RESUMO
Dyspnea, hunger for air, and urge to flee are the cardinal symptoms of panic attacks. Patients also show baseline respiratory abnormalities and a higher rate of comorbid and antecedent respiratory diseases. Panic attacks are also precipitated by infusion of sodium lactate and inhalation of 5% CO2 in predisposed patients but not in healthy volunteers or patients without panic disorder. Accordingly, Klein [Klein (1993) Arch Gen Psychiatry 50:306-317] suggested that clinical panic is the misfiring of an as-yet-unidentified suffocation alarm system. In rats, selective anoxia of chemoreceptor cells by potassium cyanide (KCN) and electrical and chemical stimulations of periaqueductal gray matter (PAG) produce defensive behaviors, which resemble panic attacks. Thus, here we examined the effects of single or combined administrations of CO2 (8% and 13%) and KCN (10-80 µg, i.v.) on spontaneous and PAG-evoked behaviors of rats either intact or bearing electrolytic lesions of PAG. Exposure to CO2 alone reduced grooming while increased exophthalmus, suggesting an arousal response to non-visual cues of environment. Unexpectedly, however, CO2 attenuated PAG-evoked immobility, trotting, and galloping while facilitated defecation and micturition. Conversely, KCN produced all defensive behaviors of the rat and facilitated PAG-evoked trotting, galloping, and defecation. There were also facilitatory trends in PAG-evoked exophthalmus, immobility, and jumping. Moreover, whereas the KCN-evoked defensive behaviors were attenuated or even suppressed by discrete lesions of PAG, they were markedly facilitated by CO2. Authors suggest that the PAG harbors an anoxia-sensitive suffocation alarm system which activation precipitates panic attacks and potentiates the subject responses to hypercapnia.
Assuntos
Asfixia/patologia , Substância Cinzenta Periaquedutal/patologia , Substância Cinzenta Periaquedutal/fisiopatologia , Análise de Variância , Animais , Comportamento Animal , Dióxido de Carbono/efeitos adversos , Cianatos/farmacologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Estimulação Elétrica , Reação de Fuga/efeitos dos fármacos , Reação de Fuga/fisiologia , Reação de Congelamento Cataléptica/efeitos dos fármacos , Reação de Congelamento Cataléptica/fisiologia , Modelos Logísticos , Masculino , Substância Cinzenta Periaquedutal/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
A 55-year-old woman with chronic spinal subdural hematoma, diagnosed by magnetic resonance (MR) is presented. There was no coagulation defect, anticoagulant therapy, or trauma.
Assuntos
Hematoma Subdural , Doenças da Medula Espinal , Doença Crônica , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
The authors describe two patients with the association of polyposis-coli and central nervous system tumor (Turcot's syndrome). Clinical, genetic and therapeutic aspects are discussed.
Assuntos
Polipose Adenomatosa do Colo/cirurgia , Neoplasias Encefálicas/cirurgia , Glioblastoma/cirurgia , Polipose Adenomatosa do Colo/genética , Polipose Adenomatosa do Colo/patologia , Adolescente , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Feminino , Glioblastoma/genética , Glioblastoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , ReoperaçãoRESUMO
An 88-year-old man was found at laminectomy to have an encapsulated spinal epidural hematoma. The surgical result was gratifying and reinforced a recent statement that spinal surgical procedures in the very elderly should not be withheld on the basis of age alone. Moreover, the rarity of this pathology in this age group and the clear identification of the lesion on the computed tomography scan of this case are to be noted.
Assuntos
Hematoma Epidural Craniano/cirurgia , Doenças da Medula Espinal/cirurgia , Idoso , Idoso de 80 Anos ou mais , Hematoma Epidural Craniano/diagnóstico por imagem , Humanos , Laminectomia , Masculino , Doenças da Medula Espinal/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Aneurisma Infectado/etiologia , Endocardite Bacteriana/complicações , Aneurisma Intracraniano/etiologia , Adolescente , Adulto , Aneurisma Infectado/líquido cefalorraquidiano , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Aneurisma Intracraniano/líquido cefalorraquidiano , Masculino , Hemorragia Subaracnóidea/etiologiaRESUMO
The radiological findings of syringomyelography are described in a five years old patient who underwent a percutaneous injection of opaque contrast medium (Lipiodol) into the intraspinal syringomyelic cavity. The clinical picture, the usual diagnostic methods and the place of syringomyelography for the diagnosis of syringomielia are discussed.
