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Arq. neuropsiquiatr ; 80(2): 153-160, Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364374


ABSTRACT Background: Melanocytic lesions of the central nervous system (CNS) are an infrequent, broad and diverse group of entities, both benign and malignant, found in all age groups, with imaging findings ranging from well-circumscribed focal lesions to diffuse leptomeningeal involvement. On MRI, they are usually distinguished by a high signal on T1WI sequences, given the paramagnetic effect of melanin, thus making it difficult to differentiate among them. Objective: To describe the imaging and epidemiological characteristics of a retrospective series of CNS melanocytic lesions. Methods: MR images of 23 patients with CNS melanocytic lesions diagnosed between January 2012 and June 2018 were analyzed. Results: Most patients were female (14/23; 61%), with a median age of 47 years (range: 3 weeks to 72 years). The primary melanocytic lesions accounted for 8/19 cases (42.1%), which included neurocutaneous melanosis, meningeal melanocytomas and primary malignant melanomas. Secondary melanocytic lesions (metastatic) accounted for 10/19 cases (52.6%). There was one case of a tumor with secondary melanization, from a melanocytic neuroectodermal tumor of infancy. There were also four cases of primary ocular melanomas. The most frequent findings were the cerebral location, high T1WI signal and marked contrast-enhancement. Conclusions: The present review describes the wide variety of melanocytic lesions that could affect the CNS, emphasizing the MRI characteristics. Knowledge of the imaging, clinical and epidemiological characteristics of CNS melanocytic lesions is essential for their correct interpretation, given the significant overlap between lesion features and the variable prognosis.

RESUMEN Antecedentes: Las lesiones melanocíticas del sistema nervioso central (SNC) corresponden a un grupo infrecuente, amplio y diverso de entidades, tanto benignas como malignas, encontradas en todos los grupos etarios, con hallazgos imagenológicos que van desde lesiones focales bien circunscritas hasta un compromiso leptomeníngeo difuso. A la RM se distinguen por la alta señal en la secuencia T1WI, dado el efecto paramagnético de la melanina, haciendo difícil la diferenciación entre ellas. Objetivo: Describir las características epidemiológicas y de de una serie retrospectiva de lesiones melanocíticas del SNC. Métodos: Revisión de imágenes de RM de 23 pacientes con lesiones melanocíticas del SNC diagnosticadas entre enero de 2012 y junio de 2018. Resultados: La mayoría de los pacientes fueron mujeres (14/23; 61%), con edades comprendidas entre las 3 semanas de vida hasta los 72 años. Las lesiones melanocíticas primarias representaron 8/19 (42,1%), incluyendo: melanosis neurocutáneas, melanocitomas meníngeos y melanomas malignos primarios. Las lesiones melanocíticas secundarias (metastásicas) representaron 10/19 casos (52,6%). Hubo un caso de tumor con melanización secundaria (tumor neuroectodermico melanocítico de la infancia). Se incluyeron cuatro casos de melanomas oculares primarios. Los hallazgos más frecuentes fueron la localización cerebral, el aumento de señal T1 y el acentuado realce con el gadolinio. Conclusiones: Se describe la amplia variedad de lesiones melanocíticas encontradas en el SNC, enfatizando sus características a la RM. El conocimiento de sus características imagenológicas, clínicas y epidemiológicas es fundamental para su correcta interpretación, dado la notable superposición entre las presentaciones de las lesiones y lo variable de sus pronósticos.

Humans , Female , Infant, Newborn , Adult , Melanosis/complications , Melanosis/pathology , Nevus, Pigmented/complications , Nevus, Pigmented/pathology , Skin Neoplasms , Central Nervous System/pathology , Retrospective Studies
Autops. Case Rep ; 11: e2020233, 2021. graf
Article in English | LILACS | ID: biblio-1153182


Mucormycosis is an opportunistic fungal disease that commonly presents as cutaneous or rhinocerebral infections associated with immunocompromised states. It may exceptionally present as isolated involvement of the brain with a varied clinical presentation, which may be difficult to diagnose early, leading to increased mortality. Herein, we report the case of a 42-year-old immunocompetent female with left-sided limb weakness and a history of recurrent vomiting and headache for the last two years. Clinically, glioma was suspected, but histopathological examination revealed a few broad aseptate fungal hyphae. As no other organ was involved, the diagnosis of isolated cerebral mucormycosis was rendered. Reporting this case, we show an unusual presentation of a central nervous system mucormycosis masquerading a tumor in an immunocompetent patient. The case also highlights the importance of a careful histopathological examination to avoid missing the presence of occasional fungal hyphae. Ideally, recognition of fungal hyphae in the brain, during intraoperative consultation, can prompt brain tissue culture for definitive diagnosis and early empirical antifungal therapy, which may prove life-saving.

