RESUMO
Spontaneous intracranial hypotension (SIH) is a rare neurological condition caused by low cerebrospinal fluid (CSF) volume, most commonly due to a CSF leak. The most common presenting symptom is an orthostatic headache, but some patients may present with atypical neurological manifestations such as cranial nerve palsies, an altered mental status, and movement disorders, which complicate the clinical diagnosis. Therefore, the diagnosis is based on the combination of clinical signs and symptoms, neuroimaging, and/or a low cerebrospinal fluid pressure. In this review, we describe the wide variety of neurological manifestations and complications seen in patients with SIH as well as the most common features described on imaging studies, including both subjective and objective measurements, in order to lead the clinician to a correct diagnosis. The prompt and correct management of patients with SIH will help prevent the development of life-threatening complications, such as subdural hematomas, cerebral venous thrombosis, and coma, and avoid unnecessary invasive procedures.
Assuntos
Hipotensão Intracraniana , Vazamento de Líquido Cefalorraquidiano , Erros de Diagnóstico , Cefaleia , Hematoma Subdural , Humanos , Hipotensão Intracraniana/diagnóstico , Hipotensão Intracraniana/diagnóstico por imagem , Imageamento por Ressonância MagnéticaRESUMO
PURPOSE: Intraventricular hemorrhage is the most important adverse neurologic event for preterm and very low weight birth infants in the neonatal period. This pathology can lead to various delays in motor, language, and cognition development. The aim of this article is to give an overview of the knowledge in diagnosis, classification, and treatment options of this pathology. METHOD: A systematic review has been made. RESULTS: The cranial ultrasound can be used to identify the hemorrhage and grade it according to the modified Papile grading system. There is no standardized protocol of intervention as there are controversial results on which of the temporizing neurosurgical procedures is best and about the appropriate parameters to consider a conversion to ventriculoperitoneal shunt. However, it has been established that the most important prognosis factor is the involvement and damage of the white matter. CONCLUSION: More evidence is required to create a standardized protocol that can ensure the best possible outcome for these patients.
Assuntos
Hemorragia Cerebral Intraventricular/classificação , Hemorragia Cerebral Intraventricular/diagnóstico , Hemorragia Cerebral Intraventricular/terapia , Doenças do Prematuro/classificação , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/terapia , Feminino , Humanos , Hidrocefalia/etiologia , Hidrocefalia/terapia , Recém-Nascido , Recém-Nascido Prematuro , MasculinoRESUMO
Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.
Assuntos
Modificação Corporal não Terapêutica/história , Indígenas Centro-Americanos/história , Indígenas Sul-Americanos/história , Crânio/patologia , Cultura , Etnicidade , História Antiga , Humanos , México , Paleopatologia , Plagiocefalia/história , Classe SocialAssuntos
Astrocitoma/etiologia , Neoplasias Encefálicas/etiologia , Neoplasias Induzidas por Radiação , Segunda Neoplasia Primária/etiologia , Glândula Pineal , Astrocitoma/diagnóstico , Neoplasias Encefálicas/radioterapia , Evolução Fatal , Feminino , Germinoma/radioterapia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnósticoAssuntos
Feminino , Humanos , Pessoa de Meia-Idade , Astrocitoma/etiologia , Neoplasias Encefálicas/etiologia , Neoplasias Induzidas por Radiação , Segunda Neoplasia Primária/etiologia , Glândula Pineal , Astrocitoma/diagnóstico , Neoplasias Encefálicas/radioterapia , Evolução Fatal , Germinoma/radioterapia , Imageamento por Ressonância Magnética , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnósticoRESUMO
BACKGROUND: Choreoacanthocytosis (CHAC) (Online Mendelian Inheritance in Man accession No. 200150) is a hereditary neurodegenerative syndrome characterized by movement disorders, cognitive decline, myopathy, behavioral changes, and acanthocytosis and is caused by mutations in the VPS13A gene. OBJECTIVE: To describe the cases of 2 Mexican women with clinical and molecular characteristics compatible with CHAC. DESIGN: Case reports. Patients Choreoacanthocytosis was identified in 2 Mexican mestizo sisters with healthy consanguineous parents. Clinical manifestations began at different ages. RESULTS: The onset of signs and symptoms of CHAC in the proband was at age 32 years and was characterized by balancing problems followed by chorea, compulsive lip and tongue biting with buccolingual self-mutilation, dysarthria, dysphagia, and weight loss. The first clinical manifestations in the proband's sister occurred at age 45 years and included multiple motor and verbal tics, with coprolalia, followed by lip and tongue biting, self-mutilation, and chorea. The clinical findings in both sisters were remarkable for acanthocytosis that developed late, when neurologic changes were already evident. Mutation screening of the VPS13A gene revealed homozygosity for the frameshift mutation c.3556_3557dupAC in exon 33. Currently, the proband's sister, in whom neurologic defects developed 13 years after onset of CHAC in the proband, is the least affected. CONCLUSIONS: The same mutation of the VPS13A gene can be expressed differently in the same family. This observation confirms the notion that there is considerable heterogeneity in the clinical manifestation of CHAC.