REVIEW
O espasmo arterial pós-traumático (EAPT) caracteriza por uma contração anormal das artérias intracranianas após um trauma, reduzindo o fluxo sanguíneo cerebral. Identificar precocemente e o manejo adequado são fundamentais para prevenir isquemia cerebral e hipertensão intracraniana (HIC). O Doppler transcraniano (DTC) destaca-se como ferramenta não invasiva para o monitoramento em tempo real. Foi realizada uma revisão sistemática nas bases de dados PubMed e Medline. A estratégia PICO foi aplicada e a metodologia PRISMA foi seguida. A busca utilizou os descritores (posttraumatic cerebral arterial spasm OR posttraumatic cerebral vasospasm OR intracranial arterial spasm OR intracranial vasospasm) AND (transcranial doppler ultrasonography), com filtros para Clinical Trial, Meta-Analysis, Randomized Controlled Trial e estudos observacionais, nos idiomas Português, Inglês e Espanhol, publicados entre 2009 e 2024. A seleção foi conduzida por dois revisores independentes, com divergências resolvidas por consenso. Foram identificados 641 estudos inicialmente. 18 foram selecionados após a triagem de títulos e resumos. Posteriormente a análise completa, 7 estudos foram incluídos. O DTC atuou positivamente na detecção de espasmos arteriais, na resistência vascular, e nas estratégias farmacológicas. O DTC é uma ferramenta valiosa para o monitoramento em pacientes com EAPT. Entretanto, estudos futuros são necessários para otimizar o manejo clínico.
Posttraumatic arterial spasm (PTAE) is characterized by an abnormal contraction of intracranial arteries after trauma, reducing cerebral blood flow. Early identification and appropriate management are essential to prevent cerebral ischemia and intracranial hypertension (ICH). Transcranial Doppler (TCD) stands out as a noninvasive tool for real-time monitoring. A systematic review was performed in the PubMed and Medline databases. The PICO strategy was applied and the PRISMA methodology was followed. The search used the descriptors (posttraumatic cerebral arterial spasm OR posttraumatic cerebral vasospasm OR intracranial arterial spasm OR intracranial vasospasm) AND (transcranial doppler ultrasonography), with filters for Clinical Trial, Meta-Analysis, Randomized Controlled Trial and observational studies, in Portuguese, English and Spanish, published between 2009 and 2024. The selection was conducted by two independent reviewers, with disagreements resolved by consensus. A total of 641 studies were initially identified. 18 were selected after screening of titles and abstracts. After the complete analysis, 7 studies were included. TCD had a positive effect on the detection of arterial spasms, vascular resistance, and pharmacological strategies. TCD is a valuable tool for monitoring patients with PTEA. However, future studies are needed to optimize clinical management.
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1Universidade de Vassouras – Univassouras, Vassouras, RJ, Brazil.
2Centro Universitário de Valença – UNIFAA, Valença, RJ, Brazil.
3Universidade Potiguar – UNP, Natal, RN, Brazil.
4IDOMED, Instituto de Educação Médica, Vista Carioca, Rio de Janeiro, RJ, Brazil.
5Universitário UniFacig – UNIFACIG, Manhuaçu, MG , Brazil.
6Centro Universitário de Várzea-Grande – UNIVAG, Várzea Grande, MT, Brazil.
7Hospital Universitário de Vassouras, Vassouras, RJ, Brazil.
8Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, RJ, Brazil.
Received Sep 25, 2025
Accepted Nov 2, 2025