Humans , Female , Adult , Central Nervous System/pathology , Immunocompromised Host , Mucormycosis/complications , Diagnosis, Differential
Kanem Journal of Medical Sciences ; 14(1): 24-30, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1264614


Background: Central Nervous System (CNS) malformations rank among the commonest malformations. These may be identified in utero or noticed immediately after birth. Most studies showed Myelomeningocoele, a Neural Tube Defect (NTD) to be the commonest. Severe defects have a significant impact on long term disability. While some are preventable, most are surgically managed. Objective: To study the profile and management of CNS malformation in a tertiary hospital. Method: we undertook a 3-year retrospective study of the profile and surgical management, including the postoperative complications among Neonates admitted into the Special Care Baby Unit (SCBU). Data on place of delivery, Gender, Gestational age, Mode of delivery, Prenatal Diagnosis (Ultrasound Scan), types of malformations, types of surgeries, and postoperative complications were retrieved. Result: We found 71 patients with CNS anomalies (31.8% of all congenital anomalies), in delivery 10 (14.1%), out delivery 46(64.8%). Male=43, females=28. Term gestation 66 (93%), preterm 3(4.2%), post-term 2(2.8%). Delivered by Vagina (SVD) in 65(91.6%), Caesarean section 4(5.6%), and undocumented in 4(5.6%). Prenatal diagnosis in only 3(4.2%). Myelomeningocoele was 35(49.3%), meningocoele was 9(12.7%), Hydrocephalus was 18(25.3%), anencephaly was 1(1.4%), occipital Encephalocoele was 6(8.5%), Sincipital Encephalocoele was 2(2.8%). Operated on 53(75%), LAMA/lost to follow was 13(18%), preoperative death was 5(7%). Excision and closure of Neural Tube Defect were 34(64.2%), VP Shunt was 13(24.5%), Excision and closure of occipital Encephalocoele were 5(9.4%) craniofacial excision and repair of Sincipital Encephalocoele was 1(1.9%). CSF leak in 4(28.6%), wound infection in 3(21.4%), shunt infection and obstruction in 2(14.3%) each. meningitis, hypertrophied scar, and pseudo meningocoele in 1(7.1%) each. Conclusion: The commonest CNS anomaly is a Myelomeningocoele a preventable condition, Sincipital Encephalocoele is not common in our environment. Concomitant treatment of hydrocephalus averts post excision CSF Leak

Central Nervous System Vascular Malformations/prevention & control , Central Nervous System/pathology , Neural Tube Defects/prevention & control , Tertiary Care Centers
Prensa méd. argent ; 104(6): 281-287, Ago2018. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1051230


During history, amylidosis was observed associated to a great variety of inflammatory diseases, and due to this, appeared the term "secondary amyloidosis". The forms of sudden presentation without any apparent cause are classified as "primary amyloidosis", and also the localized amyloidosis was characterized, the same as the heredity variant. At present, three main grops are recognized as systemic amyloidosis: amyloidosis of light chains, the amyloidosis associated to the seric protein A, and the hereditary form. Systemic amyloidosis can involve practically any organ system, being the most commonly affected the heart and the kidney, which therefore determine the clinical evolution and the prognosis of the patient. The aim of this report, was to present a case of autopsy of systemic amyloidosis with involvement of the Central Nervous System, considering besides, the great extension of the disease in our patient

Humans , Female , Middle Aged , Autopsy , Immunohistochemistry , Glasgow Coma Scale , Plaque, Amyloid/physiopathology , Dissection , Immunoglobulin Light-chain Amyloidosis , Central Nervous System/pathology
Prensa méd. argent ; 104(6): 288-294, Ago2018. fig, graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1051238


This study examines a description of pituitary tumors considering an anatomopathological casuistic. The study of the tumors of the Central Nervous System (CNS) include the pituitary gland, located in the sella turcica. The pathology of the sellar region is represented by the adenomas, tumors of slow development with or without endocrine secretion, that usually involve the population of young adults. The aim of this report, was to describe the casuistic of the " J. Fernandez Hospital" between the years 2000 through 2017. A retrospective review was performed and 234 samples of the sellar region were processed. Mean age was 42 years with a range of 17 to 77 years. Sex distribution was 57% women and 43 % men. Of these, 77% of the cases resulted adenomas. The conclusions obtained in the study are detailed.

