RESUMEN
We report a patient with chronic autonomic failure, who had exercise-induced ischemic electrocardiographic changes without coronary artery abnormalities. Orthostatic hypotension and exercise-induced release of humoral vasoconstrictors may have caused the myocardial ischemia.
Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/complicaciones , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Ejercicio Físico/fisiología , Isquemia Miocárdica/etiología , Isquemia Miocárdica/fisiopatología , Anciano , Angiografía Coronaria , Electrocardiografía , Prueba de Esfuerzo , Fatiga/fisiopatología , Humanos , Hipotensión Ortostática/complicaciones , Hipotensión Ortostática/fisiopatología , Masculino , Vasoconstricción/fisiologíaRESUMEN
Putaminal hemorrhage presenting pure sensory stroke is rare. We describe a case of left putaminal hemorrhage presenting contralateral hemisensory disturbance without hemiparesis. A 52-year-old man developed analgesia and thermoanesthesia in the right half of his body, but deep sensation was relatively well preserved. Neuroradiological and somatosensory evoked potential findings suggested that thalamocortical sensory pathways to the secondary somatosensory cortex (S2) were involved, whereas those to the primary somatosensory cortex (S1) were spared. In experimental animals, spinothalamic projections from the thalamic nucleus input directly to S2. In humans, thalamocortical pathways are still a subject of debate, but results of recent functional imaging studies suggest that the pathway of pain inputs directly to S2 and that of tactile sensation to S2 via S1. Our findings support these reports.
