RESUMO
With the advent of time-dependent thrombolytic therapy for ischemic stroke it has become increasingly important for stroke patients to arrive at the hospital quickly. This study investigated the time that our patients took since the recognition of the symptoms until the stroke diagnosis in a hospital in the city of São Paulo. We concluded that in our hospital medical personnel and paramedics did not consider stroke as a medical emergency before neurological evaluation. Social problems as lack of access to an effective emergency medical service are another important factor that was responsible for patient's delay. Our study was important in order to identify the problems that stroke patients face in our country until the diagnosis is established
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hospitalização , Acidente Vascular Cerebral , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência , Fibrinolíticos , Estudos Prospectivos , Acidente Vascular Cerebral , Fatores de Tempo , Ativador de Plasminogênio TecidualRESUMO
Malaria is a parasitic disease with high prevalence in several regions of the world. Infestation by Plasmodium faciparum can, in some cases, affect the central nervous system producing encephalitis resulting in death or neurological sequelae. The mechanisms involved in the pathophysiology of the cerebral lesion are not totally clear and there are currently two theories (mechanical and humoral) concerning this. We report a case of malaria with an atypical evolution, with a stroke lesion in the territory of the middle cerebral artery, with no association with encephalitis. We conclude that the mechanical theory is the one applicable to this patient
Assuntos
Adulto , Humanos , Masculino , Sistema Nervoso Central/parasitologia , Malária/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Antimaláricos/uso terapêutico , Malária Cerebral/epidemiologia , Malária Cerebral/fisiopatologia , Malária/epidemiologia , Plasmodium falciparum , Fatores de RiscoRESUMO
Os autores apresentam um caso de encefalopatia de Wernicke em um paciente com síndrome de obstruçäo pilórica por adenocarcinoma gástrico, sem história de alcoolismo e desnutriçäo. Comentam aspectos fisiológicos da importância da tiamina como co-enzima da transcetolase e da piruvato-descarboxilase na rota metabólica para produçäo de ATP e a possibilidade da existência de interaçäo de fatores genéticos e ambientais no surgimento do quadro clínico. Chamam a atençäo para a importância do diagnóstico clínico, que deve ser precoce para que a terapêutica específica com tiamina possa surtir efeito, principalmente em pacientes sem história prévia de alcoolismo e desnutriçäo