Humans , Adult , Middle Aged , Aged , Pituitary Gland, Anterior/pathology , Pituitary Neoplasms/pathology , Sella Turcica/pathology , Central Nervous System/pathology , Multiple Endocrine Neoplasia Type 1/genetics , Diagnosis
Article in English | LILACS | ID: biblio-894170


In Brazil, the scorpion species responsible for most severe incidents belong to the Tityus genus and, among this group, T. serrulatus, T. bahiensis, T. stigmurus and T. obscurus are the most dangerous ones. Other species such as T. metuendus, T. silvestres, T. brazilae, T. confluens, T. costatus, T. fasciolatus and T. neglectus are also found in the country, but the incidence and severity of accidents caused by them are lower. The main effects caused by scorpion venoms - such as myocardial damage, cardiac arrhythmias, pulmonary edema and shock - are mainly due to the release of mediators from the autonomic nervous system. On the other hand, some evidence show the participation of the central nervous system and inflammatory response in the process. The participation of the central nervous system in envenoming has always been questioned. Some authors claim that the central effects would be a consequence of peripheral stimulation and would be the result, not the cause, of the envenoming process. Because, they say, at least in adult individuals, the venom would be unable to cross the blood-brain barrier. In contrast, there is some evidence showing the direct participation of the central nervous system in the envenoming process. This review summarizes the major findings on the effects of Brazilian scorpion venoms on the central nervous system, both clinically and experimentally. Most of the studies have been performed with T. serrulatus and T. bahiensis. Little information is available regarding the other Brazilian Tityus species.(AU)

Animals , Poisoning/complications , Scorpion Venoms/toxicity , Scorpions , Central Nervous System/pathology , Scorpion Venoms/pharmacokinetics , Brazil
Int. j. morphol ; 35(3): 942-949, Sept. 2017.
Article in English | LILACS | ID: biblio-893078


Prolonged alcohol consumption has consequences on the liver, producing necrotic precipitates and fibrosis, on the pancreas, causing the pancreatic acini to atrophy and destroying insulin-producing cells, and on the central nervous system (CNS), causing the gray and white matter in the frontal lobes of the brain and cerebellum to atrophy. Generally, alcohol is metabolized via oxidative pathways, where the enzymes alcohol dehydrogenase and aldehyde dehydrogenase participate during its metabolization in the liver and CNS, or via non-oxidative pathways during its metabolization in the pancreas. Ethanol metabolism can produce oxidative stress and tissue damage mediated by free radicals, causing morphological and functional alterations in the liver. In the pancreas, it can cause progressive and irreversible damage affecting the endocrine and exocrine functions, a result of the activation of the stellate cells, which are activated directly by alcohol, causing pancreatic fibrosis. In the CNS ethanol can bind directly to proteins, nucleic acids and phospholipids to develop its pathogenesis. The effects produced by alcohol can be counteracted by supplementation with antioxidants, which reduce the inflammation and areas of focal necrosis in the liver, inhibit the activation of pancreatic stellate cells, and reduce oxidative stress in the CNS. Additionally, in order to reduce the negative effects associated with alcohol consumption, recent studies have suggested the administration of antioxidants as a treatment strategy.

El consumo prolongado de alcohol tiene consecuencias en hígado, produciendo precipitados necróticos y fibrosis; en páncreas, provocando atrofia del acino pancreático y destrucción de las células productoras de insulina, y en Sistema Nervioso Central (SNC) generando atrofia de la sustancia gris y blanca en lóbulos frontales del cerebro y cerebelo. En general, el metabolismo del alcohol se consigue mediante las vías oxidativas, donde participan las enzimas alcohol-deshidrogenasa y aldehído deshidrogenasa durante su metabolización en hígado y SNC; o bien, mediante las vías no oxidativas durante su metabolización en páncreas. El metabolismo del etanol es capaz de producir estrés oxidativo y daño tisular mediado por radicales libres, causando alteraciones morfológicas y funcionales del hígado; en el páncreas, puede causar daño progresivo e irreversible afectando las funciones endocrinas y exocrinas de este órgano producto de la activación de las células estrelladas que son activadas directamente por el alcohol generando fibrosis pancreática; mientras que, en SNC se puede unir directamente a proteínas, ácidos nucleicos y fosfolípidos para desarrollar su patogenia. Los efectos producidos por el alcohol pueden contrarrestarse mediante la suplementación con antioxidantes, que reducen la inflamación y las zonas de necrosis focal en el hígado, inhiben la activación de células pancreáticas estrelladas, y reducen el estrés oxidativo en SNC. Asimismo, para reducir los efectos negativos asociados al consumo de alcohol, estudios recientes han propuesto la administración de antioxidantes como estrategia terapéutica.

