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1.
Fortschr Neurol Psychiatr ; 84(9): 534-41, 2016 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-27607067

RESUMO

Sporadic cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease in the elderly. Neuropathologically, it is characterized by deposition of amyloid-ß (Aß) in the wall of small to medium-sized arteries, capillaries and venules of the cerebral cortex and leptomeninges. Over the last years it was recognized as an important cause of spontaneous intracerebral hemorrhage and cognitive deficits in the elderly. The clinical and radiological manifestations are diverse ranging from acute onset focal neurological deficits due to intracerebral lobar hemorrhage to subacute progressive cognitive impairment due to Aß-mediated inflammation confluent subcortical edema. The wide clinico-radiological spectrum of CAA is a major challenge for the neurologist and stroke physician. This review provides a structured and detailed look at recent developments in CAA, and is illustrated with case studies.


Assuntos
Angiopatia Amiloide Cerebral/diagnóstico , Angiopatia Amiloide Cerebral/patologia , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/patologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Peptídeos beta-Amiloides/metabolismo , Artérias Cerebrais/patologia , Córtex Cerebral/irrigação sanguínea , Córtex Cerebral/patologia , Veias Cerebrais/patologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/patologia , Progressão da Doença , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Meninges/irrigação sanguínea , Pessoa de Meia-Idade , Fragmentos de Peptídeos/metabolismo
2.
Fortschr Neurol Psychiatr ; 83(11): 628-33, 2015 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-26633842

RESUMO

Patients with lesions of the prefrontal cortex as a result of frontal brain tumors (intra- and extra-axial) can show impairments of executive functions 1 2 3 4. Although there are a large number of psychological tests, the detection of impairments of relevant everyday executive functions in these patients is still extremely difficult. In 30 patients with lesions of the prefrontal cortex, the executive functions were tested with the Behavioral Assessment of Dysexecutive Syndrome (BADS) and 21 patients were also followed up postoperatively. Additionally, if possible, the Wisconsin Card Sorting Test (WCST), a widely used executive function test, and the Wechsler Adult Intelligence Scale (WAIS) for general cognitive performance were conducted. Pre- and postoperatively, a total of 16 patients were followed up with all three tests. The aim was to investigate the neuropsychological assessment pre- and postoperatively, to evaluate it in terms of deficits and changes in performance and to ensure that no new relevant everyday cognitive deficits arose. Preoperatively, only one patient, who could not be tested post-surgery, showed a reduced overall profile value in the BADS.  In all tested patients, there was no evidence of deterioration of cognitive status 8 - 12 weeks postoperatively. Further investigations using fMRI should be used to clarify whether the results obtained should be interpreted as neuroplastic adaptations of prefrontal cognitive functions or as a failure to detect deficits due to a lack of sensitivity of the tests used.


Assuntos
Neoplasias Encefálicas/psicologia , Neoplasias Encefálicas/cirurgia , Transtornos Cognitivos/psicologia , Cognição , Lobo Frontal/cirurgia , Microcirurgia/efeitos adversos , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/psicologia , Adulto , Idoso , Transtornos Cognitivos/etiologia , Função Executiva , Feminino , Humanos , Inteligência , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Wechsler , Adulto Jovem
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