RESUMO
The authors report the case of a 50-day-old baby who was brought to the Pediatric Emergency Room of the "Hospital de Clinicas da UNICAMP" with seizures. At the examination she presented without external signs of trauma, hypoactive and with generalized seizures. Numerous hemorrhages were found in the ocular fundi. CT scan showed interhemisferic hemorrhage and brain swelling. The child was admitted to the Pediatric Intensive Care Unit, kept under controlled ventilation and hydantal. Although these measures, she died three days later. Since the beginning there was suspicion of child abuse. One day after the admission the father told that he had shaken the baby because she was crying too much. The present paper discuss social and epidemiological aspects, and about the difficulties in the diagnosis of this syndrome that sometimes may be fatal, as in this case.
Assuntos
Lesões Encefálicas , Maus-Tratos Infantis/diagnóstico , Lesões Encefálicas/diagnóstico por imagem , Evolução Fatal , Feminino , Humanos , Lactente , Tomografia Computadorizada por Raios XRESUMO
Forty-nine patients with clinical diagnosis of Alzheimer's disease were submitted to neuropsychological evaluation for staging the disease. The time of the initial symptoms was correlated to the stage of the disease. The evolution was protracted in 28.5% of the patients with only insidious memory deterioration. For another group of patients (12.2%) the evolution was serious since the beginning of the disease, with apraxo-agnosic signs. For the 34 patients with apraxo-agnosic impairment, in 50% this manifestation began in the first two years of the disease. Data suggest the occurrence of two subgroups. In the first the evolution of the disease is rapid, and in the second it is protracted. Also, they suggest that the evolution in the first two years is critical for characterizing the severity of progression in the clinical manifestations of Alzheimer's disease.
Assuntos
Doença de Alzheimer/fisiopatologia , Transtornos da Memória/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Doença de Alzheimer/psicologia , Feminino , Humanos , Masculino , Transtornos da Memória/etiologia , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Forty-nine patients with clinical diagnosis of Alzheimer's disease were submitted to neuropsychological evaluation for staging the disease. The time of the initial symptoms was correlated to the stage of the disease. The evolution was protracted in 28.5% of the patients with only insidious memory deterioration. For another group of patients (12.2%) the evolution was serious since the beginning of the disease, with apraxo-agnosic signs. For the 34 patients with apraxo-agnosic impairment, in 50% this manifestation began in the first two years of the disease. Data suggest the occurrence of two subgroups. In the first the evolution of the disease is rapid, and in the second it is protracted. Also, they suggest that the evolution in the first two years is critical for characterizing the severity of progression in the clinical manifestations of Alzheimer's disease
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doença de Alzheimer/fisiopatologia , Transtornos da Memória/fisiopatologia , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Fatores de Tempo , Transtornos da Memória/etiologiaRESUMO
Psychosocial aspects of patient's life were analysed in 30 patients with epilepsy aged over 18 years old. At this age people usually are apt by themselves to exert several psychosocial activities. Professional, familial, social, scholar, affective, sexual and religious activities were evaluated in our group of patients. Results evidence that epileptic patients studied show several kinds of difficulties in their psychosocial adjustment.
Assuntos
Epilepsia/psicologia , Adulto , Idoso , Escolaridade , Emprego/psicologia , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Religião , Comportamento Sexual/psicologia , Comportamento SocialRESUMO
Para o estudo de aspectos psico-sociais da vida de pacientes com epilepsia selecionamos, para entrevistas, grupo de 30 epilépticos atendidos ambulatorialmente. Optamos por estudar pacientes adultos com idades superiores a 18 anos, pois, a partir dessa idade se espera que o indivíduo esteja apto para se engajar, por si mesmo, em atividade de natureza profissional, familiar, social, acadêmica, afetiva, sexual e religiosa. Ficou claro, na amostra analisada, que pacientes epilépticos carregam consigo limitaçöes penosas em seus ajustamentos psico-sociais
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Epilepsia/fisiopatologia , Escolaridade , Emprego/psicologia , Família/psicologia , Religião , Comportamento Sexual/psicologia , Comportamento SocialRESUMO
Primary neoplasms of choroid plexus are rare. Six morphological variants have been described: papillary, cystic, acinar, mucus-secreting, oncocytic, and anaplastic. The anaplastic variant, the so-called choroid plexus carcinoma, is the rarest of all and can metastasize. The differential diagnosis of the anaplastic variant of choroid plexus neoplasms with adenocarcinomas, melanomas and undifferentiated neoplasms can be troublesome chiefly in adults. The now large use of immunocytochemical techniques in tissue section has become a powerful tool in the analysis of cell lineages, tumoral and non-tumoral. Nevertheless, the choroid plexus neoplasms have shown a complex and a somewhat confusing pattern of antigenic expression. In two choroid plexus carcinomas (one localized in the right lateral ventricle from a boy of 1 year and 9 months old, and the other localized in the left lateral ventricle from a girl of 3 years old) the following antigens were searched (using the avidin-biotin-peroxidase complex): glial fibrillary acidic protein (GFAP) with monoclonal and polyclonal antibodies; cytokeratins of 40-50kDa, cytokeratins of 60-70kDA (callus cytokeratin), neuronal specific enolase (NSE) and S-100 protein with monoclonal antibodies. The two neoplasms showed immunoreactivity against NSE, S-100 protein and cytokeratin of 40-50kDA. The neoplasm of the boy exhibited glial differentiation having immunoreactivity against GFAP with monoclonal and polyclonal antibodies.