Humans , Central Nervous System/drug effects , Ethanol/toxicity , Alcoholic Intoxication/drug therapy , Antioxidants/therapeutic use , Pancreas/drug effects , Pancreas/pathology , Central Nervous System/pathology , Oxidative Stress , Ethanol/metabolism , Liver/drug effects , Liver/pathology
Pesqui. vet. bras ; 36(10): 1021-1024, out. 2016.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-841996


O objetivo do trabalho foi identificar a presença no Brasil do gene mutante L2HGDH em cães da raça Staffordshire Bull Terrier (SBT). Para tanto foi feito o teste genético em 76 cães provenientes de diferentes regiões do Brasil, no período de 2008 a 2015, sendo encontrados 55 animais (72,37%) livres do gene mutante L2-HGDH ou homozigotos dominantes, e 21(27,63%) portadores do gene mutante ou heterozigotos. Não foi encontrado nenhum animal homozigoto recessivo (afetado), porém pode-se observar que o gene circula no Brasil e que cães afetados podem aparecer.(AU)

The aim of this study was to identify the presence of a mutation in the L2-hydroxyglutarate dehydrogenase (L2-HGDH) gene in Staffordshire bull terriers in Brazil. Genetic testing was done in 76 dogs from different regions of the country, from 2008 to 2015. Fifty-five dogs (72.37%) were free of the mutant gene L2HGDH or homozygous-dominant, and 21 (27.63%) were carriers for the mutant gene or heterozygous. No homozygous recessive dogs (affected) were found, however, it is worth noting that the gene circulates in Brazil and that affected dogs can appear.(AU)

Animals , Dogs , Central Nervous System/pathology , Congenital Abnormalities/veterinary , Genes, Recessive , Genetic Carrier Screening , Genetic Phenomena , Heredity , Nervous System Diseases/veterinary
Arq. neuropsiquiatr ; 74(9): 737-744, Sept. 2016. graf
Article in English | LILACS | ID: lil-796045


ABSTRACT Cell physiology is impaired before protein aggregation and this may be more relevant than inclusions themselves for neurodegeneration. The present study aimed to characterize an animal model to enable the analysis of the cell biology before and after protein aggregation. Ten-month-old Lewis rats were exposed either to 1 or 2 mg/kg/day of rotenone, delivered subcutaneously through mini-pumps, for one month. Hyperphosphorylated TAU, alpha-synuclein, amyloid-beta peptide and protein carbonylation (indicative of oxidative stress) were evaluated in the hippocampus, substantia nigra and locus coeruleus through immunohistochemistry or western blot. It was found that 2 mg/kg/day rotenone increased amyloid-beta peptide, hyperphosphorylation of TAU and alpha-synuclein. Rotenone at 1mg/kg/day did not alter protein levels. Protein carbonylation remained unchanged. This study demonstrated that aged Lewis rats exposed to a low dose of rotenone is a useful model to study cellular processes before protein aggregation, while the higher dose makes a good model to study the effects of protein inclusions.

RESUMO A fisiologia celular está prejudicada antes da agregação proteica podendo ser mais importante para a neurodegeneração do que as próprias inclusões. Assim, o objetivo deste estudo é caracterizar um modelo animal para analisar os mecanismos e efeitos da agregação proteica. Ratos Lewis com 10 meses de idade foram expostos a rotenona (1 ou 2 mg/kg/dia), administrada subcutaneamente, utilizando minibombas osmóticas. Os níveis de peptídeo beta-amiloide, TAU hiperfosforilada, alfa-sinucleína e proteínas carboniladas (indicativo de estresse oxidativo) foram avaliados por imunohistoquímica e western blot no hipocampo, substância negra e locus coeruleus. Foi demonstrado que 2 mg/kg/dia de rotenona promoveu aumento do peptídeo beta-amiloide, hiperfosforilação da TAU e alfa-sinucleína. Já 1 mg/kg/dia de rotenona não alterou os níveis dessas proteína nessas regiões. As proteínas carboniladas não se alteraram. Foi demonstrado que ratos Lewis idosos expostos a baixas doses de rotenona são modelo de estudo dos processos celulares antes da agregação proteica, enquanto 2 mg/kg/dia de rotenona permite estudos sobre os efeitos da agregação proteica.

