RESUMO
Two hypertensive men presented clinically with small, largely unilateral hematomas of the pons and midbrain demonstrated by computerized tomography. Clinical manifestations included "ocular bobbing," complex forms of ophthalmoplegia, Cheyne-Stokes respiration, and pyramidal tract signs. The "typical" sings of massive pontine hemorrhage--including coma, pinpoint pupils, and hyperthermia--were absent.
Assuntos
Hematoma/diagnóstico por imagem , Ponte/diagnóstico por imagem , Adulto , Encefalopatias/diagnóstico por imagem , Respiração de Cheyne-Stokes/complicações , Respiração de Cheyne-Stokes/diagnóstico , Movimentos Oculares , Hematoma/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmoplegia/complicações , Tomografia Computadorizada por Raios XRESUMO
We present a case of acute hemichorea-hemiballism associated with lacunar infarct documented by computerized tomography scan in the contralateral putamen and caudate nuclei. The pathoanatomic data of similar cases in the literature are reviewed with reference to the location of the responsible lesions. Acute hemichorea-hemiballism is most frequently caused by lacunar infarcts in the basal ganglia contralateral to the dyskinesia.
Assuntos
Doenças dos Gânglios da Base/diagnóstico por imagem , Coreia/diagnóstico por imagem , Infarto/diagnóstico por imagem , Transtornos dos Movimentos/diagnóstico por imagem , Agitação Psicomotora/diagnóstico , Gânglios da Base/irrigação sanguínea , Doenças dos Gânglios da Base/complicações , Coreia/etiologia , Feminino , Humanos , Infarto/complicações , Pessoa de Meia-Idade , Transtornos dos Movimentos/etiologia , Agitação Psicomotora/etiologia , RadiografiaRESUMO
A case of type IIIA1b mirror-image right aortic arch is described and the complementary role of angiography and computed tomography suggested.
Assuntos
Aorta Torácica/anormalidades , Aortografia , Tomografia Computadorizada por Raios X , Aorta Torácica/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Selective treatment of duodenal ulcer with perforation has been based on several premises: 1) The natural history of the ulcer following closure of a perforation is generally favorable with an acute and unfavorable with a chronic ulcer. 2) An upper gastrointestinal series with water soluble contrast media can reliably document a spontaneously sealed perforation. 3) With a spontaneous seal, nonsurgical therapy is an acceptable option and is preferable for an acute ulcer or a chronic ulcer with poor surgical risk. 4) The treatment of choice for an unsealed perforation of an acute ulcer is simple surgical closure. 5) The treatment of choice of perforation of a chronic ulcer with acceptable surgical risk is an ulcer definitive operation. Sixty cases of perforation of duodenal ulcer have been treated. Nonsurgical therapy was employed without complication in eight cases with radiologically documented spontaneous seal. Truncal vagotomy and pyloroplasty in 36 cases and truncal vagotomy and antrectomy in two cases were each without mortality. Four fatalities occurred among 13 cases of closure and omental patch, each a case with severe associated disease. The mortality was 6.7% among the 60 cases; 2.4% for chronic ulcer and 16% for acute ulcer.