RESUMEN
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.
Asunto(s)
Arteria Carótida Interna , Accidente Cerebrovascular Isquémico , Humanos , Adulto , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/anomalías , Accidente Cerebrovascular Isquémico/etiología , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Masculino , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/complicaciones , Angiografía por Tomografía Computarizada , Afasia de Broca/etiología , Afasia de Broca/diagnóstico por imagenRESUMEN
The occurrence of arterial and venous thrombosis during coronavirus infection has been widely reported since the beginning of the epidemic. Floating carotid thrombus (FCT) in the common carotid artery is exceptional and its main known cause is atherosclerosis. We describe the case of a 54-year-old man who developed, one week after the onset symptomatology of related to COVID-19 infection, an ischemic stroke, complicating a large intraluminal floating thrombus in the left common carotid artery. Despite surgery and anticoagulation, a local recurrence with other thrombotic complications occurred and the patient died.
Asunto(s)
COVID-19 , Trombosis , Masculino , Humanos , Persona de Mediana Edad , COVID-19/complicaciones , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/cirugía , Trombosis/diagnóstico por imagen , Trombosis/tratamiento farmacológico , Trombosis/etiología , Arterias Carótidas , Coagulación SanguíneaRESUMEN
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.
Asunto(s)
Colitis Ulcerosa/complicaciones , Trombosis de los Senos Intracraneales/etiología , Adulto , Anticoagulantes/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Recurrencia , Factores de Riesgo , Trombosis de los Senos Intracraneales/diagnóstico por imagen , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Jean Rodier (1920-2003), distinguished researcher and scientist, directed the Toxicology Department of Hygiene Institute of Rabat under the French Protectorate. From 1946, he developed numerous lines of research in occupational health, in particular on Manganism, a neurological disorder that impacted miners in his home country of Morocco. His many papers on Manganism, only one of which was published in English, describe field and laboratory research studies that focused its prevention and management.
Asunto(s)
Investigación Biomédica/historia , Intoxicación por Manganeso/historia , Enfermedades Profesionales/historia , Toxicología/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Intoxicación por Manganeso/diagnóstico , Intoxicación por Manganeso/epidemiología , Intoxicación por Manganeso/prevención & control , Mineros/historia , Minería/historia , Marruecos/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/prevención & control , Salud Laboral/historia , Medición de Riesgo , Factores de RiesgoAsunto(s)
Enfermedades Autoinmunes del Sistema Nervioso/complicaciones , Neuromielitis Óptica/complicaciones , Adulto , Enfermedades Autoinmunes del Sistema Nervioso/terapia , Femenino , Humanos , Imagen por Resonancia Magnética , Neuromielitis Óptica/terapia , Paraplejía/etiología , Intercambio Plasmático , Médula Espinal/patología , Vitamina B 12/uso terapéutico , Vitaminas/uso terapéuticoAsunto(s)
Malformación de Arnold-Chiari/diagnóstico , Seudotumor Cerebral/diagnóstico , Adulto , Malformación de Arnold-Chiari/complicaciones , Malformación de Arnold-Chiari/cirugía , Encéfalo/patología , Descompresión Quirúrgica , Femenino , Humanos , Imagen por Resonancia Magnética , Procedimientos Neuroquirúrgicos , Seudotumor Cerebral/etiología , Seudotumor Cerebral/cirugía , Siringomielia/patologíaAsunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico , Encéfalo/patología , Imagen por Resonancia Magnética , Debilidad Muscular/fisiopatología , Paraparesia Espástica/fisiopatología , Lengua/patología , Esclerosis Amiotrófica Lateral/patología , Esclerosis Amiotrófica Lateral/fisiopatología , Atrofia , Diagnóstico Diferencial , Electromiografía , Extremidades/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Debilidad Muscular/etiología , Paraparesia Espástica/etiología , Reflejo de Babinski/fisiopatología , Extremidad Superior/fisiopatologíaRESUMEN
INTRODUCTION: Essential thrombocythemia (ET) is a myeloproliferative syndrome; cerebral venous thrombosis (CVT) is a rare complication. OBSERVATION: We report the case of a 20-year-old woman with an uneventful history who was admitted with intracranial hypertension syndrome which had developed over the last four months in association with bilateral decline of visual acuity. Physical examination at admission revealed stage II papilloedema and absence of any focal neurological signs. The brain MRI and the venous MRA showed a thrombosis involving the superior longitudinal sinus and the lateral sinus. The etiological analysis disclosed essential thrombocythemia (ET). The patient was given an antiedema and anticoagulant treatment. Later, an etiological cytoreductive therapy was initiated. Signs of intracranial hypertension regressed progressively with persistence of acute visual disorders associated with sequelar optical atrophy. Discussion. ET is a rare cause of CVT. Reports in the literature have discussed the mechanisms, the physiology, the therapeutic modalities and the clinical course of these CVTs secondarily to ET. CONCLUSION: Stroke, especially transient ischemic attack, is the usual thrombotic expression of myeloproliferative syndrome. CVT is much more exceptional.
