RESUMO
Most anatomic features of the internal carotid artery (ICA) are described as a straight course to the skull base free of branches. In some cases, the excessive elongation of the internal carotid artery in a confined space results in a curvature showing a "C" or "S" shape, or in an abnormal vascular shape made of a single or double vessel loop. These anatomic variants are called dolichoarteriopathies of the internal carotid artery. The correlation between dolichoarteriopathy of the ICA and stroke is still questionable, however it is believed that it can be associated with cerebral ischemia with a clinical symptomatology that accompanies ischemic stroke. We report a case of a 41-year-old patient, with a history of hypertension, who was admitted for right hemiparesis with Broca's aphasia. The rest of the clinical examination was normal. Radiological investigations confirmed an acute left sylvian ischemic stroke with an abrupt occlusion of the posterior trunk of the left M2 segment on the CT angiogram, an excessive elongation of the ICA on both sides, describing a shape of coils or loops. Etiologic workup for ischemic stroke was negative.
Assuntos
Artéria Carótida Interna , AVC Isquêmico , Humanos , Adulto , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/anormalidades , AVC Isquêmico/etiologia , AVC Isquêmico/diagnóstico por imagem , Masculino , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/complicações , Angiografia por Tomografia Computadorizada , Afasia de Broca/etiologia , Afasia de Broca/diagnóstico por imagemRESUMO
Cerebral venous thrombosis (CVT) is a rare but serious complication of ulcerative colitis (UC) with a high morbidity and mortality rate. CVT is not usually readily recognized and treatment may be delayed, impacting on the prognosis. Here we are reporting 2 cases of CVT occurring during a relapse of ulcerative colitis (UC) with review of literature. The first patient was a 27-year-old woman with chronic UC who presented with headaches during a relapse of chronic UC. She was found to have cerebral venous sinus thrombosis. The second one was a 45-year-old man who presented with seizures and focal neurological symptom during a relapse of chronic UC. He was found to have cerebral venous sinus thrombosis complicated by left temporal infarction. Both of them were treated with therapeutic anticoagulation with good improvement. The presence of neurological signs in a patient with UC mostly during exacerbation period, should alert health professionals about the possibility of a CVT.
Assuntos
Colite Ulcerativa/complicações , Trombose dos Seios Intracranianos/etiologia , Adulto , Anticoagulantes/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva , Fatores de Risco , Trombose dos Seios Intracranianos/diagnóstico por imagem , Trombose dos Seios Intracranianos/tratamento farmacológico , Resultado do TratamentoRESUMO
We report a case of ischemic stroke caused by internal carotid artery dissection in a 35-year-old woman in postpartum following spontaneous labor and vaginal delivery. Ischemic stroke due to arterial dissection requires rapid diagnosis and anticoagulation.
Assuntos
Isquemia Encefálica/etiologia , Dissecação da Artéria Carótida Interna/complicações , Transtornos Puerperais/etiologia , Adulto , Anticoagulantes/uso terapêutico , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/patologia , Dissecação da Artéria Carótida Interna/epidemiologia , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/patologia , Parto Obstétrico , Feminino , Hemiplegia/etiologia , Humanos , Incidência , Imageamento por Ressonância Magnética , Gravidez , Transtornos Puerperais/epidemiologiaRESUMO
Thymectomy has a broad indication for the treatment of myasthenia gravis. Occurrence a few months or years after thymectomy of a number of autoimmune diseases including systemic lupus erythematosus in myasthenic patients is very rare. We report a 51-year-old woman who developed a systemic lupus 1 year after the thymectomy.