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1.
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286719

RESUMEN

Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.


Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , COVID-19 , Perú , Población Rural , Factores de Riesgo , Estudios de Cohortes , SARS-CoV-2 , Cefalea , Hospitales , Hipertensión , Infecciones
2.
Infectio ; 25(4): 293-295, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286725

RESUMEN

Resumen La trombosis venosa cerebral (TVC) es una presentación clínica poco común del tromboembolismo venoso caracterizada por cefalea, crisis convulsivas, déficits neurológicos focales y papiledema. El diagnóstico es confirmado con Tomografía axial computarizada (TAC) de cráneo y Resonancia magnética nuclear (RMN) cerebral. La TVC tiene una relación importante con el virus de inmunodeficiencia humana (VIH), ya que los pacientes VIH positivos cursan con hiperviscosidad san guínea, alteraciones de factores anticoagulantes endógenos y riesgo de sobreinfección, entre otros; que predisponen a estados protrombóticos y lesión vascular como lo es la TVC. El tratamiento de la TVC es terapia anticoagulante, por lo general se utiliza heparina no fraccionada o heparina de bajo peso molecular para la fase aguda y anticoagulantes orales como la warfarina para el mantenimiento posterior. Reportamos el primer caso documentado de TVC en un paciente VIH positivo en Colombia.


Abstract Cerebral venous thrombosis (CVT) is a rare clinical presentation of venous thromboembolism characterized by headache, seizures, neurological deficits and papi lledema. The diagnosis is confirmed using computed tomography scan (CT scan) and magnetic resonance imaging (MRI) of the brain. CVT has an important relationship with the human immunodeficiency virus (HIV) given that HIV-positive patients may present with blood hyperviscosity, irregular levels of endogenous anticoagulation factors and risk of sepsis among others, that predispose to prothrombotic states and vascular injury such as CVT. The treatment of CVT is anticoagulant therapy, generally unfractionated heparin or low molecular weight heparin for the early phase and oral anticoagulants such as warfarin for the late phase. This case reports the first documented case of CVT in an HIV positive patient in Colombia.


Asunto(s)
Humanos , Masculino , Adulto , Tromboembolia Venosa , Cráneo , Encéfalo , Imagen por Resonancia Magnética , VIH , Cefalea , Hepatitis B
3.
Infectio ; 25(4): 289-292, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286724

RESUMEN

Resumen La trombosis de senos venosos cerebrales es un evento infrecuente en la población pediátrica y sus manifestaciones clínicas pueden variar dependiendo de la localización y extensión de la lesión, etiología o grupo etario (1); así mismo, la asociación de esta patología con virus es poco común, sin embargo, se han repor tado casos de trombosis de senos venosos en pacientes adultos con SARS-CoV-2 en relación con los mecanismos de lesión endotelial y respuesta inflamatoria que desencadena mecanismos procoagulantes. A continuación se presenta el primer caso reportado en Colombia de un caso de trombosis venosa cerebral en un lactante previamente sano, que debuta con un cuadro infeccioso gastrointestinal que resuelve y una semana después se presenta con cefalea y paralisis del VI par craneal derecho. Se documentó por angioto mografía trombosis del seno venoso sagital con extensión a senos transversos; los laboratorios fueron negativos para otras causas sistémicas y con prueba de anticuerpos para coronavirus positiva.


Abstract Cerebral venous sinus thrombosis is infrequent in the pediatric population and its clinical manifestations may vary depending on the anatomical location and the extent of the lesion, etiology or age group(1). The association of this pathology with viruses is uncommon, however, cases in adults with SARS-Cov2 have been reported triggered by procoagulant mechanisms due to endothelial injury and inflammatory response. The following article is the first reported case in Colombia of cerebral venous thrombosis in a previously healthy child, who debuted with gastrointestinal infectious disease and a week later with headache and sixth right cranial nerve palsy . The diagnosis of sagittal venous sinus thrombosis with extension to transverse sinuses was documented in a computed tomography angiography; laboratories for systemic diseases were negative and antibodies for coronavirus were positive.


