RESUMEN
Gayet-Wernicke encephalopathy (GWE) is a neuropsychiatric syndrome due to Vitamin B1 (thiamine) deficiency, fatal in 30% of cases and preventable if treatment is initiated early, characterized by the classic triad of encephalopathy, ocular involvement: ophthalmoplegia and/or nystagmus and ataxia. GWE is mainly observed in alcoholics, but can also appear in any state of malnutrition. In obstetrics, hyperemesis gravidarum can be complicated by GWE due to low thiamine stores and increased thiamine requirements. We report a case of Gayet-Wernicke encephalopathy complicating incoercible vomiting in a pregnant woman.
RESUMEN
Introduction and importance: Intra veinous leiomyomatosis (IVL) is one pathology of a known group of ectopic leiomyomatosis that gathers many entities all defined by the presence of benign tumours arising from uterine smooth muscle cells. The authors aim through this case report to address the underdiagnosis of IVL in pre-menopausal women and the potential confusion with other cardiac tumours. Case presentation: A 48-year-old woman initially treated for a suspected intracardiac myxoma underwent two surgeries. Seeking gynaecological care for menometrorrhagia related to a polymyomatous uterus, she was scheduled for radical surgery. Unexpectedly, extended explorations during a hysterectomy revealed a tumour originating from the pelvis, extending to the right atrium and inferior vena cava, indicative of intravascular leiomyomatosis. Clinical discussion: IVL's diagnosis is often incidental during hysterectomy analysis, with symptoms mimicking uterine fibroids. Treatment involves radical surgery, emphasizing the importance of complete resection to reduce the significant risk of recurrence. Conclusion: Pre-menopausal women with a history of hysterectomy or myomectomy and a detected right chamber mass should be screened for intravascular leiomyomatosis. Diagnosis relies on histological examination, guiding tailored treatment choices such as surgical resection with a focus on bilateral adnexectomy for optimal outcomes.
RESUMEN
Lumboperitoneal shunt may be indicated as a treatment for idiopathic intracranial hypertension aiming to facilitate the dynamic flow of cerebrospinal fluid into the peritoneum for patients. Parturients with lumboperitoneal shunt are a few, making it difficult to choose the analgesic or anesthetic technique for delivery. We present the case of a successful spinal anesthesia for a cesarean delivery in a parturient who was diagnosed with idiopathic intracranial hypertension that was treated by lumboperitoneal shunt.
RESUMEN
A patient with pre-eclampsia at 31 weeks' gestation developed neurologic signs. Computerized tomography revealed a large cranial subdural hematoma. This diagnostic should be considered in any pre-eclamptic patient demonstrating neurological symptoms and must be treated effectively because of the poor maternel and fetal prognosis. Our patient was succesfully treated.
