RESUMO
Primary central nervous system vaculitis is an uncommon and invalidating disease, which has a fatal course if left untreated. We report a 63 year-old woman presenting with a history of two months of cognitive impairment, dysarthria, gait instability and tremor. After four months of evolution a right hemianopsia and a flaccid paresis of upper right limb appeared. A brain biopsy was performed and the histological findings confirmed the suspicion of primary cerebral vasculitis. The patient was treated with cyclophosphamide and prednisone, observing a partial recovery of cognitive and motor function.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Vasculite do Sistema Nervoso Central/patologia , Encéfalo/patologiaRESUMO
Wernicke encephalopathy is considered a complication of dialytic therapy, but there are few reports of this complication. We report a 57 years old man a 45 years old woman, with grade IV renal failure, who after acute peritoneodialysis and chronic hemodialysis respectively, had a confusional syndrome that responded to the administration of thiamine. CT scans in both patients discarded abnormal blood collections or new cerebrovascular episodes. The man had two previous cerebrovascular episodes, a severe anemia that was corrected, angina and an episode of arrhythmia during the dialytic procedure previous to the confusional episode. The woman had an acute uremic syndrome and a concomitant urinary tract infection during the confusional episode. Wernicke encephalopathy must be suspected in patients in dialysis with confusional episodes
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Encefalopatia de Wernicke/etiologia , Diálise/efeitos adversos , Deficiência de Tiamina/diagnóstico , Diálise Peritoneal/métodos , Insuficiência Renal Crônica/complicaçõesRESUMO
We assessed a screening instrument, adapted from a model suggested by WHO, aimed to perform population studies on the prevalence of cerebrovascular disease in Chile. Sixty-two subjects, 31 with cerebrovascular diseases and 31 without, were asked about symptoms and requested to do simple movements by trained interviewers. The results of the instrument were compared with a neurological examination performed by two specialists. Global sensitivity and specificity of the instrument, using WHO evaluation criteria, were 100 and 38.7 percent respectively. When three or more symptoms and one positive sign were considered as cutoff points, global specificity increased to 61 percent and sensitivity decreased to 93 percent. It is concluded that the present instrument is highly sensitive but lacks specificity
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos Cerebrovasculares/epidemiologia , Programas de Rastreamento , Estudos Transversais , Valor Preditivo dos Testes , Inquéritos e Questionários , Sensibilidade e Especificidade , Distribuição por Idade , Distribuição por Sexo , Exame Neurológico/métodosRESUMO
Fueron estudiados 17 pacientes portadores de arterio-esclerosis-fémoro-poplítea cronica Estado II B de Fontaine. Se les administró 200 mg. de Buflomedil en solución, por vía intra-arterial femoral. Se analizó en el trabajo los resultados obtenidos de acuerdo al método de fotopletismografía digital, que es considerado actualmente un parámetro válido en la medición de las variaciones del flujo arterial capilar. Fueron analizados estadísticamente los resultados mostrando un importante aumento del flujo capilar en la extremidad inferior tratada