Asunto(s)
Humanos , Masculino , Lactante , Trombosis de los Senos Intracraneales , SARS-CoV-2 , COVID-19 , Trombosis , Virus , Coronavirus , Trombosis de la Vena , Enfermedades de los Nervios Craneales , Senos Transversos , Cefalea
4.
J Headache Pain ; 22(1): 117, 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34615455

RESUMEN

BACKGROUND: Recent data suggest that gene expression profiles of peripheral white blood cells can reflect changes in the brain. We aimed to analyze the transcriptome of peripheral blood mononuclear cells (PBMC) and changes of plasma metabolite levels of migraineurs in a self-controlled manner during and between attacks. METHODS: Twenty-four patients with migraine were recruited and blood samples were collected in a headache-free (interictal) period and during headache (ictal) to investigate disease- and headache-specific alterations. Control samples were collected from 13 age- and sex-matched healthy volunteers. RNA was isolated from PBMCs and single-end 75 bp RNA sequencing was performed using Illumina NextSeq 550 instrument followed by gene-level differential expression analysis. Functional analysis was carried out on information related to the role of genes, such as signaling pathways and biological processes. Plasma metabolomic measurement was performed with the Biocrates MxP Quant 500 Kit. RESULTS: We identified 144 differentially-expressed genes in PBMCs between headache and headache-free samples and 163 between symptom-free patients and controls. Network analysis revealed that enriched pathways included inflammation, cytokine activity and mitochondrial dysfunction in both headache and headache-free samples compared to controls. Plasma lactate, succinate and methionine sulfoxide levels were higher in migraineurs while spermine, spermidine and aconitate were decreased during attacks. CONCLUSIONS: It is concluded that enhanced inflammatory and immune cell activity, and oxidative stress can play a role in migraine susceptibility and headache generation.


Asunto(s)
Trastornos Migrañosos , Transcriptoma , Cefalea , Humanos , Leucocitos Mononucleares , Trastornos Migrañosos/genética
5.
Transl Psychiatry ; 11(1): 499, 2021 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-34593760

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has caused large-scale economic and social losses and worldwide deaths. Although most COVID-19 patients have initially complained of respiratory insufficiency, the presence of neuropsychiatric manifestations is also reported frequently, ranging from headache, hyposmia/anosmia, and neuromuscular dysfunction to stroke, seizure, encephalopathy, altered mental status, and psychiatric disorders, both in the acute phase and in the long term. These neuropsychiatric complications have emerged as a potential indicator of worsened clinical outcomes and poor prognosis, thus contributing to mortality in COVID-19 patients. Their etiology remains largely unclear and probably involves multiple neuroinvasive pathways. Here, we summarize recent animal and human studies for neurotrophic properties of severe acute respiratory syndrome coronavirus (SARS-CoV-2) and elucidate potential neuropathogenic mechanisms involved in the viral invasion of the central nervous system as a cause for brain damage and neurological impairments. We then discuss the potential therapeutic strategy for intervening and preventing neuropsychiatric complications associated with SARS-CoV-2 infection. Time-series monitoring of clinical-neurochemical-radiological progress of neuropsychiatric and neuroimmune complications need implementation in individuals exposed to SARS-CoV-2. The development of a screening, intervention, and therapeutic framework to prevent and reduce neuropsychiatric sequela is urgently needed and crucial for the short- and long-term recovery of COVID-19 patients.


Asunto(s)
COVID-19 , Animales , Cefalea , Humanos , Pandemias , SARS-CoV-2 , Convulsiones
6.
J Nepal Health Res Counc ; 19(2): 295-299, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34601519

RESUMEN

BACKGROUND: Atrial septal defect device closure has become a standard procedure. Antiplatelet therapy is used to prevent thrombus formation in the device. There is no clear recommendation about the antiplatelets drugs. This study aims to evaluate the safety and efficacy of Aspirin vs (Aspirin +Clopidogrel) after device closure. METHODS: A cross-sectional study was conducted among all consecutive adult patients (?18 years) who underwent atrial septal defect device closure from May 2019 to April 2020 and meet the inclusion criteria were included. After successful ASD device closure patients were treated with ASA or combination of ASA and Clopidogrel for six months on physician discretion. Patients were followed up for six months to observe for Transient ischemic attack, Stroke, thrombus in the device, myocardial infarction, major bleeding, minor bleeding and increases in headache episodes compared to baseline. RESULTS: This study consisted of 130 patients: 65 in the Aspirin Group, and 65 patients in Aspirin and Clopidogrel group. There was no Transient ischemic attack, Stroke, Myocardial infarction, thrombus, major bleeding in both groups. There was no significant difference between two groups in ecchymosis; Aspirin group 4(6.1%) vs. aspirin and Clopidogrel group 3(4.6%) [Difference, 1.54% {95, % CI, -1.45%to 4.53%}]; P=0.648. There was no significant difference in increase in headache episodes compared to baseline for six months after the device closure in Aspirin Group 3(4.6%) VS Aspirin and Clopidogrel group 2 (3.0%) group [difference, 1.54% {95% CI, -1.45%to 4.53%}]; P=0.648. CONCLUSIONS: Our study suggests that single antiplatelet therapy with Aspirin is as safe and effective as aspirin and clopidogrel after device closure.