Animals , Male , Rotenone/administration & dosage , Central Nervous System/drug effects , Central Nervous System/pathology , Disease Models, Animal , Protein Aggregation, Pathological/chemically induced , Protein Aggregation, Pathological/pathology , Rats, Inbred Lew , Substantia Nigra/drug effects , Immunohistochemistry , Central Nervous System/metabolism , Blotting, Western , Reproducibility of Results , Amyloid beta-Peptides/drug effects , Amyloid beta-Peptides/metabolism , Oxidative Stress , alpha-Synuclein/drug effects , alpha-Synuclein/metabolism , Alzheimer Disease/metabolism , Alzheimer Disease/pathology , Hippocampus/drug effects , Hippocampus/metabolism , Hippocampus/pathology
Rev. cuba. pediatr ; 88(2): 120-129, abr.-jun. 2016. ilus
Article in Spanish | LILACS, CUMED | ID: lil-783766


INTRODUCCIÓN: los tumores del sistema nervioso central en los niños y adolescentes constituyen en Cuba la tercera localización en orden de frecuencia de todas las neoplasias; el tratamiento consiste en cirugía, seguida de la irradiación en la mayoría de los casos, y en algunos tipos histológicos, se añade la quimioterapia, o los anticuerpos monoclonales. OBJETIVO: valorar el empleo de la radioterapia en el tratamiento a los tumores del sistema nervioso central en niños y adolescentes. MÉTODOS: se trata de una serie de 98 niños y adolescentes entre 3 y 18 años de edad que fueron irradiados en el Instituto Nacional de Oncología y Radiobiología por padecer: 32 casos tumores del tallo cerebral (32,6 %), 19 meduloblastomas (19,4 %), 11 astrocitomas grado I-II (11,2 %), 9 astrocitomas III-IV y glioblastomas multiformes (gliomas de alto grado, 9,2 %), 6 craneofaringiomas (6,1 %), 6 tumores primitivos neuroectodérmicos (6,1 %), 5 oligodendrogliomas (5,1 %), 4 ependimomas (4,1 %), 3 germinomas (3,1 %), 2 pineoblastomas (2,1 %) y 1 caso de gliomatosis (1 %). Los pacientes fueron irradiados con aceleradores lineales, máscaras termoplásticas de inmovilización, planificación en 3D, conformada, o intensidad modulada, controles dosimétricos y de imágenes; en niños pequeños, se utilizó anestesia. RESULTADOS: 47 pacientes se encuentran vivos (47,9 %), con una tasa de supervivencia de 5 años de 50,2 %, y una mediana de 5,34 años. CONCLUSIONES: la radioterapia resulta ser un arma terapéutica eficaz para tumores del sistema nervioso central en niños y adolescentes.

INTRODUCTION: central nervous system tumors of children and adolescents are the most frequent location of neoplasias in Cuba, their treatment involves surgery followed by radiation in most cases, and chemotherapy or monoclonal antibodies in some histological types of tumors. OBJECTIVE: to evaluate the use of radiotherapy in treating central nervous system tumors of children and adolescents. METHODS: a series of 98 children and adolescents aged 3 to 18 years were treated with radiation at the National Institute of Oncology and Radiobiology including 32 brainstem tumors(32.6 %), 19 medulloblastomas (19.4 %), 11 grade I- II astrocytomas (11,2 %), 9 grade III-IV astrocytomas and multiform glioblastomas (high grade gliomas, 9.2 %), 6 craniopharyngiomas (6.1 %), 6 primitive neuroectodermal tumors (6.1 %), 5 oligodendrogliomas (5.1 %), 4 ependymonas (4.1 %), 3 germinomas (3.1 %), 2 pineoblastomas (2.1 %) and one case of gliomatosis (1 %). The patients were irradiated with linear accelerators, thermoplastic masks of immobilization, conformal 3D planning or modulated intensity, dosimetric and imaging controls whereas anesthesia was used in infants. RESULTS: forty seven patients survived (47.9 %) with a survival rate of 5 years (50.2 %) and a median of 5.34 years. CONCLUSIONs: radiation therapy proves to be an effective therapeutic tool for the treatment of central nervous tumors in children and adolescents.

Humans , Child , Radiotherapy/methods , Brain Neoplasms , Central Nervous System/pathology
Pesqui. vet. bras ; 35(10): 844-852, out. 2015. tab, graf
Article in Portuguese | LILACS | ID: lil-767746