Assuntos
Antígenos de Neoplasias/análise , Carcinoma/imunologia , Neoplasias do Ventrículo Cerebral/imunologia , Plexo Corióideo , Carcinoma/patologia , Neoplasias do Ventrículo Cerebral/patologia , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica , Lactente , MasculinoRESUMO
The authors present the analysis of 27 computed tomography scans (CT) of 18 children which were divided in three groups according to clinical and tomographic criteria. Group 1 was characterized mainly by epilepsy and calcifications. Group 2 was characterized by intracranial hypertension and several tomographic aspects: edema, cysts and nodules were seen in three patients; hydrocephaly and calcifications were seen in two patients and CT was normal in one patient. Group 3 had patients with epilepsy or headache and variable tomographic patterns. The results are discussed based on the available literature.
Assuntos
Encefalopatias/diagnóstico , Cisticercose/diagnóstico , Tomografia Computadorizada por Raios X , Encefalopatias/terapia , Criança , Cisticercose/terapia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Praziquantel/uso terapêuticoRESUMO
Multiloculated hydrocephalus is a clinicopathological entity consisting of enlarged, loculated ventricles and paraventricular poroencephalic cavities. We present two cases of multiloculated hydrocephalus: one due to infectious process of central nervous system and the other consequent to a congenital malformation. Tomographic aspects of this condition that permit the diagnosis are stressed. The pathophysiology, the management and the prognosis are discussed according to the available literature.
Assuntos
Ventrículos Cerebrais/anormalidades , Hidrocefalia/etiologia , Meningite/complicações , Pré-Escolar , Feminino , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/patologia , Lactente , Masculino , Tomografia Computadorizada por Raios XRESUMO
Case report of a patient who three weeks after a Plasmodium falciparum malaria presented the Guillain-Barré syndrome. There was a severe type of polyradiculoneuritis with tetraplegia and involvement of several cranial nerves (VI, VII, IX, X) evolving to death. The Guillain-Barré syndrome has been considered a immune disorder with several eliciting antigenic stimuli. The case suggests that protozoan may be one these antigenic factors.
Assuntos
Malária/complicações , Polirradiculoneuropatia/etiologia , Doença Aguda , Humanos , Masculino , Pessoa de Meia-Idade , Plasmodium falciparumRESUMO
The computerized tomography (C.T.) of 18 patients with sellar tumours were analysed. The C.T. made before surgery in 6 cases was positive in 3 and the type of tumour suggested by C.T. was confirmed in 3. Twelve patients had a C.T. investigation after surgery and the examination suggest recurrent tumour in 5. Two of these were re-operated. One patients with cholesteatoma had the recurrent tumour verified by surgery and the other, with a pituitary adenoma during re-operation was noted only cicatricial tissue at sellar region.
