RESUMO
A 62-year-old man had an acute, transient, flaccid paraplegia. Examination showed a primary cardiac tumor with emboli to major branches of the aorta. A myxoma was removed from the left atrium, and normal function returned. Left atrial myxoma should be suspected as a cause for embolism to the CNS.
Assuntos
Neoplasias Cardíacas/complicações , Isquemia/etiologia , Mixoma/complicações , Medula Espinal/irrigação sanguínea , Embolia/etiologia , Átrios do Coração , Humanos , Masculino , Pessoa de Meia-Idade , Paraplegia/etiologiaRESUMO
Localized polymorphic delta wave activity appears ipsilaterally in patients with intracerebral hematoma without a shift of midline structures, regardless of the location of hematoma. Appearance of delta wave slowing after thalamic bleeding is quite variable, however, and may produce localized slowing or unilateral diffuse polymorphic delta wave activity. Unilateral diffuse polymorphic delta wave activity is seen in patients with larger hematomas of 30 mL or more, which cause a shift of the midline structures. The shift of midline structures, including the hypothalamus and surrounding structures, is thought to be one of the main factors responsible for the production of unilateral responsible for the production of unilateral diffuse polymorphic delta wave slowing.
Assuntos
Hemorragia Cerebral/fisiopatologia , Encefalopatias/diagnóstico por imagem , Ritmo Delta , Hematoma/diagnóstico por imagem , Humanos , Doenças Hipotalâmicas/fisiopatologia , Sono , Doenças Talâmicas/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
In a patient with phenytoin (PHE) intoxication, the brainstem auditory evoked potentials (BAEPs) were lost except for wave I and wave V. The patient recovered. In rats given PHE, we found changes in amplitude, morphology, and latency of BAEP. Within 5 minutes, all waves disappeared except for wave I, and soon thereafter all waves were lost, with PHE plasma concentration between 45.8 and 52.1 micrograms/ml or above. Ninety minutes after infusion, waves gradually reappeared. Loss of BAEP cannot be used as a criterion for brain death unless PHE intoxication is ruled out.
Assuntos
Tronco Encefálico/efeitos dos fármacos , Potenciais Evocados Auditivos/efeitos dos fármacos , Fenitoína/efeitos adversos , Adulto , Animais , Tronco Encefálico/fisiologia , Feminino , Humanos , Masculino , Fenitoína/sangue , Ratos , Ratos EndogâmicosRESUMO
A 57-year-old man presented with a pulmonary mass and subacute onset of paraplegia. Laboratory examination revealed an increased protein content in the cerebrospinal fluid and a normal myelogram. Autopsy disclosed epidermoid carcinoma in the left lower lobe of the lung, intramedullary metastasis at the midthoracic level, and a central pencil-shaped softening above and below the metastatic lesion. The pencil-shaped softening was an ischemic infarct rather than of hemorrhagic or congestive origin. The pathogenesis of this rare association may be explained by the hypothesis of a tumor embolus in the arterial circulation that feeds the center of the cord, producing metastasis. This embolus was followed later by a second embolus to a radicular artery, causing the pencil-shaped softening of the spinal cord.