RESUMO
The association of unilateral ptosis and contralateral palpebral retraction named as "palpebral plus-minus syndrome" by Gaynard et al is an infrequent finding. Most cases described are of peripheral origin and secondary to muscle pathology or neuromuscular union. Cases secondary to central lesions are exceptional. We present the case of a female patient who developed palpebral plus-minus syndrome as a result of a vascular lesion with presumably mesencephalic localization.
Assuntos
Blefaroptose/etiologia , Encefalopatias/complicações , Encefalopatias/fisiopatologia , Pálpebras/fisiopatologia , Mesencéfalo/fisiopatologia , Idoso , Blefaroptose/fisiopatologia , Encefalopatias/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , SíndromeRESUMO
INTRODUCTION: Arteriosclerosis is the commonest aetiology of vertebro-basilar ischemia (VBI). In the literature few studies mention the risk profile of cerebrovascular accidents at this site. MATERIAL AND METHODS: In order to establish whether this profile has specific characteristics, we carried out a transversal study of 70 patients with VBI of artherothrombotic origin situated in the brain stem or cerebellum, determining the prevalence of the main risk factors (RF). The results were compared with a control group of individuals who had no cerebral vascular pathology and also with another group who had arteriosclerotic obstructive lesions of the carotid artery as an example of involvement of another vascular territory. RESULTS: In the the group of patients with VBI we found greater prevalence of hypertension, smoking, ischaemic cardiopathy, peripheral vascular disease and excessive alcohol consumption together with raised levels of arterial hypertension, haematocrit, haemoglobin and total cholesterol as compared with the control group and within a similar range to the group of patients with ischemia of the carotid territory. We underline the high prevalence of diabetes in patients with VBI (45.7%), considerably greater than that of the control group (12.5%), than those with carotid pathology (20.4%) and that described in the literature (17-25%). CONCLUSIONS: According to our results, the prevalence of RF in VBI and in carotid pathology is similar, except in the case of diabetes. This may play a more decisive role in territory such as the vertebro-basilar, where vascularization is basically by small calibre vessels.
Assuntos
Isquemia Encefálica/etiologia , Isquemia Encefálica/patologia , Cerebelo/patologia , Insuficiência Vertebrobasilar/complicações , Arteriosclerose/complicações , Arteriosclerose/patologia , Artéria Basilar/patologia , Cerebelo/irrigação sanguínea , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Artéria Vertebral/patologia , Insuficiência Vertebrobasilar/etiologia , Insuficiência Vertebrobasilar/patologiaRESUMO
Cavernous angiomas are comparatively rare vascular malformations in the central nervous system. Their location at the spinal level is rare, being but 3 to 16% of such vascular malformations. Among spinal intradural cavernous malformations most are intramedullar, the extramedullar type being less frequent. We have only came across five cases in the literature of intradural extramedullar cavernous angiomas affecting the cauda equina. We present a new such case with acute onset and later chronic evolution affecting the cauda equina through an intradural cavernous malformation at the level.