Assuntos
Sela Túrcica , Neoplasias Cranianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adenoma Acidófilo/diagnóstico por imagem , Adenoma Cromófobo/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Colesteatoma/diagnóstico por imagem , Craniofaringioma/diagnóstico por imagem , Feminino , Glioma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Sela Túrcica/diagnóstico por imagemRESUMO
Three cases of probable neurobrucellosis are reported. The diagnosis was made on the basis of immunological tests. Two patients with a clinical picture of meningomyelitis showed a definitive clinical improvement under tetracycline and streptomycin therapy. The immunological reactions found in the record case were even more positive in the spinal fluid than in the blood. In the case 3 with a clinical presentation of cerebral hemorrhage the histopathological studies demonstrated non specific chronic leptomeningitis and local hemorrhages in the caudate nucleus bilaterally. The diagnose and treatment of neurobrucellosis are discussed, stressing the importance of an early therapy.
Assuntos
Brucelose/diagnóstico , Meningite/etiologia , Mielite/etiologia , Doenças do Sistema Nervoso Periférico/etiologia , Adolescente , Adulto , Brucella/isolamento & purificação , Brucelose/tratamento farmacológico , Hemorragia Cerebral/diagnóstico , Feminino , Humanos , Masculino , Meningite/diagnóstico , Mielite/diagnóstico , Testes Sorológicos , Tetraciclina/uso terapêuticoRESUMO
Spontaneous intracerebral haematoma caused by metastatic neoplasms are reported in 11 patients, 8 males and 3 females, with age between 19 and 74 years. We had 7 melanomas, 3 carcinomas and one choriocarcinoma. The presenting symptoms were those of classical spontaneous intracerebral hemorrhage with a history of sudden headache, coma or stupor, hemiparesis or hemiplegia or other focal signal, and bloody cerebrospinal fluid. Three patients presented more than one hemorrhagic episodes. In four cases the computerized tomography revealed multiple lesions. Seven patients were operated by large craniotomy with evacuation of the hematoma and in one a cerebral biopsy revealed a melanoma and in the other six a large tumoral mass was removed. The average survival was 39 days.
Assuntos
Neoplasias Encefálicas/secundário , Hemorragia Cerebral/etiologia , Hematoma/etiologia , Melanoma/secundário , Adulto , Idoso , Neoplasias Encefálicas/complicações , Feminino , Humanos , Masculino , Melanoma/complicações , Pessoa de Meia-IdadeAssuntos
Abscesso Encefálico/microbiologia , Cromoblastomicose/patologia , Meningite/microbiologia , Abscesso Encefálico/patologia , Cromoblastomicose/líquido cefalorraquidiano , Cromoblastomicose/etiologia , Humanos , Masculino , Meningite/patologia , Pessoa de Meia-Idade , Fungos Mitospóricos/isolamento & purificação , Phialophora/isolamento & purificaçãoRESUMO
A case of a right frontal astrocytoma with spinal metastatic lesion in the region of the third dorsal vertebra is reported. The metastatic nodule was removed six months after the craniotomy. In the literature concerning to the dissemination of tumors cells is suggested that there is not a causal relationship between CSF seeding and operative intervention. Access to the ventricular system or basal cisterns is of primary importance in the production of metastases.
Assuntos
Astrocitoma/patologia , Neoplasias Encefálicas/patologia , Neoplasias da Medula Espinal/patologia , Adulto , Angiografia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Mielografia , Metástase Neoplásica , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/cirurgiaRESUMO
A study into the neurosurgical approach to thirty-five patients with increased intracranial pressure due to inflamatory diseases affecting the central nervous system and meninges is reported. The entitites under consideration were found to have similar surgical aspects despite the heterogeneity of etiologic agents. As regards the surgical treatment, two groups of cases were recognized. Group 1 comprises 7 patientes with symptoms of a space-occupying lesion; in these patients craniotomies were performed with good results. Group 2 included the remainder 28 cases with acquired hydrocephalus. In this group differents methods for ventricular drainage were used, but ventriculo-auriculostomy and specially ventriculo-peritoneal shunts proved to give more gratifying results. Chemotherapy was administred when the etiologic agent was disclosed. Corticosteroids were institued to reduce inflammatory reations and cerebral edema. A review of the literature supported the practical classification and surgical techniques employed.
Assuntos
Hidrocefalia/cirurgia , Pressão Intracraniana , Meningite/cirurgia , Adolescente , Adulto , Idoso , Criança , Humanos , Lactente , Meningite/etiologia , Pessoa de Meia-IdadeRESUMO
A case of hereditary multiple exostoses successfully operated is reported. The patient, a 15 year-old white brazilian boy, was admitted with tetraplegia and Babinski's sign. Early diagnosis followed by prompt surgery may prevent permanent spinal cord damage.