RESUMEN
Ischaemic stroke in persons with migraine may present with aura-like symptoms. In this case report a 42-year-old man with migraine with aura presented with a change in usual aura including visual loss and disorientation. A brain MRI revealed ischaemic stroke in precuneus compatible with these symptoms. We discuss the pathophysiology, the causes and the secondary prophylaxis in persons with migraine with aura and stroke.
Asunto(s)
Isquemia Encefálica , Epilepsia , Trastornos Migrañosos , Migraña con Aura , Accidente Cerebrovascular , Adulto , Humanos , Masculino , Migraña con Aura/diagnóstico por imagen , Migraña con Aura/etiología , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/etiologíaRESUMEN
BACKGROUND: Schizophrenia is associated with alterations in cortical structures and cognitive impairments, but antipsychotic medication may affect these measures. We investigated patterns of relationships between cortical structures and cognitive domains in antipsychotic-naïve patients with first-episode schizophrenia. METHODS: T1-weighted 3T magnetic resonance imaging was performed in 105 patients and 136 healthy control subjects. Using FreeSurfer, we obtained measurements of cortical thickness, surface area, and mean curvature. Using an extensive neurocognitive battery including the Danish Adult Reading Test and subtests from the Cambridge Neuropsychological Test Automated Battery, we obtained estimates of premorbid intelligence, spatial working memory, spatial planning, intra-extradimensional set shifting, and reaction and movement times. With univariate analyses, we tested group differences between cortical structures and cognition. With partial least squares correlation analyses, we investigated patterns of associations between cortical structures and cognition. RESULTS: Patients had significantly higher mean curvature and were impaired on 7 of 11 cognitive parameters. The between-group partial least squares correlation analysis revealed two cortical thickness/cognition patterns that differentiated patients and healthy control subjects (omnibus test, p = .011). Most cortical regions contributed reliably to these patterns. In patients, spatial working memory, spatial planning, reaction and movement times, and premorbid intelligence contributed reliably to the pattern; in healthy control subjects, spatial planning and intra-extradimensional set shifting contributed reliably. CONCLUSIONS: Antipsychotic-naïve patients with first-episode schizophrenia displayed a higher mean curvature, but no significant difference in other gray matter indices was found. Nevertheless, the pattern of associations between global cortical thickness and cognitive functions was markedly different between groups. These multivariate analyses reveal a novel linkage between regional cortical brain structure and cognitive deficits at the earliest, never-medicated illness stage.
Asunto(s)
Corteza Cerebral/patología , Trastornos del Conocimiento/patología , Esquizofrenia/patología , Adolescente , Adulto , Corteza Cerebral/diagnóstico por imagen , Cognición/fisiología , Trastornos del Conocimiento/diagnóstico por imagen , Trastornos del Conocimiento/etiología , Femenino , Humanos , Análisis de los Mínimos Cuadrados , Imagen por Resonancia Magnética , Masculino , Esquizofrenia/complicaciones , Esquizofrenia/diagnóstico por imagen , Adulto JovenRESUMEN
Posterior reversible encephalopathy syndrome (PRES) is a complex clinical condition with vasogenic subcortical oedema caused by hypertension. Oedema is often seen on magnetic resonance imaging. The wide clinical spectrum ranges from headaches to vision loss and even death. Early diagnosis and treatment is important for the reversibility of the condition. In this case report we emphasize the importance of blood pressure control in a post-partum woman, who had a rather complicated pregnancy. The symptoms of PRES were not recognized immediately because of failure to use and acknowledge a blood pressure test.
Asunto(s)
Síndrome de Leucoencefalopatía Posterior/diagnóstico , Adulto , Vías Clínicas , Femenino , Humanos , Hipertensión/complicaciones , Imagen por Resonancia Magnética/métodos , Síndrome de Leucoencefalopatía Posterior/etiología , Síndrome de Leucoencefalopatía Posterior/fisiopatología , Síndrome de Leucoencefalopatía Posterior/terapia , Periodo Posparto , EmbarazoAsunto(s)
Enfermedades de las Arterias Carótidas/complicaciones , Arteria Carótida Interna/patología , Hemianopsia/etiología , Anciano , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Arteria Carótida Interna/diagnóstico por imagen , Hemianopsia/diagnóstico , Hemianopsia/fisiopatología , Humanos , Hipertensión/complicaciones , Masculino , Fibras Nerviosas/patología , Células Ganglionares de la Retina/patología , Tomografía de Coherencia Óptica , Tomografía Computarizada por Rayos X , Pruebas del Campo Visual , Campos Visuales/fisiologíaRESUMEN
BACKGROUND: The circle of Willis is an important source of collateral blood flow to maintain adequate cerebral perfusion, particularly in the posterior circulation. Some studies report a relationship between incomplete circle of Willis and migraine, whereas other studies show no difference between the prevalence of incomplete circle of Willis in migraineurs and controls. In the present study we compared the prevalence of incomplete circle of Willis in female migraine patients without aura to female healthy non-migraine controls.Using 3-Tesla magnetic resonance angiography we recorded three-dimensional time-of-flight angiograms in 85 female participants (48 migraine patients without aura [median age 28 years] and 37 healthy controls [median age 25 years]). The images were subsequently analysed blindly by a neuroradiologist to detect incomplete circle of Willis. FINDINGS: We found no difference between the prevalence of incomplete circle of Willis in patients, 20/47 (43%), and controls, 15/37 (41%), p = 0.252. Post hoc analysis showed a significant relationship between age and prevalence of incomplete circle of Willis, p = 0.003. CONCLUSION: We found no relationship between migraine without aura and incomplete circle of Willis.