RESUMO
PURPOSE: This study sought to identify imaging criteria useful in discriminating anatomical variants from thrombosis of the posterior intracranial venous system. MATERIALS AND METHODS: A total of 102 patients underwent coronal unenhanced two-dimensional time-of-flight (2D ToF) magnetic resonance (MR) venography. Transverse sinus (TS) calibre and asymmetry were considered. Oval (O-FG) and linear (L-FG) flow gaps were recorded. Several slices of the 2D ToF sequence were applied perpendicularly to the TS within each FG to avoid in-plane saturation. RESULTS: Mean calibre of the right TS was significantly greater than the contralateral sinus (6.5 mm+/-1.84 vs 5.1 mm+/-1.72). Right and left dominance was observed in 61% and 17% of cases, respectively. The mean right-left TS diameter was 5.77 mm. Among 204 TS, 44 L-FG and 42 O-FG were observed. Partial L-FG (<2/3 of TS) never involved the distal TS. No L-FG was observed in a dominant TS. Supplementary sagittal 2D ToF images disclosed blood flow in all but two L-FGs. O-FGs were mostly observed laterally (91%). CONCLUSIONS: L-FGs in a dominant TS, partial L-FGs in the distal part or O-FG in the medial part of any TS, a left-right mean diameter <3 mm and absence of flow even in ToF images perpendicular to the direction of blood flow should raise the suspicion of sinus pathology.
Assuntos
Veias Cerebrais/patologia , Cavidades Cranianas/patologia , Angiografia por Ressonância Magnética/métodos , Trombose dos Seios Intracranianos/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artefatos , Velocidade do Fluxo Sanguíneo , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-IdadeAssuntos
Fluoxetina/efeitos adversos , Hypericum/efeitos adversos , Rabdomiólise/induzido quimicamente , Rabdomiólise/diagnóstico , Síndrome da Serotonina/induzido quimicamente , Síndrome da Serotonina/diagnóstico , Triptaminas/efeitos adversos , Adulto , Quimioterapia Combinada , Feminino , Fluoxetina/administração & dosagem , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Triptaminas/administração & dosagemAssuntos
Encéfalo/diagnóstico por imagem , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estado Epiléptico/diagnóstico por imagem , Encéfalo/metabolismo , Resistência a Medicamentos , Feminino , Glucose/metabolismo , Humanos , Imageamento por Ressonância Magnética , Prognóstico , Estado Epiléptico/metabolismo , Estado Epiléptico/terapia , Adulto JovemAssuntos
Amiloidose/complicações , Síndrome de Isaacs/patologia , Amiloidose/metabolismo , Amiloidose/patologia , Feminino , Glutamato Descarboxilase/metabolismo , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina , Peptídeos e Proteínas de Sinalização Intracelular , Síndrome de Isaacs/metabolismo , Proteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Doenças Musculares , Miocárdio/patologia , Proteínas do Tecido Nervoso/metabolismo , Proteínas/metabolismoRESUMO
Parkinson's disease is characterized by heterogeneity of clinical presentations, association of signs and symptoms, rate of progression, and response to therapy. The aim of this prospective 5-year study was to evaluate whether clinical features at onset were predictive of the subsequent progression. Two courses were identified which differed in the characteristics at onset. Slow course was characterized by earlier age at onset, lateralization of motor signs, rest tremor, and absence of gait disturbance. Rapid course presented older age, less evident lateralization of signs, predominance of bradykinesia-rigidity and gait disturbance. Our results confirmed that PD is clinically heterogeneous and specific patterns of onset seem to be associated with different rates of disease progression. Predictive models based on these clinical characteristics have a good sensitivity in indicating a slow disease progression but are not reliable in indicating a rapid evolution.