Asunto(s)
Cefalea , Defectos del Tabique Interatrial , Adulto , Estudios Transversales , Humanos , Nepal
7.
Pan Afr Med J ; 39: 196, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34603577

RESUMEN

Intracavernous carotid artery aneurysm is rare but it leads to major complications. Common clinical picture is characterized by ophthalmoplegia associated with intense headaches. Cerebral angiography is used to confirm clinical suspicion and it guides therapeutic management. Endovascular embolization is the standard treatment. We here report the case of a 80-year-old woman presenting to the emergency room with right-sided exophthalmos and severe headaches occurring 2 weeks before her visit. The diagnosis of fissurized intracavernous carotid artery aneurysm was retained.


Asunto(s)
Arteria Carótida Interna/patología , Exoftalmia/etiología , Aneurisma Intracraneal/diagnóstico , Anciano de 80 o más Años , Servicio de Urgencia en Hospital , Femenino , Cefalea/etiología , Humanos , Aneurisma Intracraneal/complicaciones
8.
Pan Afr Med J ; 39: 207, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603588

RESUMEN

Acute spontaneous subdural hematoma is a rare clinical situation. Among its various etiologies, underlying coagulopathy is associated with a considerable risk of mortality. A 43-year-old female patient with no comorbidity and no personal or family history of bleeding disorders, consulted for acute and intense headache. The brain computed tomography (CT) scan showed a compressive left fronto-parietal acute subdural hematoma. The cerebral magnetic resonance angiography and routine hemostasis workup were normal. Factor XIII activity was low at 41% and the etiological investigation was consistent with the diagnosis of systemic lupus erythematosus. Surgical evacuation of the hematoma, factor XIII supplementation and systemic corticosteroid therapy with hydroxy chloroquine resulted in a favorable outcome. Acquired factor XIII deficiency should be systematically investigated for any acute spontaneous subdural hematoma with a normal hemostasis assessment in an adult with no personal or family history of hemorrhage.


Asunto(s)
Deficiencia del Factor XIII/diagnóstico , Hematoma Subdural Agudo/diagnóstico , Lupus Eritematoso Sistémico/diagnóstico , Adulto , Deficiencia del Factor XIII/complicaciones , Femenino , Cefalea/etiología , Hematoma Subdural Agudo/etiología , Hematoma Subdural Agudo/terapia , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/terapia , Angiografía por Resonancia Magnética , Tomografía Computarizada por Rayos X
9.
J Headache Pain ; 22(1): 118, 2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620087

RESUMEN

OBJECTIVE: Headache is the predominant disabler in idiopathic intracranial hypertension (IIH). The aim was to characterise headache and investigate the association with intracranial pressure. METHODS: IIH:WT was a randomised controlled parallel group multicentre trial in the United Kingdom investigating weight management methods in IIH. Participants with active IIH (evidenced by papilloedema) and a body mass index (BMI) ≥35 kg/m2 were recruited. At baseline, 12 months and 24 months headache characteristics and quality of life outcome measures were collected and lumbar puncture measurements were performed. RESULTS: Sixty-six women with active IIH were included with a mean age of 32.0 years (SD ± 7.8), and mean body mass index of 43.9 ± 7.0 kg/m2. The headache phenotype was migraine-like in 90%. Headache severity correlated with ICP at baseline (r = 0.285; p = 0.024); change in headache severity and monthly headache days correlated with change in ICP at 12 months (r = 0.454, p = 0.001 and r = 0.419, p = 0.002 respectively). Cutaneous allodynia was significantly correlated with ICP at 12 months. (r = 0.479, p < 0.001). Boot strap analysis noted a positive association between ICP at 12 and 24 months and enabled prediction of both change in headache severity and monthly headache days. ICP was associated with significant improvements in quality of life (SF-36). CONCLUSIONS: We demonstrate a positive relationship between ICP and headache and cutaneous allodynia, which has not been previously reported in IIH. Those with the greatest reduction in ICP over 12 months had the greatest reduction in headache frequency and severity; this was associated with improvement of quality of life measures. TRIAL REGISTRATION: This work provides Class IIa evidence of the association of raised intracranial pressure and headache. ClinicalTrials.gov number, NCT02124486 .


