RESUMO
The ventricle-to-background ratio and clearance rate constant measured by indium-111 diethylenetriaminepenta-acetic acid single photon emission computed tomography ((111)In-DTPA SPECT) were evaluated for predicting hydrocephalus in 16 patients at 2 to 3 weeks after onset of subarachnoid hemorrhage. The activity in the lateral ventricles, basal cistern, and hemispheric convexities was measured at 6, 24, and 48 hours after lumbar injection of radionuclide. In the follow-up study, eight patients developed hydrocephalus, and required ventriculoperitoneal shunting. Radioactivity measured in the hemispheric convexity did not reach peak activity within 48 hours. The clearance rate measured by applying the mono-exponential equation failed to show delayed clearance of radionuclide in hydrocephalus. The ratio between the ventricle and basal cistern measured at 6 hours postinjection was the best predictor of hydrocephalus (F(1, 30) = 42.84, p < 0.0001). These results suggest that a single (111)In-DTPA SPECT scan may be sufficient to identify patients at risk of developing hydrocephalus.
Assuntos
Líquido Cefalorraquidiano/fisiologia , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Hidrocefalia/etiologia , Hidrocefalia/fisiopatologia , Radioisótopos de Índio , Masculino , Pessoa de Meia-Idade , Ácido Pentético , Hemorragia Subaracnóidea/complicações , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
Our aim was to localize the generator site of parasagittal epileptiform discharges in a patient with epilepsia partialis continua (EPC) in the right leg. We examined a 32-year-old woman with EPC whose conventional EEG did not show any epileptic discharge. We performed the jerk-locked back averaging (JLA) of EEG and magnetoencephalography (MEG) to localize the dipole source of sharp transients. The myoclonic discharges in the right soleus muscle were used as a trigger pulse. JLA revealed consistent EEG and MEG sharp transients that coincided consistently and constantly preceded the myoclonic jerks. JLA of EEG demonstrated sharp waves paradoxically distributed over the vertex and right hemisphere. However, the estimated dipoles of MEG were localized in a restricted area in the primary leg motor area in the left hemisphere, which was closely located in the abnormal lesion on the brain MRI. JLA of MEG is considered to be a useful non-invasive method for localizing the epileptogenic area in EPC even when paradoxical lateralization of electroencephalographic discharges was noted.
Assuntos
Potenciais de Ação/fisiologia , Eletroencefalografia/métodos , Epilepsia Parcial Contínua/diagnóstico , Epilepsia Parcial Contínua/fisiopatologia , Lateralidade Funcional/fisiologia , Magnetoencefalografia/métodos , Córtex Motor/fisiopatologia , Adulto , Encefalite/complicações , Encefalite/imunologia , Encefalite/fisiopatologia , Epilepsia Parcial Contínua/patologia , Feminino , Humanos , Perna (Membro)/inervação , Perna (Membro)/fisiopatologia , Imageamento por Ressonância Magnética , Córtex Motor/patologia , Mioclonia/etiologia , Mioclonia/patologia , Mioclonia/fisiopatologiaRESUMO
INTRODUCTION: Reported cases of arteriovenous fistula (AVF) with neurofibromatosis type1 (NF1) are rare. CASE REPORT: In this paper we report the first case of intracranial AVF in an NF1 infant who developed heart failure. Endovascular treatment using coils successfully obliterated the AVF. The mechanism underlying the AVF in this case was believed to be a congenital mesenchymal abnormality of the intracranial vessels. DISCUSSION: The mechanism underlying the development of heart failure in this case is also discussed.