RESUMO
INTRODUCTION: The intricate relationship between Chagas disease and ischemic stroke remains unclear. Limited evidence exists concerning secondary prophylaxis, etiological diagnosis, and stroke-related determinants. This study aims to discern factors linked to stroke in Chagas disease by contrasting patients with and without a history of ischemic stroke. METHODS: Retrospective data from all outpatient Chagas disease patients from two Brazilian hospitals - one Chagas center and one stroke clinic - were examined. Descriptive analyses were conducted to identify stroke-associated factors. Variables were compared between patients with and without ischemic stroke history. RESULTS: Among 678 subjects, 72 had experienced stroke. Univariate associations with stroke included male gender, heart failure, prior or ongoing alcoholism, electrocardiographic features (non-sinus rhythm, left bundle branch, right bundle branch block, left anterosuperior fascicular block, atrial fibrillation), as well as echocardiographic findings indicative of reduced left ventricular ejection fraction and segmental abnormalities. After logistic regression (multivariate analysis), congestive heart failure, right bundle branch block, left anterosuperior divisional block, and atrial fibrillation retained independent associations. CONCLUSION: In this study, cardiac involvement emerged as the predominant factor correlated with stroke in Chagas disease. While atherosclerosis-related risk factors were prevalent, their influence on ischemic stroke in Chagas disease appeared limited.
Assuntos
Fibrilação Atrial , Cardiomiopatia Chagásica , Doença de Chagas , Insuficiência Cardíaca , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Masculino , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/complicações , Estudos de Casos e Controles , Estudos Retrospectivos , Volume Sistólico , Bloqueio de Ramo/complicações , Função Ventricular Esquerda , Doença de Chagas/complicações , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/epidemiologia , Fatores de Risco , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , AVC Isquêmico/complicações , Eletrocardiografia/efeitos adversosRESUMO
Dengue fever has been associated with several neurological complications, cerebellar involvement being among the rarest of them. Here, we describe the case of a 70-year-old female who presented a cerebellar syndrome during the first day of an arboviral infection, posteriorly confirmed as dengue fever. Among the seven other cases in which the relationship between dengue virus and ataxia was reported, only in one cerebellar presentation occurred as early. Onset, course, and prognosis, as well as the adequate investigation and management of these patients, are discussed. While the disease pattern is not better characterized by future studies, differential diagnosis and close follow-up are essential tools for guaranteeing good outcomes.
