Pilonidal cyst on the vault. Case report.

Pilonidal cysts and sinuses are described as dermoid cysts which contain follicles of hairs and sebaceous glands. They clinically present as a classic case of inflammation which comes with pain, local infection and redness. The origin of pilonidal disease remains controverse. There are many hypothesis as lack of hygiene on the affected area and a penetration and growth of a hair in the subcutaneous tissue caused by constant friction or direct trauma on the damaged area. The option for clinical treatment is very frequent. However, taking into consideration the incidence and the possibility of recidive, surgical treatment is presently recommended. Complications include cellulitis and abscess formation. Pilonidal cysts are mostly found on the sacral region. In the literature is found description of pilonidal cysts on the penis, interdigital region on the hands as well as on the cervical region. We present a case of pilonidal cyst located on the vault biparietal region, without malignant degeneration.

Pseudocystic form of neurocryptococcosis in pregnancy. Case report.

We report a case of neurocryptococcosis which is unique in the literature because the patient had a pseudocystic form of the disease during pregnancy and without any evidence of AIDS. The clinical picture was that of intracranial hypertension and the epidemiological background was highly suggestive of cysticercosis. CT showed multiple round hypodense lesions in the basal ganglia and cerebellum, without contrast enhancement. Since a scolex was not visible, the diagnosis of neurocysticercosis was considered probable. CSF examination was not performed in view of its high risk. The patient had progressive downhill course. Autopsy disclosed multiple gelatinous pseudocysts in the cerebral and cerebellar gray matter, containing abundant Cryptococcus neoformans. Meningeal involvement was minimal. The child was delivered by caesarean section and was free of infection, but died later of hyaline membrane disease. The neuroimaging appearances of this rare instance of the pseudocystic form of neurocryptococcosis mimicked closely neurocysticercosis and only postmortem examination allowed correct diagnosis. The pseudocystic form has so far only been reported in AIDS.

Abnormally increased iron concentration in basal ganglia in Shy-Drager syndrome. MR imaging and autonomic study.

Report of an early case of Shy-Drager syndrome in a 67 year-old woman patient. Autonomic failure was diagnosed by functional evaluation as well as laboratory tests. MR imaging disclosed a prominent putamina hypodensity in T2-weighted images at high field strength due to iron increased depositing in this basal ganglia. MR imaging evidences confirm Shy-Drager syndrome diagnosis, and contributes for differential diagnosis of idiopathic hypotension (pure autonomic failure) in special in SDS early cases.

[Neuropathy caused by amiodarone: clinico-pathologic study of 2 cases]. / Neuropatia pela amiodarona: estudo clínico-patológico de dois casos.

Two patients, a 40-year-old woman and a 75-year-old man, were investigated due to a chronic polyneuritis. Amiodarone was used by them to treat refractory cardiac arrhythmia since 4 and 6 years before, respectively. The EMG study showed an axonal neuropathy. The light and electron-microscopical study of sural nerve displayed a loss of large myelinated fibers and a marked reduction of unmyelinated axons, associated with osmiophilic lamellated inclusions in Schwann cells and endothelial venulae. The interruption of amiodarone therapy improved neuropathy. Considered together with similar reports in perhexiline neuropathy and with chloroquine induced neuropathy this would stress the importance of these new drug-induced neurolipidosis.

Neuropatia pela amiodarona: estudo clínico-patológico de dois casos / Amiodarone neuropathy: clinico-pathological study of 2 cases

Dois pacientes, uma mulher de 40 anos e um homem de 75 anos, apresentavam polineurite sensitivo-motora, cujo único antecedentes era o uso de amiodarona há 4 e 6 anos respectivamente. O ENMG revelou quadro neuropático tipo axonal. A biópsia do nervo sural mostrou rarefaçäo axonal, mielínica e amielínica, bem como inclusöes lamelares osmiofílicas nas células de Schwann e no endotélio venular. Com a retirada da amiodarona houve regressäo da polineurite. A semelhança do que foi descrito na neuropatia pelo maleato de perhexiline e pela cloroquina, a amiodarona constitui constitui importante fator de induçäo de neurolipidose medicamentosa

Avaliacao multimodal do teste de Bender no psicodiagnostico da epilepsia. / Multi-modal evaluation of Bender test in the psychodiagnosis of epilepsy

Os autores avaliaram o poder discriminativo do Teste de Bender no psicodiagnostico da epilepsia. Foram estudados 60 pacientes 30 epilepticos (11 com epilepsia focal com ou sem generalizacao secundaria, 11 com epilepsia primariamente generalizada e oito com epilepsia tardia) e 30 pacientes com patologias funcionais, 12 dos quais apresentam um quadro de psicose. Os dados neurologicos clinicos eram complementados pelo exame EEG. O indice de concordancia media do Teste de Bender com as provas neurologicas e de 80%, correpondendo a 90% no grupo de epilepticos e a 70% no grupo de nao-organicos.O estudo e exploratorio tendo em vista as limitacoes inerentes aos tipos de provas empregadas, em particular no que se refere a epilepsia.No entanto os resultados sao promissores no que se refere a avaliacao da epilepsia tanto para fins clinicos como para fins de pesquisa