As neoplasias no sistema nervoso central (SNC) de animais de companhia são frequentemente diagnosticadas, no entanto dados sobre prevalência são escassos. O objetivo deste estudo foi avaliar retrospectivamente a ocorrência de neoplasias primárias de SNC em cães atendidos em um Hospital-Escola Veterinário e descrever aspectos clínicos, histopatológicos e imuno-histoquímicos dos tumores mais frequentes. Quatorze casos (prevalência de 0,27%) de neoplasias primárias de SNC foram identificados no período de 1998 a 2013 e destes, 11 tiveram o diagnóstico de meningiomas. A idade média dos animais com meningioma foi 10 anos, sendo machos (7/11) e a raça Boxer (3/11) os mais afetados. Sete meningiomas eram espinhais e quatro intracranianos, sendo os principais sinais clínicos alteração na locomoção e convulsões, respectivamente. Metástase pulmonar ocorreu em dois casos. Em seis animais com meningioma espinhal foi realizada a mielografia, sendo que em um também foi realizada a tomografia. Em todos os casos os exames foram efetivos na visualização de desvio ou interrupção da coluna de contraste, com alterações sugestivas da presença de massa. Em cinco animais realizou-se cirurgia exploratória visando a confirmação da suspeita clínica ou retirada da massa, sendo que a sobrevida variou de 85 a 960 dias. Na avaliação histopatológica, os meningiomas foram classificados em transicional (4/11), meningotelial (2/11), papilar (2/11), angiomatoso (1/11), microcístico (1/11) e anaplásico (1/11). Destes, oito (8/11) apresentaram marcação positiva para tricrômio de Masson e um para vermelho congo nas técnicas histoquímicas. No painel imuno-histoquímico, todos os casos apresentaram imunomarcação positiva para vimentina, mas imunomarcação negativa para fator VIII e p53. A imunomarcação para S100 (6/11), GFAP (5/11) e pancitoqueratina (3/11) foi de intensidade variável. Na graduação histológica, dez meningiomas eram grau I e um grau III. O índice médio de proliferação...

Neoplasias of the central nervous system (CNS) of small animals are frequently diagnosed; however, data relative to prevalence are scarce. The aim of this study was to evaluate retrospectively the occurrence of primary CNS tumors in dogs in a Veterinary Teaching Hospital and describe clinical, histopathological and immunohistochemical aspects of the most common tumors. Fourteen cases of CNS primary neoplasia (prevalence of 0.27%) were identified from 1998 to 2013; from these 11 were diagnosed as meningiomas. The mean age of dogs with meningiomas was 10 years; male (7/11) and the Boxer breed (3/11) were most commonly represented. Seven meningiomas were located in the spinal cord and four intracranially; the main clinical signs were impaired locomotion and seizures, respectively. Pulmonary metastasis was found in two cases. Myelography was performed in six dogs with spinal meningiomas. In these cases it was effective in demonstrating the deviation or interruption of the contrast column. Exploratory surgery to confirm diagnosis or remove the tumor was performed in five animals and the survival rate varies 85 to 960 days. Meningiomas were histologically classified as transitional (4/11), meningothelial (2/11), papillary (2/11), angiomatous (1/11), microcystic (1/11) and anaplastic (1/11). Evaluation of histological grade was performed; 10 meningiomas were classified as grade I and one as grade III. The neoplastic cells of eight tumors (8/11) were positive for Masson's trichrome and one with the Congo red histochemical techniques. The immunohistochemical assays revealed in all tumors a positive immunoreactivity for vimentin but negative staining for factor VIII and p53. Immunolabelling for S100 (6/11), GFAP (5/11) and pancytokeratin (3/11) showed a variable staining intensity. The mean cell proliferation index was 3.2 mitotic figures and 3.4% for Ki-67 immunostaining. The results confirmed that meningiomas are the most frequent primary CNS neoplasia...

Animals , Dogs , Meningioma/diagnosis , Meningioma/veterinary , Central Nervous System/pathology , Immunohistochemistry/veterinary , Myelography/veterinary , Central Nervous System Neoplasms/veterinary , Histological Techniques/veterinary
Rev. chil. neurocir ; 41(1): 39-44, jul. 2015.
Article in English | LILACS | ID: biblio-836042


Objective: To identify the most prevalent type of pain in postoperative craniotomy patients and evaluate the use of analgesic in this group of patients. Method: The case studies consisted of 55 patients undergoing craniotomy. Patients were evaluated from the first to the seventh postoperative day. Data were stored and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0. The variables analyzed were gender, demographic data, assessing the presence of pain, location of pain, severity of pain, use of analgesic, professionals who recorded the pain on the patients’ charts, and presence of insomnia. Results: The results show that headache, the main pain reported by the patients, is present from the first to the seventh postoperative day. It was observed that in some cases there was no prescription of analgesics and even in the group of patients who took analgesics, these drugs were not effective for the relief of headache. The final logistic regression model revealed that insomnia ( OR = 10.6, p = < 0.001 ), the pain recorded in the patients’ charts (OR = 2.38 , p = 0.016) and use of analgesic (OR = 2.03 , p = 0.014) adequately explained the outcome. Conclusion: Headache was the chief complaint of pain after postoperative craniotomy, and its intensity varied from mild to severe. The analgesic used was not effective for the control of postoperative headache. Proper handling of post-craniotomy headache by the multidisciplinary team can contribute to early neurological recovery of patients undergoing craniotomy, and should make the post-surgical care, with a view to early recovery and the humanization of care.

