RESUMO
INTRODUCTION: Clinical manifestations of syphilis are highly variable, and currently on the rise. We report five cases of ischemic stroke related to neurosyphilis. CASE REPORT: The cases of five men aged 37, 34, 41, 42 and 44 years are reported. A notion of a genital chancre was noted in three. The clinical presentation was typical of ischemic stroke in four patients. One presented with intellectual deterioration. Imaging revealed zones of ischemia in all five patients. Examination of the cerebrospinal fluid revealed lymphocytic meningitis and all five patients exhibited positive syphilis serology. Brain angiography demonstrated signs of arthritis in four patients and carotid dissection in one. Improvement was achieved with penicillin G in four patients. CONCLUSION: When the cause is doubtful, the routine work-up for ischemic stroke in young subjects should include syphilis serology.
Assuntos
Neurossífilis/complicações , Neurossífilis/patologia , Adulto , Artrite/etiologia , Artrite/patologia , Encéfalo/patologia , Dissecação da Artéria Carótida Interna/etiologia , Dissecação da Artéria Carótida Interna/patologia , Angiografia Cerebral , Transtornos Cerebrovasculares/etiologia , Transtornos Cerebrovasculares/patologia , Cancro/patologia , Técnicas de Laboratório Clínico , Humanos , Imageamento por Ressonância Magnética , Masculino , Meningites Bacterianas/etiologia , Meningites Bacterianas/patologia , Processos Mentais , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/patologiaRESUMO
Sneddon syndrome is an association of livedo racemosa and cerebrovascular ischemic events generally occurring in young adults. This is an uncommon chronic progressive arterio-occlusive disorder of unknown cause involving small and medium sized vessels. We report four cases. One case was disclosed by cerebral hemorrhage. One pathogenic hypothesis suggests the involvement of an idiopathic progressive inflammatory arteriopathy or secondary thrombotic disorder comparable with antiphospholipid syndrome.
Assuntos
Síndrome de Sneddon/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Sneddon/etiologiaRESUMO
Xeroderma pigmentosum is a genodermatosis with neurological manifestations in approximately 18p. 100 of cases. Polymorphous and variably associated signs are observed, progressing with the clinical course. The etiology of the neurological breach remains unknown. We report two siblings who had xeroderma pigmentosum with intellectual deficiency, a pyramidal, cerebellar and cordonal syndrome, ophthalmoplegia, and axonal peripheral neuropathy. We discuss the epidemiological, clinical and electrophysiological aspects of the neurological breach in xeroderma pigmentosum.
Assuntos
Doenças do Sistema Nervoso/fisiopatologia , Xeroderma Pigmentoso/fisiopatologia , Adulto , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Deficiência Intelectual/etiologia , Deficiência Intelectual/genética , Masculino , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/genética , Oftalmoplegia/etiologia , Oftalmoplegia/genética , Linhagem , Tomografia Computadorizada por Raios X , Xeroderma Pigmentoso/complicações , Xeroderma Pigmentoso/genéticaRESUMO
We report two cases of brainstem tuberculomas with favorable outcome after medical treatment alone. Tuberculomas should be suspected in all cases presenting space-occupying lesions of the brainstem.
Assuntos
Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/patologia , Tuberculose do Sistema Nervoso Central/diagnóstico , Adulto , Anti-Inflamatórios/uso terapêutico , Antibióticos Antituberculose/uso terapêutico , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Esteroides , Tomografia Computadorizada por Raios X , Tuberculose do Sistema Nervoso Central/tratamento farmacológicoRESUMO
Three patients aged 32, 30 and 36 years, had chicken pox then developed acute cerebellar ataxia (for two) and acute polyradiculoneuritis. Cerebrospinal fluid (CSF) protein content was increased and varicella virus serology was positive in both blood and CSF. All three patients improved with aciclovir.
Assuntos
Ataxia Cerebelar/etiologia , Varicela/complicações , Polirradiculopatia/etiologia , Doença Aguda , Adulto , Ataxia Cerebelar/líquido cefalorraquidiano , Ataxia Cerebelar/virologia , Proteínas do Líquido Cefalorraquidiano/análise , Varicela/líquido cefalorraquidiano , Herpesvirus Humano 3/isolamento & purificação , Humanos , Masculino , Polirradiculopatia/líquido cefalorraquidiano , Polirradiculopatia/virologiaRESUMO
We report a case of Miller-Fisher syndrome with ophthalmoplegia, ataxia and areflexia. The main characteristics of this case were bilateral optic neuropathy and ponto-mesencephalic abnormalities on MRI. This case confirms the possible central neurologic localisation in this rare syndrome.
Assuntos
Imageamento por Ressonância Magnética , Mesencéfalo/patologia , Síndrome de Miller Fisher/patologia , Neurite Óptica/etiologia , Ponte/patologia , Adulto , Anti-Inflamatórios/uso terapêutico , Humanos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/patologia , Masculino , Metilprednisolona/uso terapêutico , Síndrome de Miller Fisher/complicações , Síndrome de Miller Fisher/tratamento farmacológico , Neurite Óptica/tratamento farmacológico , Neurite Óptica/patologiaRESUMO
We report a clinical association of diffuse scleroderma and amyotrophic lateral sclerosis (ALS) in two patients. Scleroderma was diagnosed on skin, digestive, osteoarticular, pulmonary lesions and inflammatory syndrome. ALS was suspected on the association of diffuse amyotrophy, fasciculations, pyramidal tract involvement and electrophysiological data. Chronic medulla ischemia and or immune abnormalities are proposed as potential pathological mechanisms for ALS but fortuitous association can not be excluded.