Mucormicosis rinocerebral: comunicación de 4 casos / Rhinocerebral mucormycosis: report of 4 cases

We report four diabetic patients (one male) aged 64, 63, 61 and 77 years old with rhinocerebral mucormycosis. Three had an acute and one a chronic form of the disease. The chronic form was diagnosed with a biopsy of the nasal cavity. Three patients received amphotericin but all died. The diagnosis of the disease must be suspected in diabetics or patients with some type of immune depression

Monitorización electroencefalográfica mediante video prolongado: experiencia del Hospital Militar de Santiago: 1991-1996 / Prolonged electroencephalography and video monitoring: an experience at Hospital Militar de Santiago: 1991-1996

Background: Cerebral activity must be registered for prolonged periods in certain clinical situations that are not resolved with conventional electroencephalography. Aim: To report the experience with prolonged electroencephalographic and video monitoring at a Neurology Department, of a Military hospital in Santiago. Patients and methods: A retrospective analysis of patients referred for continuous electroencephalographic and video monitoring between 1991 and 1996. Three hundred thirty six patients, aged 3 months to 60 years old, were studied in the period and in 244, there was information about the diagnosis, treatment and evolution. Results: Monitoring was performed in an outpatient basis in 84 percent of subjects and lasted between 2 and 7 hours. One hundred ten patients were epileptics, 77 patients had a suspicion of epilepsy, 13 patients had possible pseudoseizures and 33 patients had miscellaneous diagnoses. In 154 patients, electroencephalographs recorded during wakefulness, somnolence and spontaneous dream, were normal. Intercritical recordings with epileptic activity were obtained in 76 patients and in 30 of these, critical epileptic activity was also recorded, not always associated to clinical manifestations. Unspecific electroencephalographic alterations were recorded in 14 patients. Conclusions: Prolonged electroencephalographic and video monitoring can be useful for patients with complex neurological problems

Displasia fibromuscular sistémica: compromiso de ramas supraaórticas y renales / Systemic fibromuscular dysplasia with supra aortic and renal artery involvement: report of 1 case

We report a 39 years old male presenting with an intense hemicrania pain in the tract of the carotid artery and Claude Bernard Horner syndrome. The patient had also a high blood pressure. Magnetic resonance imaging demonstrated a left carotid artery fibrodysplastic disease. Conventional angiography of 4 cerebral vessels showed a dissection of the left carotid artery and fibromuscular dysplasia of the left vertebral artery. Renal angiography showed a stenosis and occlusion of renal artery with radiological exclusion of right kidney. On the left side there was a stenosis and occlusion of segmental branches. The diagnostic importance of Claude Bernard Horner syndrome and the need to study renal artery involvement when carotid dissection is accompanied with high blood pressure, is highlighted

Trombosis venosa cerebral profunda: comunicación de un caso / Deep cerebral venous thrombosis: report of 1 case

We report a 39 years old female presenting with headache, proggressive clouding of sensorium and long pathway deficit signs. Brain CAT scan showed a process involving basal ganglia, thalami and Herophilus press. A thrombosis of this vessel was suspected. The first magnetic resonance imaging was informed as a diffuse inflammatory process compatible with an encephalitis. The patient aggravated and a second magnetic resonance imaging demonstrated a partial thrombosis of sinus rectus, Galenus vein, Herophilus press and both internal cerebral veins. Intravenous heparin was started with a progressive recovery of the patient. Two months later she had an almost complete recovery with a persistent mild right brachial paresis and a memory deficit for recent events

Romboencefalitis por listeria monocytogenes: caso clínico / Listeria monocytogenes rhomboencephalitis: report of 1 case

We report a previously healthy 44 years old female, that presented with mild clouding of consciousness, a left cerebellar syndrome, involvement of V, X and XII left cranial nerves and an alteration of epicritic sensitivity in the left half of the body. Cerebrospinal fluid had inflammatory features. Cerebrospinal fluid and blood cultures were positive for Listeria monocytogenes. Magnetic resonance imaging disclosed a rhomboencephalitis. Antibiotics were started and the clinical condition of the patient improved progressively. After three months of follow up, the patient is notably recovered and there is a regression of hyperintense lesions of the brainstem in the magnetic resonance imaging. The diagnosis of Listeria monocytogenes infection must be born in mind in the presence of a thromboencephalitis

Mixoma y sindrome de anticuerpos antifosfolípidos / Myxoma and antiphospholipid antibodies syndrome: report of one case

We report a 26 years old female with a Cerebral Palsy as a consequence of a perinatal vascular accident. She was admitted in August 1996 with a left hemiplegia due to a right M1 median artery thrombotic occlusion, as demonstrated by magnetic resonance imaging angiography. Transesophagical bi-dimensional echocardiography showed a right atrial myxoma and ruled out the persistence of an oval foramen. The study of coagulation disorders lead to the diagnosis of a primary antiphospholipid syndrome. We postulate that interleukin-6 produced by the myxoma could trigger an immunological reaction leading to the primary antiphospholipid syndrome