadual Central de Vitória, Departamento de Neuroradiologia Intervencionista, Vitória ES, Brazil.
,
José Antonio FIOROT  JUNIOR
18   Hospital Estadual Central de Vitória, Departamento de Neurologia, Vitória ES, Brazil.
,
Fabrício Buchdid CARDOSO 
2   Hospital Geral de Fortaleza, Unidade de AVC, Fortaleza CE, Brazil.
,
Leticia Costa REBELLO 
19   Instituto Hospital de Base do Distrito Federal, Departamento de Neuroradiologia, Brasília DF, Brazil.
,
Bruno de Sousa Mendes PARENTE 
19   Instituto Hospital de Base do Distrito Federal, Departamento de Neuroradiologia, Brasília DF, Brazil.
,
Mário de Barros FARIA 
20   Universidade Federal do Rio Grande do Sul, Hospital de Clínicas, Departamento de Neuroradiologia Intervencionista, Porto Alegre RS, Brazil.
,
Gabriel Rodriguez de FREITAS 
21   Universidade Federal Fluminense, Departamento de Neurologia, Niterói RJ, Brazil.
,
Viviane de Hiroki Flumignan ZÉTOLA 
22   Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brazil.
,
Jamary OLIVEIRA-FILHO 
23   Universidade Federal da Bahia, Serviço de Neurologia, Salvador BA, Brazil.
,
Daniel da Cruz BEZERRA 
24   Hospital Pro-Cardíaco, Departamento de Neurologia, Rio de Janeiro RJ, Brazil.
,
Jorge Luis Nobre RODRIGUES 
25   Universidade Federal do Ceará, Departamento de Doenças Infecciosas, Fortaleza CE, Brazil.
,
Gustavo KUSTER 
26   United Health Group, National Neurology Board, São Paulo SP, Brazil.
,
Sheila MARTINS 
27   Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil.
,
João José Freitas de CARVALHO 
2   Hospital Geral de Fortaleza, Unidade de AVC, Fortaleza CE, Brazil.
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ABSTRACT

Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.

RESUMO

Introdução: A pandemia causada pelo novo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2, COVID-19) apresenta novos e importantes desafios à gestão de saúde no Brasil. Além da difícil missão de prestar atendimento aos milhares de pacientes infectados pelo COVID-19, os sistemas de saúde têm que manter a assistência às emergências médicas comuns em períodos sem pandemia, tais como o acidente vascular cerebral (AVC), que continuam ocorrendo e requerem tratamento com presteza e eficiência. A alocação de recursos materiais e humanos para o enfrentamento à pandemia não pode comprometer o atendimento ao AVC agudo, uma emergência cujo tratamento é tempo-dependente e se não realizado implica em importante impacto na mortalidade e incapacitação a longo prazo. Objetivo: Este trabalho resume as recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, da Sociedade Brasileira de Doenças Cerebrovasculares e da Sociedade Brasileira de Neurorradiologia para o tratamento do AVC agudo e para a realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19, incluindo o uso adequado de ferramentas de triagem e equipamentos de proteção pessoal (para pacientes e profissionais de saúde), além da alocação apropriada de pacientes.

Keywords:

neurointerventional treatment - coronavirus infections - stroke

Palavras-chave:

neurointervenção - infecções por coronavirus - acidente vascular cerebral


Publication History

Received: 12 May 2020

Accepted: 13 May 2020

Article published online:
13 June 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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