Asunto(s)
Seudotumor Cerebral , Adulto , Femenino , Cefalea/complicaciones , Cefalea/epidemiología , Humanos , Presión Intracraneal , Morbilidad , Seudotumor Cerebral/complicaciones , Seudotumor Cerebral/epidemiología , Calidad de Vida
10.
Artículo en Chino | MEDLINE | ID: mdl-34624957

RESUMEN

Nighteen people at a restaurant experienced dizziness headaches and other discomforts in six days. According to the description method, the time and location distribution were found to be concentrated. A second Investigation was conducted at the same time as the onset of the case, the test found that the carbon monoxide concentration of second floor up to 539 mg/m(3). The on-site testing found that when 2 steam generator in snack room on the first floor turned on, the carbon monoxide concentration on the top of elevator on the second floor was 1225.0 mg/m(3). After the accident, the restaurant replaced a steam generator, the carbon monoxide concentration on the top of the new and old steam generator were 350 mg/m(3) and >1 000 mg/m(3), respectively. After the steam generators were fitted with exhaust smoke pipe and exhasust hood, the carbon monoxide concentrations of on the top of the vegetable transfer elevator and the room on the second floor were both 0.4 mg/m(3), and there were no cases of recurrence. It was determined that this was a carbon monoxide poisoning incident caused by a high concentration of carbon monoxide emitted by the steam generators, which spread to the second floor of the private room through the vegetable transfer elevator.


Asunto(s)
Intoxicación por Monóxido de Carbono , Accidentes , Intoxicación por Monóxido de Carbono/epidemiología , Intoxicación por Monóxido de Carbono/etiología , Cefalea , Humanos , Humo
11.
J Headache Pain ; 22(1): 122, 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627140

RESUMEN

BACKGROUND: Brain arteriovenous malformations (AVMs) consist of abnormal connections between arteries and veins via an interposing nidus. While hemorrhage is the most common presentation, unruptured AVMs can present with headaches, seizures, neurological deficits, or be found incidentally. It remains unclear as to what AVM characteristics contribute to pain generation amongst unruptured AVM patients with headaches. METHODS: To assess this relationship, the current study evaluates angiographic and clinical features amongst patients with unruptured brain AVMs presenting with headache. Loyola University Medical Center medical records were queried for diagnostic codes corresponding to AVMs. In patients with unruptured AVMs, we analyzed the correlation between the presenting symptom of headache and various demographic and angiographic features. RESULTS: Of the 144 AVMs treated at our institution between 1980 and 2017, 76 were unruptured and had sufficient clinical data available. Twenty-three presented with headaches, while 53 patients had other presenting symptoms. Patients presenting with headache were less likely to have venous stenosis compared to those with a non-headache presentation (13 % vs. 36 %, p = 0.044). CONCLUSIONS: Our study suggests that the absence of venous stenosis may contribute to headache symptomatology. This serves as a basis for further study of correlations between AVM angioarchitecture and symptomatology to direct headache management in AVM patients.


Asunto(s)
Malformaciones Arteriovenosas Intracraneales , Encéfalo , Cefalea/etiología , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Estudios Retrospectivos , Convulsiones
12.
J Headache Pain ; 22(1): 123, 2021 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-34629054

RESUMEN

BACKGROUND: Obesity confers adverse effects to every system in the body including the central nervous system. Obesity is associated with both migraine and idiopathic intracranial hypertension (IIH). The mechanisms underlying the association between obesity and these headache diseases remain unclear. METHODS: We conducted a narrative review of the evidence in both humans and rodents, for the putative mechanisms underlying the link between obesity, migraine and IIH. RESULTS: Truncal adiposity, a key feature of obesity, is associated with increased migraine morbidity and disability through increased headache severity, frequency and more severe cutaneous allodynia. Obesity may also increase intracranial pressure and could contribute to headache morbidity in migraine and be causative in IIH headache. Weight loss can improve both migraine and IIH headache. Preclinical research highlights that obesity increases the sensitivity of the trigeminovascular system to noxious stimuli including inflammatory stimuli, but the underlying molecular mechanisms remain unelucidated. CONCLUSIONS: This review highlights that at the epidemiological and clinical level, obesity increases morbidity in migraine and IIH headache, where weight loss can improve headache morbidity. However, further research is required to understand the molecular underpinnings of obesity related headache in order to generate novel treatments.


