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2.
Neurol Sci ; 45(6): 2899-2901, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38436790

RESUMO

In 1974, Sir Graham Teasdale and Bryan Jennett wrote the "Assessment of coma and impaired consciousness, A practical scale," which has become one of the most influential papers in the history of traumatic brain injury, with more than 10,000 citations as of January 2024. Today, it is one of the most widely used tools in emergency departments, providing a reliable general overview of the patient's consciousness status.


Assuntos
Aniversários e Eventos Especiais , Escala de Coma de Glasgow , Humanos , História do Século XX , História do Século XXI , Escala de Coma de Glasgow/história , Lesões Encefálicas Traumáticas/história , Lesões Encefálicas Traumáticas/diagnóstico , Coma/história , Coma/diagnóstico
4.
Acta Neurol Taiwan ; 33(3): 143-145, 2024 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-37968851

RESUMO

A 17-year-old male presented with a 20-day history of vomiting, abdominal pain, weight loss, headache and fever progressing to dysarthria, somnolence, urinary incontinence, slurred speech, weakness, and inability to walk. Neurological examination revealed diminished visual acuity and diplopia. A head computed tomography (CT) showed acute hydrocephalus (Figure 1). Cerebrospinal fluid (CSF) analysis revealed pleocytosis (lymphocyte predominant), hypoglycorrhachia (8 mg/dL), and hyperproteinorrachia (156 mg/dL). The brain magnetic resonance imaging (MRI) revealed leptomeningitis, basal ganglia infarcts and basal meningeal enhancement highly suggestive of tuberculous meningitis (TBM) (Figure 2). We calculated a positive Thwaites score (-5) for TBM. The patient responded well to antituberculous treatment and dexamethasone. At 2 year follow-up the patient remains symptom-free. Stroke is a frequent complication of TBM and might contribute to long-term disability. Brain imaging findings, such as basal meningeal enhancement and basal exudates, hydrocephalus, and infarctions (TBM triad) are useful tools to rapidly identify probable TBM(3,4). Brain infarcts in TBM are located mostly in the arterial territory of distal branching arterires(5). Other less frequent imaging findings are tuberculomas and vasospasm. Key message: Hydrocephalus, basal meningeal enhancement, and basal ganglia infarcts should raise suspicion of tuberculosis, especially in endemic regions.


Assuntos
Hidrocefalia , Acidente Vascular Cerebral , Tuberculose Meníngea , Masculino , Humanos , Adolescente , Tuberculose Meníngea/complicações , Tuberculose Meníngea/diagnóstico , Acidente Vascular Cerebral/complicações , Encéfalo , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/etiologia , Infarto Cerebral/etiologia , Infarto Cerebral/complicações
5.
Acta Neurol Taiwan ; 33(4): 206-207, 2024 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-38073163

RESUMO

A 37-year-old pregnant woman presented to the emergency department with central facial palsy, ipsilateral right hemiparesis, and seizures. Brain Computed Tomogram (CT) showed intracerebral hemorrhage (ICH) and bilateral frontal edema. Magnetic resonance imaging (MRI) revealed multifocal hemorrhages consistent with a diagnosis of multiple simultaneous ICH (MSICH) (Figure 1). We suspected cerebral venous thrombosis (CVT) and performed a MR angiogram confirming this diagnosis (Figure 2). Upon admission, the patient was treated with low-molecular-weight heparin and transitioned to direct oral anticoagulation at discharge. Non traumatic MSICH is a rare imaging finding with high mortality, usually arterial in origin (1). However, since treatment options vary, cerebral venous thrombosis should always be considered in the differential diagnosis, especially in young female patients with known risk factors, such as pregnancy and puerperium (2-4). MRI modalities (Echo-GRE) are valuable tools in identifying ICH when CT is inconclusive (5).


Assuntos
Trombose Intracraniana , Trombose Venosa , Gravidez , Humanos , Feminino , Adulto , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/etiologia , Trombose Intracraniana/diagnóstico , Trombose Intracraniana/diagnóstico por imagem , Encéfalo , Convulsões/complicações , Trombose Venosa/diagnóstico , Trombose Venosa/diagnóstico por imagem
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