RESUMEN
This study aimed to quantify 24h body core temperature (BcT°) and sleep-wake cycle rhythm alterations in craniopharyngioma (CP) patients and to identify markers related to the postsurgical outcomes. Ten consecutive CP patients underwent neuroradiological, endocrinological and ophthalmological evaluations, 24h BcT° and sleep-wake cycle recordings before and after endoscopic endonasal surgery. The sample included four women and six men. Nocturnal sleep efficiency was pathologically reduced in eight patients before surgery. Seven out of ten patients presented one to three daytime naps. 24h BcT° rhythm was pathological in six out of ten cases. Post-surgery sleep efficiency normalized in four out of eight patients, whereas nine out of ten patients presented with two to six longer daytime naps. Diurnal naps were mainly present in patients showing pre-operative involvement of the third ventricle floor. 24h BcT° remained pathological in only one out of six cases, returned to normal in two and improved in three. 24h BcT° rhythm improved more in papillary CPs than in adamantomatous CPs. Our data confirmed that both CP and surgery frequently disrupt the sleep-wake cycle and BcT° rhythms. Tumour location and histotype may be related to a worse postsurgical outcome. Therefore, in-depth investigation including circadian monitoring is crucial for surgical outcome.
Asunto(s)
Temperatura Corporal/fisiología , Ritmo Circadiano/fisiología , Craneofaringioma/fisiopatología , Craneofaringioma/cirugía , Neoplasias Hipofisarias/fisiopatología , Neoplasias Hipofisarias/cirugía , Femenino , Humanos , Hipotálamo/fisiopatología , Hipotálamo/cirugía , Masculino , Persona de Mediana Edad , Neuroendoscopía , Sueño/fisiología , Tercer Ventrículo , Cirugía Endoscópica Transanal , Resultado del Tratamiento , Vigilia/fisiologíaRESUMEN
The burden of migraine strongly increases considering its linkage with other psychiatric, neurological, cardiovascular and cerebrovascular diseases. Migraine is positively associated with many disorders: some are confirmed by several studies whereas others remain uncertain or controversial. The association with some disorders is not simply due to concomitance but it implies a linkage in terms of causality. Highlighting these relationships is important to improve treatment strategies, broaden our knowledge of the pathophysiology and understand if migraine is per se a modifiable risk factor for some disorders.
Asunto(s)
Trastornos Migrañosos/epidemiología , Trastornos Migrañosos/psicología , Animales , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/psicología , Trastornos Cerebrovasculares/epidemiología , Trastornos Cerebrovasculares/psicología , Comorbilidad , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Factores de RiesgoRESUMEN
Migraine has complex relationships with cerebrovascular and cardiovascular disorders but also with cardiac anomalies. Patients affected by migraine with aura have an increased prevalence of right-to-left shunt due to patent foramen ovale or pulmonary arteriovenous malformations. The association between ischemic heart disease, cardiovascular mortality and migraine remains unsettled. The debate focuses on a physiopathological link between migraine and cardiovascular diseases or a higher prevalence of risk factors in migraineurs.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Migraña con Aura/epidemiología , Migraña con Aura/fisiopatología , Animales , Foramen Oval Permeable/epidemiología , Foramen Oval Permeable/fisiopatología , Humanos , Malformaciones Arteriovenosas Intracraneales/epidemiología , Malformaciones Arteriovenosas Intracraneales/fisiopatología , Trastornos Migrañosos/epidemiología , Trastornos Migrañosos/fisiopatología , Factores de RiesgoRESUMEN
Slowly progressive aphemia (SPA) is a rare focal degenerative disorder characterized by severe dysarthria, frequent orofacial apraxia, dysprosody, phonetic and phonemic errors without global cognitive deterioration for many years. This condition is caused by a degeneration of anterior frontal lobe regions, mainly of the left frontal operculum. We report a case of SPA with a course of 8 years, evaluated by repeated neuropsychological, conventional, and functional MRI examinations. In our case, neuropsychological examinations showed a progressive impairment of speech articulation including dysprosody, phonetic and phonemic errors, and slight writing errors. No global cognitive deterioration was detected and the patient is still completely autonomous. Morphological and functional investigations showed, respectively, a progressive atrophy and progressive impairment of the left frontal region, confirming the role of the opercular region in determining this rare syndrome. During verbal task generation as the cortical activation of this region gradually decreased, the language articulation worsened.