Asunto(s)
Encéfalo/irrigación sanguínea , Encéfalo/patología , Venas Cerebrales/patología , Trombocitemia Esencial/complicaciones , Trombosis de la Vena/etiología , Trombosis de la Vena/patología , Adolescente , Alopurinol/uso terapéutico , Quimioterapia Combinada , Inhibidores Enzimáticos/uso terapéutico , Femenino , Humanos , Hidroxiurea/uso terapéutico , Imagen por Resonancia Magnética , Trombocitemia Esencial/diagnóstico , Trombocitemia Esencial/tratamiento farmacológicoRESUMEN
Takayasu's disease is a non specific, chronic, inflammatory panarteritis. It affects the aorta, its chief collaterals and the pulmonary arteries. Clinical manifestations depend on the site and the severity of the occlusive vascular lesion. We report a case observed in a young woman who presented ischemic stroke as the inaugural sign of Takayasu's disease.
Asunto(s)
Isquemia Encefálica/etiología , Accidente Cerebrovascular/etiología , Arteritis de Takayasu/complicaciones , Adulto , Isquemia Encefálica/diagnóstico , Femenino , Humanos , Accidente Cerebrovascular/diagnósticoRESUMEN
We investigated the effect of a restricted diet model on activity in the human motor cortex using functional magnetic resonance imaging (fMRI). Two series of blood oxygenation level-dependent (BOLD)-fMRI measurements were made in healthy subjects performing simple motor tasks using their right hands. The first series was done 5-10 days prior to the restricted diet schedule (controls), and the second series was performed after 25-28 days of restricted diet, in the form of a religious fast (Ramadan). The size and intensity of the activated area in the motor cortex increased during the time of restricted diet versus the controls. We conclude that restricted diet has a significant effect on cerebral activity, as shown by BOLD-fMRI, although the exact relationship between the images and neuronal activity due to the restricted diet is still to be determined.
Asunto(s)
Encéfalo/fisiología , Dieta , Ingestión de Alimentos/fisiología , Ayuno/fisiología , Oxígeno/sangre , Adulto , Humanos , Imagen por Resonancia Magnética , Masculino , Corteza Motora/anatomía & histología , Corteza Motora/fisiología , Movimiento/fisiologíaRESUMEN
OBJECTIVE: To describe the neuroimaging findings in eclamptic patients still symptomatic after 24 hours. PATIENTS AND METHODS: All parturients consecutively admitted over a 12-month period for eclampsia and presenting with neurological disorders (coma, focal neurological abnormalities, and eye sight disturbance) underwent cerebral CT-scan and/or MRI. RESULTS: Nineteen women were studied, and all had abnormal neuroradiological findings. The CT-scan was normal in three cases. Cerebral oedema was the predominant lesion (14 cases). It was localized in the parietal or occipital area (12 cases), paraventricular area (1 case), or was diffuse (1 case). Diffusion weighted MRI was performed in four cases and showed cytotoxic cerebral oedema in one case. There were three cases of cerebral venous thrombosis and two cases of intracerebral haemorrhage. CONCLUSION: Various neuroradiological lesions can be observed in eclamptic patients. A localized cerebral oedema is the most frequent. Diffusion weighted MRI should be systematically done when neurological disorders persist.
Asunto(s)
Encefalopatías/diagnóstico , Imagen de Difusión por Resonancia Magnética , Eclampsia/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Antihipertensivos/uso terapéutico , Encefalopatías/diagnóstico por imagen , Encefalopatías/etiología , Edema Encefálico/diagnóstico , Edema Encefálico/diagnóstico por imagen , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/diagnóstico por imagen , Venas Cerebrales/diagnóstico por imagen , Venas Cerebrales/patología , Ventrículos Cerebrales/patología , Cesárea , Femenino , Muerte Fetal/etiología , Humanos , Trombosis Intracraneal/diagnóstico , Trombosis Intracraneal/diagnóstico por imagen , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Occipital/patología , Lóbulo Parietal/diagnóstico por imagen , Lóbulo Parietal/patología , Embarazo , Resultado del EmbarazoRESUMEN
A 35 year-old heterosexual man had a six months history of cervical myelitis with progressive paraplegia, leg weakness and paresthesia of the four extremities. Spinal cord MRI showed a high T2 signal intramedullary lesion wide from the bulbo-medullary junction to D4. Post gadolinium T1 sequence revealed an enhancement in front of C3-C4 vertebrae. VIH serology was positive. Corticosteroid treatment achieved a marked improvement. In addition to vacuolar myelopathy, well-known at the advanced stages of the HIV infection (AIDS), myelitis and clinical pictures simulating multiple sclerosis were described during early stages of the infection. These inflammatory lesions of the central nervous system and sometimes of the peripheral nervous system seems to be related to the immune response dysfunction induced by the VIH.
Asunto(s)
Infecciones por VIH/complicaciones , Mielitis Transversa/diagnóstico , Mielitis Transversa/virología , Médula Espinal/patología , Adulto , Antiinflamatorios/uso terapéutico , Extremidades/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Mielitis Transversa/tratamiento farmacológico , Cuello , Paraplejía/fisiopatología , Parestesia/fisiopatología , EsteroidesRESUMEN
Meningeal Carcinomatosis (MC) is rare (4 to 5% of patients with solid tumors). We report two cases. The first case is a 53 year-old man presenting flaccid paraplegia and the second is a 76 year-old man presenting a clinical picture suggestive of normal pressure hydrocephalus. In the two cases, the diagnosis of MC was achieved by the demonstration of malignant cells in the CSF. Prognosis was poor in the two cases. The clinical presentation of MC is non specific and the diagnosis is only confirmed by demonstrating carcinomatous cells in CSF.