RESUMO
[This corrects the article DOI: 10.1371/journal.pone.0213319.].
RESUMO
OBJECTIVE: To determine if corneal confocal microscopy can identify corneal nerve and endothelial cell abnormalities and may be useful in the prognostication of patients with transient ischemic attack [1] or minor ischemic stroke (IS). METHODS: Thirty-six patients admitted with TIA (n = 14) or minor IS (n = 22) underwent transcranial Doppler evaluation and corneal confocal microscopy and were compared with 18 healthy controls. RESULTS: Corneal nerve fiber density (P = 0.002), branch density (P = 0.004) and fiber length (P = 0.004) were significantly lower in patients with TIA or minor IS compared to controls, with no difference between patients with TIA and minor IS. Endothelial cell density (P = 0.003) was lower and endothelial cell area (P = 0.003) and perimeter (P = 0.006) were significantly higher in patients with TIA or minor IS compared to controls, with no difference between patients with TIA and minor IS. There were no differences in corneal nerve or endothelial cell morphology between patients with and without abnormal cerebrovascular reactivity. HbA1c was independently associated with CNFL, and endothelial cell polymegathism and pleomorphism were associated with both HbA1c and total cholesterol. CONCLUSION: Corneal confocal microscopy identifies corneal nerve fiber loss and endothelial cell abnormalities in patients with TIA and minor IS and independent associations with HbA1c and cholesterol.
Assuntos
Isquemia Encefálica/fisiopatologia , Córnea/inervação , Endotélio Vascular/patologia , Ataque Isquêmico Transitório/fisiopatologia , Fibras Nervosas/patologia , Acidente Vascular Cerebral/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Adulto JovemAssuntos
Neoplasias do Sistema Nervoso Central/diagnóstico , Hemorragia Cerebral/diagnóstico , Linfoma de Células B/diagnóstico , Acidente Vascular Cerebral/diagnóstico , Adulto , Anti-Inflamatórios/uso terapêutico , Biópsia , Encéfalo/patologia , Neoplasias do Sistema Nervoso Central/patologia , Hemorragia Cerebral/complicações , Diagnóstico Diferencial , Cefaleia/etiologia , Humanos , Linfoma de Células B/patologia , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Exame Neurológico , Acidente Vascular Cerebral/etiologia , Tomografia Computadorizada por Raios XRESUMO
Abnormalities of body temperature are perhaps the most common features in many systemic pathologic processes. Such pathologic alterations are nearly always the result of extrinsic factors (for example, systemic pyrogens) which affect the hypothalamic thermoregulatory center by way of circulatory system. Much less common is alterations in temperature regulation resulting from intrinsic lesions of the thermoregulatory center in the hypothalamus. We report a patient with tuberculous meningitis who continued to have persistent fever despite the satisfactory treatment of her tuberculosis. A central thermoregulatory defect was documented and was attributed to a small structural lesion in the anterior hypothalamus.