Asunto(s)
Trastornos Migrañosos , Seudotumor Cerebral , Cefalea , Humanos , Presión Intracraneal , Trastornos Migrañosos/complicaciones , Trastornos Migrañosos/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Seudotumor Cerebral/complicaciones , Seudotumor Cerebral/epidemiología
13.
BMJ Case Rep ; 14(10)2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620638

RESUMEN

With increasing presentations of headaches following COVID-19 vaccination, we present one of the UK's earliest proven cases of vaccine-induced thrombotic thrombocytopaenia (VITT), with the aim of giving colleagues a case to compare other patients against. Our patient was a 48-year-old man who presented with frank haematuria, a widespread petechial rash, and headaches, 2 weeks after receiving the first dose of the Oxford AstraZeneca ChAdOx1 nCoV-19 vaccine. He had a platelet count of 14×109/L and an extensive cerebral venous sinus thrombosis (CVST) with subarachnoid haemorrhage on imaging. He developed localising neurological signs and experienced a cardiopulmonary arrest. He was successfully resuscitated and transferred to a tertiary care centre for urgent thrombectomy. This case illustrates how the diagnosis of VITT should be based on the platelet count and imaging-and how patients with VITT should be cared for in centres with urgent neurosurgical and interventional radiology services.


Asunto(s)
COVID-19 , Exantema , Trombosis de los Senos Intracraneales , Vacunas contra la COVID-19 , Cefalea , Hematuria , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Vacunación
15.
J Headache Pain ; 22(1): 107, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503441

RESUMEN

BACKGROUND: Medication-overuse headache (MOH) is a relatively frequently occurring secondary headache caused by overuse of analgesics and/or acute migraine medications. It is believed that MOH is associated with dependence behaviors and substance addiction, in which the salience network (SN) and the habenula may play an important role. This study aims to investigate the resting-state (RS) functional connectivity between the habenula and the SN in patients with MOH complicating chronic migraine (CM) compared with those with episodic migraine (EM) and healthy controls (HC). METHODS: RS-fMRI and 3-dimensional T1-weighted images of 17 patients with MOH + CM, 18 patients with EM and 30 matched healthy HC were obtained. The RS-fMRI data were analyzed using the independent component analysis (ICA) method to investigate the group differences of functional connectivity between the habenula and the SN in three groups. Correlation analysis was performed thereafter with all clinical variables by Pearson correlation. RESULTS: Increased functional connectivity between bilateral habenula and SN was detected in patients with MOH + CM compared with patients with EM and HC respectively. Correlation analysis showed significant correlation between medication overuse duration and habenula-SN connectivity in MOH + CM patients. CONCLUSIONS: The current study supported MOH to be lying within a spectrum of dependence and addiction disorder. The enhanced functional connectivity of the habenula with SN may correlate to the development or chronification of MOH. Furthermore, the habenula may be an indicator or treatment target for MOH for its integrative role involved in multiple aspects of MOH.


Asunto(s)
Habénula , Cefaleas Secundarias , Trastornos Migrañosos , Cefalea , Cefaleas Secundarias/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Trastornos Migrañosos/complicaciones , Trastornos Migrañosos/diagnóstico por imagen
16.
JNMA J Nepal Med Assoc ; 59(234): 197-199, 2021 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-34506475

RESUMEN

Idiopathic Intracranial Hypertension is a rare occurrence in young, physically fit male and a diagnosis of exclusion among most patients presenting with signs and symptoms of raised intracranial pressure. Here we describe a case of a young male in the ideal weight range with no previous exposure to offending chemicals presented with a history of headache, obscuration of vision, and photopsia. On examination, there were no positive neurological findings. Increased opening pressure was found on the lumbar puncture. Ophthalmological examination revealed bilateral papilledema. Humphrey’s Visual field test showed peripheral field loss. Magnetic resonance imaging scan of the brain and orbits were normal. The patient was diagnosed and managed in primary care setting after neurosurgical consultation. Though rare, we should suspect idiopathic intracranial hypertension in ideal body weighted male if the headache is persistent after other causes of headache have been ruled out.