Assuntos
Cistos/diagnóstico por imagem , Mielografia , Doenças da Medula Espinal/diagnóstico por imagem , Siringomielia/diagnóstico por imagem , Pré-Escolar , Diagnóstico Diferencial , Humanos , Óleo Iodado , MasculinoRESUMO
The case of 15 years old boy with an enterogenous cyst causing compression of the spinal cord at T-2 is reported. The diagnosis was made by thoracic laminectomy and confirmed by histological examination. The motor disorders improved progressively after surgery.
Assuntos
Defeitos do Tubo Neural/complicações , Compressão da Medula Espinal/etiologia , Adolescente , Humanos , Masculino , Mielografia , Defeitos do Tubo Neural/diagnósticoRESUMO
Computed Tomography (CT) has been very useful in the follow-up of patients with brain tumors. Soon after the craniotomy, CT would show any residual tumor if an incomplete excision was done. CT has been essential when one needs to evaluate any deterioration in the patient's neurological status post operatively. In such instances, CT may detect brain edema, hematoma, hydrocephalus and the presence of air. CT findings are more accurate than those obtained from conventional neuroradiology or from intracranial pressure monitoring, being also more innocuous than those methods. Later in the post operative follow-up, CT allows, besides precocious diagnosis of tumor recurrences, a good evaluation of the results obtained by chemiotherapy or radiotherapy. When hydrocephalus is accompanying the primary pathology, ventricular size can be rapidly evaluated by CT. Difficulties may arise when one wishes to differentiate CT images of radionecrosis from tumor recurrences at least in the initial stages.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-OperatóriosRESUMO
Solitary granulomatous lesions due to cysticercosis in the brain were found by computed tomography in six patients. The CT images were in all cases very similar to those from brain neoplasms. The cerebrospinal fluid complement fixation test for cysticercosis was negative in all of the cases. The definite etiological diagnosis could only be made by craniotomy in this series.
Assuntos
Encefalopatias/diagnóstico por imagem , Cisticercose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Encefalopatias/parasitologia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Granuloma/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The differential diagnosis between brain atrophy versus subdural effusion in children has shown some difficulties in a few cases, mainly when the frontal subarachnoid space is very large on computed tomography. We think that a simple procedure, that is, CT scans in the lateral and prone position following the standard examination, may be worth to clarify those cases of doubtful diagnosis.
Assuntos
Encéfalo/diagnóstico por imagem , Hematoma Subdural/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Atrofia , Encéfalo/patologia , Criança , Diagnóstico Diferencial , Humanos , PosturaRESUMO
A case of calcified choroid plexus papilloma in a 7 years old child is reported. The radiologic findings are discussed.
Assuntos
Calcinose/patologia , Neoplasias do Ventrículo Cerebral/patologia , Plexo Corióideo , Ependimoma/patologia , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Criança , Ependimoma/diagnóstico por imagem , Feminino , Humanos , RadiografiaRESUMO
In the vast majority of techniques used to treat carotid-cavernous fistulas the carotid artery has been occluded. Occlusion of the fistula with preservation of carotid blood flow is achieved by new techniques as those proposed by Parkinson, Serbinenko and Mullan. However the sophisticated equipments and surgical acts which are needed for these methods has not allowed its general use. The use of Fogarty type balloon catheters has had a place in the treatment of carotido-cavernous fistulas. The carotid artery has to be occluded too, but the procedure is much safer and easier. Our results in a series of 6 cases are reported. Considerations about indications and the technical aspects are made. The results were good and the procedure may be used with conventional equipment.
Assuntos
Fístula Arteriovenosa/cirurgia , Doenças das Artérias Carótidas/cirurgia , Cateterismo/métodos , Seio Cavernoso , Adolescente , Adulto , Artérias Carótidas/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , RadiografiaRESUMO
Techniques of microsurgical revascularization are reviewed. A series of 5 cases, submitted to 6 anastomosis of the superficial temporal artery is presented.