RESUMO
Brachioradial pruritus (BRP) is an enigmatic condition often encountered by dermatologists and passed off as a benign itch. It is an "idiopathic" pruritus, presenting as severe itching on the radial aspect of the elbow. The physical examination may be unremarkable except for mild pruritic lesions. Hence, the patient is treated with local applications of sunscreens, anti-inflammatory agents, anti-histamines and steroids, most of which prove to be ineffective. Dermatomal localization of localization of pruritis has suggested cervical myeloradiculopathy as a novel aetiology and this has been elucidated in recent studies. Here we report a young man, who presented with brachioradial pruritus and was diagnosed to have a C6-7 intramedullary cervical cord lesion.
Assuntos
Exantema , Doenças do Sistema Nervoso , Neurologia , Vértebras Cervicais/diagnóstico por imagem , Humanos , Masculino , Prurido/tratamento farmacológico , Prurido/etiologiaAssuntos
Acatisia Induzida por Medicamentos/etiologia , Anti-Inflamatórios não Esteroides/efeitos adversos , Confusão/induzido quimicamente , Diclofenaco/efeitos adversos , Anti-Inflamatórios não Esteroides/administração & dosagem , Artralgia/tratamento farmacológico , Diclofenaco/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Adesivo TransdérmicoRESUMO
Cerebral venous sinus thrombosis (CVST) is common in Asians, accounting for 15% of all strokes in the young. CVST causing malignant cerebral oedema with brain herniation and death are referred as malignant CVST. This study was aimed at evaluating the outcome of patients and factors predicting the outcome with malignant CVST after decompressive surgery. It was a retrospective, observational, single centre, hospital-based and cross-sectional study. Records of patients with malignant CVST who had decompressive surgery were analysed. Over 5 years (2010-2015), 30 patients (15 men and 15 women) underwent decompressive surgery. In univariate analysis, age more than 50 years (p = 0.05); presence of midline shift of more than 10 mm (p = 0.03) and total effacement of basal cisterns (p = 0.01) had significant correlation with poor outcome. On multivariate analysis, presence of midline shift of more than 10 mm (p = 0.01) was a significant predictor of poor outcome. Decompressive surgery is a life saving therapeutic intervention in patients with malignant CVST and more than two-thirds of patient shows favourable outcome. Age more than 50 years, midline shift >10 mm and total effacement of basal cisterns determine poor outcome following decompressive surgery.