Asunto(s)
Hipertensión Intracraneal , Papiledema , Seudotumor Cerebral , Cefalea/etiología , Humanos , Hipertensión Intracraneal/diagnóstico , Hipertensión Intracraneal/etiología , Masculino , Papiledema/diagnóstico , Papiledema/etiología , Seudotumor Cerebral/complicaciones , Seudotumor Cerebral/diagnóstico , Trastornos de la Visión
17.
Neurol India ; 69(4): 1032-1033, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34507437

RESUMEN

Moya Moya disease is an important cause for childhood strokes and morbidity. An early diagnosis and treatment can prevent strokes and disability. Here we report the case of an eight-year-old boy who had transient episodes of headache and hemiparesis secondary to Moya Moya disease. He was misdiagnosed as hemiplegic migraine, seizure disorder, paroxysmal non-kinesigenic dyskinesia and dissociative disorder during the past three years. The diagnosis was significantly delayed as an important clinical cue was overlooked. A detailed history showed that symptoms were precipitated on eating spicy food. This clinical pointer prompted evaluation for Moya Moya disease. MRI and MR angiogram confirmed Moya Moya disease.


Asunto(s)
Ataque Isquémico Transitorio , Enfermedad de Moyamoya , Accidente Cerebrovascular , Niño , Cefalea , Humanos , Masculino , Paresia
18.
JNMA J Nepal Med Assoc ; 59(238): 611-613, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34508410

RESUMEN

Menstrual migraine is a condition in females, where headaches are linked with menstruation and may be debilitating. Hormonal fluctuations could have a key role in migraine etiopathogenesis, as several women experience that their migraine attacks correlate with their menstrual cycle. Estrogen withdrawal appears to have a significant role in migraine associated with menstrual cycles, despite the fact that its pathophysiology is not well known. The treatment method can also vary from that used to treat nonmenstrual migraines. However, with proper identification and management of the condition, it can be bearable. This article highlights some portions of what is known about migraine, its triggers including the experience of a sufferer and aims to provide readers with a better understanding of migraine in women by understanding these aspects of the condition.


Asunto(s)
Menstruación , Trastornos Migrañosos , Femenino , Cefalea , Humanos , Ciclo Menstrual , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/etiología
19.
N Z Med J ; 134(1542): 38-49, 2021 09 17.
Artículo en Inglés | MEDLINE | ID: mdl-34531582

RESUMEN

AIMS: To review the demographic and clinical characteristics of confirmed COVID-19 cases within the Greater Wellington Region (GWR). METHODS: A retrospective, observational study of all 96 confirmed COVID-19 cases in the GWR. The primary outcome was time taken from onset to complete resolution of symptoms. Secondary outcomes were the epidemiological and clinical characteristics of cases. RESULTS: The mean (SD) time from symptom onset to complete resolution was 19.1 (1.1) days. The mean (SD) age was 43.1 (16.9). 51% were male. The majority were of European ethnicity (84%), resided in the top five decile neighbourhoods (76%) and had travelled to New Zealand (69%). The mean (SD) time from onset of symptoms to obtaining RT-PCR testing results was 5.3 (0.4) days. The most common symptoms at onset were cough (36%), sore throat (22%) and fatigue (21%); the overall most common symptoms were cough (65%), sore throat (43%), headache (43%) and fatigue (42%); many symptoms were late manifestations. The most common co-morbidity reported was asthma (20%), with no reported exacerbations. The rate of secondary infections within households was 0.05 per primary infection. CONCLUSION: The demography of COVID-19 cases reflected the imported nature of cases. The clinical presentation of COVID-19 was highly variable and there were no particular symptoms that could accurately predict infection.


Asunto(s)
COVID-19/diagnóstico , COVID-19/epidemiología , Examen Físico , Adulto , Causalidad , Tos/diagnóstico , Fatiga/diagnóstico , Cefalea/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Faringitis/diagnóstico , Estudios Retrospectivos
20.
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