RESUMO
INTRODUCTION: Wallerian degeneration (WD) is the irreversible axonal and myelin damage after the injury to the proximal portion of the axon or its cell body. The most frequent cause of WD in the central nervous system is ischemic stroke. Various studies have related the presence of pyramidal tract WD with the severity of motor deficit and partial motor improves. We present a patient with pyramidal tract WD without motor sequelae. CLINICAL CASE: A 55 years old man, hypertense and heavy smoker, suffered a sudden episode of dysarthria and left hemiparesis. Routine analysis showed hypercholesterolemia and an aortic valvular sclerosis on an echocardiogram. Cranial magnetic resonance imaging (MRI) showed multiple supratentorial lacunar infarctions. He was discharged without deficits, antiaggregated with aspirin. Six months later, he suffered a sudden episode of dysarthria. A new cranial MRI disclosed WD of the right pyramidal tract without pyramidal signs on neurologic exam. CONCLUSIONS: Presence of WD on the pyramidal tract is related with pyramidal disability in diverse degree but can develop a complete motor rehabilitation. We present a case of WD of the pyramidal tract without pyramidal deficits that supports the role of supplementary motor areas on motor rehabilitation.
Assuntos
Isquemia Encefálica/fisiopatologia , Tratos Piramidais/fisiologia , Degeneração Walleriana/etiologia , Degeneração Walleriana/patologia , Isquemia Encefálica/complicações , Feminino , Humanos , Cápsula Interna/irrigação sanguínea , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeAssuntos
Cefaleia/complicações , Cefaleia/imunologia , Hipertensão Intracraniana/etiologia , Linfocitose/líquido cefalorraquidiano , Doenças do Sistema Nervoso/etiologia , Adulto , Cefaleia/líquido cefalorraquidiano , Humanos , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/imunologia , Imageamento por Ressonância Magnética , Masculino , Doenças do Sistema Nervoso/líquido cefalorraquidiano , Doenças do Sistema Nervoso/imunologiaAssuntos
Adenocarcinoma/secundário , Cefaleia/etiologia , Neoplasias Meníngeas/secundário , Meningite/diagnóstico por imagem , Neoplasias Gástricas , Tomografia Computadorizada por Raios X , Adenocarcinoma/complicações , Feminino , Humanos , Neoplasias Meníngeas/líquido cefalorraquidiano , Neoplasias Meníngeas/diagnóstico por imagem , Meningite/complicações , Meningite/etiologia , Pessoa de Meia-Idade , Punção EspinalRESUMO
We herein report two patients with paroxysmal dyskinesias (PD) as the initial manifestation of multiple sclerosis (MS). PD can occur in clinically definite MS or rarely be the presenting symptom. They are produced by demyelinating lesions at any level in the motor pathway or in the thalamus. MRI disclosed an area of demyelination in the posterior limb of the internal capsule contralateral to the PD in the patients reported herein. PD associated with MS do not adjust completely to the accepted classifications of PD, therefore they should be considered a special category of dyskinesias.
Assuntos
Transtornos dos Movimentos/etiologia , Esclerose Múltipla/complicações , Adulto , Encéfalo/patologia , Humanos , Imageamento por Ressonância Magnética , Transtornos dos Movimentos/diagnóstico , Esclerose Múltipla/patologiaRESUMO
Intravascular foreign bodies can cause significant complications: thrombosis, pulmonary and peripheral embolism, etc. It is therefore necessary to remove them, and this may be accomplished through surgery or by means of radiotherapy techniques. In the past year we have percutaneously extracted three foreign bodies originating in vascular access pathways.