Humans , Male , Adult , Female , Young Adult , Middle Aged , Craniotomy , Vascular Headaches/therapy , Pain, Postoperative/therapy , Pain Measurement , Surgical Procedures, Operative , Central Nervous System/pathology
Rev. méd. Chile ; 143(1): 120-123, ene. 2015. ilus
Article in Spanish | LILACS | ID: lil-742561


We report a 37 years old male with a dermatomyositis treated with oral cyclophosphamide. He was admitted to the hospital due to a zone of skin necrosis with purulent exudate, located in the second left toe. A complete blood count showed a leukocyte count of 2,600 cells/mm³. A Chest CAT scan showed a pneumomediastinum with emphysema of adjacent soft tissue. Cyclophosphamide was discontinued and leukocyte count improved. The affected toe was amputated and a chest CAT scan showed a partial resolution of the pneumomediastinum. We discuss and review the pathogenesis, clinical presentation and management of pneumomediastinum and cutaneous necrosis in association with dermatomyositis.

Animals , Female , Rats , Benzoxazines/therapeutic use , Cannabinoids/agonists , Encephalomyelitis, Autoimmune, Experimental/drug therapy , Encephalomyelitis, Autoimmune, Experimental/pathology , Morpholines/therapeutic use , Naphthalenes/therapeutic use , Neurons/drug effects , Oligodendroglia/drug effects , Analysis of Variance , Amyloid beta-Protein Precursor/metabolism , Caspase 9/metabolism , /metabolism , Cell Count/methods , Central Nervous System/pathology , Cytokines/genetics , Cytokines/metabolism , Disease Models, Animal , Encephalomyelitis, Autoimmune, Experimental/complications , Macrophages/drug effects , Neurologic Examination , Nerve Degeneration/etiology , Nerve Degeneration/prevention & control , Poly(ADP-ribose) Polymerases/metabolism , Spinal Cord/drug effects , Spinal Cord/pathology , T-Lymphocytes/drug effects , Time Factors
Estud. av ; 27(77): 61-84, jan.-abr. 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-696216


Descritas há mais de 150 anos, as células gliais, constituintes do tecido nervoso juntamente com os neurônios, foram consideradas até pouco tempo células de suporte do cérebro, passivas e à margem do seu funcionamento. Especialmente na última década, as neurociências foram palco de uma mudança de paradigma relacionada à função e ao papel dessas células na fisiologia e patologia neurais. Neste artigo, discutimos como os avanços acerca do conhecimento sobre os astrócitos, o mais abundante tipo glial, contribuíram para o entendimento do funcionamento cerebral. Apresentamos evidências da relação entre disfunções gliais e doenças neurodegenerativas e desordens neurológicas, discutindo o potencial papel dessas células na elaboração de abordagens terapêuticas para o sistema nervoso adulto.

Male , Female , Humans , Cell Adhesion Molecules , Neurodegenerative Diseases , Neurology , Neurosciences , Synapses , Central Nervous System/physiology , Central Nervous System/pathology
J. pediatr. (Rio J.) ; 89(1): 64-69, jan.-fev. 2013. tab
Article in Portuguese | LILACS | ID: lil-668827


OBJETIVO: Analisar pacientes com menos de dois anos de idade com leucemia linfoblástica aguda atendidos no período de 1990 a 2010, em um centro de referência estadual. MÉTODOS: Estudo clínico, epidemiológico, transversal, descritivo e observacional. Pacientes incluídos tinham menos de dois anos de idade, com leucemia linfoblástica aguda, tratados no período de 1990 a 2010 na unidade de oncologia pediátrica de um centro de referência estadual, totalizando 41 casos. RESULTADOS: Todos os pacientes eram Caucasianos e 60,9% eram do sexo feminino. Com relação à idade, 24,38% tinham menos de seis meses, 17,07% tinham entre seis meses e um ano e 58,53% mais do que um ano de idade. A idade de seis meses foi estatisticamente significante para o desfecho de óbito. Os sinais e sintomas predominantes foram febre, hematomas e petéquias. Uma contagem de leucócitos superior a 100.000 foi observada em 34,14% dos casos; hemoglobina inferior a 11 em 95,13% e contagem de plaquetas inferior a 100.000, em 75,61% dos casos. Infiltração do sistema nervoso central estava presente em 12,91% dos pacientes. Em relação à linhagem, a linhagem B predominou (73%), mas a linhagem de células T foi estatisticamente significativa para o óbito. Trinta e nove por cento dos pacientes tiveram recorrência da doença. Em relação ao estado vital, 70,73% dos pacientes morreram, sendo choque séptico a principal causa. CONCLUSÕES: leucemia linfoblástica aguda em crianças tem uma alta taxa de mortalidade, principalmente em crianças menores de um ano e linhagem derivada de células T.

