RESUMEN
We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA.
Asunto(s)
Infarto Encefálico/etiología , Infarto de la Arteria Cerebral Media/etiología , Arteria Cerebral Media/efectos de la radiación , Radioterapia/efectos adversos , Adulto , Ganglios Basales/patología , Ganglios Basales/efectos de la radiación , Infarto Encefálico/patología , Infarto Encefálico/fisiopatología , Calcinosis/etiología , Calcinosis/patología , Calcinosis/fisiopatología , Imagen de Difusión por Resonancia Magnética , Femenino , Humanos , Infarto de la Arteria Cerebral Media/patología , Infarto de la Arteria Cerebral Media/fisiopatología , Cápsula Interna/irrigación sanguínea , Cápsula Interna/patología , Cápsula Interna/fisiopatología , Meduloblastoma/radioterapia , Arteria Cerebral Media/patología , Arteria Cerebral Media/fisiopatología , Tálamo/patología , Tálamo/efectos de la radiación , Tomografía Computarizada por Rayos XRESUMEN
We compared the effects of single doses of thioridazine and mesoridazine on the heart rate-corrected QT (QTc) interval in healthy adult volunteers. QTc intervals and plasma concentrations of thioridazine, mesoridazine, and metabolites were measured after single oral doses of thioridazine hydrochloride 50 mg, mesoridazine besylate 50 mg, or placebo in a double-blind, crossover study. Mean maximum increases in the QTc interval following thioridazine (37.3+/-4.1 ms, P=0.023) and mesoridazine (46.6+/-7.4 ms, P=0.021) were similar and significantly greater than following placebo (12.9+/-8.1 ms). The area under the effect-time curve over 8 h following drug administration was similar between the two drugs (129.3+/-22.1 vs 148.3+/-43.0 ms h). In conclusion, thioridazine and mesoridazine are associated with similar effects on the QTc interval.