RESUMO
We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA.
Assuntos
Infarto Encefálico/etiologia , Infarto da Artéria Cerebral Média/etiologia , Artéria Cerebral Média/efeitos da radiação , Radioterapia/efeitos adversos , Adulto , Gânglios da Base/patologia , Gânglios da Base/efeitos da radiação , Infarto Encefálico/patologia , Infarto Encefálico/fisiopatologia , Calcinose/etiologia , Calcinose/patologia , Calcinose/fisiopatologia , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Infarto da Artéria Cerebral Média/patologia , Infarto da Artéria Cerebral Média/fisiopatologia , Cápsula Interna/irrigação sanguínea , Cápsula Interna/patologia , Cápsula Interna/fisiopatologia , Meduloblastoma/radioterapia , Artéria Cerebral Média/patologia , Artéria Cerebral Média/fisiopatologia , Tálamo/patologia , Tálamo/efeitos da radiação , Tomografia Computadorizada por Raios XRESUMO
We compared the effects of single doses of thioridazine and mesoridazine on the heart rate-corrected QT (QTc) interval in healthy adult volunteers. QTc intervals and plasma concentrations of thioridazine, mesoridazine, and metabolites were measured after single oral doses of thioridazine hydrochloride 50 mg, mesoridazine besylate 50 mg, or placebo in a double-blind, crossover study. Mean maximum increases in the QTc interval following thioridazine (37.3+/-4.1 ms, P=0.023) and mesoridazine (46.6+/-7.4 ms, P=0.021) were similar and significantly greater than following placebo (12.9+/-8.1 ms). The area under the effect-time curve over 8 h following drug administration was similar between the two drugs (129.3+/-22.1 vs 148.3+/-43.0 ms h). In conclusion, thioridazine and mesoridazine are associated with similar effects on the QTc interval.