OBJECTIVE: To analyze patients younger than 2 years with acute lymphoblastic leukemia, treated in the period between 1990 and 2010 in a state reference center. METHODS: This was a clinical-epidemiological, cross-sectional, observational, and descriptive study. It included patients younger than 2 years with acute lymphoblastic leukemia, treated in the period of 1990 to 2010 in a pediatric oncology unit of a state reference center, totaling 41 cases. RESULTS: All patients were white ethnicity, and 60.9% were females. Regarding age, 24.38% were younger than 6 months, 17.07% were between 6 months and 1 year, and 58.53% were older than 1 year. The age of 6 months was statistically significant for the outcome of death. Predominant signs and symptoms were fever, bruising, and petechiae. A leukocyte count > 100,000 was found in 34.14% of cases, hemoglobin count < 11 in 95.13%, and platelet count < 100,000 in 75.61. Infiltration of central nervous system was present in 12.91% of patients. According to the lineage, B-cell lineage predominated (73%), but the T-cell line was statistically significant for death. 39% of patients had disease recurrence. In relation to vital status, 70.73% of the patients died; septic shock was the main cause. CONCLUSIONS: Acute lymphoblastic leukemia in infants has a high mortality rate, especially in children under 1 year and those with T-cell derived lineage.

Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Age Distribution , Age of Onset , Brazil/epidemiology , Cross-Sectional Studies , Central Nervous System/pathology , Follow-Up Studies , Leukemic Infiltration , Leukocyte Count , Platelet Count , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Sex Factors , Shock, Septic/mortality
In. Lopes, Ademar; Chammas, Roger; Iyeyasu, Hirofumi. Oncologia para a graduação. São Paulo, Lemar, 3; 2013. p.493-500. (Oncologia para a graduação).
Monography in Portuguese | LILACS | ID: lil-692036
Actual. SIDA ; 20(78): 97-103, nov 2012.
Article in Spanish | LILACS | ID: lil-665122


La infección de tejidos cerebrales por HIV se asocia a desórdenes neurocognitivos identificados bajo la denominación HAND y categorizados en demencia, formas moderadas y formas asintomáticas. La introducción de terapia de alta efectividad ha implicado un notorio descenso de la demencia, pero no ha influido sobre las formas moderadas y asintomáticas que afectan alrededor del 50% de los pacientes bajo tratamiento. Esa disfunción cognitiva resulta de la pérdida de neuronas que, sin embargo, no han sido infectadas por el virus. De ahí la importancia de mecanismos indirectos en la neuropatogenia de HIV, ya que las citocinas/quimiocinas pro-inflamatorias liberadas por macrófagos/microglia infectados, la excitoxidad y el stress oxidativo se evidencian como principales causas de injuria neuronal, además de la directamente provocada por proteínas virales. Un mejor conocimiento de la interacción de HIV con su huésped humano está posibilitando el desarrollo de abordajes diganósticos más confiables y de estrategias terapéuticas más efectivas a nivel de SNC

HIV-1 associated neurocognitive disorders (HAND) result from brain infection. They are categorized as dementia, mild cases and asymptomatic cases. The introduction of HAART has markedly decreased dementia but no influence has been observed in mild and asymptomatic cases, since they are still identified in around 50 % of treated patients. Such cognitive dysfunction is the outcome of the loss of neurons which, however, have not been infected by the virus. hence, the importance of indirect mechanisms in HIV neuropathogenesis in which cytokines/chemokines released by infected macrophages/microglia, excitotoxic neuronal injury and oxidative stress are relevant causes of neurodegeneration besides that exerted by viral proteins. A better understanding of the HIV interaction with th human host is enabling the development of more reliable diagnostic biomarkers and more effective therapeutic strategies at CNS level

Humans , Antiretroviral Therapy, Highly Active , AIDS Dementia Complex/pathology , AIDS Dementia Complex/therapy , Encephalitis, Viral/pathology , Neurodegenerative Diseases/immunology , Neurodegenerative Diseases/therapy , HIV , Central Nervous System/pathology