RESUMO
INTRODUCTION: Posterior reversible encephalopathy syndrome is a rare entity. Its pathophysiology is still poorly understood. CASE PRESENTATION: We report the case of a 69-year-old White European woman who presented complete and proportional right hemiplegia, confusion, deviation of her head and eyes to the right, cortical blindness, and generalized tonic-clonic seizure 12 hours following a depletive lumbar puncture. Emergency cerebral magnetic resonance imaging showed bioccipital and left-side basal ganglia hyperintensities in the fluid attenuated inversion recovery and the diffusion-weighted images suggesting a radiological diagnosis of posterior reversible encephalopathy syndrome. CONCLUSIONS: The diagnosis is established on clinical and radiological signs. This is the first report of this kind in the literature. We present a case of posterior reversible encephalopathy syndrome after depletive lumbar puncture and we discuss the pathophysiology.
Assuntos
Síndrome da Leucoencefalopatia Posterior/etiologia , Síndrome da Leucoencefalopatia Posterior/terapia , Punção Espinal/efeitos adversos , Idoso , Terapia Combinada , Diagnóstico Diferencial , Eletroencefalografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/diagnósticoRESUMO
We describe a case of foramen magnum syndrome secondary to atlanto-occipital assimilation with spinal-cord compression caused by retro-odontoid fibrous pannus. Association of atlanto-occipital assimilation with the occurrence of severe neurological symptoms resulting from upper spinal cord compression remains rare in the literature. The embryonic process leading to this malformation is discussed. The anatomy and pathogenesis of this syndrome are described.
